1.Clinicodemographic profile and treatment outcomes of patients with upper aerodigestive tract foreign bodies in the Southern Philippines Medical Center: A five-year retrospective review
John Michael P. Tagsa ; Donnie Jan D. Segocio
Philippine Journal of Otolaryngology Head and Neck Surgery 2024;39(1):26-30
Objective:
This study aims to describe the clinicodemographic profile of patients with foreign bodies in the upper aerodigestive tract and their treatment outcomes.
Methods:
Design: Retrospective review of records. Setting: Tertiary Government Training Hospital. Participants: Records of 304 patients diagnosed with aerodigestive foreign bodies
Results:
Three hundred-four (304) patients were included. The median age was 5.26 years in the pediatric age group and 42.53 years in the adult age group, with a male-to female ratio = 1.97:1. Foreign bodies were ingested in 291 (96%) patients while aspiration occurred in 13 (4%). Overall, 211 (69%) of cases involved the pediatric population (<19 years) and 93 (31%) the adult population. The most common foreign bodies reported were coins (63.5%), food (18.1%), and dentures (11.5%). Most esophageal foreign bodies (244/291; 83%) were seen at the cricopharyngeal level in all age groups. The foreign body was removed successfully in 288/291 (98%) of ingestion cases. All 13 cases of foreign body aspiration were successfully removed by bronchoscopy. All patients were discharged improved.
Conclusion
Most upper aerodigestive tract foreign bodies involved the pediatric age group.
Predisposing conditions were mainly due to accidental ingestion and aspiration while playing in the pediatric population and negligence in eating among adults. Almost all ingestion cases were successfully treated with esophagoscopy, while all aspirations were treated successfully with bronchoscopy. Most intraoperative and postoperative complications who were managed conservatively by observation, although some cases required referral to other surgical departments and were treated surgically. All patients were discharged improved.
Foreign Bodies
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Eating
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Esophagoscopy
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Bronchoscopy
2.Levothyroxine versus levothyroxine with iodine in reduction of thyroid nodule volume: a double-blind randomized controlled trial.
Donnie Jan D. SEGOCIO ; Joseph E. CACHUELA
Philippine Journal of Otolaryngology Head and Neck Surgery 2019;34(1):14-19
Objective: To compare levothyroxine alone and in combination with iodine on thyroid nodule volume reduction.
Methods:
Design: Double-Blind Randomized Controlled Trial
Setting: Tertiary Government Hospital
Participants: Nineteen (19) euthyroid patients age 19-54 with at least 1 cytologically benign thyroid nodule were randomized to receive either levothyroxine + iodine or levothyroxine + placebo, taken once a day for 6 months with ultrasound and thyroid stimulating hormone monitoring on the 3rd and 6th month of intervention.
Results: Main outcome measures included thyroid nodule volume reduction after six months of intervention. The mean change in volume from baseline to six months of levothyroxine + iodine group showed no statistically significant difference in nodule volume across time between levothyroxine + placebo group, -0.010 ± 1.250 (CI -0.521 - 0.501) versus 0.507 ± 1.128 (CI 0.025 - 0.990), p=.158. There were also new nodules (4 nodules) in the placebo group and none in the iodine group. No major adverse events were noted during the study.
Conclusion: The two groups did not significantly differ in terms of nodule volume reduction.
Keywords: thyroid nodule, prevention and control; drug therapy; iodine compounds, therapeutic use; levothyroxine, therapeutic use
Human ; Thyroid Nodule ; Drug Therapy ; Iodine Compounds ; Thyroxine
3.A 15-year occult foreign body in the subglottic area of a 50-year-old woman.
Donnie Jan L. Segocio ; Christine D. Dayanghirang ; Joseph E. Cachuela
Philippine Journal of Otolaryngology Head and Neck Surgery 2016;31(2):47-50
OBJECTIVE: To present a case of subglottic foreign body (FB) impaction in a 50-year-old woman diagnosed with bronchial asthma for 15 years.
METHODS:
Design: Case Report
Setting: Tertiary Public Hospital
Patient: One
RESULTS: A 50-year-old woman with recurrent cough and dyspnea for 15 years that had been managed as a bronchial asthma developed stridor and halitosis in the last 5 years. Flexible laryngoscopy revealed a subglottic mass and CT scan confirmed a suspicious foreign body in the lumen of the subglottis. Signs and symptoms resolved after peroral endoscopic removal of the foreign body from the larynx. Histopathology of the extracted material from the airway confirmed it to be "bone tissue".
CONCLUSION: Foreign body aspiration can occur in adults without predisposing factors. Its diagnosis can be challenging as it can mimic respiratory disorders such as bronchial asthma. Endoscopy and computed tomography are valuable for correct diagnosis and management. An incorrect initial diagnosis should be considered in the light of unresolved symptoms and prompt referral to an appropriate specialist may prevent undue suffering and dangerous complications.
Human ; Female ; Middle Aged ; Cough ; Dyspnea ; Halitosis ; Larynx ; Laryngoscopy