Giant tonsillolith: a case report and review of literature
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<p class="abstract">We had a sixty years old male patient, who had one year history of foreign body sensation in throat and the history of odynophagia for the last ten days. The NCCT neck showed 3.08×2.28 cm homogenous calcified mass in left tonsillar fossa. The stone was removed and tonsillectomy was performed. Giant tonsillolith is a rare clinical entity. As per available literature, 54 cases of giant tonsilloliths have been reported and to the best of our knowledge, this is one of the largest tonsillolith in the world till date. </p><strong>Keywords:</strong> Tonsillolith, Oral cavity<strong></strong>Keywords:
Odynophagia
Throat
Throat
Fish bone
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Throat
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Introduction Various forms of foreign bodies in the upper aero-digestive tract are found in the otorhinolarygological practice Majority are found in children and some in adults and mentally deranged individuals. Foreign bodies are usually intra-luminal but sharp FB can be found extra-luminally. This could be inserted accidentally or intentionally as in this index case. Case Presentation We present a case of a 25yr old magician/driver with a pharyngeal intramural radio-opaque foreign body inserted intentionally during his magic art 7 days prior to presentation. EUA and removal was undertaken under GA uneventfully and patient was discharged two days after the procedure. Conclusion Though Pharyngeal extra-luminal foreign bodies are quite uncommon, presentation with odynophagia, dysphagia and neck stiffness without features of airway compromise is suspicious of extra-luminal FB. Early presentation and removal of the foreign body is essential to prevent complications. Keywords: Pharyngeal, Intra-mural, foreign body, magician.
Odynophagia
Presentation (obstetrics)
Foreign Body Removal
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Foreign body ingestion is well documented entity but foreign body which was embedded in pre-vertebral space at C2 level is very uncommon. Care should be taken for symptoms like dysphagia and odynophagia, even if there is no foreign body seen clinically. X-ray soft tissue is utmost important in diagnosing foreign body, though sometimes it may be normal.
Odynophagia
Foreign Body Ingestion
Fish bone
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Aims Odynophagia is defined as a painful sensation in the oesophageal region that occurs in relation to swallowing. Endoscopy is the gold standard investigation for the diagnosis of mucosal lesions in the oesophagus. Unlike dysphagia, which has historically been an alarm symptom of oesophageal cancer, odynophagia does not form part of the suspected upper gastrointestinal (GI) cancer referral in the UK. We aimed to compare the standard ‘red flag’ indications for gastroscopy to odynophagia in terms of cancer detection.
Odynophagia
Gold standard (test)
Esophagogastroduodenoscopy
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Several investigations have been reported on the interactive relation between the normal flora and the pathogenic micro-organisms in the human upper respiratory tracts (Thompson, Sanders, etc). It has also been known that some a-streptococci have inhibitory effect on the growth of group A 3-hemolytic streptococci. A study upon the role of a-streptococci in the throat (tonsil and pharynx) was performed using 73 culture specimens (throat swabs) obtained from 42 patients. Forty-four specimens were taken from the patients who received tonsillectomy, pre- and postoperatively, and 29 were from the patients who did not receive the operation. In the group of patients who received tonsillectomy, a-streptococci with inhibitory effect on the growth of group A, 8-streptococci were detected less frequently preoperatively, when compared with the patients without tonsillectomy. On the other hand, postoperatively, marked increase of a-streptococci of these types was found in the normal flora of the throat. However, further detailed study on this subject is necessary because of the exceptional results in our observations.
Throat
Flora
Tonsil
Group A
Group B
Throat culture
Respiratory tract
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Foreign body ingestion is a common complaint frequently seen in otolaryngology. Some sharp foreign bodies may get impacted in the aerodigestive tract causing a perforation. However, hypopharyngeal perforation is a rare injury that needs early recognition due to its significant morbidity. In this case report, we report a case of hypopharyngeal perforation caused by foreign body ingestion in an adult patient. A 60-year-old female presented with a foreign body sensation in the throat, dysphagia, and odynophagia. A neck CT scan showed a foreign body in the hypopharynx with a collection of free air along the posterior pharyngeal wall. She underwent laryngoscopy and esophagoscopy for examination and foreign body removal. Following the procedure, the patient was treated conservatively for a week and then discharged home in a stable condition. Hypopharyngeal perforation following foreign body ingestion is uncommon. A high index of suspicion is required to reach an early diagnosis and treatment.
Odynophagia
Perforation
Foreign body aspiration
Throat
Foreign Body Ingestion
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Odynophagia
Gold standard (test)
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Tonsillectomy is most frequently carried out for recurrent throat infection, but there is uncertainty about its effectiveness. This paper reviews the evidence of its effectiveness obtained from a search of the Cochrane database and MEDLINE for randomized controlled trials comparing tonsillectomy with non-surgical management of recurrent throat infection. The results show that the effectiveness of a procedure such as tonsillectomy, needs to be considered in the light of its adverse effects. Attempts should be made to inform patients about the uncertainty surrounding the procedure.
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Swallowing of foreign bodies (FB), and sensation of such in the throat, is a common complaint in the emergency department setting, with roughly 80,000 visits in 2010 for FB ingestion.1 Grill wire brushes are a rarely reported, accidental FB ingestion, although recent literature suggests that it is more common than initially thought.2 This is a report of a female with acute onset odynophagia after a meal, with a normal laryngoscopic exam that used flexible fiberoptics. Evidence of a metallic linear density was present in the retropharynx on computed tomography imaging, most consistent with a wire from a grill wire brush.
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Throat
Accidental
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