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Paper 1
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
A 43 year old female patient with a history of asthma and rheumatoid arthritis has a barium swallow following GP referral. Symptoms include dysphagia and globus sensation with infrequent regurgitation. The study identifies a pharyngeal pouch.
Neck
Published in Keith Hopcroft, Vincent Forte, Symptom Sorter, 2020
SMALL PRINT: Thyroid ultrasound, radioisotope studies, barium swallow, biopsy. TFT in all cases of thyroid enlargement: May reveal hypo- or hyperthyroidism.FBC and ESR/CRP in persistent enlarged nodes: Check WCC and investigate further if abnormal or if ESR/CRP high.CXR: May reveal primary lung carcinoma, lymphoma, or other more obscure pathologies.Thyroid ultrasound and/or radioisotope studies if lump felt within the thyroid – usually arranged by endocrinologist after referral.Barium swallow: To confirm and outline a pharyngeal pouch.Biopsy: Specialist procedure to establish nature of a persistent, suspicious neck lump.
Neck
Published in Keith Hopcroft, Vincent Forte, Symptom Sorter, 2020
SMALL PRINT: thyroid ultrasound, radioisotope studies, barium swallow, biopsy. TFT in all cases of thyroid enlargement: may reveal hypo- or hyperthyroidism.FBC and ESR in persistent enlarged nodes: check WCC and investigate further if abnormal or if ESR high.CXR: may reveal primary lung carcinoma, lymphoma, or other more obscure pathologies.Thyroid ultrasound and/or radioiodine studies if lump felt within the thyroid – usually arranged by endocrinologist after referral.Barium swallow: to confirm and outline a pharyngeal pouch.Biopsy: specialist procedure to establish nature of a persistent, suspicious neck lump.
Thyroglossal duct cysts in children: a 30-year survey with emphasis on clinical presentation, surgical treatment, and outcome
Published in Acta Chirurgica Belgica, 2019
Tom Danau, Guy Verfaillie, Frans Gordts, Thomas Rose, Antoine De Backer
Thyroglossal duct cysts (TGDC) are one of the most common congenital midline deformities found in the anterior neck region in children [1]. Most of the patients are diagnosed before reaching the age of ten years [2], but TGDC can be diagnosed at any age. TGDC seem to strike both sexes almost equally [3] and appear to occur in 7% of the total population [4]. A TGDC finds its origin in the embryological development of the thyroid gland. When an embryo is 3 to 4 weeks old, a midline endodermal thickening in the primitive pharynx will occur. This thickening will evolve into a diverticulum, also known as the foramen cecum linguae. On its turn, this bilobed structure will protrude into the mesenchymal structure between the first two pharyngeal pouches. An epithelial fistula connects the foramen cecum linguae with the pharynx which is called the thyroglossal duct. During caudal projection, this duct will pass anteriorly from the mesodermal structures which will form the hyoid bone and will mount itself between the hyoid bone and the thyroid membrane. Within normal embryological development, this structure should obliterate around the tenth gestational week. However, during the descent of the duct, some epithelial structures may remain within the inferior border of the hyoid bone for unknown reasons, which can later cause the formation of a TGDC [5].
Implementation of an extended scope of practice speech-language pathology allied health practitioner service: An evaluation of service impacts and outcomes
Published in International Journal of Speech-Language Pathology, 2019
Marnie Seabrook, Maria Schwarz, Elizabeth C. Ward, Bernard Whitfield
Of the 34 patients, 32.4% (n = 11) were referred back to ENT services, of which three were re-categorised for more urgent referral by ENT. One patient was upgraded due to ENT concerns regarding anatomical variation (bulky lingual tonsil) and two were upgraded as further imaging/medical diagnosis was required (unidentified reason for globus, concerns regarding pharyngeal pouch). Details of these three patients are outlined in Table II. At the time of review these three patients had been on the ENT outpatient waiting list for an average of 556.67 days (SD = 119.04, range 436–674). The average waiting time for full medical ENT review for the three patients following re-categorisation was 27 days (SD = 10.15, range 16–36). Outcome of ENT assessment determined nil concerning pathology or need for further intervention.
Embryogenesis of Ectopic Bronchogenic Cysts: Keep It Simple
Published in Journal of Investigative Surgery, 2020
Ectopic locations of bronchogenic cysts such as in the neck (submental, thyroid) can be explained by the fact that bifurcation of the foregut toward trachea and esophagus takes place very close to the pharyngeal apparatus of the embryo. As per Bremer [4], the lung buds—after bifurcation of the tracheal bud—can be considered the most caudal pair of pharyngeal pouches. The neighborhood with pharyngeal arches and pouches explains how a bronchogenic cyst may migrate next doors into the midline neck and thyroid gland.