Hostname: page-component-78c5997874-s2hrs Total loading time: 0 Render date: 2024-11-10T13:10:12.748Z Has data issue: false hasContentIssue false

Evidenced-based management of haemoptysis by otolaryngologists

Published online by Cambridge University Press:  05 June 2015

M Bannister*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Aberdeen Royal Infirmary, Scotland, UK
K W Ah-See
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Aberdeen Royal Infirmary, Scotland, UK
*
Address for correspondence: Mr Miles Bannister, Department of Otolaryngology – Head and Neck Surgery, Aberdeen Royal Infirmary, Forresterhill, Aberdeen AB25 2ZN, Scotland, UK E-mail: miles.bannister@hotmail.co.uk

Abstract

Background:

Haemoptysis is an uncommon presenting symptom to the ENT clinic and ward, but has potentially sinister aetiology. This article aims to provide a systematic and evidence-based method of managing patients with haemoptysis.

Methods:

The data in this article are based on a literature search performed using PubMed in August 2013. The keywords used included ‘haemoptysis’ in combination with ‘otolaryngology’, ‘ENT’, ‘head & neck', ‘diagnosis’, ‘management’, ‘investigations’ and ‘treatment’.

Results:

The majority of published literature on the subject is level IV evidence. However, this can guide ENT specialists in assessing, investigating and managing presentations of haemoptysis.

Conclusion:

Understanding the different causes of haemoptysis is important for the otolaryngologist. The main concern is the detection of a malignant lesion in the upper aerodigestive tract or tracheobronchial tree. A thorough history and systematic examination can aid diagnosis.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Tremble, GE. Haemoptysis from the viewpoint of the laryngologist. Can Med Assoc J 1931;25:700–1Google ScholarPubMed
2Tsoumakidou, M, Chrysofakis, G, Tsiligianni, I, Maltezakis, G, Siafakas, NM, Tzanakis, N. A prospective analysis of 184 hemoptysis cases: diagnostic impact of chest X-ray, computer tomography, bronchoscopy. Respiration 2006;73:808–14CrossRefGoogle Scholar
3Abal, AT, Nair, PC, Cherian, J. Haemoptysis: aetiology, evaluation and outcome--a prospective study in a third-world country. Respir Med 2001;95:548–52CrossRefGoogle Scholar
4Bidwell, JL, Pachner, RW. Hemoptysis: diagnosis and management. Am Fam Physician 2005;72:1253–60Google ScholarPubMed
5Wolfe, JD, Simmons, DH. Hemoptysis: diagnosis and management. West J Med 1977;127:383–90Google ScholarPubMed
6Abbate, G, Lancella, A, Contini, R, Scotti, A. A primary squamous cell carcinoma of the trachea: case report and review of the literature. Acta Otorhinolaryngol Ital 2010;30:209–12Google ScholarPubMed
7Naqiyah, I, Zulkarnaen, AN, Rohaizak, M, Das, S. Carcinosarcoma of the thyroid: a case report. Hippokratia 2010;14:141–2Google ScholarPubMed
8Wang, X-L, Xu, P-Z, Tang, P-Z, Yue, Y. Tracheo-innominate artery fistula: diagnosis and surgical management. Head Neck 2013;35:1713–18CrossRefGoogle ScholarPubMed
9McCaffrey, TV, Lipton, RJ. Thyroid carcinoma invading the upper aerodigestive system. Laryngoscope 1990;100:824–30CrossRefGoogle ScholarPubMed
10Armstrong, MJ, Chiosea, SI, Carty, SE, Hodak, SP, Yip, L. Thyroid paragangliomas are locally aggressive. Thyroid 2012;22:8893CrossRefGoogle ScholarPubMed
11Hassani, DA, Bhananker, SM. Postoperative airway obstruction after airway tumour debulking. J Anesth 2006;20:237–9CrossRefGoogle Scholar
12Kruse, AL, Zwahlen, RA, Bredell, MG, Gengler, C, Dannemann, C, Grätz, KW. Primary blastomycosis of oral cavity. J Craniofac Surg 2010;21:121–3CrossRefGoogle ScholarPubMed
13Levy, S, Brodsky, L, Stanievich, J. Hemorrhagic tonsillitis. Laryngoscope 1989;99:1518CrossRefGoogle ScholarPubMed
14Calubiran, OV, Zackson, E, Cunha, BA. Group B streptococcus hemorrhagic tonsillopharyngitis. Ann Emerg Med 1990;19:951–2CrossRefGoogle ScholarPubMed
15Kuehnemund, M, Bootz, F. Rare living hypopharyngeal foreign body. Head Neck 2006;28:1046–8CrossRefGoogle ScholarPubMed
16O'Neill, JP, Shine, N, Timon, C. Complete traumatic laryngo-tracheal separation. Ir Med J 2009;102:291–2Google ScholarPubMed
17Bolzoni, A, Peretti, G, Piazza, C, Pedruzzi, B, Nicolai, P. Penetrating foreign body mimicking supraglottic carcinoma. Ann Otol Rhinol Laryngol 2005;114:577–8CrossRefGoogle ScholarPubMed
18Tabba, M, Anderson, T, Lamb, C. Hemoptysis: a serendipitous discovery. J Bronchology Interv Pulmonol 2011;18:365–7CrossRefGoogle ScholarPubMed
19Chu, EA, Wu, JM, Tunkel, DE, Ishman, SL. Nasopharyngeal carcinoma: the role of the Epstein-Barr virus. Medscape J Med 2008;10:165Google ScholarPubMed
20Saleem, T, Khalid, U, Hameed, A, Ghaffar, S. Supernumerary, ectopic tooth in the maxillary antrum presenting with recurrent haemoptysis. Head Face Med 2010;6:26CrossRefGoogle ScholarPubMed
21Tueche, SG, Nguyen, H, Larsimont, D, Andry, G. Late onset tonsillar metastasis from breast cancer. Eur J Surg Oncol 1999;25:439–48CrossRefGoogle ScholarPubMed
22Martines, F, Immordino, V. Arteriovenous malformation of the base of tongue in pregnancy: case report. Acta Otorhinolaryngol Ital 2009;29:274–8Google ScholarPubMed
23Park, J-H, Do, N-Y, Cho, S-I, Choi, J-Y. Granular cell tumour on larynx. Clin Exp Otorhinolaryngol 2010;3:52–5CrossRefGoogle ScholarPubMed
24Scala, WA, Fernandes, AM, Duprat, Ade, C, Costa, HO. Granular cell tumour of the larynx in children: a case report. Braz J Otorhinolaryngol 2008;74:780–5CrossRefGoogle ScholarPubMed
25Kim, DW, Chung, JH, Ahn, SH, Kwon, T-K. Laryngeal kaposiform hemangioendothelioma: case report and literature review. Auris Nasus Larynx 2010;37:258–62CrossRefGoogle ScholarPubMed
26Yu, G, Qu, G, Kong, L, Pan, X, Wang, W, Lv, J. Primary myoepithelial carcinoma of the larynx: case report and review of the literature. Pathol Res Pract 2011;207:127–30CrossRefGoogle ScholarPubMed
27Meyer, MA, Becker, JM, Quinones, W. Endobronchial granular cell tumour: a case report. J Radiol Case Rep 2010;4:2935Google ScholarPubMed
28Kuschill-Dziurda, J, Mastalerz, L, Grzanka, P, Niżankowska-Moglinicka, E. Rhabdomyoma as a tumour of the posterior mediastinum. Pol Arch Med Wewn 2009;119:599602Google ScholarPubMed
29Gavelli, G, Giampalma, E. Sensitivity and specificity of chest X-ray screening for lung cancer: review article. Cancer 2000;89:2453–63.0.CO;2-M>CrossRefGoogle ScholarPubMed
30Thirumaran, M, Sundar, R, Sutcliffe, IM, Currie, DC. Is investigation of patients with haemoptysis and normal chest radiograph justified? Thorax 2009;64:854–6CrossRefGoogle ScholarPubMed
31Clin, B, Morlais, F, Guittet, L, Gislard, A, Marquignon, MF, Paris, C et al. Performance of chest radiograph and CT scan for lung cancer screening in asbestos-exposed workers. Occup Environ Med 2009;66:529–34CrossRefGoogle ScholarPubMed
32Pastorino, U. Current status of lung screening. Thorac Surg Clin 2013;23:129–40CrossRefGoogle Scholar
33Golice, GL. Detecting lung cancer as a cause of haemoptysis in patients with a normal chest radiograph: bronchoscopy vs CT. Chest 1997;111:877–84Google Scholar
34Heaton, RW. Should patients with haemoptysis and a normal chest X-ray be bronchoscoped? Postgrad Med J 1987;63:947–9CrossRefGoogle Scholar
35Hill, AT, Pasteur, M, Cornford, C, Welham, S, Bilton, D. Primary care summary of the British Thoracic Society guideline on the management of non-cystic fibrosis bronchiectasis. Prim Care Respir J 2011;20:135–40CrossRefGoogle ScholarPubMed
36National Institute for Health and Clinical Excellence. Lung Cancer: The Diagnosis and Treatment of Lung Cancer, NICE Clinical Guideline 121. Manchester: NICE, 2011Google Scholar