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Scientific Oral Presentations

Head and Neck Surgery

Session: Scientific Oral Presentations 4 - Head and Neck Surgery

How We Separated the Wheat From the Chaff to Expedite Diagnosis of Upper Esophageal Cancers

Sunday, September 29, 2024
1:48 PM – 1:54 PM EDT
Location: MBCC, 208
Disclosure(s):
Nilima P. Ghadge, MRCS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Jabin Thaj, MBBS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Ashlesha Sardesai, MBBS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Gaurav Kumar, MBBS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Jeffrey O. Otote, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Globus pharyngeus has an incidence of 45% and represents 4% of urgent two week wait referrals in ear, nose, and throat. Infrequently, it presents as an early symptom of hypopharyngeal malignancy a rare head and neck cancer with a prevalence of 3%. The Edinburgh Dysphagia Score is a validated questionnaire that can be used to streamline the management of patients presenting with dysphagia or globus in two week wait ear, nose, and throat clinics.

Methods: In this retrospective and prospective study, we analyzed total of 154 patients seen in 9 months which were spread over a total period of 18 months presenting with dysphagia/globus on cancer pathway and scored them based on EDS. In total, 1,990 patients were seen in 9 months head and neck cancer clinics at Barking, Havering, and Redbridge NHS trust spread over July 2022 to November 2023. The low EDS scores were taken off the cancer pathway and referred for barium swallow to look for non-malignant causes of dysphagia. The high EDS scores were referred for OGD-esophagogastroscopy.

Results: In total, 7% of patients were seen in the head and neck cancer clinic at our trust were referred for dysphagia and globus sensation; 34% were having true dysphagia as main symptom and 65% presented with globus sensation. Only 1.2% patients were diagnosed with mid/lower oesophageal cancer, who had high Edinburgh dysphagia score. None of the patients presented with these symptoms were diagnosed with hypopharyngeal or upper oesophageal malignancy.

Conclusions: Our data shows that akin to vertigo, true dysphagia and weight loss is key to diagnose upper oesophageal cancers which is a watershed area between ENT and Upper GI; rapid communication is imperative to avoid delays. EDS scores help in streamlining the pathway for upper gastrointestinal malignancies.

    Presenting Author(s)

  • JT

    Jabin Thaj, MBBS

    ENT/Head and Neck Consultant
    BHRUT
    Essex, England, United Kingdom

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • Gaurav Kumar, MBBS

    Consultant
    BHRUT
    Hornchurch, England, United Kingdom

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    Resources

  • Nilima P. Ghadge, MRCS

    Speciality Doctor
    Queen's Hospital
    London, England, United Kingdom

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

    • Co-Author(s)

  • Afsal Latheef Tayyil Purayil, MBBS

    Clinical Fellow
    Queens Hospital, Romford, London
    London, England, United Kingdom

    Disclosure information not submitted.

  • OA

    Osama Al-Bairouty, MBBS

    Dr
    Queens Hospital, Romford, London, United Kingdom

    Disclosure information not submitted.

  • AG

    Annu George, MBBS

    Dr
    Queens Hospital, Romford, London, United Kingdom

    Disclosure information not submitted.

  • AS

    Ashlesha Sardesai, MBBS

    Queens Hospital, Romford, London, United Kingdom

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

  • CD

    Cassandra Dede, MBBS

    Dr
    Queens Hospital, Romford, London, United Kingdom

    Disclosure information not submitted.

  • JO

    Jeffrey O. Otote, MD

    Dr
    Queens Hospital, Romford, London
    Manchester, England, United Kingdom

    Disclosure(s):

    faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.


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