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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 

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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