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We present the case of a rare cause of epistaxis in a paediatric patient, together with the diagnostic and management challenges associated with this condition.
A previously well nine-year-old boy presented with a six-month history of intermittent unilateral epistaxis. Radiological investigation and endoscopic biopsy confirmed a highly malignant nasopharyngeal mass consistent with carcinoma. The tumour continued to grow rapidly. Whilst awaiting intervention, the patient experienced a further significant haemorrhage requiring surgical intervention.
Nasopharyngeal carcinoma is a rare cause of epistaxis amongst children in the UK. Early flexible nasendoscopy can help delineate both benign and sinister causes of symptoms in this region.
To determine whether tonsillectomy improves quality of life in adults suffering from chronic or recurrent tonsillitis.
A systematic literature search of the Medline and Pubmed databases was conducted in order to identify all relevant studies measuring quality of life directly.
Results and Conclusion:
Eight studies were identified. The Glasgow Benefit Inventory and the Short Form questionnaire were the main tools used to assess quality of life changes. Tonsillectomy is likely to improve the overall quality of life as it particularly improves patients' physical and general health. The social benefits of tonsillectomy appear to be non-significant. The effects are likely to be long-lasting and have a greater impact on younger patients. The presence of coexisting chronic conditions and the severity of infective symptoms due to tonsillitis are also influencing factors.
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