Depressive Psychosis Post Total Laryngectomy: A Case Report and Literature Survey
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 6
Abstract
The aim is to emphasize the clinical challenges associated with patient’s relative interference with clinical management. This is the first report in the department of a total laryngectomee developing depressive psychosis. A 70 year-old male with 2years history of unremitting hoarseness and difficulty in breathing of 2months duration. He took alcohol for 34years, did not smoke, was not a known hypertensive but had elevated blood pressure. He was stridulous. Laryngoscopy showed warty supraglottic mass. Assessment of upper airway obstruction secondary to laryngeal tumour was made. He had Emergency tracheostomy, Direct Laryngoscopy (DL) and Biopsy. Findings were normal trachea, warty growth from glottic to supra-glottic region. Histology was well differentiated invasive squamous cell carcinoma. Computed Tomographic (CT) Scan of Larynx was normal. He declined Total Laryngectomy. DL and biopsy was repeated and histology was severe laryngeal dysplasia. Patient and relatives doubted the result. DL and Biopsy was redone. Histology reported well differentiated keratinizing squamous cell carcinoma. A repeat CT Scan of Larynx showed laryngeal tumour. He had total laryngectomy. Findings were Transglottic fleshy tumour invading the tracheal rings. He developed pharyngocutaneous fistula, managed conservatively. He exhibited abnormal stereotyped movements, insomnia, refusal of meals, aggressiveness and violent tendencies. Mental health team placed him on Haloperidol, then Fluoxetine and frequent visitations. He had series of depressive symptoms, which improved on Risperidone. Depressive psychosis in a laryngectomee is a major medical concern which needs appropriate management to improve patient’s quality of life.
Authors and Affiliations
Akpalaba I. O.
Keywords
Related Articles
- EP ID EP285710
- DOI -
- Views 60
- Downloads 0
Carpal Tunnel Syndrome: A Clinical and Electrophysiological Appraisal in Carpal Tunnel Syndrome
Background: Indian studies, especially from this part (NCR Region) are scarce in Carpal tunnel syndrome (CTS), the most common entrapment neuropathy. Aim of this study was to analyze clinical and electrophysiological pro...
Possible Role of Renal Tubular Epithelial Cells (RTEC) in no Inflammatory Nephropathy
Present study relates to results of urinalysis of 3 patients. Microscopic examination of urine sediments revealed large number of renal tubular epithelial cells (RTEC). In addition, 1 of 3 cases also had significant mild...
Evaluation of Effectiveness of Use of Oral Vit D Supplements in Documented Vit D Insufficient or Deficient Patients- A Study in North Bihar
Vitamin D is a group of fat soluble secosteroids responsible for a variety of physiological functions and mostly in respect to calcium homeostasis in the body. The major source of Vit D is from sunlight with a few other...
Risk Factors for Twinning with Special Reference to Chorionicity – A Hospital Based Study
Background: The rise in the incidence of twin pregnancies all over the world is not only due to assisted reproductive techniques but also due to various other risk factors. Twin pregnancy is associated with increased ris...
Role of microalbuminuria and hs-CRP in Helicobacter pylori infected type 2 diabetes mellitus in Eastern India
Background: Helicobacter pylori (HP) infections are one of the few commonest worldwide which affects approximately 50% of the overall population. It is reported that high serum levels of C-reactive protein (CRP) is a nov...