Head and Neck Issues in Cirrhotic Patients
Head and neck issues in patients with liver failure include upper aerodigestive bleeding, need for tracheostomy, and head and neck cancer. Epistaxis has a higher rate of complications in patients with liver failure. Multiple management options exist for epistaxis. Severe bleeding may need surgical or radiologic intervention. Oral bleeding after dental procedures is common and can usually be managed with local interventions. Critically ill patients with liver failure often need a tracheostomy to avoid complications of prolonged intubation. Tracheostomy should be considered in patients in whom greater than 10 days of continuous mechanical ventilation are anticipated. This should be done by an experienced surgeon in the operating theater. Decannulation should be attempted when the criteria are met. The most common head and neck malignancies in liver failure patients are skin neoplasms, malignancies of the aerodigestive tract, and salivary gland cancers.
KeywordsEpistaxis Tracheostomy Oral Bleeding Head and neck squamous cell carcinoma Cutaneous cancer Salivary gland cancer Cirrhosis Coagulopathy
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