Tal Marom1, David Segal2, Tomer Erlich2, Erez Tsumi3, Ofer Merin4, Guy Lin5. 1. Israel Defense Forces Medical Corps Field Hospital, Tel Hashomer, Israel; Department of Otolaryngology - Head & Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler School of Medicine, Holon, Israel. 2. Israel Defense Forces Medical Corps Field Hospital, Tel Hashomer, Israel; Department of Military Medicine, Hebrew University Faculty of Medicine, Jerusalem, Israel. 3. Israel Defense Forces Medical Corps Field Hospital, Tel Hashomer, Israel; Department of Ophthalmology, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel. 4. Israel Defense Forces Medical Corps Field Hospital, Tel Hashomer, Israel; Department of Cardiothoracic Surgery, Shaare Zedek Medical Center, Hebrew University Faculty of Medicine, Jerusalem, Israel. 5. Israel Defense Forces Medical Corps Field Hospital, Tel Hashomer, Israel; Trauma Unit, Meir Medical Center, Tel Aviv University Sackler School of Medicine, Kfar Saba, Israel.
Abstract
OBJECTIVE: To describe clinical and ethical dilemmas in patients presenting with head and neck (H&N) tumors to a field hospital in the "subacute" period following a typhoon. METHODS: We retrospectively reviewed charts of H&N patients presenting to an integrated Israeli-Filipino medical facility, which was operated more than 11 days. RESULTS: Of the 1,844 adult patients examined, 85 (5 percent) presented with H&N tumors. Of those, 70 (82 percent) were females, with a mean age of 43 ± 15 years. Thyroid neoplasms were the most common tumors (68, 80 percent). Despite limited resources, we contributed to the workup and treatment of several patients. To better illustrate our dilemmas, we present four key patients, in whom we favored diagnostic/therapeutic interventions in two, and opted to defer any intervention in two. CONCLUSIONS: In a relief mission, despite the lack of clinical and pathological staging and questionable continuity of care, surgical interventions can be considered for therapeutic, palliative, and diagnostic purposes.
OBJECTIVE: To describe clinical and ethical dilemmas in patients presenting with head and neck (H&N) tumors to a field hospital in the "subacute" period following a typhoon. METHODS: We retrospectively reviewed charts of H&N patients presenting to an integrated Israeli-Filipino medical facility, which was operated more than 11 days. RESULTS: Of the 1,844 adult patients examined, 85 (5 percent) presented with H&N tumors. Of those, 70 (82 percent) were females, with a mean age of 43 ± 15 years. Thyroid neoplasms were the most common tumors (68, 80 percent). Despite limited resources, we contributed to the workup and treatment of several patients. To better illustrate our dilemmas, we present four key patients, in whom we favored diagnostic/therapeutic interventions in two, and opted to defer any intervention in two. CONCLUSIONS: In a relief mission, despite the lack of clinical and pathological staging and questionable continuity of care, surgical interventions can be considered for therapeutic, palliative, and diagnostic purposes.