Adenotonsillectomy for upper airway obstruction carries increased risk in children with a history of prematurity

1992 ◽  
Vol 13 (4) ◽  
pp. 222-226 ◽  
Author(s):  
Francis X. McGowan ◽  
Margaret A. Kenna ◽  
Julia A. Fleming ◽  
Theresa O'Connor
2018 ◽  
pp. bcr-2018-225079
Author(s):  
Rohan Sebastian Pinto ◽  
Anthony Simons ◽  
Rohit Verma ◽  
Neil Bateman

We present the first case of upper airway obstruction secondary to a retropharyngeal Gardner-associated fibroma (GAF). A 16-month-old infant presented with a 3-month history of worsening dyspnoea and apnoeic episodes. Examination revealed stridor and left-sided retropharyngeal asymmetry. MRI demonstrated a mass in the retropharynx. Tracheostomy and pharyngeal biopsy under anaesthesia were performed, and histology confirmed a diagnosis of GAF. The mass was excised using a transcervical approach, and postoperative recovery was unremarkable. GAF is associated with Gardner’s syndrome (GS) and familial adenomatous polyposis (FAP), both of which are associated with multiple colonic polyps and increased risk of colorectal malignancy. Subsequent testing for an APC mutation seen in GS and FAP was negative in our patient. The details of this unusual presentation of a rare disease are given in addition to a review of the literature.


2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Evan Harmon ◽  
Sebastian Estrada ◽  
Ryan J. Koene ◽  
Sula Mazimba ◽  
Younghoon Kwon

Upper airway obstruction is a potentially life-threatening emergency often encountered in the acute care, perioperative, and critical care settings. One important complication of acute obstruction is negative-pressure pulmonary edema (NPPE). We describe two cases of acute upper airway obstruction, both of which resulted in flash pulmonary edema complicated by acute hypoxic respiratory failure. Though NPPE was suspected, these patients were also found to have Takotsubo syndrome (TTS). Neither patient had prior cardiac disease, and both subsequently had a negative ischemic workup. Because TTS is a condition triggered by hyperadrenergic states, the acute airway obstruction alone or in combination with NPPE was the likely explanation for TTS in each case. These cases highlight the importance of also considering cardiogenic causes of pulmonary edema in the setting of upper airway obstruction, which we suspect generates a profound catecholamine surge and places patients at increased risk of TTS development.


2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Adrian R. Bersabe ◽  
Joshua T. Romain ◽  
Erin E. Ezzell ◽  
John S. Renshaw

Chronic Lymphocytic Leukemia (CLL) is the most prevalent form of non-Hodgkin’s lymphoma (NHL) in Western countries predominantly affecting adults over the age of 65. CLL is commonly indolent in nature but can present locally and aggressively at extranodal sites. Although CLL may commonly present with cervical lymphadenopathy, manifestation in nonlymphoid regions of the head and neck is not well described. CLL causing upper airway obstruction is even more uncommon. We describe a case of a patient with known history of CLL and stable lymphocytosis that developed an enlarging lymphoid base of tongue (BOT) mass resulting in rapid airway compromise.


Author(s):  
Edmond Cohen

Upper airway obstruction (UAO) from any cause should be considered a life-threatening emergency. In a conscious patient, UAO may present as respiratory distress, stridor, dyspnoea, altered voice, cyanosis, cough, decreased or absent breath sounds, wheezing, the hand-to-the-throat choking sign in the case of a foreign body, facial swelling, and distended neck veins. The cause of UAO should be identified and airway management devices must be immediately available prior to any airway manipulation CT scan, flexible bronchoscopy, and pulmonary function tests should be performed to evaluate the cause and the extent of the obstruction. Obstructive sleep apnoea (OSA) patients are at increased risk of developing UAO. Endotracheal intubation, insertion of a supraglottic device, laser therapy, and endotracheal stents maybe life-saving


1990 ◽  
Vol 104 (8) ◽  
pp. 654-655 ◽  
Author(s):  
Neil B. Solomons ◽  
Jonathan R. Livesey

AbstractA 67-year-old man presented with a 45-year history of a weak voice. This was the result of polio which had left him with a right vocal cord palsy.The patient underwent a Teflon injection of the right vocal cord under general anaesthesia to improve the quality of his voice. In the immediate post-operative period, he suffered acute upper airway obstruction. The problem of acute upper airway obstruction following Teflon injection is considered and its management with nebulized adrenaline and a helium/oxygen mixture is discussed.


2001 ◽  
Vol 115 (2) ◽  
pp. 161-163 ◽  
Author(s):  
Aftab Ahmed ◽  
Showkat Mirza ◽  
Michael P. Rothera

We report a rare case of mediastinal tuberculosis in a child who presented as a possible inhaled foreign body. A 10-month-old girl was admitted with a five-month history of cough, wheeze and problematic feeding, thought initially to be due to asthma. A clinical deterioration and subsequent X-rays suggested an inhaled foreign body. However, at direct laryngotracheobronchoscopy no foreign body was found and subsequent investigations revealed a subcarinal mediastinal mass. She underwent a thoracotomy and excision of the mass, the histological analysis of which revealed it to be of tuberculous origin. When a patient presents with symtoms of upper airway obstruction which are highly suggestive of a foreign body, other causes such as mediastinal tuberculosis must be borne in mind when no foreign body can be found. Although rare, cases of tuberculosis are apparently increasing and the otolaryngolgoist must be aware of its various manifestations and submit specimens for appropriate analysis. We also briefly review mediastinal lymphadenopathy due to tuberculosis.


2006 ◽  
Vol 120 (10) ◽  
pp. 882-884 ◽  
Author(s):  
B Maiya ◽  
H L Smith

Severe stridor of recent onset is a challenge to deal with because of the lack of investigations on which to base the management plan. We describe a case of an elderly lady who presented to us with a short history of severe stridor. We encountered unanticipated difficulties with tracheostomy under local anaesthesia as the thyroid was replaced by a diffuse mass and the airway had to be secured by an awake fibre-optic intubation. Awake fibre-optic intubation is thought to be a relative contraindication in acute upper airway obstruction, but occasionally tracheostomy under local anaesthesia may not be possible and in experienced hands an awake fibre-optic intubation is a reasonable alternative.


2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
H. Ahmed ◽  
C. Ndiaye ◽  
M. W. Barry ◽  
Aliou Thiongane ◽  
A. Mbaye ◽  
...  

Ventricular band cyst is a rare condition in children but can result in severe upper airway obstruction with laryngeal dyspnea or death. The diagnosis should be considered in any stridor in children with previous history of intubation or respiratory infections. We report a case of a 4-year-old girl, received in an array of severe respiratory distress, emergency endoscopy was done, and a large ventricular tape band cyst obstructing the air way was found. Complete excision was made, and postoperative prophylaxis tracheotomy was done. The postoperative course was uneventful with improvement of clinical and endoscopic signs.


2020 ◽  
Vol 60 (3) ◽  
pp. 223-226
Author(s):  
Alice Dalrymple ◽  
John D Gilbert ◽  
Roger W Byard

A 48-year-old man complained of throat swelling and difficulty swallowing after eating hot food. Several hours later, he collapsed and was observed to be gasping for breath. Bystander and ambulance-initiated cardiopulmonary resuscitation was unsuccessful, and he was pronounced deceased at the scene. At autopsy, the aryepiglottic folds were markedly oedematous, with adjacent areas of mucosal inflammation and necrosis from a recent burn. Death was attributed to upper-airway obstruction due to glottic inlet oedema associated with epiglottic and laryngopharyngeal thermal injury. Although thermal epiglottitis not involving fire is an unusual injury and is rarely fatal, the reported case demonstrates a lethal episode arising from the ingestion of excessively hot food. Thermal epiglottitis therefore represents an uncommon cause of delayed upper-airway obstruction in adults that should be considered in individuals presenting with a sore throat and shortness of breath, particularly if there is a history of hot-food ingestion.


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