Subglottic Ductal Cysts Associated with Complete Tracheal Ring Deformity: Coexistence of Two Rare Airway Abnormalities with Fatal Outcome

Subglottic cysts are rare and may cause airway obstruction. Most cases are acquired secondary to endotracheal intubation, even short-term, particularly in the premature neonate. Complete tracheal rings are rare anomalies associated with tracheal stenosis. To our knowledge, the two have not been reported coexisting. A 16-month-old ex-premature boy was found unresponsive, with his tracheostomy tube dislodged. Tracheomalacia, subglottic stenosis, and a laryngeal cyst had been diagnosed shortly after birth, and the cyst was surgically treated at that time. At autopsy, a complete tracheal ring was noted in the subglottic region, above the tracheostomy site, and the tracheal diameter was markedly decreased in this area. In addition, multiloculated cysts were present at that level, arising from both anterolateral tracheal walls. These completely occluded the airway. To our knowledge, this is the first case of a combination of tracheal ring anomaly and subglottic cysts. Pediatric pathologists must be aware of iatrogenic lesions associated with care of the premature neonate, particularly as the age of viability continues to decrease.

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A comparison of endotracheal intubation and tracheostomy in the management of acute epiglottitis in children in the tropics

The Journal of Laryngology & Otology ◽

10.1017/s0022215100100969 ◽

1986 ◽

Vol 100 (11) ◽

pp. 1273-1278 ◽

Cited By ~ 2

Author(s):

Olujimi Odetoyinbo

Keyword(s):

Human Resources ◽

Airway Obstruction ◽

Endotracheal Intubation ◽

Healthy Child ◽

Short Term ◽

Acute Epiglottitis ◽

Dead Child ◽

The Tropics

AbstractIn children, acute epiglottitis is rapidly fatal due to airway obstruction by swollen supraglottic structures, but the oedema is short-lived. Therefore, in many centres short-term endotracheal intubation has replaced tracheostomy as the method of choice for relieving the obstruction.We have tried both methods in 15 children over a period of three years under conditions of limited material and human resources. Tracheostomy was found to be safer. It was concluded that it is better to have a live healthy child with a small scar in the neck than a dead child without a scar.

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Death Due to Obstruction of Airways by a Hyperplastic Polyp: An Unusual Complication of Treated Desmoid Fibromatosis

Academic Forensic Pathology ◽

10.1177/1925362120964084 ◽

2020 ◽

Vol 10 (2) ◽

pp. 97-103

Author(s):

Natasha Richards ◽

Jayantha Herath

Keyword(s):

Airway Obstruction ◽

Tracheostomy Tube ◽

Hyperplastic Polyp ◽

Pediatric Population ◽

Unusual Complication ◽

Anterior Neck ◽

Desmoid Fibromatosis ◽

First Case ◽

Tracheostomy Tubes ◽

Abdominal Lesions

Desmoid fibromatosis (DF) is a rare, locally aggressive but benign clonal fibroblastic lesion of deep soft tissue. It can occur at any age. Extra-abdominal lesions are more common in the pediatric population, with equal sex predilection. Desmoid fibromatosis of the head and neck, particularly the anterior neck, is more difficult to manage because of the proximity to vital structures and may eventually require definitive airway management with insertion of a tracheostomy tube. Indwelling tracheostomy tubes carry their own set of complications. This is the case of a 21-month-old boy who died suddenly due to tracheal obstruction by a hyperplastic polyp. He was diagnosed with DF of the neck before he was 1 month old and required an indwelling tracheostomy tube as a result. Chronic tracheostomy intubation can be complicated by granulation tissue polyp or, less commonly, fibroepithelial polyp formation that can become large enough to cause airway obstruction. To the authors’ knowledge, this is the first case of hyperplastic polyp causing fatal airway obstruction.

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Airway Intervention in Croup and Epiglottitis: The Changing Role of the Otolaryngologist

Otolaryngology ◽

10.1177/019459987808600326 ◽

1978 ◽

Vol 86 (3) ◽

pp. ORL-513-ORL-517 ◽

Cited By ~ 1

Author(s):

Nicholas L. Schenck

Keyword(s):

Intensive Care ◽

Airway Obstruction ◽

Endotracheal Intubation ◽

Term Treatment ◽

Short Term ◽

Short Term Treatment ◽

Airway Intervention ◽

Care Facilities ◽

Changing Role

Recent evidence indicates that endotracheal intubation is supplanting tracheostomy for the short-term treatment of airway obstruction in epiglottitis and croup. Care should be provided by a triumvirate of physicians to include an otolaryngologist, a pediatrician, and an anesthesiologist. Intensive care facilities are also a prerequisite. Standard tracheostomy should be considered in cases requiring intubation longer than 72 hours.

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Prolapsed Nasal Polyp Causing Acute Airway Obstruction: An Exceptional Presentation

ORL ◽

10.1159/000513564 ◽

2021 ◽

pp. 1-3

Author(s):

Krupa R. Patel ◽

Ashton E. Lehmann ◽

Aria Jafari ◽

Daniel L. Faden

Keyword(s):

Airway Obstruction ◽

Nasal Polyp ◽

Nasal Polyposis ◽

Upper Airway ◽

Rare Presentation ◽

First Case ◽

Acute Airway Obstruction ◽

History Of ◽

Sinonasal Symptoms ◽

Or History

Although nasal polyposis is a common clinical entity, there is limited literature describing the rare presentation of sudden prolapse of a massive nasal polyp resulting in an airway emergency in an adult. We present the first case report to our knowledge of a patient without any preceding sinonasal symptoms or history of anticoagulation who experienced acute upper airway obstruction due to sudden hemorrhage and prolapse of a large nasal polyp. Based on our experience treating this patient, we discuss special considerations in all phases of care to ensure safe and effective management of such an exceptional clinical scenario.

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Short-Term Prediction of COVID-19 Cases Using Machine Learning Models

Applied Sciences ◽

10.3390/app11094266 ◽

2021 ◽

Vol 11 (9) ◽

pp. 4266

Author(s):

Md. Shahriare Satu ◽

Koushik Chandra Howlader ◽

Mufti Mahmud ◽

M. Shamim Kaiser ◽

Sheikh Mohammad Shariful Islam ◽

...

Keyword(s):

Machine Learning ◽

Web Application ◽

Learning Models ◽

Short Term ◽

Infected People ◽

Infected Case ◽

First Case ◽

Novel Coronavirus ◽

Short Term Prediction ◽

Machine Learning Models

The first case in Bangladesh of the novel coronavirus disease (COVID-19) was reported on 8 March 2020, with the number of confirmed cases rapidly rising to over 175,000 by July 2020. In the absence of effective treatment, an essential tool of health policy is the modeling and forecasting of the progress of the pandemic. We, therefore, developed a cloud-based machine learning short-term forecasting model for Bangladesh, in which several regression-based machine learning models were applied to infected case data to estimate the number of COVID-19-infected people over the following seven days. This approach can accurately forecast the number of infected cases daily by training the prior 25 days sample data recorded on our web application. The outcomes of these efforts could aid the development and assessment of prevention strategies and identify factors that most affect the spread of COVID-19 infection in Bangladesh.

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Acute upper airway obstruction as a life-threatening complication of ventral bulla osteotomy: report of two consecutive cases

Journal of Feline Medicine and Surgery Open Reports ◽

10.1177/20551169211005923 ◽

2021 ◽

Vol 7 (1) ◽

pp. 205511692110059

Author(s):

Michal Vlasin ◽

Richard Artingstall ◽

Barbora Mala

Keyword(s):

Airway Obstruction ◽

Clinical Signs ◽

Upper Airway ◽

Upper Airway Obstruction ◽

Single Session ◽

Inflammatory Polyp ◽

Case Summary ◽

First Case ◽

Life Threatening

Case summary This paper presents two cases of acute postoperative upper airway obstruction following ventral bulla osteotomy (VBO) in cats. The first cat underwent a unilateral left-sided VBO for a suspected inflammatory polyp. The second cat underwent a single-session bilateral VBO procedure for bilateral otitis media. In the first case, immediate re-intubation and a gradual lightening of the anaesthetic plane resolved the clinical signs; in the second case, the patient deteriorated and went into acute cardiorespiratory arrest and received cardiopulmonary resuscitation. Both patients recovered well and were discharged home 3 days after surgery. Both cases were reported to show no further clinical signs on postoperative follow-up 3 weeks and 4 months after surgery, respectively. Relevance and novel information Upper airway obstruction should be regarded as a potential complication of VBO in cats.

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Calcaneal Reconstruction With Free Deep Circumflex Iliac Artery Osseocutaneous Flap Following Aggressive Benign Bone Tumor Resection

Foot & Ankle International ◽

10.1177/10711007211025280 ◽

2021 ◽

pp. 107110072110252

Author(s):

Mohamad Aizat Rosli ◽

Wan Faisham Wan Ismail ◽

Wan Azman Wan Sulaiman ◽

Nor Azman Mat Zin ◽

Syurahbil Abdul Halim ◽

...

Keyword(s):

Iliac Artery ◽

Donor Site ◽

Tumor Resection ◽

Case Series ◽

Benign Tumors ◽

Reconstruction Method ◽

Short Term ◽

Deep Circumflex Iliac Artery ◽

First Case ◽

Donor Site Pain

Background: Advances in limb-salvage techniques have made total calcanectomy and primary reconstruction possible in managing calcaneal aggressive benign tumors and selected cases of intraosseous malignant tumors. However, there is still no consensus on the operative approach, oncologic margin, and the best reconstruction method to date. These 2 cases describe our experience in calcaneal reconstruction with the free deep circumflex iliac artery (DCIA) osseocutaneous flap in benign aggressive calcaneal tumors. Methods: We reported 2 consecutive male and female patients, with an average age of 25 years (age 19 and 31, respectively), who underwent total calcanectomy and primary calcaneal reconstruction with the free DCIA osseocutaneous flaps for calcaneal chondroblastoma and giant cell tumor. A marginal resection of the entire calcaneus through the subtalar and calcaneocuboid joints (intra-articular approach) was performed in the first case and a wide local resection leaving 1 cm normal calcaneal bone margin anterosuperiorly (intraosseous approach) was performed in the second case. Results: The follow-up period averaged 48 months. Negative oncologic margins were achieved in both cases. The first case was complicated with venous thrombosis; however, the graft remained viable after emergency reexploration. Normal foot function was restored with good solid osseous union and bony hypertrophy observed. Both patients achieved good short-term functional and aesthetic outcomes with no donor site pain or disability. No local recurrence was reported either. Conclusion: Primary calcaneal reconstruction with the free DCIA osseocutaneous flap can lead to good short-term functional and aesthetic outcomes. Level of Evidence: Level IV, case series.

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Fiberoptic Bronchoscopy-Assisted Endotracheal Intubation in a Patient With a Large Tracheal Tumor

International Surgery ◽

10.9738/intsurg-d-14-00020.1 ◽

2015 ◽

Vol 100 (4) ◽

pp. 589-592 ◽

Cited By ~ 4

Author(s):

Lei Pang ◽

Yan-Hua Feng ◽

Hai-Chun Ma ◽

Su Dong

Keyword(s):

Sleep Deprivation ◽

Airway Obstruction ◽

Endotracheal Intubation ◽

Tracheal Stenosis ◽

Imaging Techniques ◽

Tumor Resection ◽

Fiberoptic Bronchoscopy ◽

X Rays ◽

Tissue Mass ◽

Tracheal Tumor

In the event of a high degree of airway obstruction, endotracheal intubation can be impossible and even dangerous, because it can cause complete airway obstruction, especially in patients with high tracheal lesions. However, a smaller endotracheal tube under the guidance of a bronchoscope can be insinuated past obstructive tumor in most noncircumferential cases. Here we report a case of successful fiberoptic bronchoscopy-assisted endotracheal intubation in a patient undergoing surgical resection of a large, high tracheal tumor causing severe tracheal stenosis. A 42-year-old Chinese man presented with dyspnea, intermittent irritable cough, and sleep deprivation for one and a half years. X-rays and computed tomography scan of the chest revealed an irregular pedunculated soft tissue mass within the tracheal lumen. The mass occupied over 90% of the lumen and caused severe tracheal stenosis. Endotracheal intubation was done to perform tracheal tumor resection under general anesthesia. After several failed conventional endotracheal intubation attempts, fiberoptic bronchoscopy-assisted intubation was successful. The patient received mechanical ventilation and then underwent tumor resection and a permanent tracheostomy. This case provides evidence of the usefulness of the fiberoptic bronchoscopy-assisted intubation technique in management of an anticipated difficult airway and suggests that tracheal intubation can be performed directly in patients with a tracheal tumor who can sleep in the supine position, even if they have occasional sleep deprivation and severe tracheal obstruction as revealed by imaging techniques.

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Sub-glottic cysts causing upper airway obstruction

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20202227 ◽

2020 ◽

Vol 6 (6) ◽

pp. 1203

Author(s):

Swathi Chigicherla ◽

Shruti Tewari ◽

Rahul Deo Sharma ◽

Rajesh Nathani

Keyword(s):

Respiratory Distress ◽

Airway Obstruction ◽

Direct Laryngoscopy ◽

Upper Airway ◽

Upper Airway Obstruction ◽

First Case

<p class="abstract">Wigger and Tang reported the first case of a sub-glottic cyst (SGC) in 1968. SGC are rare but potentially reversible causes of upper airway obstruction, in previously intubated children. These children present with respiratory distress and stridor, and the diagnosis is confirmed by direct laryngoscopy. The management depends on the size of the cysts and the severity of the symptoms. We are presenting two cases of SGCs who were born prematurely and were intubated for a prolonged period. They presented with stridor and were diagnosed to have sub-glottic cysts at bronchoscopy.</p>

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