Failed tracheostomy under local anaesthesia…plan B?

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.

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Tracheal perforation managed by temporary tracheostomy in a horse : clinical communication

Journal of the South African Veterinary Association ◽

10.4102/jsava.v76i2.408 ◽

2005 ◽

Vol 76 (2) ◽

Cited By ~ 6

Author(s):

M.N. Saulez ◽

N.M. Slovis ◽

A.T. Louden

Keyword(s):

Airway Obstruction ◽

Conservative Management ◽

Local Anaesthesia ◽

Upper Airway ◽

Upper Airway Obstruction ◽

Cervical Region ◽

Respiratory Obstruction ◽

Clinical Communication ◽

Severe Emphysema ◽

Upper Respiratory

Tracheal trauma with resultant rupture is uncommonly reported in veterinary literature. We report the case of a 16-year-old Thoroughbred gelding that sustained a 1 cm longitudinal perforation of the dorsal tracheal membrane in the proximal cervical region. The horse subsequently developed dyspnoea due to acute upper respiratory obstruction secondary to severe emphysema of the guttural pouches. A temporary tracheostomy caudal to the site of tracheal perforation was performed under local anaesthesia. This procedure helped relieve the upper airway obstruction and aided resolution of the injury by diverting air away from the site of tracheal perforation. After conservative management, the gelding recovered completely.

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Chronic Lymphocytic Leukemia as an Unusual Cause of Rapid Airway Compromise

Case Reports in Oncological Medicine ◽

10.1155/2017/8247353 ◽

2017 ◽

Vol 2017 ◽

pp. 1-4

Author(s):

Adrian R. Bersabe ◽

Joshua T. Romain ◽

Erin E. Ezzell ◽

John S. Renshaw

Keyword(s):

Chronic Lymphocytic Leukemia ◽

Airway Obstruction ◽

Head And Neck ◽

Cervical Lymphadenopathy ◽

Upper Airway ◽

Lymphocytic Leukemia ◽

Upper Airway Obstruction ◽

Airway Compromise ◽

History Of ◽

Prevalent Form

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.

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Epstein–Barr virus-associated infectious mononucleosis causing upper airway obstruction in a child with a history of adenoid hypertrophy

Pediatrics & Neonatology ◽

10.1016/j.pedneo.2019.09.010 ◽

2020 ◽

Vol 61 (1) ◽

pp. 127-128

Author(s):

Xin-Tian He ◽

Chiao-Hua Lee ◽

Po-Wei Wu ◽

Chih-Chien Wang

Keyword(s):

Airway Obstruction ◽

Infectious Mononucleosis ◽

Epstein Barr Virus ◽

Upper Airway ◽

Upper Airway Obstruction ◽

Adenoid Hypertrophy ◽

Barr Virus ◽

History Of ◽

Epstein Barr

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Acute upper airway obstruction following Teflon injection of a vocal cord; the value of nebulized adrenaline and a helium/oxygen mixture in its management

The Journal of Laryngology & Otology ◽

10.1017/s0022215100113519 ◽

1990 ◽

Vol 104 (8) ◽

pp. 654-655 ◽

Cited By ~ 11

Author(s):

Neil B. Solomons ◽

Jonathan R. Livesey

Keyword(s):

Airway Obstruction ◽

Vocal Cord ◽

Upper Airway ◽

Vocal Cord Palsy ◽

Upper Airway Obstruction ◽

Oxygen Mixture ◽

Post Operative Period ◽

History Of ◽

The Right

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.

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Mediastinal tuberculosis in a 10-month-old child

The Journal of Laryngology & Otology ◽

10.1258/0022215011907622 ◽

2001 ◽

Vol 115 (2) ◽

pp. 161-163 ◽

Cited By ~ 7

Author(s):

Aftab Ahmed ◽

Showkat Mirza ◽

Michael P. Rothera

Keyword(s):

Foreign Body ◽

Airway Obstruction ◽

Rare Case ◽

Mediastinal Mass ◽

Histological Analysis ◽

Upper Airway ◽

Upper Airway Obstruction ◽

Mediastinal Lymphadenopathy ◽

X Rays ◽

History Of

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.

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A Rare Cause of Upper Airway Obstruction in a Child

Case Reports in Otolaryngology ◽

10.1155/2017/2017265 ◽

2017 ◽

Vol 2017 ◽

pp. 1-3

Author(s):

H. Ahmed ◽

C. Ndiaye ◽

M. W. Barry ◽

Aliou Thiongane ◽

A. Mbaye ◽

...

Keyword(s):

Airway Obstruction ◽

Respiratory Infections ◽

Previous History ◽

Upper Airway ◽

Rare Condition ◽

Upper Airway Obstruction ◽

Complete Excision ◽

Severe Respiratory Distress ◽

History Of ◽

Laryngeal Dyspnea

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.

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Gardener-associated fibroma: an unusual cause of upper airway obstruction

BMJ Case Reports ◽

10.1136/bcr-2018-225079 ◽

2018 ◽

pp. bcr-2018-225079

Author(s):

Rohan Sebastian Pinto ◽

Anthony Simons ◽

Rohit Verma ◽

Neil Bateman

Keyword(s):

Airway Obstruction ◽

Upper Airway ◽

Colonic Polyps ◽

Postoperative Recovery ◽

Upper Airway Obstruction ◽

Transcervical Approach ◽

First Case ◽

Increased Risk ◽

History Of ◽

Apc Mutation

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.

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Delayed fatal upper-airway obstruction due to laryngopharyngeal burns and thermal epiglottis

Medicine Science and the Law ◽

10.1177/0025802420918040 ◽

2020 ◽

Vol 60 (3) ◽

pp. 223-226

Author(s):

Alice Dalrymple ◽

John D Gilbert ◽

Roger W Byard

Keyword(s):

Cardiopulmonary Resuscitation ◽

Airway Obstruction ◽

Thermal Injury ◽

Upper Airway ◽

Upper Airway Obstruction ◽

Mucosal Inflammation ◽

Shortness Of Breath ◽

Food Ingestion ◽

History Of ◽

Unusual Injury

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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Infectious mononucleosis and bilateral peritonsillar abscesses resulting in airway obstruction

The Journal of Laryngology & Otology ◽

10.1017/s002221510014280x ◽

1998 ◽

Vol 112 (12) ◽

pp. 1186-1188 ◽

Cited By ~ 16

Author(s):

P. P. Burstin ◽

C. L. Marshall

Keyword(s):

Airway Obstruction ◽

Infectious Mononucleosis ◽

Upper Airway ◽

Upper Airway Obstruction ◽

Airway Compromise ◽

Fibre Optic ◽

First Report ◽

Severe Airway Obstruction

AbstractUpper airway obstruction is an uncommon but recognized complication of infectious mononucleosis. The management depends upon the degree of airway compromise. In the case described, severe airway obstruction was treated by securing the airway with awake fibre-optic endoscopic intubation and then proceeding to tonsillectomy. Bilateral inferiorly loculated quinsies were encountered unexpectedly and drained. This is the first report of ‘bilateral’ quinsies, associated with infectious mononucleosis and severe airway obstruction. The association, pathogenesis and significance of this finding are also discussed.

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