A Hunsaker Mon-Jet tube trapped in the larynx

AbstractObjective:We report a unique complication arising from the use of a Hunsaker Mon-Jet ventilation tube during microlaryngeal surgery, and we briefly review the literature on the use of this tube for jet ventilation.Method:A case report on the safe and successful management of a potential airway compromise, and a brief literature review on using the Hunsaker Mon-Jet ventilation tube during microlaryngeal surgery.Case report:A 46-year-old woman was scheduled to undergo removal of a vocal cord polyp under general anaesthesia. However, the polyp became stuck in the basket of the Hunsaker tube during intubation. The polyp and the Hunsaker tube were removed safely after a microlaryngeal tube was passed beyond the vocal cords. To our knowledge, this complication has not previously been reported.Conclusion:This case highlights the potential risk of laryngeal growths, especially vocal cord polyps, becoming trapped in the Hunsaker tube during intubation. Both the anaesthetist and the operating surgeon should be aware of this possible complication and, more importantly, how to deal with such a problem.

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Autopolypectomy of a Vocal Cord Polyp

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2018.v26i2.194 ◽

2018 ◽

Vol 26 (2) ◽

pp. 134-136

Author(s):

Saud Ahmed ◽

Altaf Hussain ◽

Basharat Nadeem ◽

Faroq Ali

Keyword(s):

Case Report ◽

Vocal Cord ◽

Histopathological Examination ◽

Surgical Excision ◽

Acute Cough ◽

Unique Case ◽

Vocal Cord Polyp ◽

History Of ◽

Microlaryngeal Surgery ◽

The Right

Introduction Vocal cord polyps commonly occur in those with a history of vocal abuse. Patients with large lesions generally undergo microlaryngeal surgery under general anaesthesia. This unique case report highlights a strange scenario where the patient coughed out a fleshy mass during his morning walk and which was later confirmed as a vocal cord polyp. Case Report A 62 year old male with a history of hoarseness of voice for 3 months presented to the ENT OPD holding a chunk of tissue which was apparently coughed out by him during his morning walk. After the incident, his symptoms had immediately improved. A videolaryngoscopy showed a congested spot on the right vocal cord being the probable site of origin of the lesion. On Histopathological examination, the tissue was reported as a vocal cord polyp. The patient was managed conservatively but the lesion recurred at the same site after a month for which a microlaryngeal excision was performed. Discussion Vocal cord polyps are fairly common in ENT practice and usually present to the clinic with hoarseness of voice. Polyps that are small are usually managed conservatively by voice therapy alone whereas large polyps require surgical excision. This unique case report highlights a strange clinical scenario where the patient coughed out a large vocal cord polyp (Auto-polypectomy) during a bout of acute cough. This event saved him a surgery at the first instance, but eventually had a recurrence and had to undergo an excision under GA.

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Large Vocal Cord Polyp Causing Dyspnea: A Case Report

Practica Oto-Rhino-Laryngologica ◽

10.5631/jibirin.100.57 ◽

2007 ◽

Vol 100 (1) ◽

pp. 57-60

Author(s):

Shinya Hori ◽

Kenichi Kaneko ◽

Rie Kanai ◽

Seita Kubo

Keyword(s):

Case Report ◽

Vocal Cord ◽

Vocal Cord Polyp

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Bilateral vocal cord paresis as a rare complication of endoscopic retrograde cholangiopancreatography: a case report for the attention of endoscopist

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20194951 ◽

2019 ◽

Vol 5 (6) ◽

pp. 1691

Author(s):

Vinota Paniselvam ◽

Ahmad Nordin

Keyword(s):

Case Report ◽

Vocal Cord ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Rare Complication ◽

Endoscopic Retrograde ◽

Vocal Cords ◽

Present Case Report ◽

Vocal Cord Paresis

Bilateral vocal cord paresis is an extremely rare complication of endoscopic retrograde cholangiopancreatography (ERCP) with no case reported prior to this. We present a case of a 38 years old gentleman who suddenly developed aphonia and aspiration symptoms following ERCP. A rigid laryngoscopy done showed adductor paresis of bilateral vocal cords causing his symptoms, which was presumed to be a complication of the ERCP. He was treated conservatively and clinically improved with time. The present case report emphasizes that bilateral vocal cord paresis could occur as a complication of ERCP.

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Head and Neck Myxoma Presenting as Isolated Laryngeal Polyp

Case Reports in Otolaryngology ◽

10.1155/2018/6868737 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Smriti Panda ◽

Rajeev Kumar ◽

Vikram Raj Gopinath ◽

Prem Sagar

Keyword(s):

Differential Diagnosis ◽

Head And Neck ◽

Vocal Cord ◽

Vocal Fold ◽

Web Of Science ◽

Anecdotal Evidence ◽

Local Infiltration ◽

Vocal Cord Polyp ◽

History Of ◽

Microlaryngeal Surgery

Myxoma is a benign tumour with a propensity for local infiltration and recurrence. Laryngeal myxoma presents as a submucosal polyp. Being an uncommon tumour and mimicking vocal cord polyp, only anecdotal evidence is available in the literature. The literature was reviewed from 1986 onwards using the keywords “myxoma” and “larynx.” The databases used were PubMed, Google Scholar, Scopus, and Web of Science. Along with this, we also report our case of vocal fold myxoma. We found a total of 19 studies reporting laryngeal myxoma. Laryngeal myxoma typically affects males in the 6th decade with a history of smoking. Unlike myxomas originating outside the larynx, recurrence is not widely described, and microlaryngeal surgery will usually suffice. Laryngeal myxomas should definitely be kept in the list of differential diagnosis when dealing with a benign-looking vocal fold lesion.

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CASE REPORT: RESECTION OF SYMPTOMATIC VOCAL CORD NODULE BY MICROLARYNGEAL SURGERY USING 0 0 , 30 0 ENDOSCOPE

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2015/1669 ◽

2015 ◽

Vol 4 (66) ◽

pp. 11567-11569 ◽

Cited By ~ 1

Author(s):

Mahesh V. Kattimani ◽

Shweta Anand

Keyword(s):

Case Report ◽

Vocal Cord ◽

Microlaryngeal Surgery

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Role of stroboscopy in diagnosis of laryngeal disorder

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20191457 ◽

2019 ◽

Vol 5 (3) ◽

pp. 560

Author(s):

Nimisha Nimkar ◽

Hiren Soni

Keyword(s):

Vocal Cord ◽

Vocal Folds ◽

Neck Surgery ◽

Vocal Cord Palsy ◽

Vocal Cords ◽

Medical College ◽

Vocal Cord Polyp ◽

Common Diagnosis ◽

Main Culprit ◽

One Year

Background: Laryngeal disorders are the main culprit for change of voice. Patient presenting with change of voice needs to be assessed for laryngeal disorder. Larynx being part of hypopharynx in the deeper part of cavity has been difficult organ to examine since long, but with technological evolution from artificial light to flexible scopes to stroboscope has made life easier for a laryngologist to evaluate laryngeal disorder thoroughly.Methods: In this study we have included all cases of change of voice coming to department of ENT and head and neck surgery at GMERS Medical College and Hospital, Gotri in last one year with change of voice for more than one month including vocal cord malignancy. A detailed history and thorough examination of ENT and in particular larynx done. Further work up and management was done according to case base need. Results: Out of 50 patients enrolled in the study we found 48% males and 42% females. Most of the patients were adults. Only 4% were in geriatric age group. Most common diagnosis was vocal cord nodules 26% followed by hypertrophy of vocal cords16%. Malignancy of the vocal cords was found to be 14% followed by10% of vocal cord polyp and vocal cord palsy 10%. Other conditions were found to be 6%.Conclusions: Stroboscopy is a great tool for evaluation of vocal cord pathology in particular subtle diseases of vocal cords. Along with diagnosis we can have proper documentation of dynamic movement of vocal folds with help of stroboscopy.

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The Hunsaker Mon-Jet Ventilation Tube for Microlaryngeal Surgery: Optimal Laryngeal Exposure

Ear Nose & Throat Journal ◽

10.1177/014556130208100610 ◽

2002 ◽

Vol 81 (6) ◽

pp. 390-394 ◽

Cited By ~ 21

Author(s):

Lisa A. Orloff ◽

Nooshin Parhizkar ◽

Erica Ortiz

Keyword(s):

Ventilation System ◽

Ventilation Tube ◽

Jet Ventilation ◽

Anesthetic Induction ◽

Airway Control ◽

Laryngeal Exposure ◽

Duration Of Surgery ◽

Recovery Times ◽

Microlaryngeal Surgery ◽

End Tidal

Methods of delivering and monitoring anesthesia during microlaryngeal surgery are constantly evolving. In 1994, Hunsaker and colleagues introduced a laser-safe subglottic Mon-Jet ventilation tube, which has the ability to periodically measure end-tidal carbon dioxide levels. We conducted a retrospective review of 84 consecutive patients who had undergone microlaryngeal procedures with the aid of the Hunsaker Mon-Jet tube. Study parameters included the length of anesthetic induction and recovery times, the duration of surgery, the degree of surgical access to the larynx, and the incidence of anesthetic and surgical complications. We found that anesthetic induction and recovery times with the use of the Mon-Jet tube were comparable to those seen with standard endotracheal intubation. We also observed an apparent reduction in surgical time and a consistent subjective improvement in surgical visualization and access. The complication rate was acceptable, airway control was adequate, and use of the Mon-Jet tube was safe in all patients. We conclude that the Mon-Jet tube is a safe and effective subglottic jet ventilation system and that it has distinct advantages over other methods for both the surgeon and the anesthesiologist.

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Anaesthesia for microlaryngeal and laser laryngeal surgery: impact of subglottic jet ventilation

The Journal of Laryngology & Otology ◽

10.1017/s0022215109992532 ◽

2010 ◽

Vol 124 (6) ◽

pp. 641-645 ◽

Cited By ~ 13

Author(s):

M Barakate ◽

E Maver ◽

G Wotherspoon ◽

T Havas

Keyword(s):

Outer Diameter ◽

Ventilation Tube ◽

Jet Ventilation ◽

Tracheal Mucosa ◽

Laryngeal Surgery ◽

Surgical Access ◽

South Wales ◽

Accurate Treatment ◽

Microlaryngeal Surgery ◽

End Tidal

AbstractObjective:Over the past 20 years, jet ventilation techniques have been developed to enable safe and controlled microlaryngoscopy and the accurate treatment of laryngeal pathology. This study examined how advances in jet ventilation tube design have facilitated safe endolaryngeal surgery.Study design:The study documented the development and use of the Jockjet subglottic jet ventilation tube system at the Prince of Wales Hospital, Sydney. The new system consisted of two components: a Teflon tube with an outer diameter of 4 mm at the larynx, and a companion ventilator. The facility for end-tidal carbon dioxide and distal airways pressure monitoring was incorporated via dedicated channels. The Venturi jet was produced via a covered tip to prevent trauma to the tracheal mucosa.Setting:The Prince of Wales and Sydney Children's Hospitals, incorporated with The University of New South Wales.Patients:From June 2002 to March 2008 inclusive, 1000 consecutive patients underwent microlaryngeal surgery at this institution. Subglottic jet ventilation, via the Jockjet tube, was employed for 332 patients.Main outcome measures:Anaesthetic safety and intra-operative surgical access.Results:In all the 332 patients observed, surgical access was optimised and no adverse anaesthetic outcomes were encountered.Conclusion:Subglottic jet ventilation facilitates safe airway management during microlaryngeal and laser laryngeal surgery.

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A Rare Case of Sessile Polypoidal Xanthoma of Vocal Cord

International Journal of Phonosurgery & Laryngology ◽

10.5005/jp-journals-10023-1040 ◽

2012 ◽

Vol 2 (2) ◽

pp. 66-68

Author(s):

Pankaj Shah ◽

Ashish Katarkar ◽

Datt Modh ◽

Anil Kumar Jain ◽

Sanyogita Jain ◽

...

Keyword(s):

Vocal Cord ◽

Clinical Diagnosis ◽

Rare Case ◽

Sessile Polyp ◽

Histopathological Findings ◽

Anterior Aspect ◽

Vocal Cord Polyp ◽

Microlaryngeal Surgery

ABSTRACT We report a rare case of sessile polypoidal xanthoma of vocal cord in a 38-year-old female, presented with complaint of hoarseness of voice for 3 months. Hopkins telescopic examination showed a sessile polyp arising from the anterior aspect of laryngeal vocal cord. With clinical diagnosis of vocal cord polyp, microlaryngeal surgery was done and tissue was sent for histopathological and culture examination. Histopathological findings showed features of polypoidal xanthoma. Culture was negative. How to cite this article Jain AK, Jain S, Katarkar A, Alam N, Lakum N, Shah P, Modh D. A Rare Case of Sessile Polypoidal Xanthoma of Vocal Cord. Int J Phonosurg Laryngol 2012;2(2): 66-68.

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