Tracheal Bronchus: Classification, Endoscopic Analysis, and Airway Management

2002 ◽  
Vol 126 (3) ◽  
pp. 240-243 ◽  
Author(s):  
Andrew M. Doolittle ◽  
Eric A. Mair
Keyword(s):  
Congenital Anomaly ◽  
Airway Management ◽  
Main Bronchus ◽  
Case Series ◽  
Tracheal Bronchus ◽  
Lobe Bronchus ◽  
Retrospective Case ◽  
Tracheal Diverticulum ◽  
Pediatric Bronchoscopy ◽  
The Right

OBJECTIVE: Tracheal bronchus ( bronchus suis) is an unusual congenital anomaly in which the right upper lobe has its origin in the trachea rather than distal to the carina. We sought to analyze the anatomy, presentation, and airway management principles of tracheal bronchi, and we present the first endoscopically documented tracheal diverticulum. STUDY DESIGN/METHODS: Retrospective case series. RESULTS: The tracheal bronchus is located at the junction of the mid and distal thirds of the right lateral trachea, is more common in males and children with other congenital anomalies, and may be associated with right main bronchus stenosis. Bronchoscopy provides a clear definitive view of the anomaly, which we found in 5 children during a 12-year period (0.5% of pediatric bronchoscopy procedures). We illustrate 3 types of tracheal bronchi: (1) vestigial tracheal diverticulum (newly described), (2) high apical lobe, and (3) fully developed supranumerary aerated tracheal bronchus. Endoscopic documentation of each type is presented. Children with tracheal bronchi may present with stridor, cough, and/or recurrent right-sided pneumonia and/or to have foreign body aspiration ruled out. Treatment is based on the severity of symptoms and ranges from observation to right upper lobectomy. CONCLUSIONS: Otolaryngologists should be aware of the tracheal bronchus, to include classification, endoscopic analysis, and airway management of this uncommon anomaly. Bronchoscopy with selected radiographic imaging allows the otolaryngologist to fully evaluate the child with a tracheal bronchus and to present timely therapeutic options. Tracheal bronchus is a congenital anomaly in which a right upper lobe bronchus has its origin in the trachea rather than at the carina. Bronchus suis, or “pig bronchus,” is an alternate name that is used because a tracheal bronchus is normal in swine and other ruminant animals. In approximately 1000 pediatric bronchoscopy procedures performed by the senior author during a 12-year period, only 5 children (approximately 0.5%) were identified with a tracheal bronchus. We present 3 representative cases to highlight salient features of each variant of the tracheal bronchus. A newly described “tracheal diverticulum” variant is presented. Tracheal bronchus classification based on endoscopic analysis assists with airway management for this uncommon anomaly.

scholarly journals Airway management in mucopolysaccharidosis: a retrospective case series review

2021 ◽  
Author(s):  
Murat Tümer ◽  
Aysun Ankay Yılbaş ◽  
Sehend Debbağ ◽  
Fatma Sarıcaoğlu ◽  
Özgür Canbay
Keyword(s):  
Airway Management ◽  
Case Series ◽  
Retrospective Case ◽  
Retrospective Case Series

Absent right superior caval vein in situs solitus

2015 ◽  
Vol 26 (2) ◽  
pp. 334-339 ◽  
Author(s):  
Rebekka Lytzen ◽  
Karin Sundberg ◽  
Niels Vejlstrup
Keyword(s):  
Incidental Finding ◽  
Clinical Manifestations ◽  
Case Series ◽  
Retrospective Case ◽  
Caval Vein ◽  
Cardinal Vein ◽  
Benign Condition ◽  
Superior Caval Vein ◽  
Case Series Study ◽  
The Right

AbstractIntroductionIn up to 0.07% of the general population, the right anterior cardinal vein obliterates and the left remains open, creating an absent right superior caval vein and a persistent left superior caval vein. Absent right superior caval vein is associated with additional congenital heart disease in about half the patients. We wished to study the consequences of absent right superior caval vein as an incidental finding on prenatal ultrasonic malformation screening.Material and methodsThis is a retrospective case series study of all foetuses diagnosed with absent right superior caval vein at the national referral hospital, Rigshospitalet, Denmark, from 2009 to 2012.ResultsIn total, five cases of absent right superior caval vein were reviewed. No significant associated cardiac, extra-cardiac, or genetic anomalies were found. Postnatal echocardiographies confirmed the diagnosis and there were no postnatal complications. All children were found to have healthy hearts at follow-up.ConclusionsIn all cases, the findings proved to be a benign condition with no clinical manifestations or complications. Although isolated absent right superior caval vein does not seem to affect the outcome, associated anomalies may be serious. Absent right superior caval vein should, therefore, prompt a search for additional malformations. Furthermore, the diagnosis of an isolated absent right superior caval vein is important, because knowledge of the anomaly can prevent future problems when invasive procedures are necessary.

scholarly journals A Retrospective Case Series of Anesthetic Patients With Epiglottic Cysts

2021 ◽  
Vol 68 (3) ◽  
pp. 168-177
Author(s):  
Kazumi Takaishi ◽  
Ryo Otsuka ◽  
Shigeki Josephluke Fujiwara ◽  
Satoru Eguchi ◽  
Shinji Kawahito ◽  
...  
Keyword(s):  
Airway Management ◽  
General Anesthesia ◽  
Oral Surgery ◽  
Case Series ◽  
Preoperative Imaging ◽  
Retrospective Case ◽  
Anesthetic Care ◽  
Retrospective Case Series

Previously undiagnosed or asymptomatic epiglottic cysts may be coincidentally detected during intubation. This retrospective case series identified undiagnosed epiglottic cysts that were discovered during intubation in 4 patients who underwent oral surgery under general anesthesia at our hospital during a 6-year period. Including 2 additional cases, 1 previously diagnosed and 1 detected during preoperative imaging, epiglottic cysts were observed in 6 of 1112 cases (0.54%) total. Among the undiagnosed epiglottic cyst cases, mild dyspnea on effort or snoring was reported in 2 patients, but all others were asymptomatic. Upon discovering previously undiagnosed epiglottic cysts during intubation, it is essential to proceed cautiously, remain alert for potential airway management difficulties, and avoid injuring or rupturing the cysts. In addition, any available preoperative imaging should be reviewed as information pertinent to the airway and any abnormalities may be useful. This report discusses the anesthetic care of 6 patients with epiglottic cysts that were previously known or initially discovered during intubation.

A word of caution: diabolic behaviour of AndraStents®: inflation of supporting balloon leads to “diabolo”-misconfiguration of the stent

2019 ◽  
Vol 29 (7) ◽  
pp. 972-976
Author(s):  
Christoph M. Happel ◽  
Jose L. Zunzunegui Martínez ◽  
María Jesús del Cerro ◽  
Dietmar Schranz ◽  
Markus Khalil ◽  
...  
Keyword(s):  
High Pressure ◽  
Right Ventricular ◽  
Case Series ◽  
Right Ventricular Outflow Tract ◽  
Ventricular Outflow Tract ◽  
Middle Part ◽  
Outflow Tract ◽  
Retrospective Case ◽  
The Right ◽  
Fatal Complications

AbstractAims:Transcatheter implantation of pulmonary balloon-expandable stent-valves requires pre-stenting of the right ventricular outflow tract with large calibre stents. To increase awareness of the associated risks of this part of transcatheter pulmonary valve replacement therapy, we report potential fatal complications during the implantation of AndraStents® in the right ventricular outflow tract in six cases from five different European institutions and their management.Method and result:We present a retrospective case series analysis looking at the time period from 2013 to 2018. Of 127 AndraStents® implanted in the right ventricular outflow tract, in six patients, age from 13 to 71 years, a misconfiguration of the AndraStent® occurred forming a “diabolo”-configuration. During inflation of the balloon, the stent showed extreme “dog-boning”, an expansion of the stent at both ends with the middle part remaining unexpanded. This led to rupture of the balloon and loss of manoeuvrability in four patients. Out of the total six cases, in four patients the stent was eventually expanded with high-pressure balloons, and in one case the stent was surgically retrieved. In one patient, in whom a percutaneous retrieval of the embolised stent was attempted, a fatal bleeding occurred.Conclusions:Pre-stenting of the right ventricular outflow tract by AndraStents® can lead to misconfiguration of the stent with potentially fatal complications. Rescue strategies of misconfigured stents include stent inflation and placement with high pressure non-compliant balloons or surgical backup. Interventional retrieval measures of AndraStents® cannot be advised.

scholarly journals Submandibular Approach for Tracheal Intubation in Oro-maxillofacial Surgery: An Initial Experience in a Dental College Hospital in Bangladesh

2017 ◽  
Vol 1 (2) ◽  
pp. 41-46
Author(s):  
Md Shahadat Hossain ◽  
Hasina Begum ◽  
Ismat Ara Haider ◽  
Md. Selim Sarker
Keyword(s):  
Tracheal Intubation ◽  
Airway Management ◽  
Main Bronchus ◽  
Maxillofacial Surgery ◽  
Upper Airway ◽  
Dental Occlusion ◽  
College Hospital ◽  
The Right ◽  
Age Range ◽  
Oromaxillofacial Surgery

Background: Tracheal intubation in oro-maxillofacial surgery is an important issue during operation. Objective: The purpose of the present study was to demonstrate the feasibility and the reliability of submandibular tracheal intubation as an alternative method for airway management in oro-maxillofacial surgery. Methodology: This clinical trial was conducted in the Department of oromaxillofacial Surgery at Dhaka Dental College and Hospital, Dhaka from January 2010 to June 2011 for a period of one and half year. Patients suffering from painful fractures associated with displaced nasal fracture were selected as study population. Results: A total number of 9 patients were recruited for this study of which 1 was female and 8 were males and the age range was between 16 to 51 years. The technique was found easy and offers a secure airway to the anaesthetist, an optimal operating field and an opportunity to check the dental occlusion with limited morbidity for the patient. In all patients the submandibular tracheal tube was extubated after the operation without complications or difficulties. Accidental dislodgement of the tube to the right main bronchus occurred in one patient while carrying out the procedure. It was rapidly detectedand corrected. No other complications were encountered. Conclusion: Submandibular tracheal intubation is a safe, simple and effective technique for upper airway management when both oral and nasal tracheal intubations are not convenient in some oromaxillofacial surgery. Journal of National Institute of Neurosciences Bangladesh, 2015;1(2): 41-46

Review of Othello Syndrome and its Relationship with Neurological Disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S225-S225 ◽  
Author(s):  
P. Michielsen ◽  
L. De Jonge ◽  
S. Petrykiv ◽  
M. Arts
Keyword(s):  
Neurological Disorders ◽  
Neurological Diseases ◽  
Case Reports ◽  
Case Series ◽  
Lewy Body Disease ◽  
Original Research ◽  
Elderly Persons ◽  
Retrospective Case ◽  
Competing Interest ◽  
The Right

IntroductionOthello syndrome is a psychotic disorder characterized by delusion of infidelity or jealousy. It predominantly occurs in the context of specific psychiatric or neurological disorders. Othello syndrome is associated with mental changes including excessive aggression, hostility, and irritability. Patients with Othello syndrome misinterpret the behaviour of the spouse or sexual partner to provide evidence for their false perception.Objectives and aimsThe purpose of this paper is to examine the phenomenon of Othello syndrome as a result of specific neurological diseases.MethodsThe study design was a retrospective case series of patients with Othello syndrome. We searched the electronic databases PubMed and Embase for review articles and original research using the search terms ‘Othello syndrome, Morbid Jealousy, Pathological Jealousy, Delusional Jealousy, Delusions and Infidelity, Delusions of Jealousy or Infidelity’.ResultsIn the present study of 95 case reports, the relationship between Othello syndrome and a neurological pathology was described. This syndrome was most commonly associated with neurodegenerative diseases (59%), followed by medication induced Othello syndrome (13.7%) and vascular dementia (8.4%). Lesions particularly in the right (dorsolateral) frontal lobes were associated with this syndrome.ConclusionThis study demonstrates that Othello syndrome occurs most frequently in patients with right frontal lobe dysfunction. It is predominantly related with Lewy Body Disease and Alzheimer's disease. Clinicians should keep an “index of suspicion” regarding dementia when Othello syndrome presents in elderly persons.Disclosure of interestThe authors have not supplied their declaration of competing interest.

510 Case Series: Four cases of Orbital Extension of Cutaneous Squamous Cell Carcinoma and Their Management

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Gaston-Grubb ◽  
C Boylan
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Case Series ◽  
Cutaneous Squamous Cell Carcinoma ◽  
Infraorbital Nerve ◽  
Temporal Region ◽  
Soft Tissue Reconstruction ◽  
Retrospective Case ◽  
The Right

Abstract Introduction Cutaneous squamous cell carcinoma (cSCC) invading the orbit is exceedingly rare. Understanding its presentation and management is of great value to the plastic surgeon. Method Retrospective case series of four patients aged 54 to 88 years. All patients presented with cSCC of the face or scalp which infiltrated the orbit. All underwent tumour excision and appropriate reconstruction. Results Case 1 and 2 involved cSCC originating from the right temporal and medial maxilla region, respectively. Case 1 posed the further challenge of irreversible blindness in the other eye, making exenteration very undesirable. In Case 2 the tumour extended along the infraorbital nerve and required several reconstructions of the eyelid to improve functionality and aesthetics. Cases 3 and 4 involved cSCC originating from the forehead and temporal region, respectively. Both required burring of the bony outer table and soft tissue reconstruction. Case 4 presented with the additional challenge of perineural spread to the cavernous sinus. Conclusions This case series provides an insight into a rare, advanced presentation of cSCC. Eyeball exenteration has significant physical, aesthetic, and psychological impacts and therefore should be avoided if possible, particularly if the tumour has not breached the orbital septum.

scholarly journals Airway Management for a Pediatric Patient With a Tracheal Bronchus

2018 ◽  
Vol 65 (1) ◽  
pp. 50-51
Author(s):  
Masanori Tsukamoto ◽  
Jun Hirokawa ◽  
Takashi Hitosugi ◽  
Takeshi Yokoyama
Keyword(s):  
Airway Management ◽  
Endotracheal Intubation ◽  
Pediatric Patient ◽  
Tracheal Wall ◽  
Tracheal Bronchus ◽  
The Right

Tracheal bronchus is an ectopic bronchus almost arising from the right side of the tracheal wall above the carina. The incidence of a tracheal bronchus is reported as 0.1 to 3%. We experienced a patient with tracheal bronchus that was incidentally found at induction of anesthesia. Endotracheal intubation in a patient with tracheal bronchus might cause obstruction of the tracheal bronchus, although in this case, ventilation was not impaired.

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