DOZ047.77: Extraluminal airway stabilization for localized tracheomalacia: a case report

2019 ◽  
Vol 32 (Supplement_1) ◽  
Author(s):  
A Laín ◽  
F Pumarola ◽  
C Giné ◽  
L García ◽  
P Barila ◽  
...  
Keyword(s):  
Case Report ◽  
Respiratory Infections ◽  
Neurological Status ◽  
Middle Part ◽  
Transcervical Approach ◽  
Endoscopic Control ◽  
Effective Option ◽  
Cervical Trachea ◽  
Genetic Anomaly

Abstract Aim In the last years several treatments for tracheomalacia have been reported. However, management of this entity is still a complex matter. This study presents a case diagnosed of severe proximal tracheomalacia managed by external tracheal resorbable plates. Case Report A seven-year-old child was tracheostomized in the neonatal period in relation to severe generalized tracheomalacia in association with swallowing incoordination and recurrent respiratory infections. Data to point out of his personal history were prematurity, a mosaic type genetic anomaly, cognitive and development impairment, and bilateral hypoacusia. After improvement of the neurological status and his feeding and swallow problems he was evaluated by the Airway Unit of our centre. Dynamic transnasal flexible laryngotracheobronchoscopy showed severe tracheomalacia. The collapse was 100% in the proximal airway (from the subglotis to the middle part of the trachea) and decannulation was not possible. Given the extent, localization, and proximity of the tracheomalacia to the vocal cords a surgical approach with external bioresorbable plates was indicated. By a transcervical approach, dissection of the larynx and cervical trachea was carried out. Two 2.5 cm multiperforated plates of ‘poly [L-lactide-co-glycolide] copolymer’ were modeled and fixed to the anteromedial laryngotracheal surface. Direct intraoperative endoscopy defined the proper location to fix the plates and showed significant improvement of the collapse thanks to the rigidification of the airway. Three weeks after the procedure endoscopic control was realized and the patient was successfully decannulated. He remains asymptomatic with a 6 months follow-up. No complications were reported. Conclusion Extraluminal stabilization with resorbable plates can be a safe and effective option for selected patients with localized tracheomalacias. It represents a valid alternative for the management of this complex entity.

scholarly journals Pragmatic approach to rehabilitate maxillary teeth in aesthetic zone using resin bonded FDP- A case report

2021 ◽  
Vol 7 (4) ◽  
pp. 226-229
Author(s):  
Saurav Kumar ◽  
Harsh Rathee ◽  
Parag Dua
Keyword(s):  
Case Report ◽  
Cost Effective ◽  
Missing Teeth ◽  
Maxillary Central Incisor ◽  
Clinical Complications ◽  
Fixed Partial Denture ◽  
Fixed Dental Prosthesis ◽  
Effective Option ◽  
Aesthetic Results

Resin bonded fixed dental prosthesis offers most conservative and cost-effective option with missing teeth in aesthetic zone specially when an implant prosthesis is not indicated. This case report describes a treatment option for the replacement of a missing maxillary central incisor using a double-retainer resin-bonded fixed partial denture (RBFPD), fabricated from zirconium dioxide (ZrO) ceramic. No clinical complications were observed at follow-up examination after placement of the prosthesis. Satisfactory functional and aesthetic results were achieved. A treatment modality using a ZrO ceramic RBFPD is an alternative for single anterior tooth replacement.

MULTISESSION CYBERKNIFE STEREOTACTIC RADIOSURGERY OF LARGE, BENIGN CRANIAL BASE TUMORS

Neurosurgery ◽  
2009 ◽  
Vol 65 (5) ◽  
pp. 898-907 ◽  
Author(s):  
Francesco Tuniz ◽  
Scott G. Soltys ◽  
Clara Y. Choi ◽  
Steven D. Chang ◽  
Iris C. Gibbs ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Stereotactic Radiosurgery ◽  
Radiation Injury ◽  
Tumor Volume ◽  
Neurological Status ◽  
Cranial Base ◽  
Single Session ◽  
Effective Option ◽  
Cyberknife Radiosurgery

Abstract OBJECTIVE Although radiosurgery plays an important role in managing benign cranial base lesions, the potential for increased toxicity with single-session treatment of large tumors is a concern. In this retrospective study, we report the intermediate-term rate of local control, morbidity, and clinical outcomes of patients with large cranial base tumors treated with multisession stereotactic radiosurgery with the CyberKnife (Accuray, Inc., Sunnyvale, CA). METHODS Between 1999 and 2008, 34 consecutive patients with large (>15 cm3), benign cranial base tumors (21 meningiomas, 9 schwannomas, 4 glomus jugulare tumors) underwent primary or postoperative radiosurgical treatment using a multisession approach at Stanford University and were considered in this retrospective study. Forty-four percent of these patients had undergone previous subtotal surgical resection or radiotherapy. CyberKnife radiosurgery was delivered in 2 to 5 sessions (median, 3 sessions) to a median tumor volume of 19.3 cm3 (range, 15.8–69.3 cm3). The median marginal dose was 24 Gy (range, 18–25 Gy) prescribed to a median 78% isodose line. RESULTS After a median clinical follow-up of 31 months (range, 12–77 months), 21% of patients experienced clinical improvement of neurological symptoms, whereas neurological status remained unchanged among the rest. Four patients experienced prolonged use of glucocorticoids owing to transient neurological worsening and radiographic signs of radiation injury. No permanent neurotoxicity was seen. To date, all tumors remain locally controlled. CONCLUSION Over our modest length of follow-up, multisession radiosurgery appears to be a safe and effective option for selected large, benign brain and cranial base lesions.

Tubes of Vascularized Cartilage Used for Replacement of Rabbit Cervical Trachea

2003 ◽  
Vol 112 (9) ◽  
pp. 807-812 ◽  
Author(s):  
Pierre R. Delaere ◽  
Jose Hardillo
Keyword(s):  
Healing Process ◽  
Respiratory Epithelium ◽  
Middle Part ◽  
Control Group ◽  
Initial Surface ◽  
Ear Cartilage ◽  
Cervical Trachea ◽  
Experimental Group ◽  
Fascia Flap

This study was performed to evaluate the healing process of vascularized cartilage tubes after reconstruction of circumferential tracheal defects in rabbits. Vascularized cartilage was obtained by applying ear cartilage to a vascularized fascia flap in the lateral thoracic area in 10 animals. Five animals (control group) were used to evaluate the viability of the vascularized cartilage after 2 weeks. Circumferential tracheal defects were reconstructed in 5 animals by means of tubes of vascularized cartilage with preservation of the established blood supply around the grafts. The experimental animals were followed until signs of dyspnea became apparent. After follow-up and euthanasia, cartilage viability and regeneration of respiratory epithelium were evaluated. A viable plate of cartilage that was intensely attached to the vascularized fascia flap was found in the control animals. The animals from the experimental group showed dyspnea after a mean follow-up period of 22.6 days because of cartilage necrosis with loss of airway support. Cartilage graft revascularization and remucosalization were limited to 18.1% of the initial surface area of the cartilage tube. Mucosal coverage was seen at the anastomoses, whereas the middle part of the cartilage tube underwent necrosis. We conclude that tubes of autologous cartilage show problematic healing when placed inside the airway. Migration of vascularized connective tissue, migration of respiratory epithelium, and preservation of the viability of the cartilaginous graft were limited to a short segment at the anastomotic sites.

scholarly journals Displaced Type II Odontoid Fracture with Congenital Proximal Cervical Spine Anomalies Treated with Noninvasive Halo Vest: Clinical, Functional And Radiological Outcome. A Case Report.

2020 ◽  
Author(s):  
Mustafa Eltayeb
Keyword(s):  
Case Report ◽  
Cervical Spine ◽  
Range Of Motion ◽  
Odontoid Process ◽  
Neurological Status ◽  
Odontoid Fracture ◽  
Halo Vest ◽  
Study Objective

Abstract Study Design: A retrospective study. Objective: To evaluate the clinical, functional and radiological outcomes of noninvasive halo in the treatment of a displaced type 2 odontoid fracture in a patient with congenital proximal cervical spine anomalies. Case report: A 42 years old male applied to our institution 2 years ago with the complaint of neck pain after falling down from a 10 meters height. The patient was neurologically intact and diagnosed as displaced type 2 odontoid fracture. The patient had congenital elongated odontoid process and posterior fusion of C2-C3. Against medical advice the patient refused surgery and also refused the invasive halo vest. Noninvasive halo vest was applied for 8 weeks. The patient was followed up clinically radiologically and functionally. Results: Neurological status remained same till the last follow up which was ASIA E. VAS score was 9 initially and it was improved up to 2 during the last follow up. The patient had normal range of motion during the last follow up. Reduction of the fracture was maintained and fracture healed after 8 weeks confirmed by X-ray. Initially Patient had transient facial edema subsided by day 4, pressure ulcer which responded to dressing, also the patient had difficulties to chew hard food and self-hygiene. Conclusion : Noninvasive halo can be a salvage option to reduce type 2 displaced odontoid fractures. Maintaining range of motion of cervical spine especially in young patient with proximal cervical spine congenital anomalies. In addition it is more Cost effective than surgery.

scholarly journals Spinal Tuberculosis with Paraplegia in Pregnancy: a Case Report with Management of Spinal TB in Pregnancy

2015 ◽  
Vol 53 (198) ◽  
pp. 123-125
Author(s):  
Sushruti Kaushal ◽  
Santosh Kumar Dora ◽  
Sunil Thakur
Keyword(s):  
Case Report ◽  
Surgical Intervention ◽  
Spinal Tuberculosis ◽  
Neurological Status ◽  
Term Infant ◽  
Therapeutic Challenge ◽  
Healthy Term Infant ◽  
Mother And Child ◽  
In Pregnancy

Spinal tuberculosis leading to paraplegia is uncommon in pregnancy and is a diagnostic and therapeutic challenge. We report a case of tubercular paraplegia presenting at 35 weeks of gestation. She was managed with Anti-tubercular drugs and did not require surgical intervention. Her neurological status improved and she was allowed to go in labour. She delivered a healthy term infant by cesarean. At three months follow-up, both mother and child are doing well.  Keywords: paraplegia; pregnancy; spinal tuberculosis.

Intensive Stuttering Therapy With Telepractice Follow-up: A Case Study

2011 ◽  
Vol 21 (1) ◽  
pp. 11-21 ◽  
Author(s):  
Farzan Irani ◽  
Rodney Gabel
Keyword(s):  
Case Report ◽  
Therapeutic Intervention ◽  
Intensive Therapy ◽  
Positive Outcome ◽  
Eclectic Approach

This case report describes the positive outcome of a therapeutic intervention that integrated an intensive, residential component with follow-up telepractice for a 21 year old male who stutters. This therapy utilized an eclectic approach to intensive therapy in conjunction with a 12-month follow-up via video telepractice. The results indicated that the client benefited from the program as demonstrated by a reduction in percent stuttered syllables, a reduction in stuttering severity, and a change in attitudes and feelings related to stuttering and speaking.

Congenital Syphilis Simulating Bone Neoplasm in 2-Month Old Infant – Case Report

2017 ◽  
Vol 2 (1) ◽  
Keyword(s):  
Case Report ◽  
Congenital Syphilis ◽  
Eosinophilic Granuloma ◽  
Osteolytic Lesion ◽  
Lower Limbs ◽  
Upper Body ◽  
Elective Cesarean Section ◽  
Distal Fibula ◽  
X Ray

Introduction: Congenital Syphilis (CS) occurs through the transplacental transmission of Treponema pallidum in inadequately treated or non-treated pregnant women, and is capable of severe consequences such as miscarriage, preterm birth, congenital disease and/or neonatal death. CS has been showing an increasing incidence worldwide, with an increase of 208% from 2009 to 2015 in Brazil. Case report: 2-month old infant receives care in emergency service due to edema of right lower limb with pain in mobilization. X-ray with osteolytic lesion in distal fibula. Infant was sent to the Pediatrics Oncology clinic. Perinatal data: 7 prenatal appointments, negative serology at 10 and 30 weeks of gestation. End of pregnancy tests were not examined and tests for mother’s hospital admission were not requested. Mother undergone elective cesarean section at 38 weeks without complications. During the pediatric oncologist appointment, patient showed erythematous-squamous lesions in neck and other scar-like lesions in upper body. A new X-ray of lower limbs showed lesions in right fibula with periosteal reaction associated with aggressive osteolytic lesion compromising distal diaphysis, with cortical bone rupture and signs of pathological fracture, suggestive of eosinophilic granuloma. She was hospitalized for a lesion biopsy. Laboratory tests: hematocrit: 23.1 / hemoglobin 7.7 / leukocytes 10,130 (without left deviation) / platelets 638,000 / Negative Cytomegalovirus IgG and IgM and Toxoplasmosis IgG and IgM / VDRL 1:128. Congenital syphilis diagnosis with skin lesions, bone alterations and anemia. Lumbar puncture: glucose 55 / total proteins 26 / VDRL non reagent / 13 leukocytes (8% neutrophils; 84% monomorphonuclear; 8% macrophages) and 160 erythrocytes / negative VDRL and culture. X-ray of other long bones, ophthalmological evaluation and abdominal ultrasound without alterations. Patient was hospitalized for 14 days for treatment with Ceftriaxone 100mg/kg/day, due to the lack of Crystalline Penicillin in the hospital. She is now under outpatient follow-up. Discussion: CS is responsible for high rates of morbidity and mortality. The ongoing increase of cases of this pathology reflects a severe health issue and indicates failures in policies for the prevention of sexually transmitted diseases, with inadequate follow-up of prenatal and maternity protocols.

Incidental paraganglioma, diagnosis and follow-up - case report

2017 ◽  
Author(s):  
Alice Violante ◽  
Roberto Lemme ◽  
Sarah Galvao ◽  
Erika Naliato
Keyword(s):  
Case Report
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