Emergency tracheostomy for failed intubation due to glottic stenosis

2021 ◽  
Vol 14 (2) ◽  
pp. e239806
Author(s):  
Tessa Yap ◽  
Mark Quick ◽  
Paige Moore
Keyword(s):  
Unexpected Finding ◽  
Failed Intubation ◽  
Critical Approach ◽  
Laryngeal Pathology ◽  
Post Surgery ◽  
Laryngotracheal Reconstruction ◽  
Emergency Tracheostomy ◽  
Respiratory Conditions

Glottic stenosis can be an unexpected finding during an intubation, causing difficulties that may result in a ‘can’t intubate, can’t ventilate’ situation. We present a case of a patient who required an emergency tracheostomy, in the setting of a failed intubation secondary to glottic stenosis. The patient underwent open laryngotracheal reconstruction, followed by tracheostomy decannulation 2 months post-surgery. This paper highlights the importance of awareness of laryngeal pathology masquerading as respiratory conditions. It also outlines the critical approach to managing ‘can’t intubate, can’t ventilate’ situations.

scholarly journals Upper airway obstruction caused by primary lymphoplasmacytic lymphoma of the retropharyngeal space: a case report

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Chinyere N. Asoegwu ◽  
Okezie O. Kanu ◽  
Clement C. Nwawolo
Keyword(s):  
Lymph Nodes ◽  
Airway Obstruction ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Retropharyngeal Space ◽  
Histopathological Diagnosis ◽  
Lymphoplasmacytic Lymphoma ◽  
Malignant Tumours ◽  
Post Surgery ◽  
Emergency Tracheostomy

Abstract Background Primary malignant tumours of the retropharyngeal space are rare with only a few case reports in the literature. Lymphoplasmacytic lymphoma is a rare subtype of non-Hodgkin lymphoma and is very rarely found as a primary tumour of the retropharyngeal space. Case presentation We report the case of progressive upper airway obstruction in a 49-year-old male caused by a primary malignant tumour of the retropharyngeal space lymph nodes. He had an emergency tracheostomy to relieve the upper airway obstruction followed a week later by an elective surgical excision of the tumour via the trans-cervical route. A mixed population of lymphocytes, with a marked presence of Dutcher bodies, was noted on histopathology and positive CD20 on immunohistochemistry, confirming the lymphoplasmacytic lymphoma of the retropharyngeal space. The watchful waiting treatment method for the lymphoma was employed for him since he had no symptoms relating to lymphoma and no serum Waldenström’s macroglobulinemia. He has remained symptom-free 3 years post-surgery. Conclusion Primary malignant tumours involving the retropharyngeal space lymph nodes are very rare. They can rarely grow to a size huge enough to cause obstructive upper aerodigestive symptoms. Primary lymphoma of the retropharyngeal space should be considered in the diagnosis of the tumours involving the retropharyngeal space lymph nodes. Excisional biopsy is important to obtain tissue for histopathological diagnosis and the relief of upper aerodigestive tract obstruction when present.

Effects of Hypophysectomy on the Occurrence and Calcifiability of Matrix Vesicles in the Epiphyseal Growth Plate of Immature Rats

1980 ◽  
Vol 38 ◽  
pp. 578-579
Author(s):  
S. I. Coleman ◽  
W. J. Dougherty
Keyword(s):  
Growth Plate ◽  
Matrix Vesicles ◽  
Epiphyseal Growth Plate ◽  
Hard Tissue ◽  
Hormonal Factors ◽  
Post Surgery ◽  
Mineral Deposition ◽  
Thin Sectioning ◽  
Integral Role ◽  
Cellular Secretion

In the cellular secretion theory of mineral deposition, extracellular matrix vesicles are believed to play an integral role in hard tissue mineralization (1). Membrane limited matrix vesicles arise from the plasma membrane of epiphyseal chondrocytes and tooth odontoblasts by a budding process (2, 3). Nutritional and hormonal factors have been postulated to play essential roles in mineral deposition and apparently have a direct effect on matrix vesicles of calcifying cartilage as concluded by Anderson and Sajdera (4). Immature (75-85 gm) Long-Evans hooded rats were hypophysectomized by the parapharyngeal approach and maintained fourteen (14) days post-surgery. At this time, the animals were anesthetized and perfusion fixed in cacodylate buffered 2.5% glutaraldehyde. The proximal tibias were quickly dissected out and split sagittally. One half was used for light microscopy (LM) and the other for electron microscopy (EM). The halves used for EM were cut into blocks approximately 1×3 mm. The tissue blocks were prepared for ultra-thin sectioning and transmission EM. The tissue was oriented so as to section through the epiphyseal growth plate from the zone of proliferating cartilage on down through the hypertrophic zone and into the initial trabecular bone. Sections were studied stained (double heavy metal) and unstained.

The Voiced/Voiceless Phonation Time in Children With and Without Laryngeal Pathology

1992 ◽  
Vol 23 (2) ◽  
pp. 163-168 ◽  
Author(s):  
David N. Sorensen ◽  
Pamela Ann Parker
Keyword(s):  
Laryngeal Pathology ◽  
Maximum Duration ◽  
Normal Speaking

Eleven children with vocal pathology were matched to 11 normal speaking children. All subjects produced maximum duration of phonation for /s/and /z/from detailed instructions and clinician models. The s/z ratio also was calculated. Results showed no difference in /s/durations between groups, but /z/durations and s/z ratios were significantly different. The /z/durations and s/z ratio results differ from those of previous research. Possible reasons for these differences are task construction and instructional variables. Results are discussed in relationship to these variables, as well as in relationship to reduced glottal efficiency.

Psychophysiological correlates of pre- and post-surgery stress in cardiosurgical patients

2008 ◽  
Author(s):  
E. A. Levin ◽  
A. N. Savostyanov ◽  
V. G. Postnov ◽  
M. Kh. Kadochnikova ◽  
O. V . Zhukova
Keyword(s):  
Post Surgery ◽  
Psychophysiological Correlates

The Hemostatic Mechanism after Open-Heart Surgery

1978 ◽  
Vol 39 (02) ◽  
pp. 474-487 ◽  
Author(s):  
E R Cole ◽  
F Bachmann ◽  
C A Curry ◽  
D Roby
Keyword(s):  
Extracorporeal Circulation ◽  
Heart Surgery ◽  
Polyacrylamide Gel Electrophoresis ◽  
Open Heart Surgery ◽  
Coagulation System ◽  
Open Heart ◽  
Time Activity ◽  
Post Surgery ◽  
Plasma Fractions ◽  
The Mean

SummaryA prospective study in 13 patients undergoing open-heart surgery with extracorporeal circulation revealed a marked decrease of the mean one-stage prothrombin time activity from 88% to 54% (p <0.005) but lesser decreases of factors I, II, V, VII and X. This apparent discrepancy was due to the appearance of an inhibitor of the extrinsic coagulation system, termed PEC (Protein after Extracorporeal Circulation). The mean plasma PEC level rose from 0.05 U/ml pre-surgery to 0.65 U/ml post-surgery (p <0.0005), and was accompanied by the appearance of additional proteins as evidenced by disc polyacrylamide gel electrophoresis of plasma fractions (p <0.0005). The observed increases of PEC, appearance of abnormal protein bands and concomitant increases of LDH and SGOT suggest that the release of an inhibitor of the coagulation system (similar or identical to PIVKA) may be due to hypoxic liver damage during extracorporeal circulation.

Free Protein S Deficiency Is a Risk Factor for Venous Thrombosis

1997 ◽  
Vol 78 (05) ◽  
pp. 1343-1346 ◽  
Author(s):  
Elena M Faioni ◽  
Carla Valsecchi ◽  
Alessandra Palla ◽  
Emanuela Taioli ◽  
Cristina Razzari ◽  
...  
Keyword(s):  
Risk Factor ◽  
Relative Risk ◽  
Venous Thrombosis ◽  
Protein S ◽  
Unexpected Finding ◽  
Reference Ranges ◽  
Protein S Deficiency ◽  
Men And Women ◽  
Free Protein ◽  
S Deficiency

SummaryA recent study suggests that protein S deficiency is not a risk factor for venous thrombosis. Since this unexpected finding would have important clinical implications if confirmed, we performed a case-control study with the aim to determine the prevalence of protein S deficiency in patients with thrombosis and in healthy individuals taken from the general population and the relative risk of thrombosis in protein S-deficient patients. Free protein S concentration was measured in 327 consecutive patients with at least one venous thrombotic episode and in 317 age- and sex-matched control individuals. Different normal reference ranges were obtained and adopted for men and women. Protein S deficiency was found in 3.1% (95% Cl: 1.5-5.2) of patients and in 1.3% of controls (95% Cl: 0.3-2.8). Ten patients and 4 control subjects had protein S deficiency, which determined a relative risk of thrombosis (sex- and age-adjusted odds ratio) of 2.4 (95% Cl: 0.8-7.9). When men and women were analyzed separately, the risk was 5.0 (95% CI: 0.6-43.6) and 1.6 (95% Cl: 0.4-6.7) respectively. PS-deficient men had more thrombotic episodes than women and later in life. Multivariate analysis established that sex was an independent determinant of the number of episodes, as was age, while PS deficiency was not. However sex and PS deficiency status were both determinants of age at first thrombotic episode.

UNEXPECTED FINDING DURING CROHN’S DISEASE FOLLOW-UP

2020 ◽  
Author(s):  
LM Grazioli ◽  
V Gerardi ◽  
SM Milluzzo ◽  
C Spada
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Unexpected Finding

HUBUNGAN JENIS PERSALINAN DENGAN STATUS KESEHATAN BAYI BARU LAHIR DI KOTA BUKITTINGGI

2019 ◽  
Vol 1 (1) ◽  
pp. 29
Author(s):  
Nurhayati Nurhayati
Keyword(s):  
Health Status ◽  
Infectious Diseases ◽  
Apgar Score ◽  
Health Workers ◽  
Statistical Tests ◽  
City Hospital ◽  
Cross Sectional ◽  
Normal Delivery ◽  
Meconium Aspiration ◽  
Respiratory Conditions

<p><em>Every woman wants her labor to run smoothly and can give birth to a baby perfectly. Childbirth can run normally, but it is not uncommon for labor to experience obstacles and must be done through surgery. This means the fetus and mother are in an emergency and can only be saved if labor is performed by surgery. The purpose of this study is to find out the related to the health status of newborn babies at delivery in the City of Bukittinggi.</em></p><p><em>Type of analytic survey research with design cross-sectional</em><em>.</em><em>The object of the study was a newborn baby with Caesarean section and normal delivery at Bukittinggi City Hospital. The test used is thetest Chi-Square with a 95% confidence level.</em></p><p><em>The results showed that as many as 65 people (54.2%) had the incidence of asphyxia. 65 people (54.2%) had normal respiratory conditions, 62 people (51.7%) had meconium aspiration</em><em>.</em><em>63 people (52.5%) had trauma to an abnormal baby</em><em>.</em><em>64 people (53.3%) had infectious diseases. 70 people (58.3%) had IMD.</em><em>72 people (60%) have joined care. 60 people (50%) with type of labor SC. Statistical tests showed that there was a relationship between apgar score (p = 0.003), respiratory conditions (p = 0.010), meconium aspiration (p = 0.0005), trauma in infants (p = 0.0005), joint care (p = 0.002 ) and IMD (p = 0.0005) for the type of labor. While infectious diseases do not have a relationship to the type of labor (p = 0.583).</em></p><p><em>It was concluded that there was a relationship between apgar score, respiratory condition, meconium aspiration, admission and IMD with different types of delivery. Expected to health workers especially midwives can be used as input in order to improve health status in newborns.</em></p>

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