scholarly journals Airway management for tracheal resection proximal to carina in a cat

2019 ◽  
Vol 7 (3) ◽  
pp. e000874 ◽  
Author(s):  
Ivana Calice ◽  
Attilio Rocchi

Tracheal tumours in cats are rare, and most primary tumours respond well to complete surgical excision. Providing secure airway management during resection of the trachea is particularly challenging and in some cases represents a limitation to surgery. We present the case of a cat with a primary tracheal neoplasm located close to the carina, undergoing complete resection. Successful management of the airway was accomplished by intubating the distal tracheal stump with a modified polyvinyl chloride endotracheal tube. Effective seal of the airway and adequate ventilation of both lungs were achieved. We describe a reliable, simple, low-cost technique which provides control of the airways even in situations where the distal stump of the trachea is either too short or non-existent.

2017 ◽  
Vol 21 (4) ◽  
pp. 360-363 ◽  
Author(s):  
Sang Kim ◽  
Maryna Khromava ◽  
Jeron Zerillo ◽  
George Silvay ◽  
Adam I. Levine

We present a case of a patient with complete tracheal dehiscence and multiple false passages after recent tracheal resection and anastomosis. Loss of tracheal continuity after disruption of anastomosis with distal stump retraction presents a unique anesthetic challenge given lack of access to the trachea and the need for adequate anesthesia and analgesia for surgical neck dissection. Traditional airway management, including awake fiberoptic intubation, intubation via direct laryngoscopy, needle cricothyrotomy, and awake tracheostomy are not viable options. Using total intravenous anesthesia with spontaneous ventilation, surgeons dissected the neck, retrieved the distal tracheal stump, repaired the trachea, and formalized the tracheostomy. We highlight the importance of recognizing the symptoms of a tracheal rupture, understanding the extreme limitation of securing the airway with traditional techniques, and discuss the alternative techniques including use of extracorporeal membrane oxygenation to avoid airway management. Awareness of increased mortality risk with tracheal reoperation and the significance of close communication between the anesthesiologists, the surgeons, and the patient is necessary for successful management.


2021 ◽  
Vol 13 (1) ◽  
pp. 157-161
Author(s):  
Santosh Chaudhary ◽  
Aashish Raj Pant ◽  
Badri Prasad Badhu

Introduction: Management of orbital lymphangioma is challenging. Complete surgical excision is often impossible due to its infiltrative nature. Sclerosing agents have been used in its management with variable outcomes. We report a case of recurrent orbital lymphangioma managed with intralesional bleomycin.  Case: A 14-year-old female presented with proptosis of the right eye for two weeks. She had a similar history at five years of age for which she underwent surgical excision. We performed negative pressure aspiration using a 20-gauge angiocatheter, injected bleomycin, and left the cannula in situ for repeat aspiration to maintain cyst collapse.  Observation: The lymphangioma regressed, and there was no recurrence at six months of follow-up.  Conclusion: This report highlights the use of negative pressure aspiration and intralesional bleomycin injection by minimal intervention using angiocatheter in the successful management of orbital lymphangioma.


2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Moaied A. Hassan ◽  
Hasan K. Gatea ◽  
Thura K. Ja’afar

Abstract Background Lymphatic malformations are rare benign cystic tumors that result from localized disordered embryologic development of the lymphatic system and can develop anywhere in the body, predominantly in the head and neck. These lesions are classified according to the diameter of the largest cystic cavity within the lesion into microcystic and macrocystic types. Historically, surgical excision has been considered the mainstay of treatment and still remains the first therapeutic option of choice for many surgeons particularly for giant macrocystic lesions. Several alternative therapeutic modalities emerged including intralesional sclerotherapy and laser therapy with encouraging results. The study is designed to assess the effectiveness and safety of surgical excision as an initial therapeutic option in the management of these malformations. Results Asymptomatic mass with parental cosmetic and functional concerns was the mode of presentation in six (66.7%) patients. Seven (77.8%) patients were presented before the age of 2 years. Six (66.7%) of the patients had their lesions in the neck. Complete surgical excision was achieved in eight (88.9%) patients without any evident significant injury to vital neurovascular structures. None of the patients had any difficulties with breathing, swallowing, or phonation and cosmetic results were satisfactory in the majority (88.9%) of them. Conclusion Radical surgical excision of giant macrocystic lymphatic malformations in children is possible in experienced hands. It is an effective and safe initial therapeutic option and gives satisfactory esthetic and functional results.


2020 ◽  
Vol 28 (1) ◽  
pp. 220-225
Author(s):  
Ashley Drohan ◽  
Jennifer Melvin ◽  
Joanne Murphy ◽  
Carman Giacomantonio ◽  
Lucy Helyer

Eccrine porocarcinoma is a rare aggressive cutaneous malignancy. Complete surgical excision is the standard of care, although there are high rates of local and distant recurrence. We present a unique case of locally recurrent and metastatic subungal porocarcinoma successfully treated with intralesional interleukin-2.


2021 ◽  
Vol 9 ◽  
pp. 2050313X2110145
Author(s):  
Chaerim Oh ◽  
Hyun Joo Kim

In patients with intratracheal tumors, airway management while maintaining oxygenation and providing surgical access to the airway can be challenging. Here, we present a case of a two-stage operation to remove an intratracheal tumor causing partial obstruction near the carina. In the otorhinolaryngology department, a biopsy was performed during apnea under high-flow nasal oxygenation support. A few days later, a thoracic surgeon performed tracheal resection after sternotomy under general anesthesia. Mechanical ventilation was performed by inserting a sterile endotracheal tube in the resected distal part of the trachea in the surgical field for tracheal end-to-end anastomosis. Airway was successfully secured through close communication between teams of anesthesiologists and surgeons.


Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 728
Author(s):  
Jeong-Hyouk Choi ◽  
Koo-Han Yoo ◽  
Dong-Gi Lee ◽  
Gyeong-Eun Min ◽  
Gou-Young Kim ◽  
...  

Background and Objectives: Retroperitoneal schwannoma is a very rare case of schwannoma which commonly occurs in the other part of the body. However, it is difficult to distinguish schwannoma from other tumors before pathological examination because they do not show specific characteristics on imaging study such as ultrasound, computed tomography (CT), and magnetic resonance image (MRI). Case summary: A 60-year-old male showed a retroperitoneal cystic tumor which is found incidentally during evaluation of coexisted bladder tumor. Neurogenic tumor was suspicious for the retroperitoneal tumor through pre-operative imaging study. Finally, a schwannoma was diagnosed by immunohistochemical examination after complete surgical excision laparoscopically. Conclusion: As imaging technology is developed, there may be more chances to differentiate schwannoma from other neoplasm. However, still surgical resection and histopathological examination is feasible for diagnosis of schwannoma.


1999 ◽  
Vol 46 (12) ◽  
pp. 1178-1180 ◽  
Author(s):  
Napoleon Burt ◽  
Mary M. Pruner ◽  
Andrea R. Williams

2010 ◽  
Vol 128 (5) ◽  
pp. 302-305 ◽  
Author(s):  
Giulianno Molina de Melo ◽  
Gabrielle do Nascimento Holanda Gonçalves ◽  
Ricardo Antenor de Souza e Souza ◽  
Danilo Anunciatto Sguillar

CONTEXT: Neuroglial ectopia has been defined as a mass composed of differentiated neuroectodermal tissue isolated from the spinal canal or cranial cavity and remains rare. This lesion has to be considered in the differential diagnosis among newborn infants with classical symptoms of respiratory distress, neck mass and feeding difficulties. We present a rare case of extensive parapharyngeal and skull base neuroglial ectopia in 6-month-old girl who presented respiratory and feeding obstruction at birth. CASE REPORT: A six-month-old girl who presented upper respiratory and feeding obstruction at birth and was using tracheostomy and gastrostomy tubes was referred to our institution. Complete surgical excision of the mass consisted of a transcervical-transparotid approach with extension to the infratemporal fossa by means of a lateral transzygomatic incision, allowing preservation of all vital neurovascular structures. The anatomopathological examination showed a solid mass with nests of neural tissue, with some neurons embedded in poorly encapsulated fibrovascular stroma, without mitotic areas, and with presence of functioning choroid plexus in the immunohistochemistry assay. Neurovascular function was preserved, thus allowing postoperative decannulation and oral feeding. Despite the large size of the mass, the child has completed one year and six months of follow-up without complications or recurrence. Neuroglial ectopia needs to be considered in diagnosing airway obstruction among newborns. Surgical treatment is the best choice and should be performed on clinically stable patients. An algorithm to guide the differential diagnosis and improve the treatment was proposed.


Author(s):  
Nithya J. ◽  
Banumathy M. ◽  
Radha A.

Solitary nerve sheath tumor such as Benign schwannomas arising in the pelvic retro peritoneum is infrequently reported. Retroperitoneal location accounts for 0.3-3.2% of primary schwannomas. We report a case of benign retroperitoneal pelvic schwannoma in pregnancy that was incidentally diagnosed when it presented with Preterm premature rupture of membranes and mechanical obstruction for labour. She underwent caesarean section and delivered a healthy baby. She was evaluated in the postoperative period by computerized tomography (CT) imaging studies and CT guided fine needle aspiration cytology (FNAC) was not diagnostic. Complete surgical excision of the tumor was achieved in the postpartum period. The adjacent vascular and urinary channels sustained no injuries and she had no neurologic deficit. Histology revealed spindle cell neoplasm composed of interlacing fascicles and sheets of spindle cell with focal areas of nuclear palisading and thick walled blood vessels. Immunohistochemistry was positive for S 100 suggesting schwannoma. Retroperitoneal location of schwannomas is rare and surgery is curative. Prognosis is good, since recurrence is rare. 


Author(s):  
Chandra Veer Singh ◽  
Sheetal Radia ◽  
Saalim Sheikh ◽  
Vijay Haribhakti

<p class="abstract">Schwannoma are slow growing tumours, which can arise from any peripheral nerve. 10% of schwannomas that occur in the head and neck region mostly originate from the vagus or sympathetic nervous system. Extracranial schwannomas in the head and neck region are rare neoplasm. Intraoral schwannoma are only 1% of the all head and neck tumours. Diagnosis is established by imaging studies such as magnetic resonance imaging or computed tomography, while FNAC is used to rule out other conditions. We report a rare case of lingual schwannomas generally present as a painless lump schwannoma of the tongue in a 27-year-old male complaining of asymptomatic swelling over a posterolateral surface of the tongue, treated by complete surgical excision. The diagnosis was established on the basis of clinical, histopathological, and immunohistochemical examination. We report a rare case of schwannoma over the posterolateral surface of tongue. Prognosis is good for the patient when this condition is correctly diagnosed as the condition rarely recurs after complete resection.</p>


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