Cricoid Chondronecrosis: Case Report and Review of Literature

2020 ◽  
Vol 129 (7) ◽  
pp. 662-668
Author(s):  
Mark M. Mims ◽  
Andree A. Leclerc ◽  
Libby J. Smith
Keyword(s):  
Case Report ◽  
Endotracheal Intubation ◽  
Surgical Techniques ◽  
Upper Airway ◽  
Signs And Symptoms ◽  
Rare Entity ◽  
Level Of Evidence ◽  
Radiologic Findings ◽  
Short Period ◽  
History Of

Objective: Cricoid chondronecrosis is a rare entity that has significant consequences for patients. Reports of its occurrence are scattered in the literature and currently there is no comprehensive review to help guide providers. Methods: A case report from our institution is presented. A review of available literature is then provided with assessment of risk factors, signs and symptoms at presentation, laryngeal exam findings, radiologic findings, and surgical techniques. Results: Twenty-four cases of cricoid chondronecrosis were reviewed from the literature. Patient age ranged from 8 months to 76 years. A history of endotracheal intubation for various reasons was present in all but two cases, and duration of intubation ranged from 6 hours to 28 days. Patients presented with airway compromise in all but two cases—one asymptomatic patient with prior tracheostomy and another with dysphagia after radiation. Dysphonia (n = 6) and dysphagia (n = 3) were less commonly present. Subglottic stenosis (n = 19) was the most common exam finding followed by vocal fold impairment (n = 11). When CT scan findings were reported, fragmentation of the cartilage and/or hypodensity of the central lamina were described in all but one case. Interventions ranged from observation on antibiotics and steroids to surgical therapies including tracheostomy, dilation, and posterior cricoid split, with or without stent placement. Conclusions: Cricoid chondronecrosis is a serious, rare entity that can occur even after a short period of endotracheal intubation. Providers must have a high level of suspicion in patients that present with upper airway dyspnea with a history of prior intubation. Level of evidence: Level 4

scholarly journals Case report: Manual therapies promote resolution of persistent post-concussion symptoms in a 24-year-old athlete

2021 ◽  
Vol 9 ◽  
pp. 2050313X2095222
Author(s):  
Susan Vaughan Kratz
Keyword(s):  
Case Report ◽  
Symptom Severity ◽  
Impact Test ◽  
Manual Therapies ◽  
Symptom Checklist ◽  
Post Concussion Syndrome ◽  
Persistent Symptoms ◽  
Short Period ◽  
History Of ◽  
Headache Impact

This case report illustrates the treatment outcomes of a collegiate athlete presenting with an 18-month history of post-concussion syndrome who received a series of mixed manual therapies in isolation of other therapy. Persistent symptoms were self-reported as debilitating, contributing to self-removal from participation in school, work, and leisure activities. Patient and parent interviews captured the history of multiple concussions and other sports-related injuries. Neurological screening and activities of daily living were baseline measured. Post-Concussion Symptom Checklist and Headache Impact Test-6™ were utilized to track symptom severity. Treatments applied included craniosacral therapy, manual lymphatic drainage, and glymphatic techniques. Eleven treatment sessions were administered over 3 months. Results indicated restoration of oxygen saturation, normalized pupil reactivity, and satisfactory sleep. Post-concussion syndrome symptom severity was reduced by 87% as reflected by accumulative Post-Concussion Symptom Checklist scores. Relief from chronic headaches was achieved, reflected by Headache Impact Test-6 scores. Restoration of mood and quality of life were reported. A 6-month follow-up revealed symptoms remained abated with full re-engagement of daily activities. The author hypothesized that post-concussion syndrome symptoms were related to compression of craniosacral system structures and lymphatic fluid stagnation that contributed to head pressure pain, severe sleep deprivation, and multiple neurological and psychological symptoms. Positive outcomes over a relatively short period of time without adverse effects suggest these therapies may offer viable options for the treatment of post-concussion syndrome.

Clear cell carcinoma of Mullerian origin in the urinary bladder: A rare entity

2021 ◽  
pp. 205141582098766
Author(s):  
Harshit Garg ◽  
Brusabhanu Nayak ◽  
Tripti Nakra ◽  
Prabhjot Singh ◽  
Seema Kaushal
Keyword(s):  
Urinary Bladder ◽  
Cell Carcinoma ◽  
Clear Cell ◽  
Clear Cell Carcinoma ◽  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Rare Entity ◽  
Level Of Evidence ◽  
History Of ◽  
Carcinoma Of The Bladder

Mullerian neoplasms of the urinary system are rare but complex tumor-like lesions. The identification of the Mullerian neoplasm is crucial for patient management owing to its etiology, natural history, and prognosis. We present a case of a 42-year-old female with a history of three lower segment cesarean sections presenting with complaints of dysmenorrhea and suprapubic pain with no history of hematuria or any urinary symptoms. Magnetic resonance imaging revealed a 2 cm×2 cm exophytic lesion suspicious of being either a bladder lesion or an endometrial lesion infiltrating the urinary bladder. Cystoscopy and transurethral biopsy of this suspicious bladder tumor revealed a malignant tumor with papillary and tubulocystic architecture. Based on the overall histomorphological and immunohistochemical features, a diagnosis of clear cell carcinoma of Mullerian origin was made, and the patient underwent a total abdominal hysterectomy with bilateral salpingo-oophorectomy and partial cystectomy. The patient was kept on regular surveillance and showed no signs of recurrence at the one-year follow-up. Clear cell carcinoma of the bladder of Mullerian origin is a rare entity and is established on histopathology. Prompt diagnosis and a multidisciplinary approach are indispensable for management. Level of evidence: Level 4.

Lyme Disease: Acute Focal Meningoencephalitis in a Child

PEDIATRICS ◽  
1988 ◽  
Vol 82 (6) ◽  
pp. 931-934
Author(s):  
HENRY M. FEDER ◽  
EDWIN L. ZALNERAITIS ◽  
LOUIS REIK
Keyword(s):  
Nervous System ◽  
Case Report ◽  
Lyme Disease ◽  
Signs And Symptoms ◽  
Brain Parenchyma ◽  
Tick Bite ◽  
System Involvement ◽  
History Of ◽  
Csf Pleocytosis ◽  
The Brain

Nervous system involvement in Lyme disease was originally described as meningitis, cranial neuritis, and radiculoneuritis,1-3 but Lyme disease can also involve the brain parenchyma. We describe a child whose first manifestation of Lyme disease was an acute, focal meningoencephalitis with signs and symptoms such as fever, headache, slurred speech, hemiparesis, seizure, and CSF pleocytosis. CASE REPORT A 7-year-old boy was hospitalized Aug 27, 1985, because of hemiparesis. Six weeks prior to admission he had vacationed at Old Lyme, CT. There was no history of rash or tick bite. He had been well until eight hours prior to admission when fever and headache developed.

scholarly journals Angiofibrolipoma of the soft palate: A very rare cause of upper air way obstruction in an infant.

2020 ◽  
Vol 6 (1) ◽  
pp. 45-48
Author(s):  
Sonam Gyamtsho
Keyword(s):  
Case Report ◽  
Airway Obstruction ◽  
Soft Palate ◽  
Rare Case ◽  
Upper Airway ◽  
Female Child ◽  
Airway Compromise ◽  
Bipolar Cautery ◽  
History Of ◽  
Infant Case

Introduction: Infants and children are very prone to air way obstruction due to smaller and immature air ways. There are multiple causes of upper airway obstruction in infants like infections, congenital lesions and rarely tumours of the upper airway. However, angiofibrolipoma, a rare variant of lipoma causing intermittent respiratory distress in an infant has not been reported until now. Objective: To report a very rare case of angiofibrolipoma arising from the soft palate in an infant. Case report: Two and half months old female child reported to the department of otolaryngology with a history of intermittent airway obstruction since one month of age. After evaluation she was found to have a fleshy polypoidal mass above the laryngeal inlet arising from soft palate causing airway compromise. She underwent surgical excison with bipolar cautery under general anaesthesia. Conclusion: Few cases of angiofibrolipoma has been reported in adults but none has been reported in children. This is to report a case of angiofibrolipoma in child causing airway obstruction.

Sublingual dermoid cysts: case report and review of the literature

2015 ◽  
Vol 129 (10) ◽  
pp. 1036-1039 ◽  
Author(s):  
E Kyriakidou ◽  
T Howe ◽  
B Veale ◽  
S Atkins
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Surgical Techniques ◽  
Surgical Excision ◽  
Cystic Lesions ◽  
Review Of The Literature ◽  
Mylohyoid Muscle ◽  
Floor Of The Mouth ◽  
Intraoral Approach ◽  
History Of

AbstractBackground:Dermoid cysts in the floor of the mouth are relatively uncommon developmental lesions. They are thought to arise in the midline and along the lines of embryonic fusion of the facial processes containing ectodermal tissue.Case report:A 17-year-old female presented with a 3-month history of a growing, progressive swelling in the mouth floor. Clinical examination revealed a rather large symmetrical, soft swelling in the mouth floor, displacing the tongue superiorly. The fast growing nature and size of the lesion raised suspicion of potential compromise to the airway. Surgical excision was therefore performed.Conclusion:Differential diagnosis of cystic lesions in the floor of the mouth is of paramount importance, as the recommended surgical techniques vary depending on the anatomical position of the lesions. The intraoral approach is preferred for those lesions that do not extend beyond the mylohyoid muscle boundaries; this leads to a satisfactory cosmetic and functional outcome.

scholarly journals Tuberculosis Infection Could Mimic Malignant Lymphoma In F-18 FDG PET: A Case Report

2020 ◽  
Vol 14 (4) ◽  
pp. 135
Author(s):  
Ryan Yudistiro ◽  
Ivana Dewi Mulyanto ◽  
Febby Hutomo ◽  
Daniel Chung ◽  
Andree Kurniawan ◽  
...  
Keyword(s):  
Case Report ◽  
Clinical Features ◽  
Fdg Pet ◽  
Recurrent Disease ◽  
Neck Region ◽  
B Cell Lymphoma ◽  
Signs And Symptoms ◽  
Tuberculosis Infection ◽  
Chop Regimen ◽  
History Of

Introduction: Lymphoma and tuberculosis in several cases share similar clinical features that are difficult to differentiate. Lymphadenopathy, fever, malaise, weight loss, and respiratory symptoms are clinical features that could be found in both lymphoma and tuberculosis. Positron Emission Tomography/Computed Tomography Fluorodeoxyglucose (F-18 FDG PET) is a pivotal modality for imaging patients with cancer. Several non-malignant diseases like tuberculosis infection show high FDG uptake and lead to low specificity of F-18 FDG PET.Case Presentation: This case report describes a 55-year-old male patient with a history of Diffuse Large B-cell Lymphoma (DLBCL) who was suspected of having a recurrent disease. The patient has had a 6-month remission period after 6 cycles of R-CHOP regimen chemotherapy. He denied any known history of tuberculosis infection and HIV. F-18 FDG PET was performed to assess the extent of suspected lymphoma recurrent disease. F-18 FDG PET demonstrated multiple hypermetabolic bilateral neck region, mediastinum, and bilateral axilla lymphadenopathies. There were also multiple high FDG uptakes in the liver, mesocolon, and bones. The patient was suspected of having a lymphoma recurrent disease based on these findings. He underwent an excisional biopsy in the neck and was found to have lymphadenitis granulomatous disease from tuberculosis. Based on the histopathology finding, the patient received anti-tuberculosis drugs for 12 months and showed relief of signs and symptoms. F-18 FDG PET for anti-tuberculosis treatment evaluation revealed a complete metabolic response.Conclusion: Tuberculosis should be one of the differential diagnoses when a lymphoma recurrent disease is suspected. Clinical features, laboratory results, and imaging findings sometimes show similarities between lymphoma and tuberculosis. Histopathology evaluation is mandatory to confirm the diagnosis.

scholarly journals Fish in Hypopharynx: A Rare Case Report

2015 ◽  
Vol 7 (2) ◽  
pp. 81-82
Author(s):  
Rabindra Kumar Khatua
Keyword(s):  
Case Report ◽  
Airway Obstruction ◽  
Rare Case ◽  
Management Strategies ◽  
Upper Airway ◽  
Successful Outcome ◽  
Emergency Airway ◽  
Rare Case Report ◽  
History Of ◽  
Severe Airway Obstruction

ABSTRACT We present a case of a 10 years old child who swallowed a live fish, which resulted in severe upper airway obstruction. The child presented to the casuality with severe airway obstruction with a history of accidental slippage of a live Koi fish into the throat. He was restless, dysphasic, dyspneic, typically placing his hands in front of his neck. On physical examination, there was suprasternal retraction and bilateral decreased breath sound. Direct laryngoscopy was done and fish was removed from hypopharynx as an emergency procedure. We outline our emergency airway management strategies and focus our discussion on the technique used to remove the impacted fish from the upper airway, which was paramount for the successful outcome of this case. How to cite this article Khatua RK. Fish in Hypopharynx: A Rare Case Report. Int J Otorhinolaryngol Clin 2015;7(2):81-82.

scholarly journals Dyke-Davidoff-Masson Syndrome: A case Report in a patient presenting with drug-resistant epilepsy and pseudoseizures

2021 ◽  
Author(s):  
Pedro Schmidt dos Reis Matos Figueiredo ◽  
Thiago Oliveira Chaves
Keyword(s):  
Case Report ◽  
Cognitive Dysfunction ◽  
Brain Magnetic Resonance Imaging ◽  
Rare Condition ◽  
Signs And Symptoms ◽  
Drug Resistant ◽  
Cerebral Hemiatrophy ◽  
History Of ◽  
Magnetic Resonance Imaging Mri ◽  
Drug Resistant Epilepsy

Context: Dyke-Davidoff-Masson (DDM) syndrome is a rare neurological condition, first described in 1933. Characteristics include cerebral hemiatrophy, contralateral hemiparesis, seizures, and cognitive dysfunction, combined into different degrees and patterns. Brain magnetic resonance imaging (MRI) is used to perform diagnosis throughout its specific findings. Case Report: A eighteen-year-old female presented to our service with a history of cognitive dysfunction and seizures since early childhood, which persistence even with adequate use of antiepileptic drugs. During Investigation were found signs and symptoms compatible with DDM syndrome, and evidence of pseudoseizures captured in a video electroencephalography monitoring. Conclusion: DDM syndrome is a rare condition that must be part of differential diagnosis in patients with seizures and cerebral hemiatrophy. Management is based on adequate control of seizures and other comorbidities.

scholarly journals Case Report: Pediatric pharmacobezoar with subacute intestinal obstruction

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 1037
Author(s):  
Mahnaz Hakeem ◽  
Heeramani Lohana ◽  
Sarwat Urooj ◽  
Sheraz Ahmed
Keyword(s):  
Case Report ◽  
Intestinal Obstruction ◽  
Abdominal Distension ◽  
Acute Intestinal Obstruction ◽  
Rare Entity ◽  
Persistent Vomiting ◽  
Delay In Diagnosis ◽  
History Of ◽  
Subacute Intestinal Obstruction ◽  
High Index Of Suspicion

Bezoars are an undigested mass causing an intraluminal obstruction in children.  Pharmacobezoars are formed from medicines or their vehicle, considered as a less frequent type observed in children. Our objective is to report a relatively rare entity as a potential cause of intestinal obstruction in children.  Here we report a case of 13-year-old girl with a history of herbal medicine intake who presented with persistent vomiting and abdominal distension. She was diagnosed with acute intestinal obstruction and managed conservatively without any complications. The patient became stable within two days so was discharged home. We found that ineffective history could lead to a delay in diagnosis and management. Clinicians should have a high index of suspicion for pica and psychiatric disorders, especially in adolescent children.

scholarly journals Intra orbital Schwanoma of the supraorbital nerve

2018 ◽  
Vol 22 (4) ◽  
pp. 179-182
Author(s):  
Apio Antunes ◽  
Mateus F. L. Beck ◽  
Andre C. Franciscatto ◽  
Mateus Franzoi ◽  
Atahualpa C. P. Strapassom
Keyword(s):  
Case Report ◽  
Cranial Nerves ◽  
Signs And Symptoms ◽  
Surgical Approaches ◽  
Total Removal ◽  
Combined Surgery ◽  
Supraorbital Nerve ◽  
History Of ◽  
One Year ◽  
Orbital Region

Background: The orbital region can be occupied by various lesions including both neoplastic or non-neoplastic. Schwannomas of the supraorbital nerve are very rare tumors. Case Report: A case of a 15 years-old female patient with a one year history of progressive proptosis and no visual symptoms is presented with. This patient underwent a combined surgery with total removal of the tumor. Discussion: Intraorbital schwannomas are usually associated with neurofibromatosis and different structures can originate these tumours, including peripheral and cranial nerves. The signs and symptoms usually follow a chronic process. Surgical treatment is necessary, with various reported surgical approaches. Conclusion: We report, to the best of our knowledge, the eleventh case of schwannoma of the supraorbital nerve, describing the main features of this pathology. 

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