Metal Allergy in Tracheostomy Tube Placement Resulting in Complete Subglottic Stenosis: A Case Report

2022 ◽  
pp. 000348942110701
Author(s):  
Roger Bui ◽  
Lindsay Boven ◽  
David Kaufman ◽  
Paul Weinberger
Keyword(s):  
Tracheostomy Tube ◽  
Interdisciplinary Collaboration ◽  
Subglottic Stenosis ◽  
Tube Placement ◽  
Tracheal Resection ◽  
Surgical Morbidity ◽  
Metal Hypersensitivity ◽  
Surgical Implants ◽  
Initial Intervention ◽  
History Of

Objectives: Metal hypersensitivity reaction to surgical implants is a well- known phenomenon that is associated with pain, swelling, inflammation, and decreased efficacy of the implant. We present a unique case of a patient with placement a metal Jackson tracheostomy tube that led to expeditious total subglottic stenosis. Methods: The patient was a 33-year old, severely atopic woman with history of asthma exacerbations requiring several intubations for acute respiratory failure with several subsequent tracheal dilations with steroid injections, and eventual tracheostomy placement with a metal Jackson tracheostomy tube that led to expeditious total subglottic stenosis. Results: Initial intervention included performing an airway evaluation, CO2 laser, and steroid injection of the area of complete subglottic stenosis. Follow up several months later revealed little improvement in level of tracheal narrowing proximal to the tracheostomy tube. Patient did not have shortness of breath but continued to be aphonic. Cricotracheal versus tracheal resection have been proposed but surgical morbidity was deemed too high due to patient’s obesity. Conclusions: Metal hypersensitivity reactions are well known phenomena as it relates to surgical implants in other surgical specialties but are seldom reported within the ear, nose and throat literature. Oftentimes, it takes astute observation to diagnose and establish a connection. Prompt recognition and treatment can be acquired from interdisciplinary collaboration with allergy.

Passy-Muir Speaking Valve Use in a Children's Hospital: An Interdisciplinary Approach

2008 ◽  
Vol 18 (2) ◽  
pp. 76-86 ◽  
Author(s):  
Lauren Hofmann ◽  
Joseph Bolton ◽  
Susan Ferry
Keyword(s):  
Tracheostomy Tube ◽  
Pediatric Population ◽  
Interdisciplinary Approach ◽  
Extended Period ◽  
Speech Development ◽  
Tube Placement ◽  
Background Information ◽  
Speaking Valve ◽  
Children's Hospital ◽  
Children’S Hospital

Abstract At The Children's Hospital of Philadelphia (CHOP) we treat many children requiring tracheostomy tube placement. With potential for a tracheostomy tube to be in place for an extended period of time, these children may be at risk for long-term disruption to normal speech development. As such, speaking valves that restore more normal phonation are often key tools in the effort to restore speech and promote more typical language development in this population. However, successful use of speaking valves is frequently more challenging with infant and pediatric patients than with adult patients. The purpose of this article is to review background information related to speaking valves, the indications for one-way valve use, criteria for candidacy, and the benefits of using speaking valves in the pediatric population. This review will emphasize the importance of interdisciplinary collaboration from the perspectives of speech-language pathology and respiratory therapy. Along with the background information, we will present current practices and a case study to illustrate a safe and systematic approach to speaking valve implementation based upon our experiences.

scholarly journals First case report of acute cholangitis secondary to Cronobacter sakazakii

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Syeda Sahra ◽  
Abdullah Jahangir ◽  
Neville Mobarakai ◽  
Allison Glaser ◽  
Ahmad Jahangir ◽  
...  
Keyword(s):  
Acute Cholangitis ◽  
Tube Placement ◽  
Cronobacter Sakazakii ◽  
First Case ◽  
Shunt Procedure ◽  
Intrahepatic Portosystemic Shunt ◽  
History Of ◽  
Cholecystostomy Tube ◽  
Percutaneous Cholecystostomy Tube ◽  
First Time

Abstract Introduction Cronobacter sakazakii is an opportunistic Gram-negative, rod-shaped bacterium which may be a causative agent of meningitis in premature infants and enterocolitis and bacteremia in neonates and adults. While there have been multiple cases of C. sakazakii infections, there have been no acute cholangitis cases reported in humans. Case presentation An 81-year-old male with a past medical history of basal cell carcinoma, alcoholic liver cirrhosis, transjugular intrahepatic portosystemic shunt procedure, complicated by staphylococcus bacteremia, pituitary tumor, glaucoma, and hypothyroidism presented to the emergency room with the complaint of diffuse and generalized 10/10 abdominal pain of 1 day’s duration. There was a concern for pancreatitis, acute cholangitis, and possible cholecystitis, and the patient underwent a percutaneous cholecystostomy tube placement. Blood cultures from admission and biliary fluid cultures both grew C. sakazakii. The patient was treated with a carbapenem and clinically improved. Conclusions The case study described a patient with multiple medical comorbidities that presented with C. sakazakii bacteremia and cholangitis. While this bacterium has been implicated in other infections, we believe this is the first time the bacteria is being documented to have caused acute cholangitis.

Respiratory Muscle Dysfunction Secondary to Chronic Tracheostomy Tube Placement

CHEST Journal ◽  
1987 ◽  
Vol 91 (1) ◽  
pp. 139-141 ◽  
Author(s):  
Gerard Criner ◽  
Barry Make ◽  
Bartolome Celli
Keyword(s):  
Tracheostomy Tube ◽  
Respiratory Muscle ◽  
Tube Placement ◽  
Muscle Dysfunction

Idiopathic subglottic stenosis in a young female patient

2021 ◽  
Vol 14 (5) ◽  
pp. e241525
Author(s):  
Benjamin Pomerantz ◽  
Michael Pomerantz ◽  
Arkadiy Finn
Keyword(s):  
Balloon Dilatation ◽  
Young Female ◽  
Rigid Bronchoscopy ◽  
Pulmonary Function Testing ◽  
Subglottic Stenosis ◽  
Productive Cough ◽  
Shortness Of Breath ◽  
History Of ◽  
One Year ◽  
Function Testing

A previously healthy 30-year-old woman presented with 3 years of progressive shortness of breath and audible wheezing. One year prior to presentation, she developed a chronic non-productive cough. Pulmonary function testing revealed flattened inspiratory and expiratory peaks, characteristic of an extrathoracic fixed tracheal obstruction. Bronchoscopy confirmed subglottic stenosis (SGS). She had no history of intubation, tracheostomy or evidence of a systemic inflammatory illness. She was diagnosed with idiopathic SGS and referred for rigid bronchoscopy with balloon dilatation resulting in improvement in her symptoms.

Troubadours and Trouvères

Music ◽  
2021 ◽  
Author(s):  
Ardis Butterfield ◽  
Elizabeth Hebbard
Keyword(s):  
Social History ◽  
20Th Century ◽  
Interdisciplinary Collaboration ◽  
Old French ◽  
Musical Life ◽  
Guillaume De Machaut ◽  
Single Text ◽  
Old Occitan ◽  
History Of ◽  
General Studies

In the 12th and 13th centuries, the troubadours in Occitania and the trouvères in northern France composed songs with texts in the vernacular and monophonic melodies. For the troubadours, the vernacular was Old Occitan; for their northern counterparts, Old French. This difference in idiom is sometimes held to mark a distinction between two separate but analogous traditions of medieval song. The medieval practices of compiling multilingual lyric anthologies and of borrowing melodies seem instead to affirm the contiguity of song culture across different languages. The term “lyric” during this period typically designates a text set to melody, but not all manuscripts of troubadour and trouvère lyric preserve song melodies. Music survives for nearly half of the trouvère repertory (about three thousand songs) but only about 10 percent of the twenty-six hundred extant troubadour songs. The compositional period for troubadours and trouvères is conventionally defined rather rigidly as 1100–1300, and the songs themselves as strophic and monophonic. However, the troubadours and trouvères also composed in non-strophic genres (lais and descorts), and the trouvères composed in non-musical lyric genres (congés, dits) as well as in polyphonic forms. Adam de la Halle and Jehan de Lescurel, for example, produced small but significant collections of single-text polyphonic pieces. Of course, the composition of French and Occitan song also continued beyond 1300, albeit in different social and cultural contexts, by which point the long history of its study and reception had already begun. Some of the most important reference works, such as the Pillet-Carstens Bibliographie, date from the early 20th century and come from France and Germany, while Anglophone publications on troubadour and trouvère music only began to emerge in the second half of the 20th century. Modern scholars continually renew this material by bringing it into conversation with critical theory (Giving Voice to Love: Song and Self-Expression from the Troubadours to Guillaume de Machaut, cited under General Studies), feminist theory (Songs of the Women Trouvères, cited under Anthologies), and social history (The Owl and the Nightingale: Musical Life and Ideas in France 1100–1300, cited under Musical, Literary, Social, and Political Studies; The World of the Troubadours: Medieval Occitan Society, c. 1100-c.1300 and Parler d’amour au puy d’Arras: Lyrique en jeu, both cited under Regional Studies). The vibrancy in troubadour and trouvère scholarship also comes from interdisciplinary collaboration and exchange among musicologists, historians, paleographers, and literary scholars. Despite their shared primary sources, the fields of musicology and of literary studies have approached troubadour and trouvère material differently, and with different emphases. In part, these differences can be ascribed to the difficulty of defining a corpus of study, which does not always overlap for the two fields. The organization of this article echoes some of these tensions between older but fundamental reference works and newer directions of inquiry, and the sometimes separate, sometimes unified, treatment of troubadour and trouvère song.

scholarly journals Management of acquired benign tracheoesophageal fistula in adults: a twelve-year experience

2013 ◽  
Vol 12 (4) ◽  
pp. 196-203
Author(s):  
Nerijus Šileika ◽  
Vytautas Jovaišas ◽  
Žymantas Jagelavičius ◽  
Ričardas Janilionis
Keyword(s):  
Tracheoesophageal Fistula ◽  
University Hospital ◽  
Tube Placement ◽  
Endoscopic Management ◽  
Tracheal Resection ◽  
Management Options ◽  
Surgical Closure ◽  
General Thoracic Surgery ◽  
Vilnius University ◽  
Simple Repair

Background / ObjectivesAcquired nonmalignant tracheoesophageal fistula (TEF) in adult patients develops in a variety of conditions, the predominant being postintubation. Several management options have been suggested, while the optimal strategy remains controversial.The aim of this review is to present our clinical experience and to find the optimal management for TEF.MethodsThis study is a retrospective review of all patients who underwent management for benign TEF at the Vilnius University Hospital between January 2000 and December 2012.ResultsSeven patients (three female and four male) with a benign TEF were referred to the Department of General Thoracic Surgery of the Vilnius University Hospital from January 2000 to December 2012. Their mean age was 48.3 ± 11.4 years. PostintubationTEF accounted for six fistulas (85.7%), while one patient (14.3%) suffered from injury during percutaneous dilational tracheostomy. Five patients underwent TEF closure (71.4%). Four patients underwent a simple repair of the fistula, while one patient required tracheal resection and reconstruction. Endoscopic management with tracheal dilation and T tube placement was performed to one (14.3%) and additional jejunostomy was done also to one patient (14.3%). Four patients (57.1%) hadpostoperative complications. Two postoperative deaths occurred (28.6%).ConclusionsSingle-stage surgical repair with or without tracheal resection and reconstruction can be successfully performed after the weaning from mechanical ventilation in patients with acquired nonmalignant TEF.Key words: tracheoesophageal fistula, surgical closure, tracheal resection, nonmalignant fistulaĮgytos tracheoezofaginės jungties gydymas: dvylikos metų patirtis Įvadas / tikslasĮgytos nenavikinės kilmės tracheoezofaginės jungties (TEJ) priežastys yra įvairios, dažniausia iš jų – pointubacinė. Yra pasiūlyta keletas gydymo metodų, tačiau dėl geriausios gydymo taktikos vis dar diskutuojama. Šios apžvalgos tikslas – išnagrinėtimūsų klinikinę patirtį ir rasti optimalų gydymą tų ligonių, kuriems nustatyta TEJ.MetodaiRetrospektyviai išanalizuoti ligoniai, kurie 2000–2012 m. buvo chirurginiu būdu gydomi Vilniaus universiteto ligoninės Krūtinės chirugijos skyriuje. Rezultatai2000–2012 m. nuo nenavikinės kilmės TEJ gydyti 7 ligoniai (3 moterys ir 4 vyrai), kurių amžiaus vidurkis buvo 48,3±11,4 metų. Pointubacinė TEJ nustatyta šešiems ligoniams (85,7 %), vienam ligoniui (14,3 %) TEJ atsirado po perkutaninės dilatacinės tracheostomijos. Penki ligoniai gydyti chirurginiu būdu (keturiems ligoniams trachėja atskirta nuo stemplės, o jų sienų defektai užsiūti; vienam ligoniui papildomai atlikta trachėjos rezekcija ir rekontstrukcija). Endoskopinis trachėjos spindžio plėtimas ir stentavimas T formos endoprotezu taikytas vienam ligoniui (14,3 %); maitinimui skirta jejunostoma atlikta taip pat vienam ligoniui (14,3 %). Keturiems ligoniams pasitaikė pooperacinių komplikacijų (57,1 %). Po gydymo mirė du ligoniai.IšvadaVienmomentė TEJ šalinimo operacija su trachėjos rezekcija ir rekonstrukcija arba be jos gali būti sėkmingai atlikta savaime kvėpuojantiems ligoniams, kuriems yra nenavikinės kilmės TEJ.Reikšminiai žodžiai: tracheoezofaginė jungtis, trachėjos rezekcija, nenavikinės kilmės jungtis.

Archaeology enters the ‘atomic age’: a short history of radiocarbon, 1946–1960

2020 ◽  
Vol 53 (2) ◽  
pp. 207-227
Author(s):  
EMILY M. KERN
Keyword(s):  
United States ◽  
Cold War ◽  
Radiocarbon Dating ◽  
Interdisciplinary Collaboration ◽  
Manhattan Project ◽  
The United States ◽  
Short History ◽  
Cultural Objects ◽  
Carbon 14 ◽  
History Of

AbstractToday, the most powerful research technique available for assigning chronometric age to human cultural objects is radiocarbon dating. Developed in the United States in the late 1940s by an alumnus of the Manhattan Project, radiocarbon dating measures the decay of the radioactive isotope carbon-14 (C14) in organic material, and calculates the time elapsed since the materials were removed from the life cycle. This paper traces the interdisciplinary collaboration between archaeology and radiochemistry that led to the successful development of radiocarbon dating in the early 1950s, following the movement of people and ideas from Willard Libby's Chicago radiocarbon laboratory to museums, universities and government labs in the United States, Australia, Denmark and New Zealand. I show how radiocarbon research built on existing technologies and networks in atomic chemistry and physics but was deeply shaped by its original private philanthropic funders and archaeologist users, and ultimately remained to the side of many contemporaneous Cold War scientific and military projects.

scholarly journals Broken metallic tracheostomy tube migrating into the tracheobronchial tree

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Nilam U. Sathe ◽  
Ratna Priya ◽  
Sheetal Shelke ◽  
Kartik Krishnan
Keyword(s):  
Foreign Body ◽  
Tracheostomy Tube ◽  
Main Bronchus ◽  
Tracheobronchial Tree ◽  
Life Saving ◽  
Wear And Tear ◽  
Life Threatening ◽  
History Of ◽  
The Right ◽  
Periodic Replacement

Foreign body aspiration can be a life-threatening emergency. Broken tracheostomy tube in tracheobronchial tree is one of the rarest types of foreign body reported. Here we report two cases of fracture of metallic tracheostomy tube, leading to foreign body in tracheobronchial tree. A 14-year-old girl presented to our Emergency Department with history of respiratory distress and violent bouts of cough since 2 days. Chest X-ray showed that the broken part of the tube was lodged in the right main bronchus. The presence of Parkinson’s disease in the patient and restricted neck flexion offered a challenge both for the anaesthetist and the surgeon. We were successful in removing the broken tube in 13 small pieces. Check bronchoscopy was clear and the procedure went uneventful. We would like to conclude that broken tracheostomy tube presenting as foreign body bronchus is infrequent but it is a preventable complication of tarcheostomy. The patient must be kept on regular follow up to check for signs of wear and tear. Timely and periodic replacement of tracehostomy tube should also be done, otherwise such life-saving surgery can become lifethreatening.

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