scholarly journals A case of a different approach for difficult airway: transorbital endotracheal intubation

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Ozge Dereli ◽  
Cengiz Sahutoglu ◽  
Taner Balcioglu
Keyword(s):  
Spinal Cord ◽  
Muscle Strength ◽  
Difficult Airway ◽  
Mouth Opening ◽  
Emergency Operation ◽  
Neck Surgery ◽  
Good Alternative ◽  
Orbital Exenteration ◽  
Case Presentation ◽  
Safe Method

Abstract Background In patients who have undergone head and neck surgery and received radiotherapy, airway management presents serious difficulties for the anesthesiologist. Case presentation We report a case of a 23-year-old male patient undergoing an emergency operation due to a rhabdomyosarcoma pressed spinal cord that loss of muscle strength and loss of sensation developed below the level of thoracal 6–7 vertebrae. Because of the previous radiotherapy reducing the mouth opening (less than 1 cm), the patient was intubated by transorbital pathway without any difficulty. Conclusions Transorbital intubation seems to be a safe method and may be a good alternative to difficult airway in the patient undergoing orbital exenteration.

scholarly journals Perforation of the atrial wall and aortic sinus after closure of an atrial septal defect with an Atriasept occluder: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zai-Qiang Zhang ◽  
Jia-Wang Ding
Keyword(s):  
Case Report ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Emergency Operation ◽  
Atrial Wall ◽  
Aortic Sinus ◽  
Case Presentation ◽  
Lethal Complications ◽  
Life Threatening

Abstract Background While the perforation of the atrial wall and aortic sinus after closure of an atrial septal defect (ASD) is rare, it’s life-threatening, with rapid progress and high mortality. To the best of our knowledge, 21 similar cases have been reported since 1976. Case presentation We report a 16-year-old male whose atrial septal defect (ASD) was closed using a 12-mm Amplatzer septal occluder (ASO). Atrial wall and aortic sinus perforation occurred 3 months after transcatheter closure, and the patient was discharged after emergency operation. He was discharged on the 12th postoperative day in good overall condition. Conclusions With this case report, we want to illustrate that although percutaneous closure of ASD is regarded as a routine procedure, we should not forget the potentially lethal complications, especially cardiac erosion. Therefore, we should carefully evaluate the risk of erosion before surgery, and careful lifelong follow-up is needed.

The use of simple muscle strength tests to reflect body compositions among individuals with spinal cord injury

Spinal Cord ◽  
2021 ◽  
Author(s):  
Arpassanan Wiyanad ◽  
Pipatana Amatachaya ◽  
Thanat Sooknuan ◽  
Charoonsak Somboonporn ◽  
Thiwabhorn Thaweewannakij ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Muscle Strength ◽  
Cord Injury ◽  
Strength Tests ◽  
Body Compositions

scholarly journals Removal of a suture needle: a case report

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Suyun Seon ◽  
Baek-Soo Lee ◽  
Byung-Joon Choi ◽  
Joo-Young Ohe ◽  
Jung-Woo Lee ◽  
...  
Keyword(s):  
Foreign Bodies ◽  
Mouth Opening ◽  
Ct Scanning ◽  
Purulent Discharge ◽  
Dental Clinic ◽  
Case Presentation ◽  
Left Behind ◽  
Successful Removal ◽  
Oral Surgical Procedure ◽  
Location Measurement

Abstract Background Foreign bodies may be embedded or left behind in the oral cavity during oral surgical procedure. The loss of instruments such as impression material, surgical gauze, and broken injection needles are commonly reported in the dental field. These complications are generally symptomatic and show signs of inflammation, pain, and purulent discharge. Accidental breakage of suture needles is a rare but potentially dangerous event. Case presentation In this report, we present one case of lost suture needle during the procedure of flap operation at local dental clinic and its successful removal under local/general anesthesia administration via CBCT with a help of two reference needles to localize the 6-0 nylon needle and consulting with the clinician. Conclusion CT scanning taken while mouth-closing may not be accurate with regard to real location measurement performed while mouth-opening. If so, other up-to-date radiographic devices and methods to retrieve a needle are recommended.

Fibreoptic intubation in ankylosing spondylitis patients

2021 ◽  
Vol 19 (1) ◽  
pp. 17-20
Author(s):  
Raghu K C ◽  
◽  
Nagesh R ◽  
Viswash G K ◽  
◽  
...  
Keyword(s):  
Spinal Cord ◽  
Ankylosing Spondylitis ◽  
Difficult Airway ◽  
Fibreoptic Intubation ◽  
Cardiovascular Complications ◽  
Inflammatory Disorder ◽  
Double Blind Study ◽  
Double Blind ◽  
Chronic Inflammatory Disorder ◽  
Group A

Background: Ankylosing spondylytes is a chronic inflammatory disorder characterized by inflammation in spines and spinal arthritis with a complex polygenic aetiology. The disease is more common in young males and risk factors include both genetic and environmental. Anesthesia management for ankylosing spondylitis is a challenge due to management of difficult airway, respiratory and cardiovascular complications, as well as the medications for disease and pain control. Both airway management and neuraxial access may prove to be difficult. Awake fibreoptic intubation is the safest option (²) in these patients with a potentially difficult airway as it allows continuous neurological monitoring while achieving a difficult airway. Methods: This is a Prospective Randomized Double-Blind Study conducted in Sri Sathya Sai Institute of Higher Medical Sciences; Total 70 Patients (Group A – 35, Group A – 35). All the subjects included after informed consent, blood samples and urine samples are collected from the all the subjects. Hb, RBCs, WBCs and Platelets was measured by laboratory standard methods. Along with Chest X- ray and ECG-for patients over 40 years of age. Results: This study was evaluated that in ankylosing spondylitis cases most of the physicians prefer to give general anaesthesia because to prevent trauma to the spinal cord but in these cases spine and surrounding tissues also it will involve at that time for maintain airway to the patient is challenge to the physicians by using fibreoptic intubation is good way to approach and maintain airway to the ankylosing patients. Conclusion: In this study suggest that in ankylosing spondylitis patients during surgery in place of tracheal intubation fibreoptic intubation is the best way to maintain airway to the patients and also we can prevent spinal cord damage.

scholarly journals Anaesthesia management of a difficult airway patient with severe aortic stenosis for major oncosurgery

2021 ◽  
Vol 8 (4) ◽  
pp. 597-599
Author(s):  
Ninad Chodankar ◽  
Disha Kapadia ◽  
Hemant Mehta
Keyword(s):  
Aortic Stenosis ◽  
Difficult Airway ◽  
Severe Aortic Stenosis ◽  
Mouth Opening ◽  
Perioperative Period ◽  
Fiberoptic Intubation ◽  
Team Approach ◽  
Free Fibula Flap ◽  
Early Recovery ◽  
Perioperative Morbidity

Over the past few decades, oncosurgical procedures are increasing in number, require considerable expertise and training for anaesthetising such patients. Aortic Stenosis itself poses great challenge, causes significant increase in morbidity and mortality in the perioperative period. Head, neck oncosurgical procedures with difficult airway requiring awake fiberoptic intubation in such patients adds to the challenge.We describe once such case of previously operated Carcinoma of oral cavity with new growth involving mandible for excision of tumour with neck dissection and mandibular reconstruction with a free Fibula flap. This patient now presented with anticipated difficult airway with restricted mouth opening and a recent diagnosis of severe Aortic stenosis with mean gradient across aortic valve of 52mmHg and valve area 0.8 cm2.Such patient requires multidisciplinary team approach by cardiologist, anaesthesiologist, surgeon and intensivist to prevent perioperative morbidity and facilitate early recovery.

scholarly journals Segmental analysis in cervical spinal cord injury reveals the recovery potential of hand muscles with preserved corticospinal tract: Insights beyond impairment scales

2021 ◽  
Author(s):  
Gustavo Balbinot ◽  
Guijin Li ◽  
Sukhvinder Kalsi-Ryan ◽  
Rainer Abel ◽  
Doris Maier ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Muscle Strength ◽  
Evoked Potentials ◽  
Corticospinal Tract ◽  
Cervical Spinal Cord ◽  
Hand Muscles ◽  
Recovery Potential ◽  
Strength Recovery ◽  
Cord Injury

Cervical spinal cord injury (SCI) severely impacts widespread bodily functions with extensive impairments for individuals, who prioritize regaining hand function. Although prior work has focused on the recovery at the person-level, the factors determining the recovery potential of individual muscles are poorly understood. There is a need for changing this paradigm in the field by moving beyond person-level classification of residual strength and sacral sparing to a muscle-specific analysis with a focus on the role of corticospinal tract (CST) sparing. The most striking part of human evolution involved the development of dextrous hand use with a respective expansion of the sensorimotor cortex controlling hand movements, which, because of the extensive CST projections, may constitute a drawback after SCI. Here, we investigated the muscle-specific natural recovery after cervical SCI in 748 patients from the European Multicenter Study about SCI (EMSCI), one of the largest datasets analysed to date. All participants were assessed within the first 4 weeks after SCI and re-assessed at 12, 24, and 48 weeks. Subsets of individuals underwent electrophysiological multimodal evaluations to discern CST and lower motor neuron (LMN) integrity [motor evoked potentials (MEP): N = 203; somatosensory evoked potentials (SSEP): N = 313; nerve conduction studies (NCS): N = 280]. We show the first evidence of the importance of CST sparing for proportional recovery in SCI, which is known in stroke survivors to represent the biological limits of structural and functional plasticity. In AIS D, baseline strength is a good predictor of segmental muscle strength recovery, while the proportionality in relation to baseline strength is lower for AIS B/C and breaks for AIS A. More severely impaired individuals showed non-linear and more variable recovery profiles, especially for hand muscles, while measures of CST sparing (by means of MEP) improved the prediction of hand muscle strength recovery. Therefore, assessment strategies for muscle-specific motor recovery in acute SCI improve by accounting for CST sparing and complement gross person-level predictions. The latter is of paramount importance for clinical trial outcomes and to target neurorehabilitation of upper limb function, where any single muscle function impacts the outcome of independence in cervical SCI.

Paddle lead cervical spinal cord stimulation for failed neck surgery syndrome

2013 ◽  
Vol 115 (10) ◽  
pp. 2254-2256 ◽  
Author(s):  
Srinivas Chivukula ◽  
Nestor D. Tomycz ◽  
John J. Moossy
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Stimulation ◽  
Cervical Spinal Cord ◽  
Neck Surgery

Extramedullary Spinal Cord Tumors

2018 ◽  
Author(s):  
J. Bradley Elder ◽  
Ahmed Mohyeldin
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Specific Area ◽  
Spinal Cord Tumors ◽  
Central Nervous System Neoplasms ◽  
Case Presentation ◽  
Presenting Symptoms ◽  
Spine Tumors ◽  
Nervous System Neoplasms

Tumors of the spine that occur within the dura but outside of the spinal cord are characterized as intradural but extramedullary spine tumors. The vast majority of these tumors are benign. This chapter uses a case presentation to present diagnostic and management pearls for this anatomic category of central nervous system neoplasms. These tumors are typically diagnosed due to presenting symptoms including pain or neurologic symptoms that localize the tumor to a specific area of the spine. Management is typically surgical. Some types of tumors are associated with syndromes such as neurofibromatosis. This chapter also discusses potential pitfalls and complications and their management.

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