Fish bones in the vallecula and tongue base: removal with the rigid nasal endoscope

2002 ◽  
Vol 116 (10) ◽  
pp. 842-843 ◽  
Author(s):  
Julian Savage ◽  
Natalie Brookes ◽  
Simon Lloyd ◽  
Ian Mackay
Keyword(s):  
Simple Procedure ◽  
Flexible Endoscopy ◽  
Tongue Base ◽  
General Anaesthetic ◽  
Nasal Endoscope ◽  
Rigid Endoscopy ◽  
Fish Bones ◽  
Visual Aid

The tongue base and vallecula are common anatomical sites for impaction of inadvertently swallowed fish bones. Many techniques for their removal have been described but this apparently simple procedure can still pose a surgical challenge. We describe a previously unreported technique using rigid endoscopy with the 4 mm 30 degree Hopkins’ rod as a visual aid for transoral removal of the impacted bone. The technique has proved to be very well tolerated by the patient and more acceptable in terms of morbidity, time and resources than either flexible endoscopy or rigid endoscopy under general anaesthetic.

Adenoid measurement accuracy: A comparison of lateral skull film, flexible endoscopy, and intraoperative rigid endoscopy (gold standard)

2021 ◽  
Author(s):  
Nattha Pisutsiri ◽  
Vannipa Vathanophas ◽  
Panrasee Boonyabut ◽  
Sirion Tritrakarn ◽  
Nichanun Vitayaudom ◽  
...  
Keyword(s):  
Gold Standard ◽  
Measurement Accuracy ◽  
Flexible Endoscopy ◽  
Rigid Endoscopy

Rigid versus flexible neuroendoscopy: a systematic review and meta-analysis of endoscopic third ventriculostomy for the management of pediatric hydrocephalus

2021 ◽  
pp. 1-11
Author(s):  
Daphne Li ◽  
Vijay M. Ravindra ◽  
Sandi K. Lam
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Statistical Significance ◽  
Flexible Endoscopy ◽  
Third Ventriculostomy ◽  
Complication Rates ◽  
Inclusion Criteria ◽  
Related Complication ◽  
Rigid Endoscopy ◽  
Pediatric Hydrocephalus ◽  
Significant Difference

OBJECTIVE Endoscopic third ventriculostomy (ETV), with or without choroid plexus cauterization (±CPC), is a technique used for the treatment of pediatric hydrocephalus. Rigid or flexible neuroendoscopy can be used, but few studies directly compare the two techniques. Here, the authors sought to compare these methods in treating pediatric hydrocephalus. METHODS A systematic MEDLINE search was conducted using combinations of keywords: “flexible,” “rigid,” “endoscope/endoscopic,” “ETV,” and “hydrocephalus.” Inclusion criteria were as follows: English-language studies with patients 2 years of age and younger who had undergone ETV±CPC using rigid or flexible endoscopy for hydrocephalus. The primary outcome was ETV success (i.e., without the need for further CSF diversion procedures). Secondary outcomes included ETV-related and other complications. Statistical significance was determined via independent t-tests and Mood’s median tests. RESULTS Forty-eight articles met the study inclusion criteria: 37 involving rigid endoscopy, 10 involving flexible endoscopy, and 1 propensity scored–matched comparison. A cumulative 560 patients had undergone 578 rigid ETV±CPC, and 661 patients had undergone 672 flexible ETV±CPC. The flexible endoscopy cohort had a significantly lower average age at the time of the procedure (0.33 vs 0.53 years, p = 0.001) and a lower preoperatively predicted ETV success score (median 40, IQR 32.5–57.5 vs 62.5, IQR 50–70; p = 0.033). Average ETV success rates in the rigid versus flexible groups were 54.98% and 59.65% (p = 0.63), respectively. ETV-related complication rates did not differ significantly at 0.63% for flexible endoscopy and 3.46% for rigid endoscopy (p = 0.30). There was no significant difference in ETV success or complication rate in comparing ETV, ETV+CPC, and ETV with other concurrent procedures. CONCLUSIONS Despite the lower expected ETV success scores for patients treated with flexible endoscopy, the authors found similar ETV success and complication rates for ETV±CPC with flexible versus rigid endoscopy, as reported in the literature. Further direct comparison between the techniques is necessary.

The utility of lateral neck radiographs in the management of fish bones

2019 ◽  
Vol 133 (12) ◽  
pp. 1064-1067
Author(s):  
T Pitts-Tucker ◽  
T C Biggs ◽  
N N Patel
Keyword(s):  
Treatment Algorithm ◽  
Fish Bone ◽  
Aerodigestive Tract ◽  
University Hospital ◽  
Junior Doctors ◽  
General Anaesthetic ◽  
Lateral Neck ◽  
Upper Aerodigestive Tract ◽  
Fish Bones ◽  
Anaesthetic Assessment

AbstractBackgroundLateral neck radiographs are commonly used in the investigation and management of patients presenting with suspected fish bone impaction. The effectiveness of these is questioned, as many fish do not have radio-opaque bones.ObjectiveThis study evaluated the utility of lateral neck radiographs in the management of patients presenting with fish bones retained in the upper aerodigestive tract, with the creation of a treatment algorithm to guide further management.MethodsAn audit of practice was undertaken at the University Hospital of Southampton, identifying all patients admitted with potential fish bone impaction in the upper aerodigestive tract. Following analysis, a treatment algorithm was constructed for use by junior doctors.ResultsIn total, 34 per cent of patients with a normal radiograph were subsequently found to have a fish bone present under local or general anaesthetic assessment. The sensitivity of radiographs in the detection of fish bones was found to be 51.6 per cent.ConclusionLateral neck radiographs have limited value in the management of suspected fish bone impaction, and should only be used following detailed clinical examination of the upper aerodigestive tract.

scholarly journals An algorithm for retrieval tools in foreign body ingestion and food impaction in children

2020 ◽  
Author(s):  
Ergun Ergun ◽  
Ufuk Ates ◽  
Gulnur Gollu ◽  
Kutay Bahadir ◽  
Aydin Yagmurlu ◽  
...  
Keyword(s):  
Foreign Body ◽  
Material Removal ◽  
Demographic Data ◽  
Flexible Endoscopy ◽  
Foreign Body Ingestion ◽  
Food Impaction ◽  
Endoscopic Techniques ◽  
Rigid Endoscopy ◽  
Removal Technique ◽  
Button Batteries

Summary The aim of this study is to review the experience on managing foreign body ingestion in children with special emphasis on the endoscopic techniques and specific retrieval devices used for foreign body (FB) extraction. The charts of 341 children were reviewed retrospectively. Demographic data, ingested material, removal technique and tool, level of FB, complications, and outcomes were recorded. A total of 364 FBs were removed from 341 children. Among these, 56.5% (n: 206) were entrapped in esophagus, 39% (n: 142) were in stomach, and 4.5% (n: 16) in duodenum and intestine. The most frequently ingested items were coin (42.5%), button batteries (20.6%), and safety pins (12%). Optical forceps (37.9%) were the most commonly used tool and they were used during retrieval of esophageal FB by rigid endoscopy. Retrieval net (20.7%) was the second most common tool and the most common one during flexible endoscopy. Depending on our experience, we strongly advocate rigid endoscopy for esophageal FBs and food impaction in children because it allows both to use optical forceps with a strong grasping ability for blunt FBs and to position sharp and pointed objects inside the rigid endoscope. We recommend retrieval net as the first tool for the extraction of blunt objects and rat tooth retrieval forceps is the best tool for sharp and pointed FBs in stomach.

The use of nasal endoscopy to control profuse epistaxis from a fracture of the basi-sphenoid in a seven-year-old child

1999 ◽  
Vol 113 (6) ◽  
pp. 561-563 ◽  
Author(s):  
N. Bateman ◽  
N. S. Jones
Keyword(s):  
Fracture Site ◽  
Nasal Endoscopy ◽  
Oxidized Cellulose ◽  
Nasal Endoscope ◽  
Nasal Pack ◽  
Rigid Endoscopy ◽  
Life Threatening

AbstractA seven-year-old child sustained a fracture of her basisphenoid resulting in profuse, life-threatening haemorrhage which could not be controlled with a post-nasal pack. The fracture site was identified using rigid endoscopy and packed with oxidized cellulose, resulting in immediate control of the haemorrhage. The use of the nasal endoscope in the management of posterior epistaxis is discussed.

scholarly journals Foreign bodies in adult upper digestive tract: a series of 30 cases

2018 ◽  
Vol 4 (2) ◽  
pp. 575
Author(s):  
Nirmal Kumar Jayaraman ◽  
Vikram V. J. ◽  
Kalaiselvi M. ◽  
Sudha M.
Keyword(s):  
Foreign Body ◽  
General Anaesthesia ◽  
Digestive Tract ◽  
Foreign Bodies ◽  
Flexible Endoscopy ◽  
Oesophageal Perforation ◽  
Rigid Endoscopy ◽  
Upper Digestive Tract ◽  
Madras Medical College ◽  
Sharp Foreign Body

<p class="abstract"><strong>Background:</strong> Rigid endoscopy under general anaesthesia has traditionally been used by otolaryngologist for diagnosis and management of variety of disorders affecting the upper digestive tract including the removal of foreign body. Smooth foreign bodies does not pose much threat but may cause airway obstruction. Sharp foreign bodies, if not removed the earliest may penetrate oesophageal wall and cause complications.</p><p class="abstract"><strong>Methods:</strong> A Retrospective analysis was done for patients who underwent rigid oesophaghoscopy under general anaesthesia for 30 patients of foreign body ingestion at Upgraded Institute of Otorhinolaryngology, Madras Medical College, Chennai, between November 2016 – November 2017. The records of age, sex, co-morbidities, X-ray finding, complications were recorded.  </p><p class="abstract"><strong>Results:</strong> Majority of adults in this group belonged to 40-50 years age. The most common foreign body impacted was chicken bone totalling 16. 2 patients of denture ingestion were referred for flexible endoscopy after failed attempt, 1 developed oesophageal perforation.</p><p><strong>Conclusions:</strong> Rigid endoscopy is the gold standard for removal of sharp foreign body as the sharp ends can be clasped and brought in to the endoscope there by preventing damage to the mucosa. Foreign body with multiple sharp ends which cannot be negotiated into rigid endoscope, should be pushed into the stomach and attempted removal by cutting sharp ends of foreign body or by gastrostomy, as pulling such foreign body will lead to full length tear of oesophagus leading to morbidity and mortality. </p>

An alternative use of video-telescopic guidance for insertion of myringotomy tube

2006 ◽  
Vol 120 (2) ◽  
pp. 1-3 ◽  
Author(s):  
Fei-Peng Lee
Keyword(s):  
Tympanic Membrane ◽  
Video Monitor ◽  
Older Children ◽  
Rigid Endoscopy ◽  
Visual Aid

The insertion of a myringotomy tube is a common ENT procedure. Traditionally, this procedure is performed under otomicroscopic view. In this paper I describe a technique using rigid endoscopy with the Hopkins rod and a video monitor as a visual aid for the insertion of myringotomy tube in older children and adults. The technique is safe and effective; it allows demonstration of the entire tympanic membrane during surgery and also enables better teaching of the procedure than does the otomicroscope.

Flexible nasopharyngoscopy for fish bone removal from the pharynx

1992 ◽  
Vol 106 (8) ◽  
pp. 709-711 ◽  
Author(s):  
A. T. K. Choy ◽  
P. G. C. Gluckman ◽  
M. C. F. Tong ◽  
C. A. Van Hasselt
Keyword(s):  
Digestive Tract ◽  
Fish Bone ◽  
Indirect Laryngoscopy ◽  
General Anaesthetic ◽  
Biopsy Forceps ◽  
Bone Removal ◽  
Fish Bones ◽  
Cricopharyngeus Muscle ◽  
Rigid Oesophagoscopy

AbstractThe use of flexible nasopharyngoscopy with biopsy forceps for the removal of fish bones found in the oropharynx and hypopharynx is described. One hundred and sixty-eight patients with ingested fish bones in the upper aero-digestive tract were studied over a 12-month period. Of these, 73 percent were removed per-orally, or by indirect laryngoscopy. Fifteen percent were removed using the fibreoptic nasopharyngoscope. Twelve percent required a general anaesthetic and rigid oesophagoscopy for removal of fish bones at or below the level of the cricopharyngeus muscle. The technique has proven to be quick, well tolerated and low in morbidity. It is invaluable in patients in whom indirect laryngoscopy is unsatisfactory.

Targeting Platelets Containing Electro-encapsulated lloprost to Balloon Injured Aorta in Rats

1995 ◽  
Vol 73 (03) ◽  
pp. 535-542 ◽  
Author(s):  
N Crawford ◽  
A Chajara ◽  
G Pfliegler ◽  
B EI Gamal ◽  
L Brewer ◽  
...  
Keyword(s):  
Time Course ◽  
Therapeutic Potential ◽  
Simple Procedure ◽  
Rat Aorta ◽  
Balloon Injury ◽  
Post Injury ◽  
Antiproliferative Effects ◽  
Platelet Deposition ◽  
Total Dna ◽  
Novel Drug

SummaryDrugs can be electro-encapsulated within platelets and targeted to damaged blood vessels by exploiting the platelet’s natural haemostatic properties to adhere to collagen and other vessel wall constituents revealed by injury. A rat aorta balloon angioplasty model has been used to study the effect on platelet deposition of giving iloprost loaded platelets i.v. during the balloon injury. After labelling the circulating platelets with 111-Indium before balloon injury, time course studies showed maximum platelet deposition on the injured aorta occurred at about 1 h post-injury and the deposition remained stable over the next 2-3 h. When iloprost-loaded platelets were given i.v. during injury and the circulating platelet pool labelled with 111-Indium 30 min later, platelet deposition, measured at 2 h postinjury, was substantially and significantly reduced compared with control platelet treatment. Some antiproliferative effects of iloprost-loaded platelets given i.v. during injury have also been observed. Whereas the incorporation of [3H]-thymidine into aorta intima-media DNA at 3 days post injury was 62-fold higher in balloon injured rats than in control sham operated rats, thymidine incorporation into intima/media of rats which had received iloprost loaded platelets during injury was reduced as compared with rats subjected only to the injury procedure. The reduction was only of near significance, however, but at 14 days after injury the total DNA content of the aorta intima/media of rats given iloprost loaded platelets during injury was significantly reduced. Although iloprost loaded platelets can clearly inhibit excessive platelet deposition, other encapsulated agents may have greater anti-proliferative effects. These studies have shown that drug loaded platelets can be targeted to injured arteries, where they may be retained as depots for local release. We believe this novel drug delivery protocol may have therapeutic potential in reducing the incidence of occlusion and restenosis after angioplasty and thrombolysis treatment. Electro-encapsulation of drugs into platelets is a simple procedure and, using autologous and fully biocompatible and biodegradable platelets as delivery vehicles, might overcome some of the immunological and toxicological problems which have been encountered with other delivery vectors such as liposomes, microbeads, synthetic microcapsules and antibodies.

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