scholarly journals Fabricating A Maxillofacial Prosthesis with A Novel Suspension Technique for A Person with Exenteration: A Case Report

Introduction: Making a prosthesis is challenging for people who have lost an eye and parts of their cheekbones and nasal tissues. Suspending the prosthesis is a significant problem because of the open nasal cavity and the vast lesion area on the face. Case Presentation: This case report describes a new suspension technique used for a maxillofacial prosthesis on a person who had an exenterated left eye and parts of his maxillary and frontal sinuses had been removed due to infection. Since the sinus and nasal cavities were exposed, we could not use the conventional methods (anatomical, mechanical, chemical, and surgical) for suspending the prosthesis. Therefore, a new prosthetic suspension technique was used to solve this problem. Conclusion: In this clinical report, we used an optimal and effective method to make a prosthesis that can be used in similar cases of eye loss and extensive loss of the face. This new method does not need adhesives and minimizes the donning and doffing time of the prosthesis.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Wen Wang ◽  
Hongwei Cai ◽  
Huiping Ding ◽  
Xiaoping Xu

Abstract Background Trigeminal-cardiac reflex (TCR) is a brainstem vagus reflex that occurs when any center or peripheral branch of the trigeminal nerve was stimulated or operated on. The typical clinical manifestation is sudden bradycardia with or without blood pressure decline. The rhino-cardiac reflex which is one type of TCR is rare in clinical practice. As the rhino-cardiac reflex caused by disinfection of the nasal cavity is very rare, we report these two cases to remind other anesthesiologists to be vigilant to this situation. Case presentation This case report describes two cases of cardiac arrest caused by rhino-cardiac reflex while disinfecting nasal cavity before endoscopic transsphenoidal removal of pituitary adenomas. Their heart rate all dropped suddenly at the very moment of nasal stimulation and recovered quickly after stimulation was stopped and the administration of drugs or cardiac support. Conclusion Although the occurrence of rhino-cardiac reflex is rare, we should pay attention to it in clinical anesthesia. It is necessary to know the risk factors for preventing it. Once it occurs, we should take active and effective rescue measures to avoid serious complications.


2021 ◽  
Vol 13 (1) ◽  
pp. 152-156
Author(s):  
Binita Bhattarai ◽  
Koshal Shrestha ◽  
Laxmi Devi Manandhar

Introduction: Non Endoscopic endo-nasal dacryocystorhinostomy retains the benefit of an Endo-nasal approach and can be done without using an expensive video endoscope or laser system. Case presentation: A 22 years old female presented with epiphora and medial canthal mass in her left eye, accompanied by discharge and recurrent conjunctival congestion since childhood. Physical examination revealed loss of height of the nose with discharge in her left eye, and am immobile and non-tender mass below the level of medial canthal tendon. On applying pressure over the lesion there was mucopurulent discharge from both the upper and lower punctum . The bridge of the nose was very flat and external dacryocystectomy was a challenge. A non-endoscopic endonasal dacryocystorhinostomy with silicon tube intubation was planned. During the procedure, the bone was lower than normal requiring more bone nibbling. Epiphora was resolved immediately after surgery. Conclusion: Non-Endoscopic endo-nasal dacryocystorhinostomy has the benefit of doing it through an endo-nasal approach without expensive and space consuming video-endoscope making more room for bone nibbling even in a narrow and deformed nasal cavity.


2020 ◽  
pp. 1-5
Author(s):  
Anton Stift ◽  
Kerstin Wimmer ◽  
Felix Harpain ◽  
Katharina Wöran ◽  
Thomas Mang ◽  
...  

Introduction: Congenital as well as acquired diseases may be responsible for the development of a megacolon. In adult patients, Clostridium difficile associated infection as well as late-onset of Morbus Hirschsprung disease are known to cause a megacolon. In addition, malignant as well as benign colorectal strictures may lead to intestinal dilatation. In case of an idiopathic megacolon, the underlying cause remains unclear. Case Presentation: We describe the case of a 44-year-old male patient suffering from a long history of chronic constipation. He presented himself with an obscurely dilated large intestine with bowel loops up to 17 centimeters in diameter. Radiological as well as endoscopic examination gave evidence of a spastic process in the sigmoid colon. The patient was treated with a subtotal colectomy and the intraoperative findings revealed a stenotic stricture in the sigmoid colon. Since the histological examination did not find a conclusive reason for the functional stenosis, an immunohistochemical staining was advised. This showed a decrease in interstitial cells of Cajal (ICC) in the stenotic part of the sigmoid colon. Discussion: This case report describes a patient with an idiopathic megacolon, where the underlying cause remained unclear until an immunohistochemical staining of the stenotic colon showed a substantial decrease of ICCs. Various pathologies leading to a megacolon are reviewed and discussed.


Author(s):  
Josué Saúl Almaraz Lira ◽  
Alfredo Luis Chávez Haro ◽  
Cristian Alfredo López López ◽  
Remedios del Pilar González Jiménez

Introduction. Scorpion stings occur mainly in spring and summer, with an estimate of 1.2 million cases per year worldwide. About 300,000 poisonings occur within a year, primarily affecting children and adults older than 65 years. In 2019, Guanajuato (Mexico) ranked third in poisoning by scorpion sting with a total of 43,913 cases. The intoxication grades are three where the signs and symptoms are varied. There are two types of antivenom in the Mexican market, and we use Alacramyn® in our case. Case presentation. A 70-year-old female —with grade 1 scorpion sting poisoning, 30 minutes of evolution, with type 2 diabetes and high blood pressure— received two vials of antivenom according to current regulations. She presented transient vagal reaction and subsequent transient pain in the cervical region that radiates to the sacral region. At discharge, there are no data compatible with scorpion sting poisoning. Conclusions. Transient pain in the cervical region to the sacral region may be secondary to an anxiety crisis, hypersensitivity to IgG, or secondary reaction to administration in less time than recommended by the provider. The benefit was greater than the reactions that occurred.


2020 ◽  
Vol 30 (3) ◽  
pp. 56-59
Author(s):  
Jūratė Gudaitytė ◽  
Justina Jermolajevaitė ◽  
Martynas Judickas

Background and objectives: Acromegaly is endocri­nal disorder which results in changes involving ge­neral appearance as well as upper airway abnorma­lities, cardiovascular and metabolic disorders which can aggravate the anesthesia and can lead to compli­cations. We aim to discuss the challenges for anesthe­siologist that occurs facing patient with acromegaly and are necessary to investigate before performing any kind of intervention. Case Presentation: 79 years old male patient presen­ted the hospital with recently diagnosed acromegaly for rectal prolapse surgery. From anamnesis he had NYHAIII with cardiomyopathy, atrial fibrillation and arterial hypertension, also multiple old compressive fractures Th10 – L5. He was graded with Mallam­pati score IV and ASA class IV. The complemen­tary examinations were made to assess the possible complications. In induction of general anesthesia the intubation was performed using fibro- bronchoscope and anesthesia went without complications except hypotension which was managed. After surgery the patient was leaded to the postoperative room for furt­her monitoring. Discussion and Conclusion: Acromegalic patients have an increased risk of difficulty during anesthe­sia compared to general population due to difficult intubation, cardiovascular complications , OSA , alte­ration in intraoperative glucose intolerance and fluid regulation. Therefore profound investigation and as­sessment are necessary to predict and prepare for possible difficulties in the surgery room.


2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Anne-Jet S. Jansen ◽  
Paul M. van Schaik ◽  
Jasper M. Martens ◽  
Michel M. P. J. Reijnen

Abstract Background This case report demonstrates the value of IMPEDE-FX plugs in an embolization procedure of a false lumen of an infrarenal post-dissection aneurysm. Case presentation A 69-year-old patient was treated with mitral valve replacement, complicated by a Stanford type-A dissection. After 9 years he presented with an enlarging infrarenal post-dissection aneurysm. The false lumen was embolized using multiple IMPEDE-FX plugs as part of the treatment in addition to embolization of the inferior mesenteric artery and overstenting of the re-entry in the right iliac artery. At 15 months the CTA showed a fully thrombosed false lumen and remodeling of the true lumen. Conclusions The false lumen of an infrarenal post-dissection aneurysm can successfully be embolized using IMPEDE-FX embolization plugs as part of the treatment strategy. Prospective trials on patients with non-thrombosed false lumina are indicated.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi Zhang ◽  
Cheng Chen ◽  
Min Lin ◽  
Kan Deng ◽  
Huijuan Zhu ◽  
...  

Abstract Background Functional gonadotroph adenomas (FGAs) are rare adenomas that most commonly secrete FSH. However, solitary LH-secreting pituitary adenomas are unusual. Case presentation A 30-year-old woman with elevated LH and normal FSH presented with inability to conceive. An MRI revealed an enlarged sella turcica and an intrasellar mass. Treatment with transsphenoidal resection led to normalization of LH and estradiol, as well as successful pregnancy. And we reviewed 6 cases of LH-secreting pituitary adenomas from 1981 to 2020. Conclusions Our case is unique because of the LH-secreting pituitary adenoma without FSH hypersecretion. This case indicates that pituitary adenoma should be considered when other diseases causing infertility have been excluded.


2021 ◽  
Vol 44 ◽  
pp. 100530
Author(s):  
Lucas Cavalli Kluthcovsky ◽  
Thayana Neiva de Lima Queiroz ◽  
Malena Somensi ◽  
Jorge Luiz Costa Castro ◽  
Jair Rodini Engracia Filho
Keyword(s):  

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Min Li ◽  
Gang Zhu ◽  
Hao Guo ◽  
Shun Nan Ge ◽  
Guo Dong Gao ◽  
...  

AbstractBackgroundCerebral fat embolism (CFE) syndrome at high altitude was rare complicated with paroxysmal sympathetic hyperactivity (PSH) syndrome and septic shock. It is a challenge to differential diagnosis and treatment at high altitude.Case presentationThis case presents a CFE with PSH and septic shock of a 23-year-old man occurred at high altitude of 3800 m above sea level, transferred by airplane successfully and cured in the department of neurosurgery, Xi’an Tangdu Hospital.ConclusionsIt is key that CFE with PSH can be rapid diagnosed and treatment bundles of septic shock should be initiated as soon as possible. Early neurological rehabilitation played an important role for good outcome.


2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Henry Robayo-Amortegui ◽  
Natalia Valenzuela-Faccini ◽  
Cesar Quecano-Rosas ◽  
Darlyng Zabala-Muñoz ◽  
Michel Perez-Garzon

Abstract Background The new coronavirus disease 2019 pandemic has spread throughout most of the world. Cerebral venous thrombosis is a rare thromboembolic disease that can present as an extrapulmonary complication in coronavirus disease 2019 infection. Case presentation We report the case of a Hispanic woman with Down syndrome who has coronavirus disease 2019 and presents as a complication extensive cerebral venous thrombosis. Conclusions Cerebral venous thrombosis is a rare thromboembolic disease that can present as an extrapulmonary complication in coronavirus disease 2019 infection. In the absence of clinical and epidemiological data, it is important to carry out further investigation of the risk factors and pathophysiological causes related to the development of cerebrovascular thrombotic events in patients with Down syndrome with coronavirus disease 2019 infection.


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