Nasal and Facial Reconstruction in a Dog Following Severe Trauma

2003 ◽  
Vol 39 (4) ◽  
pp. 407-415 ◽  
Author(s):  
Janet A. Welch ◽  
Steven F. Swaim
Keyword(s):  
Surgical Procedures ◽  
Granulation Tissue ◽  
Upper Airway ◽  
Severe Trauma ◽  
Nasal Passage ◽  
Traumatic Amputation ◽  
Rubber Tubing ◽  
Novel Technique ◽  
Cosmetic Appearance ◽  
Oronasal Fistula

Successful reconstruction of the nasomaxillary region requires closure of oronasal communication and maintenance of a patent upper airway. A dog with traumatic amputation of the nasomaxillary region was presented for reconstructive surgery. Staged surgical procedures were performed with the goal of closing the oronasal fistula, reapposing facial tissues, forming a granulation bed in each nasal passage, and harvesting and placing mucosal grafts in the nasal passages. A novel technique for developing a granulation tissue bed for mucosal grafts using silicone rubber tubing was employed. The end result of the reconstructive surgeries was a relatively cosmetic appearance with patent nasal openings.

How we do it: impacted oesophageal foreign body removal using a dilatation balloon

2021 ◽  
pp. 1-3
Author(s):  
P D Chakravarty ◽  
T Kunanandam ◽  
G Walker
Keyword(s):  
Foreign Body ◽  
Granulation Tissue ◽  
Foreign Bodies ◽  
Fluoroscopic Guidance ◽  
Tertiary Referral ◽  
Foreign Body Removal ◽  
Novel Technique ◽  
Common Presentation ◽  
Reproducible Technique ◽  
Rigid Oesophagoscopy

Abstract Background Ingested foreign bodies are a common presentation to paediatric ENT services. Depending on the site, these are usually managed with flexible or rigid oesophagoscopy and retrieval. This paper presents a novel technique for removing a hollow foreign body that could not be removed using conventional means. Method and results After rigid and flexible approaches failed, a guidewire was passed through the foreign body under fluoroscopic guidance and a dilatation balloon passed through the lumen of the object. Inflating the balloon allowed dilatation of the inflamed mucosa above and below the object, facilitating straightforward removal under traction. Conclusion This is a novel and reproducible technique that uses equipment readily available in tertiary referral centres. Employed in this context, the technique enabled removal of an impacted object surrounded by granulation tissue, and would be appropriate for other objects with a lumen.

scholarly journals Nasopharyngeal nephroblastoma in a 3-month-old Boer goat

2020 ◽  
Vol 33 (1) ◽  
pp. 108-111
Author(s):  
Jillian M. Athey ◽  
Laura E. Rice ◽  
Aja B. Harvey ◽  
Kevin E. Washburn ◽  
Aline Rodrigues-Hoffmann
Keyword(s):  
Wilms Tumor ◽  
Soft Tissue Mass ◽  
Upper Airway ◽  
Nasal Passage ◽  
Cardiorespiratory Arrest ◽  
Tissue Mass ◽  
Boer Goat ◽  
Wilms Tumor 1 ◽  
Glomeruloid Structures ◽  
Firm Mass

A 3-mo-old, female Boer goat was presented because of respiratory difficulties. Tachypnea and inspiratory dyspnea were noted during physical examination. Thoracic radiographs were unremarkable; however, upper airway and nasal passage radiographs revealed a soft tissue mass within the nasal passages. The patient underwent cardiorespiratory arrest and did not respond to resuscitation efforts during endoscopy. A large, pedunculated, semi-firm mass originated from the soft palate and obstructed 90% of the nasopharynx on autopsy. Histologically, the mass was composed of primitive cells that multifocally formed tubules and glomeruloid structures intermingled with areas of fusiform and blastemal cells. The neoplastic cells were positive for cytokeratin (tubular and glomeruloid cells), vimentin (fusiform population and blastemal cells), and Wilms tumor 1 protein (glomeruloid structures) on immunohistochemistry, consistent with a triphasic nephroblastoma. To our knowledge, nasopharyngeal nephroblastoma has not been reported previously in any species.

Update on tooth notation, guidelines for extraction and a new technique for extractions: intra-oral dental marking

Dental Update ◽  
2020 ◽  
Vol 47 (11) ◽  
pp. 951-955
Author(s):  
Krishna Patel ◽  
Huw G Jeremiah ◽  
Andrew Barber
Keyword(s):  
Surgical Procedures ◽  
Clinical Relevance ◽  
Tooth Extraction ◽  
Effective Communication ◽  
New Technique ◽  
Novel Technique ◽  
A New Technique ◽  
Dental Professionals

Effective communication is required when referring patients for extractions and surgical procedures. There are multiple notation systems used for the identification of teeth, making communication for dental extractions challenging. The aim of this article is to provide an overview of the methods available to identify teeth and to propose a novel technique to identify erupted teeth for extraction. CPD/Clinical Relevance: Dental professionals should be aware of the importance of effective communication when identifying teeth planned for extraction and using a method that will minimize the chances of wrong tooth extraction.

Intubation-Related Laryngeal Pathology Precluding Tracheostomy Decannulation: Incidence and Associated Risk Factors

2021 ◽  
pp. 000348942199528
Author(s):  
Kirsten Meenan ◽  
Kavita Bhatnagar ◽  
Elizabeth Guardiani
Keyword(s):  
Risk Factors ◽  
Granulation Tissue ◽  
Large Population ◽  
Upper Airway ◽  
Endoscopic Evaluation ◽  
Retrospective Case ◽  
Airway Pathology ◽  
Laryngeal Lesions ◽  
Associated Risk Factors ◽  
Head And Neck Radiation

Objectives: To identify the incidence and risk factors for intubation-related laryngeal lesions that preclude tracheostomy decannulation in a large population. Methods: A 3-year retrospective case-control study was performed of tracheotomized adults in acute rehabilitation facilities who underwent routine endoscopic evaluation of the airway as part of the facilities’ decannulation protocol. Patients with known upper airway pathology, external laryngeal trauma, cricothyrotomy or emergent tracheostomy, prior head and neck radiation, isolated tracheal lesions, and patients with incomplete reports were excluded. The laryngeal pathologies were classified, and demographics and clinical features were compared between those whose lesions precluded decannulation and all other patients. Results: Three hundred seventy-one patients met inclusion criteria. One hundred six (28.6%) had laryngotracheal lesions. Forty-nine patients (13.2%) had intubation-related lesions of the larynx that precluded decannulation. These lesions included posterior glottic stenosis (30.6%), granulation tissue (24.5%), vocal fold immobility (16.3%), subglottic stenosis (16.3%), a combination of granulation tissue and stenosis (10.2%), and glottic edema (2.0%). A BMI ≥ 25 kg/m2 was associated with laryngeal lesions precluding decannulation. There was no difference in age, sex, race, diabetes mellitus, endotracheal tube size, number of days intubated, and number of intubations between groups. Seventy-eight percent of patients with lesions precluding decannulation were decannulated after medical or surgical therapy. The decannulation rate of patients without lesions precluding decannulation was 79.9%. Conclusions: BMI ≥ 25 kg/m2 may increase the risk of development of laryngeal lesions preventing decannulation. Given that 13.2% of tracheotomized patients have laryngeal lesions precluding decannulation, an endoscopic evaluation of the airway is important to prevent decannulation failure and future airway symptoms.

Paediatric tracheostomy: an analysis of 40 cases

1999 ◽  
Vol 113 (7) ◽  
pp. 645-651 ◽  
Author(s):  
S. P. Dubey ◽  
J. P. Garap
Keyword(s):  
Paediatric Patient ◽  
Airway Obstruction ◽  
General Anaesthesia ◽  
Surgical Procedures ◽  
Disease Process ◽  
Upper Airway ◽  
Significant Morbidity ◽  
Maximum Duration ◽  
Operative Complications ◽  
One Year

AbstractTracheostomy in the paediatric patient has been associated with significant morbidity and mortality compared to that in the adult. A retrospective analysis was made of 40 patients up to the age of 12 years having tracheostomies. Upper airway obstruction made up the commonest (32 patients, or 80 per cent) indication for paediatric tracheostomy in our series where males slightly outnumbered females. The majority (31 patients, or 77.5 per cent) underwent the operation under general anaesthesia with endotracheal intubation. Thirty-four (85 per cent) patients underwent ‘planned’ tracheostomies and six (15 per cent) underwent ‘crash’ procedures. Thirteen (32.5 per cent) patients were under the age of one year when tracheostomies were performed. The maximum duration of tracheostomies was between one week to within a month and after one month to within three months; each containing 11 (27.5 per cent) patients.Sixty-four different surgical procedures were performed on these patients in which laryngoscopy and bronchoscopy were the commonest procedures. Nine (22.5 per cent) had early post-operative and 14 (35 per cent) had late post-operative complications. Among these 40 children with tracheostomies, one (2.5 per cent) died due to a tracheostomy-related cause and 10 (25 per cent) due to the primary disease process itself. Tracheostomies performed to provide access for general anaesthesia for other surgical procedures were associated with a better prognosis.

End-to-end anastomosis in the management of laryngotracheal defects

2017 ◽  
Vol 131 (5) ◽  
pp. 447-454 ◽  
Author(s):  
E D Gozen ◽  
M Yener ◽  
Z B Erdur ◽  
E Karaman
Keyword(s):  
Surgical Procedures ◽  
Granulation Tissue ◽  
Vocal Fold ◽  
Laryngotracheal Stenosis ◽  
Thyroid Malignancy ◽  
Operative Complications ◽  
Vocal Fold Palsy ◽  
Grade Ii ◽  
End To End ◽  
Grade Iii

AbstractObjective:To present clinical experience and surgical outcomes of end-to-end anastomosis in the management of laryngotracheal stenosis and tracheal defects following invasive thyroid malignancy resection.Methods:A retrospective analysis was performed of 14 patients with laryngotracheal stenosis and tracheal invasive thyroid malignancy. All patients underwent tracheal or cricotracheal resection and primary end-to-end anastomosis.Results:Length of stenosis was 1.7–4 cm. Stenosis was classified as Myer and Cotton grade II in 4 patients, grade III in 6 and grade IV in 2. Surgical procedures included tracheotracheal end-to-end anastomosis (n= 4), cricotracheal anastomosis (n= 2) and thyrotracheal anastomosis (n= 6). Patients with invasive thyroid malignancy underwent segmental resection of the involved segment with tumour-free margins, and tracheal or cricotracheal end-to-end anastomosis. Successful decannulation was achieved in 13 patients (93 per cent). Post-operative complications were: wound infection (n= 1), subcutaneous emphysema (n= 1), temporary unilateral vocal fold palsy (n= 1), granulation tissue development (n= 1), and restenosis (n= 2).Conclusion:End-to-end anastomosis can be used safely and successfully in the management of advanced laryngotracheal stenosis and wide laryngotracheal defects. Greater success can be achieved using previously described surgical rules and laryngotracheal release manoeuvres.

scholarly journals Complex chest wall wound managed by a novel technique of thoracoplasty

2019 ◽  
Vol 12 (12) ◽  
pp. e230782
Author(s):  
Biplab Mishra ◽  
Mohit Kumar Joshi ◽  
Raja Tiwari ◽  
Madhur Uniyal
Keyword(s):  
Functional Outcome ◽  
Chest Wall ◽  
Dead Space ◽  
Large Cavity ◽  
Thoracic Cavity ◽  
Wall Defect ◽  
Novel Technique ◽  
Cosmetic Appearance ◽  
Residual Space ◽  
And Function

Thoracoplasty is a procedure to collapse the chest wall over a residual space in the thoracic cavity in order to abolish and avoid the complications associated with this dead space. Although effective in achieving this, the procedure is crippled by poor cosmetic appearance and functional outcome. We report a case of recalcitrant complex chest wall defect with a large cavity, marred by visible heart and poor availability of local muscles, that was successfully managed by a novel technique of thoracoplasty with acceptable postoperative appearance and function.

scholarly journals Permeabilization surgery of the upper respiratory tract and its effects on sleep fragmentation and REM sleep

2017 ◽  
Vol 7 (25) ◽  
pp. 47-56 ◽  
Author(s):  
Ionut Tanase ◽  
Claudiu Manea ◽  
Codrut Sarafoleanu
Keyword(s):  
Sleep Disorders ◽  
Surgical Procedures ◽  
Rem Sleep ◽  
Slow Wave Sleep ◽  
Upper Airway ◽  
Sleep Fragmentation ◽  
Upper Respiratory Tract ◽  
Upper Airways ◽  
Falling Asleep ◽  
Before And After

AbstractUsually, patients with sleep disorders may complain of tiredness, fatigue, daytime sleepiness, difficulty in concentrating, and can reach up to falling asleep in inappropriate situations – condition known as the Pickwick syndrome. To avoid these unpleasant symptoms, a series of surgical procedures regarding the anatomical structures involved in sleep apnea were developed.The article is a general review regarding the sleep disorders and the influence of upper airways permeability on the quality of sleep and the sleep staging distribution. Also, we present some preliminary data obtained in a clinical study underwent in CESITO Centre “Sfanta Maria” Hospital, Bucharest, involving patients with sleep pathology that had polysomnographic evaluations before and after various surgical procedures of nasal and pharyngeal permeabilization.AIMS.To determine that permeabilization surgery of the upper airway tract may be used successfully in order to decrease the sleep fragmentation and increase the time of slow-wave sleep.CONCLUSION.6 months after the permeabilization surgery of the upper airway tract, the polysomnography reveals that the arousals index decreased and the sleep architecture undergoes changes that consist in decreasing the Stage 1 and Stage 2 sleep, therefore REM sleep reaches a better score.

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