Choanal atresia and secondary nasopharyngeal stenosis in a dog

1998 ◽  
Vol 34 (6) ◽  
pp. 497-501 ◽  
Author(s):  
BR Coolman ◽  
SM Marretta ◽  
BC McKiernan ◽  
JF Zachary
Keyword(s):  
Nasal Cavity ◽  
Surgical Intervention ◽  
Choanal Atresia ◽  
Upper Airway ◽  
Airway Disease ◽  
Scar Tissue ◽  
Endoscopic Examination ◽  
Intact Male ◽  
Temporary Relief

A 20-month-old, intact male shih tzu was evaluated for chronic upper airway disease. Endoscopic examination established a diagnosis of choanal atresia, a developmental anomaly of the posterior nasal cavity. Although surgical intervention provided temporary relief, stenosis of the nasopharynx by obstructive scar tissue was confirmed within four weeks. A permanent tracheostomy provided long-term relief of the respiratory difficulty. This is the first report of choanal atresia or nasopharyngeal stenosis in a dog.

scholarly journals Benefits and harm of systemic steroids for short- and long-term use in rhinitis and rhinosinusitis: an EAACI position paper

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Valerie Hox ◽  
Evelijn Lourijsen ◽  
Arnout Jordens ◽  
Kristian Aasbjerg ◽  
Ioana Agache ◽  
...  
Keyword(s):  
Upper Airway ◽  
Airway Disease ◽  
Systemic Steroid ◽  
Systemic Steroids ◽  
Consensus Document ◽  
Airway Diseases ◽  
Short And Long Term ◽  
International Experts ◽  
Upper Airway Disease

Abstract Because of the inflammatory mechanisms of most chronic upper airway diseases such as rhinitis and chronic rhinosinusitis, systemic steroids have been used for their treatment for decades. However, it has been very well documented that—potentially severe—side-effects can occur with the accumulation of systemic steroid courses over the years. A consensus document summarizing the benefits of systemic steroids for each upper airway disease type, as well as highlighting the potential harms of this treatment is currently lacking. Therefore, a panel of international experts in the field of Rhinology reviewed the available literature with the aim of providing recommendations for the use of systemic steroids in treating upper airway disease.

scholarly journals Efficacy of a Conservative Weight Loss Program in the Long-Term Management of Chronic Upper Airway Obstruction

2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Ryan C. Case ◽  
John Schweinfurth
Keyword(s):  
Weight Loss ◽  
Airway Obstruction ◽  
Weight Reduction ◽  
Oxygen Demand ◽  
Upper Airway ◽  
Airway Disease ◽  
Disease Etiology ◽  
Obstructive Sleep ◽  
The Mean

Objective. Obesity is a significant contributor to oxygen demand and dynamic airway obstruction. The objective of the current study is to determine the long-term success of conservative measures directed toward weight reduction on airway management without respect to specific airway disease etiology.Methods. Patients with chronic airway obstruction secondary anatomic lesions or obstructive sleep apnea were recruited and followed prospectively. Demographics, initial and final weights, diagnosis, and followup information were recorded. Patients were referred to a registered dietician, provided counseling, and started on a weight-loss regimen. Outcome measures were change in body mass index (BMI) and rate of decannulation from weight loss alone.Results. Of fourteen patients, ten remained tracheostomy-dependent and four had high-grade lesions with the potential for improvement in oxygen demand and dynamic airway collapse with weight loss. The mean follow up period was 25 months. The mean change in BMI was an increase of 1.4 kg/m2per patient.Conclusions. Conservative measures alone were not effective in achieving weight reduction in the population studied. This may be due to comorbid disease and poor compliance. The promise of decannulation was an insufficient independent motivator for weight loss in this study. Although the theoretical benefits of weight loss support its continued recommendation, the long-term success rate of conservative measures is low. More aggressive facilitated interventions including pharmacotherapy or bariatric surgery should be considered early in the course of treating airway disease complicated by obesity.

Surgical Treatment of Congenital Choanal Atresia

1978 ◽  
Vol 87 (3) ◽  
pp. 346-350 ◽  
Author(s):  
Atle Freng
Keyword(s):  
Surgical Treatment ◽  
Nasal Cavity ◽  
High Frequency ◽  
Choanal Atresia ◽  
Posterior Part ◽  
Scar Tissue ◽  
Postoperative Treatment ◽  
Surgical Method ◽  
Dental Drill

— In a follow-up, 2 to 27 years postoperatively, of 43 patients with unilateral choanal atresia a high frequency of relapses was observed. In 47% of the cases, preoperative symptoms had reappeared, and in 84% scar tissue had reduced the choanal opening to less than half of normal size. In most of the patients a transpalatinal approach was used, either ad modum Ruddy, Wilson or Owens. In order to improve the results, the surgical method and the postoperative treatment were changed in a new series of 15 patients with unilateral atresia. These patients, 6 to 26 years of age, were operated on by a transpalatinal approach during two months in the autumn of 1974. After removal of the atresia, the posterior part of the nasal cavity was modeled, with a dental drill, to increasing diameter towards epipharynx. To keep the opening patent a PVC tube was left in the choana for six weeks postoperatively. The results were encouraging. Two and a half years after the operation there were no relapses.

Vertebral Body Osteolysis 6 Years After Cervical Disk Arthroplasty

2020 ◽  
Vol 81 (02) ◽  
pp. 188-192 ◽  
Author(s):  
Ali Harati ◽  
Paul Oni ◽  
Lucas Oles ◽  
Thomas Reuter ◽  
Mohammad Hamdan
Keyword(s):  
Vertebral Body ◽  
Surgical Intervention ◽  
Clinical Symptoms ◽  
Scar Tissue ◽  
Cervical Arthroplasty ◽  
Arm Pain ◽  
The Core ◽  
Pathologic Evaluation ◽  
Cervical Disk

AbstractCervical arthroplasty is an accepted and widely performed surgical intervention with usually favorable outcomes. We report a rare case of a 37-year-old woman who presented with vertebral body osteolysis, 6 years after two-level cervical arthroplasty (C5–C6 and C6–C7). The patient showed no initial complications, but at year 6 she presented with neck and radicular arm pain. Diagnostic imaging revealed osteolysis of the vertebral body C6. The patient subsequently underwent removal of the two prostheses and C6 corpectomy, followed by bridging C5 to C7 and anterior fixation. During surgery, the mantle of the prostheses appeared broken, with the core expulsed anteriorly and embedded in granulomatous scar tissue. Pathologic evaluation of the samples showed partially proliferating fibroblasts, giant cell reaction, and textile particles. Postoperatively, clinical symptoms resolved with no residual deficits. Additional research should be performed to assess the long-term complications of this procedure that should be included in the patient informed consent materials.

Neonatal Upper Airway Assessment by Awake Flexible Laryngoscopy

1998 ◽  
Vol 107 (1) ◽  
pp. 75-80 ◽  
Author(s):  
Robert G. Berkowitz
Keyword(s):  
Vocal Cord Paralysis ◽  
Choanal Atresia ◽  
Upper Airway ◽  
Airway Disease ◽  
Corrective Surgery ◽  
Flexible Laryngoscopy ◽  
Airway Assessment ◽  
A Prospective Study ◽  
And Function ◽  
Made In

Awake flexible laryngoscopy (AFL) provides simple and quick assessment of both the structure and function of the upper airway. To determine its value in neonates, a prospective study was carried out over 2 years of 110 neonates (80 term, 30 premature) under 6 weeks of age (corrected for prematurity) presenting with symptoms suggestive of upper airway disease who underwent AFL performed by the author. A diagnosis was made in 79 cases, while no cause was found for the symptoms in 31. The commonest diagnoses were vocal cord paralysis (29; bilateral 16, unilateral 13), nasal stenosis (9), laryngomalacia (9), glossoptosis (7), subglottic stenosis (6), and choanal atresia (5; bilateral 2, unilateral 3). The AFL was repeated in 31 neonates and the condition was found to be stable in 16, improved in 8, resolved in 2, and progressed in 1, and an additional diagnosis was made in 4. Endoscopy under general anesthesia with or without corrective surgery was performed in 15 neonates (7 also having repeat AFL). The diagnosis was confirmed in 14 and an additional tracheal abnormality was found in 1. The AFL was complicated by cyanosis in 2 neonates and epistaxis in 1, but all complications resolved with minimal intervention. These data suggest that the neonatal upper airway can be relatively safely and reliably assessed by AFL performed by an experienced clinician.

scholarly journals Delta neutrophil index levels can be a good indicator to predict patients with chronic rhinosinusitis who need surgery

2021 ◽  
pp. 014556132110584
Author(s):  
Sumin Son ◽  
Hong Geun An ◽  
Joong Su Park ◽  
Seung Ho Kim ◽  
Seung Min In ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Operating Characteristic ◽  
Surgical Intervention ◽  
Upper Airway ◽  
Roc Curves ◽  
Airway Disease ◽  
Severity Of The Disease ◽  
Wbc Count ◽  
Delta Neutrophil Index

Objectives Predicting the need for surgical treatment among patients with chronic rhinosinusitis (CRS) is challenging. The delta neutrophil index (DNI) has been proposed as a useful laboratory marker of immature granulocytes, which indicates infection or severe inflammation in several diseases. This study evaluated DNI as an early predictor of the need for surgery in patients with CRS. Methods A total of 117 patients diagnosed with CRS were enrolled in this retrospective and observational study. Medical records, including symptoms data, WBC count, ESR level, LUC count, Lund-Mackay scores, and DNI, were reviewed. The receiver operating characteristic (ROC) curves were analyzed to determine the optimal cut-off values for predicting surgery. Results Among 117 patients, 49 patients (41.9%) needed surgical intervention. The areas under the WBC, ESR, LUC, and DNI ROC curves were .571, .600, .592, and .782, respectively. The optimal cut-off value of DNI to predict surgery was .9%. The prognostic precision of DNI showed that the sensitivity was 59.2% and the specificity was 98.5%. In the analysis of risk factors, DNI levels were significantly associated with surgical intervention (odds ratio, 2.22; 95% confidence interval, 1.48-3.34; P < .01). Conclusions The level of DNI, which reflects the severity of the disease, may be a useful predictor for determining the need for surgical intervention in patients with CRS. This is the first literature to verify the role of DNI in upper airway disease.

A long term follow up of conchal flap meatoplasty in chronic otitis externa

2006 ◽  
Vol 121 (1) ◽  
pp. 1-4 ◽  
Author(s):  
P Jayanth Kumar ◽  
G J C Smelt
Keyword(s):  
Otitis Externa ◽  
Surgical Intervention ◽  
Scar Tissue ◽  
Skin Changes ◽  
Canal Stenosis ◽  
Long Term Follow Up ◽  
Downward Spiral ◽  
Poor Ventilation

A long-standing diffuse chronic otitis externa can lead to itching. Resultant scratching may then lead to irreversible skin changes with canal stenosis by scar tissue. The poor ventilation and increased humidity gives rise to bacterial and fungal growths leading to breakdown of the skin defences and worsening itching. This vicious itching–scratch cycle or downward spiral often fails to respond to medical treatment. For these cases a simple conchal flap meatoplasty may improve ventilation of the external auditory canal and may lead to a self cleaning ear. We reviewed 84 patients who had undergone conchal flap meatoplasty in Calderdale and Huddersfield NHS Trust Hospitals from April 1993 to June 2002. A long-term follow up of conchal flap meatoplasty in chronic otitis externa showed no records of complications or further otitis in 93.2 per cent of cases. Thus surgical intervention plays an important role in the treatment of otitis externa not responding to treatment.

Application of Nasomer in surgical treatment of patients with polyposis rhinosinusitis

2018 ◽  
pp. 39-42
Author(s):  
Vladimir Bereznyuk ◽  
Alexander Chernokur ◽  
Oleg Gospod
Keyword(s):  
Nasal Cavity ◽  
Postoperative Period ◽  
Paranasal Sinuses ◽  
Standard Treatment ◽  
Surgical Intervention ◽  
Sodium Hyaluronate ◽  
Main Group ◽  
Control Group ◽  
Nasal Breathing ◽  
Minimal Invasiveness

Relevance: Modern endonasal surgery allows to remove polyps from all affected paranasal sinuses, following the principles of minimal invasiveness. Minimal traumatic of surgical intervention gives the best results, accompanied by less progression of the disease. Minimal invasiveness of surgical intervention and its obligatory combination with postoperative medical treatment are common practice in many countries. One of the drugs that actively effect the restoration of the mucous membrane of the nasal cavity and paranasal sinuses in the early postoperative period is Nazomer, which includes sodium hyaluronate and dexpanthenol in saline solution. The purpose of the study is to investigate the effectiveness of the drug Nazomer in patients with polyposis rhinosinusitis after endoscopic polyposynosotomy. Results and discussion: The main group consisted of 30 patients with polyposis rhinosinusitis, who were prescribed Nasomer in addition to standard treatment in the postoperative period. The control group included 30 patients who underwent standard treatment in the postoperative period. As criteria for clinical efficacy, data from endoscopic examination of the nasal cavity and indicators of anterior rhinomatometry, measured by the «Optimus» device, were selected. In the main group, the index of nasal breathing according to rhinomatometry was better than the results of patients in the control group on the 3rd and 5th day of the postoperative period by 26% and 24%, respectively. Conclusion: The use of the drug Nazomer in the postoperative period in patients with polyposis rhinosinusitis contributes to more active restoration of respiratory function of the nasal cavity compared with the control group, according to rhinomatometry, up to 26%. Based on the results obtained, the drug Nazomer is an effective anti-inflammatory and regenerative agent in the postoperative period in patients with polyposis rhinosinusitis.

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