The influence of bilateral hyperplasia of the coronoid process of the mandible for difficult tracheal intubation

2018 ◽  
Vol 68 (3) ◽  
pp. 309-318
Author(s):  
Katarzyna Chmielińska-Popiołek ◽  
Zbigniew Kucharski
Keyword(s):  
Tracheal Intubation ◽  
Medical History ◽  
Mouth Opening ◽  
Rare Condition ◽  
Difficult Tracheal Intubation ◽  
Coronoid Process ◽  
History Of

Bilateral hyperplasia of the coronoid process of the mandible is rare condition. Commonly there is only one mechanical symptom, limiting mouth opening. The aim of this article is to introduct medical history of a 38 year-old female with bilateral hyperplasia of the coronoid process of the mandible confirmed by examination and RTG diagnostic. There is also the question of difficulties during intubation due to bilateral hyperplasia in this case.

scholarly journals Comparison of Incidence of Difficult Intubation between Obese and Nonobese Patients, and Comparison of Three Predictors of Difficult Intubation in Obese Patients

2016 ◽  
Vol 1 (2) ◽  
pp. 41-44
Author(s):  
Johann Mathew
Keyword(s):  
Tracheal Intubation ◽  
Difficult Intubation ◽  
Mouth Opening ◽  
Difficult Tracheal Intubation ◽  
Neck Circumference ◽  
Obese Patients ◽  
Chi Square ◽  
Neck Extension ◽  
Difficulty Scale ◽  
Nonobese Patients

ABSTRACT Background Anticipating a difficult airway is of prime importance to an anesthesiologist. Data available are inconclusive to say that tracheal intubation is more difficult in the obese. The deficiency occurring with individual factors can be avoided by adopting multiple airway assessment factors. In this study, we aim to compare the incidence of difficult intubation between obese and nonobese patients and compare three predictors of difficult intubation. Study design Prospective observational study. Materials and methods About 250 patients were assigned to two groups, obese and nonobese based on their body mass index. Preoperatively, neck circumference (NC), mouth opening, thyromental distance (TMD), neck extension, NC/TM ratio, Mallampati classification (MPC), and Wilson score (WS) were calculated. Difficulty of intubation was assessed using the intubation difficulty scale (IDS). All tracheal intubations were performed by anesthetists with more than 2 years of experience. Statistical analysis used Data analysis was done with the help of Statistical Package for the Social Sciences (SPSS) version 15, MedCalc version 11, and Epi data software. Qualitative data are presented with the help of frequency and percentage table, and association among various study parameters is done with chi-square test. Results The incidence of difficult intubation determined by the IDS (≥5) was more frequent in the obese group (88.6% in obese vs 11.4% in nonobese). Of the three variables, WS was found to be statistically significant (p < 0.005). Neck circumference to thyromental ratio is a new predictor for difficult tracheal intubation (DTI). But an NC/TM ratio of ≥5 gives high false positive for our population. How to cite this article Mathew J, Gvalani SK. Comparison of Incidence of Difficult Intubation between Obese and Nonobese Patients, and Comparison of Three Predictors of Difficult Intubation in Obese Patients. Res Inno in Anesth 2016;1(2):41-44.

scholarly journals Mandibular coronoid process hyperplasia: a case report

Revista CEFAC ◽  
2018 ◽  
Vol 20 (3) ◽  
pp. 400-405 ◽  
Author(s):  
Meire Cristiane Alves Tolentino ◽  
Jocasta Santos Assis ◽  
Claudia Assunção e Alves Cardoso ◽  
Flávio Ricardo Manzi
Keyword(s):  
Computed Tomography ◽  
Treatment Plan ◽  
Mouth Opening ◽  
Facial Asymmetry ◽  
Rare Condition ◽  
Coronoid Process ◽  
Temporomandibular Joint Dysfunction ◽  
Normal Bone ◽  
Recommended Treatment ◽  
Proper Diagnosis

ABSTRACT Coronoid Process Hyperplasia is a rare condition characterized by the increase in size of a histologically normal bone. It can be confused with Temporomandibular Joint Dysfunction, due to the presence of major signs/symptoms, including the limitation of mouth opening, pain, and facial asymmetry. Although several theories have been proposed, the etiology remains unknown. The recommended treatment is mandibular coronoidectomy. In the present study, the importance of computed tomography to reach the proper diagnosis and the surgical treatment plan is demonstrated.

scholarly journals A data review of airway management in patients with oral cavity or oropharyngeal cancer: A single-institution experiences

2019 ◽  
Author(s):  
Gang Zheng ◽  
Lei Feng ◽  
Carol M Lewis
Keyword(s):  
Body Mass Index ◽  
Tracheal Intubation ◽  
Oral Cavity ◽  
Airway Management ◽  
Range Of Motion ◽  
Body Mass ◽  
Oropharyngeal Cancer ◽  
Difficult Tracheal Intubation ◽  
Mallampati Score ◽  
History Of

Abstract Background: Oral cavity and oropharyngeal cancer impose significant threat to airway management. Head and neck radiotherapy (HNRT) may further increase the difficulty of tracheal intubation. We hypothesized that a history of HNRT would be associated with a high rate of difficult tracheal intubation. Methods: Adult patients with a history of HNRT were identified. Non-HNRT controls were case-matched by age, sex and body mass index. The tracheal intubation status between the two patient groups (treated vs. untreated with HNRT) was compared. The t test was used to evaluate differences in continuous variables between the 2 groups. Fisher’s exact test or a chi-square test was used to test for associations between radiation status and patient characteristics that may be associated with difficult tracheal intubation. Odds ratio and its confidence interval were used to assess the effect of radiation status on intubation status. Results: The final cohort of 472 matched patients in age, sex and body mass index consisted of 236 patients who had HNRT before surgery and 236 who had upfront surgery without HNRT. The percentage of patients who had restricted neck range of motion in the HNRT group was significantly higher than in the control group (22.3% vs. 11.0%; P = 0.001). The proportion of patients with trismus (P = 0.11) or difficult tracheal intubation (p = 0.73) did not differ significantly between the 2 groups. 12.7% patients in the study had difficult tracheal intubation. Patients who had mallampati scores of 3 or 4 had significantly higher rate of difficult tracheal intubation than did patients with mallampati scores of 1 or 2 (17.8% vs. 8.7%; p = 0.004). Multivariate logistic regression model showed no difference between HNRT and intubation status after adjusting neck range of motion and mallampati score (OR=0.91, 95% CI: 0.510 to1.612) Conclusions: Previous treatment with HNRT was not associated with additional risk of difficult tracheal intubation. Mallampati score may be a sensitive measurement for difficult tracheal intubation in this patient population.

Impaired Extension of the Digits due to Bilateral Idiopathic Intrinsic Contracture: A Case Report

2019 ◽  
Vol 24 (03) ◽  
pp. 383-385
Author(s):  
Yuki Kawasaki ◽  
Soichi Ejiri ◽  
Michiyuki Hakozaki ◽  
Shinichi Konno
Keyword(s):  
Eating Disorder ◽  
Case Report ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Medical History ◽  
Rare Condition ◽  
Tendon Sheath ◽  
Past Medical History ◽  
Thenar Muscle ◽  
History Of

Idiopathic intrinsic contracture (IIC) with no history of trauma, ischemia, or spasticity is extremely rare. We report herein a case of impaired extension of the digits due to bilateral IICs occurred in a 30-year-old woman with a past medical history of eating disorder and amenorrhea. Although no previous case has been reported in the literature, eight similar cases of IIC have been presented at Japanese domestic conferences. In these eight cases and the present case, resection of the thenar muscle cords and unilateral resection of the lateral band were effective. Since IIC in patients with an eating disorder is a rare condition, it would be treated conservatively at first as tendon sheath inflammation or locking. However, this condition may be resistant to conservative treatment, and surgical treatment should be considered in such cases.

scholarly journals Development of temporomandibular ankylosis after diagnosis of Jacob’s disease: clinical and tomographic assessment

2020 ◽  
Vol 9 (5) ◽  
pp. 426-428
Author(s):  
Rafael Linard Avelar ◽  
Roque Soares Martins Neto ◽  
Bruno da Silva Gaspar ◽  
Raimundo Antonio de Lima Praxedes Neto ◽  
Paulo Paulo Goberlânio Barros Silva
Keyword(s):  
Literature Review ◽  
Temporomandibular Joint ◽  
Delayed Diagnosis ◽  
Mouth Opening ◽  
Rare Condition ◽  
Temporomandibular Joint Disorders ◽  
Zygomatic Arch ◽  
Coronoid Process ◽  
Limited Mouth Opening ◽  
Joint Formation

Jacob's disease is a rare condition that consists of the formation of a pseudo joint structure between the mandibular coronoid process and the zygomatic bone, resulting in limited mouth opening. The disease is difficult to diagnose and etiology is uncertain. This article describes a clinical case of a 6-year-old child with limited mouth opening, which resulted in the formation of a temporomandibular ankylosis leading to complete immobility due to delayed diagnosis and treatment of the disease. A review of this pathology and the most precise imaging exams are discussed for the early and differential diagnosis of the disease. Descriptors: Ankylosis; Temporomandibular Joint; Temporomandibular Joint Disorders. Referências Wang WH, Xu B, Zhang BJ, Lou HQ. Temporomandibular joint ankylosis contributing to coronoid process hyperplasia. Int J Oral Maxillofac Surg. 2016;45(10):1229-33. Zhong SC, Xu ZJ, Zhang ZG, Zheng YH, Li TX, Su K. Bilateral coronoid hyperplasia (Jacob disease on right and elongation on left): report of a case and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009 Mar;107(3):e64-7. Coll-Anglada M, Acero-Sanz J, Vila-Masana I, Navarro-Cuéllar C, Ochandiano-Caycoia S, López de-Atalaya J, Navarro-Vila C. Jacob's disease secondary to coronoid process osteochondroma. A case report. Med Oral Patol Oral Cir Bucal. 2011;16(6):e708-10. Yesildag A, Yariktas M, Doner F, Aydin G, Munduz M, Topal U. Osteochondroma of the coronoid process and joint formation with zygomatic arch (jacob disease): report of a case. Eur J Dent. 2010;4(1):91-4.  Çorumlu U, Kopuz C, Demir MT, Pirzirenli ME. Bilateral elongated mandibular coronoid process in an Anatolian skull. Anat Cell Biol. 2016;49(3):217-20. Choi JG, Kim SY, Perez-Atayde AR, Padwa BL. Bilateral coronoid process hyperplasia with pseudocartilaginous joint formation: Jacob disease. J Oral Maxillofac Surg. 2013;71(2):316–21. Losa-Muñoz PM, Burgueño-García M, González-Martín-Moro J, Sánchez-Burgos R. Osteochondroma of coronoid process: a rare etiology of jacob disease. Craniomaxillofac Trauma Reconstr. 2014;7(4):306-9.  Escuder i de la Torre O, Vert Klok E, Marí i Roig A, Mommaerts MY, Pericot i Ayats J. Jacob's disease: report of two cases and review of the literature. J Craniomaxillofac Surg. 2001;29(6):372-76. Hernández-Alfaro F, Escuder O, Marco V. Joint formation between an osteochondroma of the coronoid process and the zygomatic arch (Jacob disease): report of case and review of literature. J Oral Maxillofac Surg. 2000;58(2):227-32. Sreeramaneni SK, Chakravarthi PS, Krishna Prasad L, Raja Satish P, Beeram RK. Jacob's disease: report of a rare case and literature review. Int J Oral Maxillofac Surg. 2011;40(7):753-57.  D'Ambrosio N, Kellman RM, Karimi S. Osteochondroma of the coronoid process (Jacob's disease): an unusual cause of restricted jaw motion. Am J Otolaryngol. 2011;32(1):52-4. Shackelford RT, Brown WH. Restricted jaw motion due to osteochondroma of the coronoid process. J Bone Joint Surg Am. 1949;31A(1):107-14.

scholarly journals Assessment of Airway in Patients with Acromegaly Undergoing Surgery: Predicting Successful Tracheal Intubation

2019 ◽  
Author(s):  
Indu Kapoor ◽  
Charu Mahajan ◽  
Hemanshu Prabhakar
Keyword(s):  
Tracheal Intubation ◽  
Mouth Opening ◽  
Pituitary Surgery ◽  
Difficult Tracheal Intubation ◽  
Lower Percentage ◽  
P Value ◽  
Female Ratio ◽  
Airway Assessment ◽  
Assessment Tests ◽  
Obstructive Sleep

Abstract Background In the field of anesthesia, acromegaly is considered a cause of difficult tracheal intubation and airway management. There is a high probability of unanticipated difficult intubation in acromegalic patients despite a lower percentage of patients being identified preoperatively as having a difficult airway. In this study, we carried out various airway assessment tests preoperatively and during induction of anesthesia to find out the predictors of easy tracheal intubation in patients with acromegaly. Materials and Methods All patients of either sex, diagnosed as a case of acromegaly and scheduled to undergo pituitary surgery were enrolled over a period of 3 years. Various airway assessment tests were performed prior to surgery, which included modified Mallampati (MP) classification (sitting and supine), mouth opening (MO), upper lip bite test (ULBT), neck movement (NM), thyromental (TM) distance, thyrohyoid (TH) distance, sternomental (SM) distance, hyomental (HM) distance, length of upper incisors (IL), receding mandible (RM), any history of obstructive sleep apnea (OSA), mask ventilation (MV), Cormack-Lehane (CL) III and IV, and external laryngeal manipulation (ELM). Results were reported as odds ratios (95% confidence interval [CI]). The p-value < 0.05 was considered statistically significant. Results A total of 42 patients were enrolled over a period of 3 years. The male-to-female ratio was 19:23 with a mean age of 37.95 years and mean weight of 72.7 kg. Out of 15 airway assessment parameters, only ULBT and CL grade showed significant results. Conclusion We conclude that ULBT and CL grading are reliable predictors of easy intubation in patients with acromegaly undergoing surgery.

Pseudocyesis as a cause of abdomen enlargement in a female adolescent

Open Medicine ◽  
2011 ◽  
Vol 6 (6) ◽  
pp. 720-722 ◽  
Author(s):  
Veselin Škrabić ◽  
Željka Vlastelica ◽  
Zoran Vučinović
Keyword(s):  
Mental Disorders ◽  
Effective Treatment ◽  
Medical History ◽  
Psychiatric Illness ◽  
Pediatric Population ◽  
Rare Condition ◽  
Signs And Symptoms ◽  
Female Adolescent ◽  
History Of

AbstractPseudocyesis is a rare condition in the pediatric population characterized by all signs and symptoms of pregnancy except the existence of a fetus [1]. In some patients it is associated with organic etiology, in others with mental disorders, also occurs in those without disorders in their medical history. Pseudocyesis occurs in both sexes, but more frequently in women. An effective treatment is a combination of psychotherapy and pharmacotherapy with antidepressants and antipsychotics [2]. We present a 15,9-year old girl with pseudocyesis as a cause of abdomen enlargement, who comes from an ordinary family with a negative history of psychiatric illness. The organic etiology of her condition was excluded, and therefore she was treated with antidepressants which contributed to the resolution of her case.

scholarly journals Osteochondroma of the Coronoid Process and Joint Formation with Zygomatic Arch (Jacob Disease): Report of a Case

2010 ◽  
Vol 04 (01) ◽  
pp. 091-094 ◽  
Author(s):  
Ahmet Yesildag ◽  
Murat Yariktas ◽  
Fehmi Doner ◽  
Gulsen Aydin ◽  
Mehmet Munduz ◽  
...  
Keyword(s):  
Male Patient ◽  
Surgical Approach ◽  
Mouth Opening ◽  
Rare Condition ◽  
Zygomatic Arch ◽  
Coronoid Process ◽  
Joint Formation ◽  
Histopathological Findings ◽  
Inner Surface ◽  
The Right

ABSTRACTJacob disease is a rare condition consisting of pseudo joint formation between enlarged mandibular coronoid process and the inner surface of the zygoma. We report a 16-years-old male patient with Jacob disease who presented with restricted mouth opening and swelling of the right zygoma. In this report, clinical, radiological, and histopathological findings of the Jacob disease and its surgical approach are discussed. (Eur J Dent 2010;4:91-94)

scholarly journals A data review of airway management in patients with oral cavity or oropharyngeal cancer: A single-institution experiences

2019 ◽  
Author(s):  
Gang Zheng ◽  
Lei Feng ◽  
Carol M Lewis
Keyword(s):  
Body Mass Index ◽  
Tracheal Intubation ◽  
Oral Cavity ◽  
Airway Management ◽  
Range Of Motion ◽  
Body Mass ◽  
Oropharyngeal Cancer ◽  
Difficult Tracheal Intubation ◽  
Mallampati Score ◽  
History Of

Abstract Background: Oral cavity and oropharyngeal cancer impose significant threat to airway management. Head and neck radiotherapy (HNRT) may further increase the difficulty of tracheal intubation. We hypothesized that a history of HNRT would be associated with a high rate of difficult tracheal intubation. Methods: Adult patients with a history of HNRT were identified. Non-HNRT controls were case-matched by age, sex and body mass index. The tracheal intubation status between the two patient groups (treated vs. untreated with HNRT) was compared. The t test was used to evaluate differences in continuous variables between the 2 groups. Fisher’s exact test or a chi-square test was used to test for associations between radiation status and patient characteristics that may be associated with difficult tracheal intubation. Odds ratio and its confidence interval were used to assess the effect of radiation status on intubation status. Results: The final cohort of 472 matched patients in age, sex and body mass index consisted of 236 patients who had HNRT before surgery and 236 who had upfront surgery without HNRT. The percentage of patients who had restricted neck range of motion in the HNRT group was significantly higher than in the control group (22.3% vs. 11.0%; P = 0.001). The proportion of patients with trismus (P = 0.11) or difficult tracheal intubation (p = 0.73) did not differ significantly between the 2 groups. 12.7% patients in the study had difficult tracheal intubation. Patients who had mallampati scores of 3 or 4 had significantly higher rate of difficult tracheal intubation than did patients with mallampati scores of 1 or 2 (17.8% vs. 8.7%; p = 0.004). Multivariate logistic regression model showed no difference between HNRT and intubation status after adjusting neck range of motion and mallampati score (OR=0.91, 95% CI: 0.510 to1.612) Conclusions: Previous treatment with HNRT was not associated with additional risk of difficult tracheal intubation. Mallampati score may be a sensitive measurement for difficult tracheal intubation in this patient population.

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