Uncommon cause of respiratory failure due to a bezoar in the hypopharynx: a case report

Background Trichotillomania and trichophagia cause trichobezoars, which are masses made of hair. The main presentation of this condition is abdominal pain. However, other complications include gastric outlet obstruction, nausea, vomiting, weight loss, malnutrition, hematemesis, diarrhea, and constipation. Case presentation A 57-year-old woman with trichotillomania was admitted to the Emergency Department with the chief complaints of dyspnea on exertion, shortness of breath, dysphagia, generalized weakness, and hoarseness. Spiral chest computed tomography (CT) scan did not reveal any parenchymal lesions Pulmonary CT angiography did not reveal pulmonary embolism. The patient was admitted to the Surgery Department for hand fasciotomy due to contrast leakage, and during laryngoscopy, a trichobezoar was detected that was removed with Magill forceps. Conclusions Rare cases of trichobezoars can be observed in humans with gastrointestinal and respiratory symptoms. Precise and timely diagnosis are key for the prevention of more invasive diagnostic procedures.

Effectiveness and safety of cuff inflation technique over conventional method of Magill forceps for Nasotracheal intubation under direct laryngoscopy: Randomized controlled trial

The aim of the study is to compare the effectiveness and safety of cuff inflation technique over conventional method of Magill forceps for Nasotracheal intubation NTI under direct laryngoscopy.After taking permission from institutional ethical committee, patients of 18-60 years of either sex of ASA grade I and ll were divided into groups of 40 each. In group C, cuff inflation technique and in group M, Magill forceps technique was used for navigating the endotracheal tube from oropharynx to glottic opening to achieve intubation. Parameters observed were time required for intubation, attempts of intubation, injury occurring to oropharyngeal structures during intubation and hemodynamic parameters. Cuff of endotracheal tube was assessed postoperatively for any leaksAnalysis of the data for the various parameters was done using paired t-test for intra-group comparison and student t-test for intergroup comparison and chi-square test was used for qualitative (non parametric) data.There was no significant difference in demographic parameters, time required for intubation, number of attempts for intubation and hemodynamic parameters, but trauma to oropharyngeal structures was more in group M (8/40) compared to group C (0/40). (p≤0.05) Trauma to cuff of endotracheal tube was seen in group M (1/40) while none in group C (0/40) which was statistically not significant (p≤0.05).Thus, Cuff inflation technique can be used as an effective alternative to Magill forceps for oropharyngeal navigation of endotracheal tube under direct laryngoscopy guided nasotracheal intubation in patients with normal airways.

Comparison of a tube core and Magill forceps for nasotracheal intubation: a randomised controlled trial

Background Magill forceps are frequently used to complete nasotracheal intubation (NTI). We aimed to identify a tube core that could conveniently facilitate the NTI process without using Magill forceps. Methods Sixty patients scheduled for oral and maxillofacial surgeries were enrolled in our study and divided into two groups (30 per group) with no differences with regard to demographic data. In the Magill forceps group (Group M), a wire-reinforced endotracheal catheter was inserted into the trachea using Magill forceps. However, in the tube core group (Group T), a tube core bent to the physiological curve of the nasal cavity and lubricated with aseptic paraffin oil was inserted into the endotracheal catheter and was then withdrawn after the endotracheal catheter was advanced through the glottis under direct vision. Results All NTIs were completed successfully, and Magill forceps were not used on any patient in Group T. There was a significant difference in total NTI time between the two groups (Group M, 59.7 (5.1) s vs Group T, 52.4 (3.1) s). Mild epistaxis was observed in 6 patients in Group M and 5 patients in Group T (6/30 vs 5/30, respectively). No damage to oral tissue or teeth was observed in either group. Conclusions We conclude that using a tube core, consisting of a disposable sterilised stylet, is a convenient choice for NTI. Trial registration Patient enrolment was conducted after registration in the Chinese Clinical Trial Registry (www.Chictr.org.cn, ChiCTR190002 7387). This trial was prospectively registered on 11 November 2019.

Thoracic esophageal perforation by the use of Magill forceps in infant, success with non-operative treatment: case report

Background Esophageal perforation is a rare surgical pathology in children. Thoracic esophageal perforation is more severe than cervical esophageal perforation. Iatrogenic cause, mainly by endoscopy, is the most common in esophageal perforation. However, perforation induced by “Magill forceps” is exceptional. Case presentation A systematic physical examination revealed pyrexia severe respiratory distress and right-sided pleural effusion. We report the success of non-operative treatment applied to thoracic esophageal perforation due to Magill forceps in a 24-month-old male infant. The immediate and short-term outcomes were excellent. Conclusions Non-operative treatment is possible in iatrogenic perforation of thoracic esophageal in infants. This treatment delivers excellent outcome in carefully selected patients.

Comparison of A Tube Core And Magill Forceps For Nasotracheal Intubation: A Randomised Controlled Trial

Background: Magill forceps are frequently used to complete nasotracheal intubation (NTI). We aimed to identify a tube core that could conveniently facilitate the NTI process without using Magill forceps. Methods: Sixty patients scheduled for oral and maxillofacial surgeries were enrolled in our study and divided into two groups (30 per group) with no differences with regard to demographic data. In the Magill forceps group (Group M), a wire-reinforced endotracheal catheter was inserted into the trachea using Magill forceps. However, in the tube core group (Group T), a tube core bent to the physiological curve of the nasal cavity and lubricated with aseptic paraffin oil was inserted into the endotracheal catheter and was then withdrawn after the endotracheal catheter was advanced through the glottis under direct vision. Results: All NTIs were completed successfully, and Magill forceps were not used on any patient in Group T. There was a significant difference in total NTI time between the two groups (Group M, 59.7 (5.1) sec vs Group T, 52.4 (3.1) sec). Mild epistaxis was observed in 6 patients in Group M and 5 patients in Group T (6/30 vs 5/30, respectively). No damage to oral tissue or teeth was observed in either group. Conclusions: We conclude that using a tube core, consisting of a disposable sterilised stylet, is a convenient choice for NTI. Trial registration: Patient enrolment was conducted after registration in the Chinese Clinical Trial Registry ( www.Chictr.org.cn , ChiCTR190002 7387). This trial was prospectively registered on 11 November 2019.

Comparison of a tube core and Magill forceps for nasotracheal intubation: a randomised controlled trial

Background: Magill forceps are frequently used to complete nasotracheal intubation (NTI). We aimed to identify a tube core that could conveniently facilitate the NTI process without using Magill forceps.Methods: Sixty patients scheduled for oral and maxillofacial surgeries were enrolled in our study and divided into two groups (30 per group) with no differences with regard to demographic data. In the Magill forceps group (Group M), a wire-reinforced endotracheal catheter was inserted into the trachea using Magill forceps. However, in the tube core group (Group T), a tube core bent to the physiological curve of the nasal cavity and lubricated with aseptic paraffin oil was inserted into the endotracheal catheter and was then withdrawn after the endotracheal catheter was advanced through the glottis under direct vision.Results: All NTIs were completed successfully, and Magill forceps were not used on any patient in Group T. There was a significant difference in total NTI time between the two groups (Group M, 59.7 (5.1) sec vs Group T, 52.4 (3.1) sec). Mild epistaxis was observed in 6 patients in Group M and 5 patients in Group T (6/30 vs 5/30, respectively). No damage to oral tissue or teeth was observed in either group.Conclusions: We conclude that using a tube core, consisting of a disposable sterilised stylet, is a convenient choice for NTI.Trial registration: Patient enrolment was conducted after registration in the Chinese Clinical Trial Registry (www.Chictr.org.cn, ChiCTR1900027387). This trial was prospectively registered on 11 November 2019.

Oesophagal foreign Bodies Ingestion: Experience of 109 Cases

Esophageal foreign bodies ingestion is a worldwide surgical issue in pediatric age group while less likely in adults. We estimate endoscopic, clinical and therapeutic sides of this situation in the surgical department in Al-Hussein Teaching Hospital, Karbala city, Iraq and in Al-Sader Medical City, Najaf city, Iraq. The study made to revise our experience for all patients admitted to our hospitals with a diagnosis of oesophagal foreign bodies and their treatments and outcome. The medical registrations resolved concerning demographic information, symptoms presented, investigation and treatments. We revised 109 (61 males and 48 females) patients ranged from 4 months to 65 years with (median age of 2 years). Coins most repeatedly ingested objects (27.5%), miscellaneous metal objects (17.4%), batteries (13.8%) and food (9.2%). The clinical features we encountered vomiting (27.5%), dysphagia (22.9%), asymptomatic (15.6%), drooling and food refusal (12.8 %) and foreign body sensation (8.3%). Usually X-ray screen finding the foreign body in 89(81%) patients. Magill forceps and rigid oesophagoscope performed within six hours from admission under general anaesthesia and from 12-48 from time of ingestion. Foreign body Impaction in the hypopharynx and the upper part of the oesophagus (68.8%) middle part (23%) and the lower part (8.2 %).100(91.7%) patients recovered completely without any complications,9 (18.3%) patient get bleeding, mucosal ulceration and infection which treated successfully.

Comparing Video and Direct Laryngoscopy for Nasotracheal Intubation

This parallel group randomized controlled clinical trial compared intubation duration and success using video laryngoscopy (VL) versus direct laryngoscopy (DL) during routine nasotracheal intubation. Fifty patients undergoing oral and maxillofacial surgery under general anesthesia were randomly assigned into 2 groups receiving either VL or DL to facilitate nasotracheal intubation. The primary outcome was the amount of time required to complete nasotracheal intubation. The secondary outcomes included the success of first attempt at intubation and the use of Magill forceps. Results demonstrated a mean time to intubation of 142 seconds in the DL group and 94 seconds in the VL group (p = .011). First attempt intubation success was 92.0% in the VL group and 84.0% in the DL group (p = .34). The use of Magill forceps was significantly increased in the DL group (p = .007). VL for routine nasotracheal intubation in oral and maxillofacial surgery procedures results in significantly faster intubation times and decreased use of Magill forceps compared with traditional DL.

Comparison with tube core and Magill forceps for nasotracheal intubation: a randomized controlled trial

Objective: Magill forceps are frequently used to complete the process of nasotracheal intubation (NTI). We aimed to identify a tube core that could facilitate the NTI process conveniently without Magill forceps. Methods: Sixty patients scheduled for oral and maxillofacial surgeries with no differences between the two groups (30 per group) with regard to demographic data were enrolled in our study. In Group M, the wire-reinforced endotracheal catheter was inserted into the trachea using Magill forceps. However, in Group T, a tube core bent to the physiological curve of the nasal cavity lubricated with aseptic paraffin oil was inserted into the endotracheal catheter, and it was then withdrawn after the endotracheal catheter was advanced through the glottis under direct vision. Results: All NTIs were completed successfully, and no Magill forceps were used in Group T. There was a significant difference in total NTI time between the two groups (Group M, 59.7 (5.1) sec vs Group T, 52.4 (3.1) sec). Mild epistaxis was observed in 6 patients in Group M and 5 patients in Group T (6/30 vs 5/30, respectively). There was no presence of damaged oral tissue or damage to the teeth in either group. Conclusion: We conclude that using the tube core, which is a disposable sterilised stylet, for NTI is a convenient choice.