scholarly journals Surgical options in suprastomal collapse-induced severe airway obstruction

2020 ◽  
Vol 277 (12) ◽  
pp. 3415-3421
Author(s):  
Serap Sahin Onder ◽  
A. Ishii ◽  
K. Sandu

Abstract Purpose A single institutions experience with various surgical options in the treatment of severe suprastomal collapse (SSC). Methods The study included 18 tracheostomized children with SSC treated between January 2012 and December 2018. Data included: patient demography, initial airway lesions, comorbidities, indication and age at tracheostomy, prior airway surgery, stomal demography, type of surgery, postoperative management, complications and treatment outcomes. Results Four techniques were used to correct SSC. The surgical choice was dependent on stoma demography and associated airway lesions. Excision was done in eight patients and rib cartilage augmentation in five. Three patients had single stage tracheal resection and anastomosis. Two patients received stomal rigidification and temporary placement of Montgomery T tube. Three patients with anterior rib graft augmentation required additional lateral tracheal wall rigidification. Three patients (two with cartilage augmentation, and one with stomal rigidification) developed minimal granulation tissue in the postoperative period. Complete SSC resolution was seen in all except two patients who had a partial response to the treatment. All patients were successful decannulated and are currently asymptomatic. Conclusion Decannulation failures may be due to severe suprastomal collapse that could be either unique or associated with obstructing laryngotracheal lesions. Therefore, it is essential to select the most appropriate surgical treatment to obtain overall favorable outcomes.

1996 ◽  
Vol 14 (3) ◽  
pp. 451-464 ◽  
Author(s):  
Davis C. Drinkwater ◽  
Hillel Laks ◽  
John S. Child

1998 ◽  
Vol 16 (1) ◽  
pp. 101-106 ◽  
Author(s):  
E Guadagnoli ◽  
J C Weeks ◽  
C L Shapiro ◽  
J H Gurwitz ◽  
C Borbas ◽  
...  

PURPOSE To assess the use of breast-conserving surgery in two states reported to differ with respect to surgical treatment of breast cancer. METHODS A retrospective cohort study based on data collected from medical records and patients was performed among 1,514 patients diagnosed with early-stage breast cancer in Massachusetts and 1,061 patients in Minnesota. Patients were identified at 18 randomly selected hospitals in Massachusetts and at 30 hospitals in Minnesota. The rate of breast-conserving surgery in both states and the correlates of breast-conserving surgery among women eligible for the procedure were determined. RESULTS The rate of breast-conserving surgery in both states was much higher than previously reported. Among those eligible for the procedure, nearly 75% underwent breast-conserving surgery in Massachusetts and nearly half did so in Minnesota. Significantly (P < .003) more women who underwent mastectomy in Minnesota (27%) than in Massachusetts (15%) reported that their surgeon did not discuss breast-conserving surgery with them. Among women who underwent mastectomy and who reported being informed of both surgical alternatives, more women (P < .001) in Minnesota (74%) than in Massachusetts (62%) said they ultimately chose mastectomy because their surgeon recommended it. In Massachusetts, women treated at teaching hospitals were twice as likely as other women to undergo breast-conserving surgery. In Minnesota, women over age 70 and those who lived in rural areas were less likely than other women to undergo breast-conserving surgery. CONCLUSION Although the rate of breast-conserving surgery in each state was higher than expected based on earlier reports, the rates differed considerably between states. Additional studies are needed to determine whether variation in practice between geographic areas is due to differences in patients' preferences and values or to surgeons' propensity for one type of surgery based on where they practice.


2001 ◽  
Vol 18 (4) ◽  
pp. 289-293 ◽  
Author(s):  
Orhan Elbir ◽  
Haldun Gundogdu ◽  
Mehmet Caglikulekci ◽  
Cuneyt Kayaalp ◽  
Fuat Atalay ◽  
...  

2010 ◽  
Vol 20 (S3) ◽  
pp. 68-85 ◽  
Author(s):  
Sameh M. Said ◽  
Joseph A. Dearani ◽  
Harold M. Burkhart ◽  
Hartzell V. Schaff

AbstractCongenital anomalies of the coronary arteries are an uncommon, but important, cause of pain in the chest, myocardial ischaemia and even sudden cardiac death, especially in young individuals. This paper focuses on the surgical treatment of congenital anomalies of the coronary arteries in adults; indications for surgery and the different surgical options will be reviewed.


2008 ◽  
Vol 55 (2) ◽  
pp. 27-31 ◽  
Author(s):  
B.D. Antic ◽  
P. Peric ◽  
S.Lj. Stefanovic

Between April 1989 and September 2007, 181 patients with disease of lower cranial nerves (DLCN) underwent posterior fossa exploration. As a cause of DLCN, vascular compression (VC) was present in 89 patients with trigeminal neuralgia (TN), in 6 with hemifacial spasm (HFS), in 1 with glossopharyngeal neuralgia, in 1 with Meniere?s disease, and in 5 with multiple DLCN. Depending on intraoperative findings, different surgical options were used: microvascular decompression (MVD), MVD with partial sensory rhizotomy (PSR) or total sensory rhizotomy (TSR). Statistic analysis was made using the Fisher?s exact 2-side test. In patients with TN, excellent outcome was archived in 83 patients and good in 6. Postoperative outcome was better (p = 0.007) in cases with severe VC, but without significant correlation between used surgical option and outcome (p = 0.402). Frequency rate of relapses did not depend on severity of VC (p = 0.502) and used surgical option (p = 0.175). In 6 patients with HFS, excellent outcome was archived in 5 with arterial compression and poor in 1 with venous contact. In patients with Meniere?s disease and glossopharyngeal neuralgia, MVD result with excellent outcome. In 5 patients with multiple DLCN, excellent outcome was archived in 3 and good in 2. MVD is method of choice in surgical treatment of DLCN caused by VC. Overall outcome is better with severity of VC.


2021 ◽  
pp. 76-82
Author(s):  
S. O. Samusenko ◽  
I. V. Filatova

The urgency of improving the effectiveness of dacryocystitis treatment is determined by: their stable proportion among eye diseases, a high percentage of post−traumatic, iatrogenic and chronic forms, ability to be a source of dangerous complications and social significance. Existing anatomical and physiological relations and values of rhinogenic factors determine the involvement of otolaryngologists in dacryocystitis treatment. In order to determine the characteristics of the contingent of patients with dacryocystitis, structure of rhinogenic factors, methods of examination, surgical treatment and principles of postoperative management of patients, a study was conducted with 107 patients with chronic disease. The clinical effectiveness in diagnosis and planning of surgical intervention of the combination of endonasal optical rhinoscopy, probing and contrast of the nasolacrimal pathway with triombrast with subsequent radiological and (or) CT examination was determined. It is shown that the correction of endonasal structures should be performed simultaneously with dacryocystorhinostomy. The efficiency of the classical West−Bokstein surgery has been determined, the necessity of an individual approach to its planning has been shown. The main tasks of each stage of the surgery, which significantly affect its outcome, are established. When performed correctly, the effectiveness of "plastic" and "simple" rhinostomy, management of patients with and without stenting is almost the same. It has been proven that the use of radio wave and shaver techniques can greatly simplify the stages of the surgery and improve healing. Based on the obtained results, a conclusion was made about the expediency of involving an otolaryngologist in the consultation of patients with chronic dacryocystitis in each case. The criterion for choosing treatment tactics in favor of endonasal endoscopic dacryocystorhinostomy is the presence of rhinogenic factors of dacryocystitis. Key words: dacryocystitis, endonasal endoscopic dacryocystorhinostomy, rhinogenic factors, stenting, surgical treatment, epiphora, lacrimation.


2020 ◽  
Author(s):  
Ginger Xu ◽  
Paul Hwang ◽  
Nargiz Seyidova ◽  
Samuel J. Lin

Rhinoplasty is often considered the black box of plastic surgery. This apprehension can be overcome by having a fine-tuned understanding of nasal anatomy, developing an appreciation for nasal aesthetics, and becoming well-versed in the array of surgical techniques available to address specific cosmetic and functional concerns. Technical care and finesse are required in this type of surgery, where even 1 mm of change can result in a profound difference. Nasal function must also be assessed and preserved during rhinoplasty. Aside from these technical points, it is equally important to accurately and thoroughly understand each patient’s goals and to communicate the realistic outcomes and limitations of what can be done through surgery.   Key words: open rhinoplasty, nasal anatomy, nasofacial analysis, rhinoplasty techniques, rhinoplasty preoperative evaluation, rhinoplasty postoperative management, lateral nasal osteotomies, nasal tip grafts, nasal tip suture techniques This review contains 23 figures, 2 tables, and 43 references.


2012 ◽  
Vol 48 (No. 11) ◽  
pp. 339-342 ◽  
Author(s):  
Z. Mutlu ◽  
Acar SE ◽  
C. Perk

A case of tracheal stenosis in the cervical portion of the trachea was encountered in a 5.5-month-old St. Bernard-Ro􀄴weiler cross dog. Breathing difficulty was seen in the clinical examination and presence of an obvious narrowing between the 3rd&ndash;5th cervical tracheal rings was determined in the radiological examination. Under general anesthesia the portion with stenosis was resected and the healthy trachea ends were anastomosed using the split cartilage technique. In the postoperative period the breathing difficulty disappeared and there was no development of a new stenosis in the anastomosis region. In the late period check-up the patient was seen to lead a healthy life.


1993 ◽  
Vol 107 (6) ◽  
pp. 550-552 ◽  
Author(s):  
S. Baer ◽  
S. Hehar ◽  
A. R. Maw

Ossification of the tympanic membrane after myringoplasty is recorded for the first time. Myringoplasty was performed for closure of a perforation which followed the surgical treatment of Otitis media with effusion and had included the insertion of a long-term T-tube.


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