Outcomes of Children Presenting with Button Battery in Esophagus: A Retrospective Review

Introduction Foreign body in esophagus is a common ENT emergency. Button batteries tend to have more grievous outcomes due to caustic mucosal injury to the esophagus. The objective of our study was to review the clinical profile and outcomes of the paediatric population in our center who presented with button battery in esophagus following accidental ingestion. MethodsThis was a retrospective study conducted in Tribhuvan University Teaching Hospital, Kathmandu, Nepal. Hospital records of all the patients who presented with button battery esophagus and underwent rigid oesophagoscopic removal from January 2013 to January 2019 were reviewed and analyzed for patient demographics, time interval between ingestion and presentation, site of impaction, status of oesophageal mucosa at the time of rigid oesophagoscopic removal of the battery, early post-operative complications, outcomes at the time of discharge and on follow-up. ResultsOur final sample size was 11 and all cases were <15 years. The average duration from time of ingestion to presentation to our hospital ranged from 1 day to 2 months. Variable oesophageal mucosal findings such as superficial mucosal erosion, superficial ulcer with slough and granulations with deep discrete ulcer were seen at the site of impaction of the button battery. One case was diagnosed with bilateral abductor palsy on 10th post-operative day following rigid oesophagoscopic removal of the battery. All other cases didn’t develop any significant complications. ConclusionButton battery in esophagus results in oesophageal ulceration and thus warrants an early endoscopic removal. Delayed removal can also cause bilateral abductor palsy from the caustic damage to recurrent laryngeal nerve.

Effect of Kashima's Surgery in Bilateral Abductor Vocal Cord Palsy

ABSTRACT Introduction Bilateral abductor palsy is treated by tracheostomy or any lateralization procedure. Kashima's surgery is a lateralization procedure introduced by Kashima in 1989. Objective To evaluate the effect of Kashima's surgery using subjective measures of breathing quality in patients with bilateral abductor palsy. Materials and methods This is a prospective study with 31 patients (3 men, 28 women) who underwent Kashima's surgery between January 2013 and December 2015 in the Laryngology department. Subjective evaluation was done by using dyspnea index score in the pre- and postoperative periods. Dyspnea index score is calculated based on answers given to a 7-point questionnaire and assessed by Likert scale, a self-assessment scale. For each point, the scores range from 0 to 3, and the maximum score is 21. Patients who already had tracheotomy were given a score of 14. This score was calculated again using the same questionnaire in the pretracheostomy scenario. Results There is significant reduction in the dyspnea index score with a median reduction score of 9 and improvement of quality-of-life after Kashima's surgery. Conclusion Dyspnea index score is easy to administer. Considering the cost of treatment and high success rate of decannulation, it is obvious that Kashima's surgery is effective and affordable in bilateral abductor palsy. How to cite this article Issac ME. Effect of Kashima's Surgery in Bilateral Abductor Vocal Cord Palsy. Int J Phonosurg Laryngol 2017;7(1):10-12.

Laser arytenoidectomy for bilateral vocal fold palsy in Parkinson's disease

We report a case of laser arytenoidectomy for bilateral abductor palsy of the vocal fold in a patient with Parkinson's disease. Parkinson's disease is known to be a rare cause for bilateral vocal fold palsy and this is the second case reported in the English literature. Majority of the reports to date are in the non-English literature. Tracheostomy has been the classic treatment option offered to these patients. To date no report has been found in the literature about a laser arytenoidectomy being performed in a patient suffering from bilateral vocal fold palsy in Parkinson's disease. We have suggested this option as it improves the quality of life of the individual and avoids the difficulty faced by a Parkinson's patient in managing tracheostomy care due to bradykinesia, rigidity and tremor.