Upper aerodigestive tract endoscopy during the first year of life: A current review.

A five-year retrospective review of 52 infants who underwent 67 endoscopic procedures of the upper aerodigestive tract was performed. The ages of the patients ranged from one day to one year with a mean of 157 days. The most common indication of endoscopy was stridor/respiratory distress (46.3 per cent) and persistent wheezing (16.4 per cent). Congenital anomalies were the causes of airway problems in more than half of the patients and laryngomalacia was the most common diagnosis (34.6 per cent), followed by congenital subglottic stenosis (7.6 per cent). There were 19.2 per cent of cases who had more than one airway lesion. Diagnosis was obtained from endoscopy in90.4 per cent of cases. There were two cases of gastroesophageal reflux (GER) diagnosed by nuclear scintigraphy. Therapeutic procedures during and after endoscopy were also reviewed. Only minor complications were found in three cases (4.5 per cent) (one bronchospasm, two subglottic oedema ). Endoscopy was found to be a safe, accurate diagnostic method which also offered useful therapeutic interventions.

Deep neck infection from cervical osteomyelitis in an intravenous drug abuser: A case report.

Prevertebral space abscess in the cervical region is a rare deep neck infection. Tuberculosis of the spine used to be the most frequent cause. We report a case of a 33-years-old male with Staphylococcal cervical osteomyelitis as a cause of prevertebral abscess. The patient was an IV drug abuser with positive HIV. The skin was the most likely source of infection in this patient. Diagnosis was made by lateral neck x-rays which showed collapse of an intervertebral disk between C4 and C5 with destructive lesions of the body of the spines, along with an abnormal widening of the prevertebral soft tissue. Management of the prevertebral abscess was discussed and the literature was literature was reviewed. Appropriate management should include establishment of the airway, stabilization of the spine, antibiotics and incision and drainage by external approach.

Nasal airway resistance in asymptomatic Thai population.

Active anterior rhinomanometry was performed for the first time on one hundred and forty-six Thai adults without nasal symptoms. The subjects were divided into two groups : group I – with normal rhinoscopic appearance and Group II – with slight septal deformity. Transnasal airflow and nasal airway resistance (NAR) were measured by ATMOS Rhinomanometer 220 in each subject before and after decongestion. The statistical analysis showed that the nasal airflow and ANR in both groups were not significantly different. The normal NAR at a differential pressure of 75 Pascals in Thai adults was 0.22 + 0.10 Pa/cc/sec before decongestion and 0.16 + 0.06 Pa/cc/sec after decongestion. This value is slightly lower than the average NAR reported in Caucasian and in Negroid Nigerians. We also found that NAR in female subjects was significantly higher than in males. There was no correlation between NAR and age and weight, but a statistically significant inverse correlation with the height of the subject was observed.

Subdermal myiasis caused by maggots of chrysomyia bezziana.

Subdermal myasis due to the maggots of Chrysomyia Bezziana was reports from an Eastern province of Thailand namely Srakeaw. The patient was a 41 year old Thai female farmer whom underwent total thyroidectomy following the diagnosis of thyroid cancer about seven years ago. The tracheostomy was again adult female C. Bezziana deposited the eggs onto the rim of tracheostomy would about one week before the patient had severe pain. Myiasis due to C. Bezziana had previously been reported from the Southern provinces namely Trang, Yala and Satun. The present report was a case from another location and confirmed the exisyence of the fly in Thailand.

Platysma myocutaneous flap for hypopharyngeal reconstruction.

Ten male patients with hypopharyngeal and/or laryngeal cancer underwent hypopharyngeal reconstruction after tumor ablation, using platysma myocutaneous flaps. Their age ranged from 41-82 years, (mean age of 62.7 years). All were examined by barium swallowing before and 2 weeks after operation in order to compare the size and function of hypopharynx. The immediate postoperative period was uneventful and satisfactory except one patient (10%) who suffered from the separation of suture lines on the flap leading to the development of saliva fistula and neck infection. The surgical technique, minor complications and long-term postoperative results were fully described in the report.

Laryngeal tuberculosis.

Laryngeal tuberculosis has recently decreased in number and infectivity. To evaluate the changing patterns, we reviewed 14 patients who were diagnosed as laryngeal tuberculosis seen at Department of Otolaryngology, Siriraj Hospital, during the 5 year period, from 1 January 1982 to 31 December 1986. The results showed 10 male and 4 female patients, aged 34-84 years with an average of 58.7 years. The common presenting symptom was hoarsest of voice (52.6%), with a mean duration of 2.8 months. The most common site in the larynx was the vocal cord, in about 40% of the cases. The lesions were mass like lesions and there normal vocal cord movement in about 50%. Nearly all of the patients (92.9%) had pulmonary tuberculosis in their chest x-ray, but only a few had active or infective lesions in previous reports. The finding of acid fast bacilli in pathological section was 50%.