ABSTRACT
Failure of pulmonary ventilation capacity results in carbon dioxide (CO2) retention. When this produces loss of consciousness, it is called CO2 narcosis. Chronic obstructive pulmonary disease is a common cause of CO2 retention. Bilateral vocal cord paralysis is a typical disorder resulting in upper airway obstruction. However, bilateral vocal cord paralysis has been rarely documented in the chronic course of obstructive diseases related to the ear/nose/throat because its symptoms are relatively obvious. A 49-year-old man who complained of hoarseness and dyspnea for several years was diagnosed with bilateral vocal cord paralysis. CO2 narcosis occurred after tracheostomy and laser posterior cordotomy had been applied to relieve dyspnea. Details of the case are provided along with a review of the relevant literature.
Subject(s)
Humans , Middle Aged , Airway Obstruction , Carbon , Carbon Dioxide , Cordotomy , Dyspnea , Hoarseness , Pulmonary Disease, Chronic Obstructive , Pulmonary Ventilation , Retention, Psychology , Stupor , Tracheostomy , Tracheotomy , Unconsciousness , Vocal Cord Paralysis , Vocal CordsABSTRACT
BACKGROUND AND OBJECTIVES: Low concentration hypochlorous acid is known for being an endogenous anti-bacterial and anti-viral agent. Saline irrigation has been used as an adjunctive treatment for patients with chronic sinusitis. In this study, we tried to compare the effectiveness of hypochlorous acid and saline nasal irrigation to patients with intractable sinusitis after surgery. SUBJECTS AND METHOD: A total of 35 patients who had a frequent relapse of chronic sinusitis or had persisting symptoms post-surgically were recruited. The experimental group was given hypochlorous acid and saline nasal irrigation, while the control group was given saline nasal irrigation for eight weeks. The curative effects were assessed on the basis of the symptom score, nasal endoscopic score, bacterial culture, and inflammatory cytokines on the first day, fourth week, and eighth week after treatment. RESULTS: A total of 26 participants were assessed. The study finally consisted of 15 patients in experimental group and 11 in the control group. The symptom scores in the experimental group were substantially lower before, and after four and eight weeks of treatment. However, there was no specific difference in symptom score improvement between the two groups. The endoscopic score improved in experimental group (p<0.01). Similar tendencies were shown in the bacterial culture test of both groups. In the experimental group, the values of TNF-alpha, IL-8, and IL-1beta decreased in the fourth week, whereas they increased in the eighth week. CONCLUSION: Hypochlorous acid nasal irrigation may be to used as an alternative adjunctive treatment in addition to saline irrigation.
Subject(s)
Humans , Cytokines , Hypochlorous Acid , Interleukin-8 , Nasal Cavity , Nasal Lavage , Recurrence , Sinusitis , Tumor Necrosis Factor-alphaABSTRACT
The common causes of anosmia include sinonasal disorder, post-upper respiratory infection, trauma and chemicals. Intracranial tumor also frequently cause anosmia, so it is not easy to diagnose an intracranial tumor in patients who present with no definite related symptoms other than anosmia. Therefore, otolaryngologists should focus their attention on these disorders when they see patients with anosmia. We have experienced a case of olfactory groove menigioma presenting with only anosmia. We herein report this case with a brief review of the literature.