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1.
Rev. argent. cir. plást ; 30(3): 202-210, 20240000. fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1577821

ABSTRACT

El lifting de cuello profundo es un nuevo desafío quirúrgico. El proceso de envejecimiento cervical es un proceso de ptosis y voluminización de las estructuras profundas. El concepto de plicatura o tensión sobre la piel y/o musculo platisma para mejorar el ángulo cervicomental ha fracasado en la duración de sus resultados. La defi ciencia continente-contenido entre las estructuras del piso de la boca y la mandíbula. La redistribución grasa y la hipertrofi a de la glándula submaxilar solo puede tratarse mediante su reducción quirúrgica del tejido graso, muscular y glandular simultánea. El presente trabajo pretende brindar una guía para el diagnóstico y tratamiento quirúrgico del cuello obtuso


The deep neck lift is a new surgical challenge. The cervical aging process is a process of ptosis and volumization of deep structures. The concept of plication or tension on the skin and the platysma muscle to improve the mental cervical angle has failed in the duration of its results. Continent defi ciency contained between the structures of the fl oor of the mouth and the mandible. Fat redistribution and hypertrophy of the submandibular gland can only be treated through its simultaneous surgical reduction of fatty, muscular and glandular tissue. This work aims to provide a guide for the diagnosis and surgical treatment of the obtuse neck.


Subject(s)
Humans , Female , Skin Aging , Lifting , Neck/surgery
2.
Int. j. morphol ; 41(2): 423-430, abr. 2023. ilus, tab
Article in English | LILACS | ID: biblio-1440305

ABSTRACT

SUMMARY: Cervical necrotizing fasciitis (NF) is a rare complication of oral cavity infection with high morbi-mortality. Given its low prevalence, adequately reporting cases of NF, its therapeutic management, and associated morphofunctional modifications to the clinical and scientific community is pivotal. To that end, we herein describe a case of cervical NF in a 60-year-old patient with comorbidities and patient presented large, painful cervical swelling associated with a necrotic ulcer lesion in the anterior neck region. Intraoral examination indicated a periodontal abscess in the right mandibular area, while computed tomography indicated the lesion's extension from the right mandibular to the submandibular region. Following empirical intravenous antibiotic treatment, a broad surgical debridement was performed, and the foci of oral infection were removed. Debridement revealed communication between deep and superficial anatomical regions in the submandibular area, where we subsequently placed a Penrose drain. Biopsies showing acute inflammatory infiltrate associated with necrotic and hemorrhagic regions confirmed the diagnosis of NF. When an antibiogram revealed resistance to the empirical treatment, the antibiotic scheme was replaced with an adequate alternative. After a second debridement, we closed the defect with fascio-mucocutaneous advancement flaps with a lateral base while maintaining suction drainage. Having reacted positively, the patient was discharged 10 days after the operation. Despite an extensive morphofunctional change generated in the treated area, the patient showed no difficulties with breathing, phonation, swallowing, or mobilizing the area during control sessions. Altogether, this report contributes to the highly limited literature describing morphological aspects that can facilitate or delay the spread of infection or the morphofunctional disorders associated with the size and depth of surgical interventions for cervical NF, information that is relevant for the comprehensive, long-term prognosis of the treatment of NF.


La fascitis necrosante (FN) cervical es una rara complicación de una infección proveniente de la cavidad bucal asociada a una alta morbimortalidad. Por lo anterior, es fundamental informar a la comunidad clínica y científica los casos de FN, su manejo terapéutico y las modificaciones morfofuncionales asociadas. Se describe un caso de FN cervical en una paciente de 60 años quien presentó una gran tumefacción dolorosa asociada a una lesión ulcerosa necrótica en la región anterior del cuello. El examen intraoral mostró un absceso periodontal en el área mandibular derecha y la tomografía computarizada mostró la extensión de la lesión hacia la región submandibular. Tras el tratamiento antibiótico empírico, se realizó un desbridamiento quirúrgico extenso y se extirparon los focos de infección oral. El desbridamiento reveló comunicación entre las regiones anatómicas profundas y superficiales del área submandibular, donde se colocó un drenaje Penrose. Las biopsias mostraron un infiltrado inflamatorio agudo asociado con regiones necróticas y hemorrágicas, confirmando el diagnóstico de FN. El antibiograma reveló resistencia al tratamiento empírico, por lo que el esquema antibiótico se sustituyó. Tras un segundo desbridamiento, se cerró el defecto con colgajos de avance fascio-mucocutáneos de base lateral manteniendo drenaje aspirativo. El positivo progreso del paciente permitió su alta 10 días después. Aun cuando se generó una gran modificación morfofuncional en el área tratada, la paciente no presentó dificultades para respirar, hablar, deglutir o movilizar el área cervical intervenida durante las sesiones de control. Este informe contribuye a la limitada literatura que describe los aspectos morfológicos que pueden facilitar o retrasar la propagación de la FN y las consecuencias asociadas a los trastornos morfofuncionales provocadas por el tamaño y profundidad de las intervenciones quirúrgicas requeridas por la FN, información relevante para el pronóstico integral a largo plazo del tratamiento de la FN.


Subject(s)
Humans , Female , Middle Aged , Fasciitis, Necrotizing/surgery , Periodontal Abscess/complications , Treatment Outcome , Fasciitis, Necrotizing/etiology , Fasciitis, Necrotizing/microbiology , Fasciitis, Necrotizing/pathology , Recovery of Function , Debridement , Neck/surgery , Neck/pathology
3.
J. biomed. eng ; Sheng wu yi xue gong cheng xue za zhi;(6): 1175-1184, 2023.
Article in Chinese | WPRIM | ID: wpr-1008948

ABSTRACT

Soft tissue defects resulting from head and neck tumor resection seriously impact the physical appearance and psychological well-being of patients. The complex curvature of the human head and neck poses a formidable challenge for maxillofacial surgeons to achieve precise aesthetic and functional restoration after surgery. To this end, a normal head and neck volunteer was selected as the subject of investigation. Employing Gaussian curvature analysis, combined with mechanical constraints and principal curvature analysis methods of soft tissue clinical treatment, a precise developable/non-developable area partition map of the head and neck surface was obtained, and a non-developable surface was constructed. Subsequently, a digital design method was proposed for the repair of head and neck soft tissue defects, and an in vitro simulated surgery experiment was conducted. Clinical verification was performed on a patient with tonsil tumor, and the results demonstrated that digital technology-designed flaps improved the accuracy and aesthetic outcome of head and neck soft tissue defect repair surgery. This study validates the feasibility of digital precision repair technology for soft tissue defects after head and neck tumor resection, which effectively assists surgeons in achieving precise flap transplantation reconstruction and improves patients' postoperative satisfaction.


Subject(s)
Humans , Plastic Surgery Procedures , Surgical Flaps/surgery , Head and Neck Neoplasms/surgery , Head/surgery , Neck/surgery
4.
Article in Chinese | WPRIM | ID: wpr-1011069

ABSTRACT

Objective:To investigate the clinical characteristics and surgical treatment outcomes of children with cervical bronchogenic cysts. Methods:A retrospective study of 6 pediatric patients with bronchogenic cysts in the neck region treated in our hospital during 2014 to 2020 was performed. All children underwent complete resection of cervical mass under general anesthesia. Results:There were 6 children, aged from 1 to 5 years, with a median of 2.25 years. There were 3 males and 3 females. The lesions were located on the left neck in 3 cases, the midline neck in 2 cases and the right neck in 1 case. The clinical manifestations were painless mass in 5 cases and recurrent neck infection in 1 case. The size of the mass ranged from 2.1 to 7.5 cm. There was no characteristic clinical or imaging features of bronchogenic cysts. Misdiagnosed as lymphangioma in 3 cases, thyroglossal cyst in 2 cases and piriform fistula in 1 case. The follow-up ranged from 1.50 to 7.75 years, with a median of 4.13 years. All 6 children had no recurrence or complications. Conclusion:Although rare, bronchogenic cysts should be considered in the differential diagnosis of cervical cystic masses in children. Surgery is the most effective way to treat cervical bronchogenic cyst, and histopathological examination is the gold standard for diagnosis.


Subject(s)
Male , Female , Humans , Child , Bronchogenic Cyst/pathology , Retrospective Studies , Neck/surgery , Diagnosis, Differential , Treatment Outcome
5.
Article in Chinese | WPRIM | ID: wpr-971408

ABSTRACT

Objective: To explore risk factors affecting treatment for deep neck space infections (DNSIs) so as to provide guidance for appropriate early managements. Methods: A retrospective cohort study was conducted on inpatients with DNSIs admitted to the Department of Otolaryngology, Head and Neck Surgery, Affiliated Hospital of Qingdao University from March 2013 to February 2021. Patients were divided into surgical and non-surgical groups based on whether they had surgery or not. Information collected included demographic data, disease-related signs and symptoms, treatment history, systemic comorbidities, imaging data and laboratory indicators. Hypothesis testing, univariate Logistic regression and multivariate Logistic regression were used for data processing. Resuts A total of 61 patients were included, including 37 males and 24 females, aged 6-96 years. There were 35 cases (57.4%) in the surgical group and 26 cases (42.6%) in the non-surgical group. Multivariate analysis showed that risk factors for surgery as followings: neck dyskinesia (OR=0.03, 95%CI: 0.00-0.24), dysphagia (OR=0.10, 95%CI: 0.02-0.72), serum white blood cell count≥16.74×109/L (OR=1.18, 95%CI: 1.01-1.39) and interspace gas (OR=0.03, 95%CI: 0.00-0.30). Conclusion: Clinicians should be alert to these risk factors for surgery in the course of treatment and timely surgical treatment for patients who meet the conditions.


Subject(s)
Male , Female , Humans , Retrospective Studies , Neck/surgery , Risk Factors , Deglutition Disorders
6.
Rev. fac. cienc. méd. (Impr.) ; 19(1): 15-22, ene.-jun. 2022. tab.
Article in Spanish | LILACS, BIMENA | ID: biblio-1519636

ABSTRACT

El hipoparatiroidismo postquirúrgico se caracteriza por hipocalcemia, hiperfosfatemia, e hipercalciuria, secundarios a concentraciones bajas de la hormona paratiroidea. La prevalencia en Estados Unidos es 23-37 casos/100.000 años-persona. Tras la cirugía de cuello ocurre como complicación en 78% de los casos; 75% resuelve espontáneamente en los primeros 6 meses y en el 25% restante es permanente. El tratamiento requiere administrar calcio oral y análogos de vitamina D (calcitriol y alfacalcidol) de forma crónica; en casos complicados se puede emplear calcio intravenoso en el postquirúrgico inmediato y mediato; algunos pacientes no responden a la terapia estándar. Objetivo: describir las características clínicas y la respuesta al tratamiento médico en pacientes con hipoparatiroidismo postquirúrgico permanente. Material y métodos: estudio descriptivo, transversal, con componente analítico mediante revisión de expedientes clínicos de pacientes que asistieron a la consulta externa del Servicio de Endocrinología del Centro Médico Nacional 20 de Noviembre; universo 88 expedientes, muestra por conveniencia 55 expedientes. Resultados: 35(63.6%) pacientes alcanzaron control óptimo de tratamiento a dosis de calcio elemental de 5.7-9.79g/24h (p= 0.0001 chi cuadrado), mostrando calcio sérico promedio 8.36 0.55 mg/dl y calcitriol con mediana de 0.5µg/24 h. 15(27.2%) pacientes presentaron efectos secundarios al uso de calcio oral, 3 de ellos requirieron manejo con Hormona Paratiroidea Recombinante Humana para alcanzar control óptimo. Conclusión: el calcio elemental por vía oral continúa siendo la piedra angular en el tratamiento del hipoparatiroidismo post quirúrgico permanente, con pocos efectos adversos. Se recomiendan más estudios aleatorizados para identificar las características de los pacientes candidatos al manejo con Hormona Paratiroidea Recombinante Humana...(AU)


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Endocrine Surgical Procedures , Hypoparathyroidism/drug therapy , Hypocalcemia , Neck/surgery
7.
Prensa méd. argent ; Prensa méd. argent;108(3): 136-145, 20220000. fig
Article in Spanish | LILACS, BINACIS | ID: biblio-1373083

ABSTRACT

Introducción: la Pandemia por SARS CoV ­ 2 (COVID ­ 19) tuvo un impacto significativo en el desarrollo de los servicios quirúrgicos en general y obligo a establecer protocolos de actuación para las distintas patologías a fin de cuidar al máximo los recursos humanos y la capacidad instalada de los hospitales para hacer frente a esta contingencia mundial. Objetivos: presentar una casuística de 7 pacientes con reconstrucción microquirúrgica de patología de cabeza y cuello en estadios avanzados y patología de miembros inferiores durante la pandemia por COVID - 19. Materiales y Métodos: trabajo retrospectivo, se revisaron las historias clínicas físicas y digitales. Se incluyeron 5 pacientes con patología avanzada de cabeza y cuello y 2 pacientes con patología de miembros inferiores. Resultados: cinco pacientes fueron operados por patología avanzada de cabeza y cuello: 3 pacientes con carcinomas escamosos de cavidad oral estadio IVa, 1 paciente con carcinoma escamoso de piel avanzado estadio IV y 1 paciente con fractura compleja de maxilar inferior por herida de arma de fuego con fistula oro-cutánea crónica, con exposición del material de osteosíntesis, mala oclusión y pérdida de peso importante por dificultad para alimentación. Dos pacientes fueron operados por patología de miembros inferiores en tercio inferior de pierna, uno por fractura expuesta grave con defecto de tejidos blandos y el otro por una ulcera arterial. Conclusión: la cirugía reconstructiva microquirúrgica puede realizarse con buenos niveles de seguridad para el personal de salud y para los pacientes afectados por patologías avanzadas de cabeza y cuello y otras patologías que requieran colgajos libres. Es fundamental respetar estrictamente los protocolos para evitar los contagios en el medio intrahospitalario, entendiendo que debe considerarse todo paciente que ingrese al hospital como COVID (+) hasta que se demuestre lo contrario


Introduction: the SARS CoV ­ 2 (COVID ­ 19) Pandemic had a significant impact on the development of surgical services in general and forced the establishment of action protocols for the different pathologies in order to take maximum care of human resources and capacity. installed in hospitals to deal with this global contingency. Objectives: to present a casuistry of 7 patients with microsurgical reconstruction of head and neck pathology in advanced stages and lower limb pathology during the COVID - 19 pandemic. Materials and Methods: retrospective work, physical and digital medical records were reviewed. Five patients with advanced head and neck disease and 2 patients with lower limb disease were included. Results: five patients underwent surgery for advanced head and neck disease: 3 patients with stage IVa squamous cell carcinoma of the oral cavity, 1 patient with stage IV advanced squamous cell carcinoma of the skin, and 1 patient with a complex fracture of the lower jaw due to a gunshot wound. with chronic oro-cutaneous fistula, with exposure of the osteosynthesis material, poor occlusion and significant weight loss due to difficulty feeding. Two patients underwent surgery for pathology of the lower limbs in the lower third of the leg, one for a severe open fracture with a soft tissue defect and the other for an arterial ulcer. Conclusion: microsurgical reconstructive surgery can be performed with good levels of safety for health personnel and for patients affected by advanced pathologies of the head and neck and other pathologies that require free flaps. It is essential to strictly respect the protocols to avoid contagion in the hospital environment, understanding that every patient who enters the hospital must be considered as COVID (+) until proven otherwise.


Subject(s)
Humans , Security Measures/standards , Surgical Procedures, Operative , Clinical Protocols , /prevention & control , Lower Extremity/surgery , Personal Protective Equipment , COVID-19 , Head/surgery , Neck/surgery
8.
Rev. cir. (Impr.) ; 73(1): 95-99, feb. 2021. ilus
Article in Spanish | LILACS | ID: biblio-1388794

ABSTRACT

Resumen Introducción: El tratamiento inoportuno e ineficaz de las infecciones odontogénicas puede causar complicaciones potencialmente mortales como la mediastinitis necrotizante descendente (MND). La MDN es una infección grave que afecta al cuello-tórax, con una alta tasa de mortalidad por sepsis e insuficiencia orgánica si no se trata de manera rápida y efectiva. Objetivo: Describir un caso de MND de origen odontogénico y su manejo médico-quirúrgico. Caso clínico: Presentamos un paciente de sexo masculino de 34 años que ingresa con un cuadro infeccioso agudo de origen odontogénico, que compromete espacios de la cabeza, cuello y tórax (mediastino superior), el cual se trata exitosamente. Discusión: Las infecciones odontogénicas son generalmente localizadas y que se pueden tratar mediante terapias convencionales. A pesar de esto, si estas infecciones no pueden controlarse, ya sea por no realización de tratamientos oportunos o por estados inmunosuprimidos del paciente, se pueden desarrollar diferentes complicaciones como la MND. Conclusión: Un diagnóstico rápido, el tratamiento quirúrgico agresivo, la terapia antibiótica adecuada y la atención de apoyo son los pilares fundamentales para el manejo de la MND.


Introduction: Inappropriate and ineffective treatment of odontogenic infections can cause life-threatening complications such as Descending Necrotizing Mediastinitis (MND). MDN is a serious infection that affects the neck-thorax, with a high mortality rate from sepsis and organ failure if it is not treated quickly and effectively. Aim: To describe a case of MND of odontogenic origin and its medical-surgical management. Case report: We present a 34-year-old male patient who is admitted with an acute infectious condition of odontogenic origin, which compromises spaces of the head, neck and thorax (upper mediastinum), which is treated successfully. Discussion: Odontogenic infections are generally localized and can be treated by conventional therapies. In spite of this, if these infections cannot be controlled, either by not carrying out appropriate treatments or by immunosuppressed states of the patient, different complications such as MND can develop. Conclusion: A rapid diagnosis, aggressive surgical treatment, adequate antibiotic therapy and supportive care are the fundamental pillars for the management of MND.


Subject(s)
Humans , Male , Adult , Focal Infection, Dental/surgery , Focal Infection, Dental/complications , Mediastinitis/surgery , Mediastinitis/etiology , Necrosis/therapy , Radiography, Thoracic , Tomography, X-Ray Computed , Treatment Outcome , Focal Infection, Dental/diagnostic imaging , Mediastinitis/diagnostic imaging , Neck/surgery
9.
Repert.Med.Cir ; 30(3): 219-255, 2021.
Article in English, Spanish | LILACS, COLNAL | ID: biblio-1362933

ABSTRACT

Introducción: revisión narrativa que explica el panorama actual de la hipocalcemia y el hipoparatiroidismo como complicaciones de la tiroidectomía, su diagnóstico y tratamiento; con una descripción de las nuevas estrategias de prevención y tratamiento. Métodos: los motores de búsqueda utilizados fueron PubMed, Clinical Key, Embase, Cochrane y Lilacs, se incluyeron referencias en español e inglés, publicadas entre 2016 y 2020. Los artículos seleccionados se revisaron utilizando CONSORT, STROBE o PRISMA, según el caso. Resultados: fueron seleccionados 35 artículos que tenían relación directa con el tema, entre ellos: metanálisis, revisiones sistemáticas, estudios prospectivos y observacionales, revisiones narrativas y consensos de expertos, procedentes de los cinco continentes. La hipocalcemia y el hipotiroidismo en sus dos formas se relacionan con la afectación de la vascularización de las glándulas paratiroides o su exérecis accidental, existiendo factores predisponentes propios del paciente, derivados de la técnica quirúrgica o la característica patológica de la lesión en el tiroides. Como estrategias de prevención disponemos de herramientas ópticas para definir en el perioperatorio la disposición de las paratiroides; además existe la posibilidad de autotrasplantarlas al identificarlas en la pieza anatómica. El mejor marcador del estado metabólico del calcio es la PTHi. Conclusiones: la preservación de las paratiroides y de su irrigación es la mejor estrategia para prevenir los trastornos posoperatorios del calcio


Introduction: narrative review explaining the current picture of hypocalcemia and hypoparathyroidism as complications of thyroidectomy, describing new strategies employed for their diagnosis and treatment. Methods: searches in the PubMed, Clinical Key, Embase, Cochrane and Lilacs databases; references in Spanish and English, published between 2016 and 2020 were included. The selected articles were reviewed using CONSORT, STROBE or PRISMA, as appropriate. Results: 35 articles directly related with the topic were selected, including meta-analyses, systematic reviews, prospective and observational studies, narrative reviews and expert consensus, on all five continents. The two forms of hypocalcemia and hypoparathyroidism can result from devascularization or accidental removal of the parathyroid glands, patient-specific factors, or from the surgical technique or the pathological characteristics of the thyroid lesion. Preventive strategies include the use of optical tools for preoperative determination of parathyroid glands location; as well as the possibility of autotransplantation after confirming parathyroid tissue in the biopsy specimen. The best marker of calcium metabolism is iPTH. Conclusions: preservation of the parathyroid glands and their irrigation is the best strategy to prevent postoperative calcium disorders.


Subject(s)
Calcium , Hypocalcemia , Hypoparathyroidism , Metabolism , Thyroidectomy , Thyroid Neoplasms , Neck/surgery
10.
Article in Spanish | LILACS | ID: biblio-1280968

ABSTRACT

Este año celebramos los 60 años de fundada la Asociación Colombiana de Otorrinolaringología y cirugía de cabeza y cuello, estos sesenta años que se cumplen ,resultan ser una fecha muy importante para esta agremiación y donde considero importante recordar y homenajear a las cabezas lideres y fundadoras de esta sociedad. Descargas


Subject(s)
Humans , Otolaryngology/history , Academies and Institutes/history , Head/surgery , Neck/surgery , Colombia
11.
Rev. bras. anestesiol ; Rev. bras. anestesiol;70(6): 595-604, Nov.-Dec. 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1155768

ABSTRACT

Abstract Background and objectives: In this study, we aimed to investigate the predictive value of different airway assessment tools, including parts of the Simplified Predictive Intubation Difficulty Score (SPIDS), the SPIDS itself and the Thyromental Height Test (TMHT), in intubations defined as difficult by the Intubation Difficulty Score (IDS) in a group of patients who have head and neck pathologies. Methods: One hundred fifty-three patients who underwent head and neck surgeries were included in the study. The Modified Mallampati Test (MMT) result, Thyromental Distance (TMD), Ratio of the Height/Thyromental Distance (RHTMD), TMHT, maximum range of head and neck motion and mouth opening were measured. The SPIDSs were calculated, and the IDSs were determined. Results: A total of 25.4% of the patients had difficult intubations. SPIDS scores >10 had 86.27% sensitivity, 71.57% specificity and 91.2% Negative Predictive Value (NPV). The results of the Receiver Operating Curve (ROC) analysis for the airway screening tests and SPIDS revealed that the SPIDS had the highest area under the curve; however, it was statistically similar to other tests, except for the MMT. Conclusions: The current study demonstrates the practical use of the SPIDS in predicting intubation difficulty in patients with head and neck pathologies. The performance of the SPIDS in predicting airway difficulty was found to be as efficient as those of the other tests evaluated in this study. The SPIDS may be considered a comprehensive, detailed tool for predicting airway difficulty.


Resumo Justificativa e objetivos: Neste estudo, avaliamos o valor preditivo de diferentes ferramentas de avaliação das vias aéreas, incluindo componentes do Escore Simplificado Preditivo de Intubação Difícil (ESPID), o próprio ESPID e a Medida da Altura Tireomentoniana (MATM), em intubações definidas como difícies pelo Escore de Dificuldade de Intubação (EDI) em um grupo de pacientes com patologia de cabeça e pescoço. Método: Incluímos no estudo 153 pacientes submetidos a cirurgia de cabeça e pescoço. Coletamos os resultados do Teste de Mallampati Modificado (TMM), Distância Tireomentoniana (DTM), Razão Altura/Distância Tireomentoniana (RADTM), MATM, amplitude máxima de movimentação da cabeça e pescoço e da abertura da boca. Os ESPIDs foram calculados e os EDIs, determinados. Resultados: Observamos intubação difícil em 25,4% dos pacientes. Os escores de ESPID > 10 tiveram sensibilidade de 86,27%, especificidade de 71,57% e valor preditivo negativo de 91,2% (VPN). O resultado da análise da curva de operação do receptor (curva ROC) para os testes de avaliação das vias aéreas e ESPID mostrou que o ESPID tinha a maior área sob a curva; no entanto, foi estatisticamente semelhante a outros testes, exceto para o TMM. Conclusões: O presente estudo demonstra o uso prático do ESPID na previsão da dificuldade de intubação em pacientes com patologia de cabeça e pescoço. O desempenho do ESPID na predição de via aérea difícil mostrou-se tão eficiente quanto os demais testes avaliados neste estudo. O ESPID pode ser considerado ferramenta abrangente e detalhada para prever via aérea difícil.


Subject(s)
Humans , Adult , Aged , Aged, 80 and over , Young Adult , Intubation, Intratracheal/methods , Neck/surgery , Neck Dissection/statistics & numerical data , Thyroid Gland/surgery , Tongue Neoplasms/surgery , Nasopharyngeal Neoplasms , Predictive Value of Tests , Prospective Studies , ROC Curve , Range of Motion, Articular , Sensitivity and Specificity , Outcome Assessment, Health Care , Mandibular Advancement , Head and Neck Neoplasms/surgery , Intubation, Intratracheal/instrumentation , Laryngectomy/statistics & numerical data , Maxillofacial Injuries/surgery , Middle Aged , Mouth/physiology , Neck/anatomy & histology
12.
Rev. Asoc. Méd. Argent ; 132(2): 12-14, jun. 2019.
Article in Spanish | LILACS | ID: biblio-1026330

ABSTRACT

Se revisan la fisiopatología y los mecanismos que producen la sofocación en el hematoma cervical y se determina que el único tratamiento con posibilidades de éxito vital es el inmediato drenaje del hematoma.


In this article are reviewed the physiopathology and the mechanisms that causes suffocation in the cervical hematoma. It is determined that the only treatment with possibilities of vital success is the immediate drainage of the hematoma.


Subject(s)
Humans , Asphyxia/etiology , Drainage , Hematoma/physiopathology , Hematoma/therapy , Postoperative Complications , Asphyxia/physiopathology , Cervical Vertebrae/surgery , Neck/surgery
14.
Clin. biomed. res ; 39(3): 251-253, 2019.
Article in Portuguese | LILACS | ID: biblio-1053130

ABSTRACT

O lipossarcoma de laringe é uma neoplasia extremamente rara, acomete principalmente o sexo masculino, principalmente na quinta década de vida. Existindo apenas cerca de 40 casos descritos na literatura, desses nenhum em língua portuguesa. O presente caso relata o diagnóstico em um paciente do sexo masculino, 57 anos, ex-tabagista, apresentando alteração de voz e obstrução de via área. Foi optado por ressecção cirúrgica completa com achados sugestivos de lipossarcoma bem diferenciado. Foi optado por manter seguimento, não tendo sido indicado quimioterapia e radioterapia adjuvantes.(AU)


Laryngeal liposarcoma is an extremely rare neoplasm that affects especially men in the fifth decade of life. There are only about 40 cases described in the literature, none of them in the Portuguese language. We report the case of a 57-year-old, former smoker man presenting with voice disorders and airway obstruction. We opted for complete surgical resection with findings suggestive of well-differentiated liposarcoma. We chose to keep following the patient, and no adjuvant chemotherapy and radiotherapy were indicated. (AU)


Subject(s)
Humans , Male , Middle Aged , Laryngeal Neoplasms/surgery , Liposarcoma/surgery , Liposarcoma/diagnosis , Larynx/surgery , Neck/surgery
15.
J. vasc. bras ; 17(4): 290-295, out.-dez. 2018. ilus, tab
Article in English | LILACS | ID: biblio-969064

ABSTRACT

The major arterial supply to the thyroid gland is from the superior and inferior thyroid arteries, arising from the external carotid artery and the thyrocervical trunk respectively. The external laryngeal nerve runs in close proximity to the origin of the superior thyroid artery in relation to the thyroid gland. The superior thyroid artery is clinically important in head and neck surgeries. Objectives: To locate the origin of the superior thyroid artery, because wide variability is reported. To provide knowledge of possible variations in its origin, because it is important for surgical procedures in the neck. Methods: The origin of the superior thyroid artery was studied by dissecting sixty adult human hemineck specimens from donated cadavers in a Department of Anatomy. Results: The highest incidence observed was origin of the superior thyroid artery from the external carotid artery (88.33%), whereas origin from the common carotid bifurcation only occurred in 8.33%. However, in 3.33% of cases, the superior thyroid artery originated from the common carotid artery and in a single case, the external laryngeal nerve did not cross the stem of the superior thyroid artery at all, but ran ventral and parallel to the artery. Conclusions: It is important to rule out anomalous origin of superior thyroid artery and verify its relationship to the external laryngeal nerve prior to ligation of the artery in thyroid surgeries, in order to prevent iatrogenic injuries. Moreover, because anomalous origins of the superior thyroid artery are only anatomic variants, thorough knowledge of these is decisive for head and neck surgeries


O suprimento arterial principal para a glândula tireoide provém das artérias tireoideas superior e inferior, que têm origem na artéria carótida externa e no tronco tireocervical, respectivamente. O nervo laríngeo externo faz um percurso bem próximo à origem da artéria tireoidea superior em relação à glândula tireoide. A artéria tireoidea superior é clinicamente importante em cirurgias da cabeça e do pescoço. Objetivos: Localizar a origem da artéria tireoidea superior, considerando a ampla variabilidade descrita na literatura; e oferecer informações sobre possíveis variações em sua origem, devido à importância disso para procedimentos cirúrgicos realizados no pescoço. Métodos: A origem da artéria tireoidea superior foi estudada dissecando-se 60 espécimes de hemipescoço adulto de cadáveres humanos doados ao Departamento de Anatomia. Resultados: A maior incidência observada foi da artéria tireoidea superior com origem na artéria carótida externa (88,33%), enquanto a origem na bifurcação da artéria carótida comum ocorreu em apenas 8,33%. No entanto, em 3,33% dos casos, a artéria tireoidea superior teve origem na artéria carótida comum, e em um único caso, o nervo laríngeo externo não cruzou o tronco da artéria tireoidea superior em nenhum momento, embora tenha cursado ventral e paralelamente a essa artéria. Conclusões: É importante descartar origem anômala da artéria tireoidea superior e confirmar sua relação com o nervo laríngeo externo antes da ligadura da artéria em cirurgias da tireoide, para evitar efeitos iatrogênicos. Além disso, como origens anômalas da artéria tireoidea superior são apenas variantes anatômicas, o conhecimento detalhado dessas variações é decisivo para cirurgias da cabeça e do pescoço


Subject(s)
Humans , Male , Female , Thyroid Gland/anatomy & histology , Carotid Artery, External/anatomy & histology , Carotid Artery, External/surgery , Anatomic Variation , Laryngeal Nerves/anatomy & histology , Larynx/anatomy & histology , Neck/surgery
16.
Arch. endocrinol. metab. (Online) ; 62(5): 495-500, Oct. 2018. tab
Article in English | LILACS | ID: biblio-983800

ABSTRACT

ABSTRACT Objective: Our aim was to present our experiences related to performing neck surgery using the guided intraoperative scintigraphic tumor targeting (GOSTT) procedure for patients who had locally recurrent or persistent differentiated thyroid cancer (DTC) and who had undergone previous thyroid surgery. Subjects and methods: We retrospectively evaluated 11 patients who had locally recurrent or persistent DTC, who had undergone previous surgery, and for whom reoperation was planned for metastatic cervical lymph nodes (LNs). We performed the neck surgery using the GOSTT procedure on all patients and at a single academic institution. Results: The 11 patients had a total of 26 LNs, as marked with a radiotracer, and those LNs' mean size was 14.7 ± 8.2 mm (range: 5-34 mm). Histopathological examinations revealed DTC metastasis in all 26 of the preoperatively marked LNs. Of the 11 patients, only one needed a reoperation in the neck; she had another successful surgery (also using the GOSTT procedure). In the evaluation of the patients' final status, all were disease-free in their necks. There also were no GOSTT-associated postoperative complications. Conclusion: The GOSTT procedure is a useful, successful, inexpensive, and comfortable procedure for marking and mapping metastatic LNs, especially in DTC patients who have undergone previous surgery.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Thyroid Neoplasms/pathology , Carcinoma, Papillary/surgery , Carcinoma, Papillary/secondary , Lymph Node Excision/methods , Lymph Nodes/surgery , Neck/surgery , Carcinoma, Papillary/diagnostic imaging , Radionuclide Imaging/methods , Radiography, Interventional , Reproducibility of Results , Retrospective Studies , Treatment Outcome , Lymph Nodes/pathology , Lymph Nodes/diagnostic imaging , Lymphatic Metastasis , Neck/pathology , Neck/diagnostic imaging , Neoplasm Recurrence, Local
17.
Rev. medica electron ; 39(2): 353-360, mar.-abr. 2017.
Article in Spanish | LILACS, CUMED | ID: biblio-845417

ABSTRACT

Los tumores del cuerpo carotídeo son relativamente infrecuentes y raramente se diagnostican antes de la exposición quirúrgica, su diagnóstico es benigno, pero suelen ser muy vasculares por lo que su extirpación quirúrgica muchas veces resulta difícil. Estos tumores son de crecimiento lento y pueden evolucionar durante años. El objetivo de este estudio es presentar un caso con un tumor del cuerpo carotídeo en región lateral derecha del cuello. Clínicamente se observó un aumento de volumen de aproximadamente 4 cm, no doloroso a la palpación, de tipo gomoso y adherido a planos profundos, asintomático, tratado en nuestra institución durante el año 2014. Se le realizó exéresis simple de la lesión, y el departamento de Anatomía Patológica reportó el diagnóstico de referencia. La evolución de la paciente después de 17 meses ha sido satisfactoria (AU).


The tumors of the carotid body are relatively uncommon and rarely diagnosed before the surgical exeresis, their diagnosis is benign, but they are usually very vascular and its extirpation is very difficult. These tumors have a slow growth and it can evolve during years. The aim of this study is to present a case with a tumor of the carotid body in the right lateral region of the neck. An increase of volume was observed of approximately 4 cm, not painful, of gummy type and stuck to deep, asymptomatic plans, treaty in our institution during the year 2014. It was carried out exeresis of the lesion, and the department of Pathological Anatomy reported the reference diagnosis. The patient's evolution after 17 months has been satisfactory (AU).


Subject(s)
Humans , Female , Aged , Carotid Body Tumor/surgery , Carotid Body Tumor/diagnosis , Carotid Body Tumor/epidemiology , Neoplasms/surgery , Neoplasms/complications , Neoplasms/diagnosis , General Surgery/methods , Neck/abnormalities , Neck/surgery
18.
Int. j. odontostomatol. (Print) ; 11(1): 67-70, abr. 2017. ilus
Article in English | LILACS | ID: biblio-841018

ABSTRACT

The management of a difficult airway is one of the biggest challenges of perioperative anesthesia management. The maxillofacial trauma can cause serious disturbances of the soft and hard tissues of the anatomical components of the upper airway and often with little external evidence of deformity. The submental intubation is a procedure that was reported to avoid tracheostomy and allow for the concomitant restoration of occlusion and reduction of facial fractures in patients with craniomaxillofacial trauma ineligibles for nasotracheal intubation. We described a modification of the original technique by performing a retrograde submental intubation assisted by direct laryngoscope video in a maxillofacial trauma patient with restricted mouth opening. In addition, the surgical anatomy of the technique is detailed described.


El manejo de una vía aérea difícil es uno de los mayores desafíos del manejo anestésico perioperatorio. El trauma maxilofacial puede causar serias alteraciones a los tejidos blandos y duros de la vía aérea superior, y muchas veces con pequeña evidencia externa de deformidad. La intubación submentoniana es un procedimiento que fue reportado para evitar la traqueostomía y permitir la concomitante restauración de la oclusión para la reducción de fracturas faciales en pacientes donde la intubación nasotraqueal está contraindicada. Describimos una modificación de la técnica original, realizando una intubación submentoniana retrógrada asistida con videolaringoscopio en un paciente de trauma maxilofacial con apertura de la cavidad disminuida. Adicionalmente se describe detalladamente la anatomía quirúrgica de la técnica.


Subject(s)
Humans , Male , Adult , Intubation, Intratracheal/methods , Laryngoscopy/methods , Maxillofacial Injuries/surgery , Intubation, Intratracheal/instrumentation , Neck/surgery , Video-Assisted Surgery
19.
An. bras. dermatol ; An. bras. dermatol;91(3): 351-353, graf
Article in Portuguese | LILACS | ID: lil-787310

ABSTRACT

Abstract Squamous cell carcinoma (SCC) is the second-most common malignant cutaneous cancer, with 60% occurring in the head and neck region. Metastases are uncommon and imply a more conservative prognosis. This report describes a case of parotid-invasive, facial squamous cell carcinoma, highlighting the importance of its prognostic and therapeutic management. The patient is an 81-year-old female, exhibiting extensive tumoral lesions in the pre-auricular region, affecting the parotid parenchyma and implying the metastatic involvement of the intra-parotid lymph node. Parotid involvement caused by SCC in specificity tumors is discussed herein. Parotid invasion is currently recognized as an isolated variable. It affects survival rates and determines certain changes in case management, such as the broadening of resection areas and adjuvant radiotherapy.


Subject(s)
Humans , Female , Aged, 80 and over , Facial Neoplasms/pathology , Parotid Neoplasms/secondary , Carcinoma, Squamous Cell/secondary , Prognosis , Facial Neoplasms/surgery , Parotid Neoplasms/surgery , Carcinoma, Squamous Cell/surgery , Follow-Up Studies , Lymph Node Excision , Neck/surgery
20.
Rev. bras. neurol ; 52(2): 23-26, abr.-jun. 2016. ilus
Article in Portuguese | LILACS | ID: biblio-1596

ABSTRACT

Doenças degenerativas na coluna cervical são comuns nos pacientes idosos. Os autores apresentam caso de paciente do sexo feminino, 44 anos, com quadro de disfagia progressiva relacionada à osteofitose cervical anterior em (C5-C6 e C6-C7). Esofagograma mostrou a compreensão esofágica pelos osteófitos anteriores. O tratamento realizado foi brocagem dos osteófitos, discectomia cervical em dois níveis e artrodese cervical, resultando na remissão completa do sintoma. Embora seja uma causa de disfagia, osteófito deve ser incluído como diagnóstico diferencial pois é uma causa tratável e reversível do sintoma.


Degenerative diseases of the cervical spine are common in elderly patients. The authors present a case report of female, 44 years old, with progressive dysphagia due to anterior cervical osteophytes (C5-C6 and C6-C7). Esophagogram showed esophageal compression by anterior osteophytes. The treatment was removal of osteophytes by drill, cervical discectomy on two levels and cervical arthrodesis, resulting in complete remission of symptoms. Although it is an un-common cause of dysphagia, osteophytes should be included in the differential diagnosis because it is a reatable and reversible cause of the symptom.


Subject(s)
Humans , Female , Adult , Spinal Osteophytosis/complications , Spinal Osteophytosis/diagnosis , Deglutition Disorders/etiology , Cervical Vertebrae/surgery , Cervical Vertebrae/diagnostic imaging , Tomography, X-Ray Computed/instrumentation , Neck Pain/etiology , Neck/surgery
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