RESUMEN
Reinforced endotracheal tubes (ETTs) are designed to resist kinking or compression. However, these have a potential risk of being obstructed or severed by a patient's bite. We report a case in which a reinforced ETT was severed by tube-bite while the patient was in the prone position during an intensive care unit stay. Bronchoscopic evaluation showed that the severed distal part of the tube had lodged in the patient's right main bronchus, and it had to be surgically removed. The patency of reinforced ETTs should be carefully monitored in patients intubated in the prone position.
Asunto(s)
Humanos , Obstrucción de las Vías Aéreas , Bronquios , Broncoscopía , Unidades de Cuidados Intensivos , Intubación , Derechos del Paciente , Posición PronaRESUMEN
Reinforced endotracheal tubes (ETTs) are designed to resist kinking or compression. However, these have a potential risk of being obstructed or severed by a patient's bite. We report a case in which a reinforced ETT was severed by tube-bite while the patient was in the prone position during an intensive care unit stay. Bronchoscopic evaluation showed that the severed distal part of the tube had lodged in the patient's right main bronchus, and it had to be surgically removed. The patency of reinforced ETTs should be carefully monitored in patients intubated in the prone position.
Asunto(s)
Humanos , Obstrucción de las Vías Aéreas , Bronquios , Broncoscopía , Unidades de Cuidados Intensivos , Intubación , Derechos del Paciente , Posición PronaRESUMEN
Temporal hollowing is a common complication that occurs after coronal approach surgeries. However, temporal hollowing without previous nerve damage or trauma history is rare. Herein, we present a patient with cryptogenic temporal hollowing. A 22-year-old man without any history of craniofacial interventions or trauma presented with temporal hallowing. Magnetic resonance imaging revealed fatty degeneration of the left temporalis muscle. Electromyography and nerve conduction study showed no signs of neurologic abnormalities. The patient received autologous fat injection of 30 mL harvested from the left thigh using the modified Coleman technique. Temporal hollowing is commonly caused by atrophy of the superficial temporal fat pad. Its incidence is reported to be as high as 6% after coronal approach operation. Augmentation using porous hydroxyapatite or titanium mesh is a treatment option. Autologous fat graft can also be an option for mild to moderate temporal hollowing. In this case, a patient with no history of trauma, surgery, or myogenic disease developed temporal hollowing. Further study of the littleknown cryptogenic form of temporal hollowing is warranted.
Asunto(s)
Humanos , Adulto Joven , Tejido Adiposo , Atrofia , Durapatita , Electromiografía , Incidencia , Imagen por Resonancia Magnética , Conducción Nerviosa , Muslo , Titanio , TrasplantesRESUMEN
BACKGROUND: Various surgical techniques have been developed to address senile upper eyelids. Upper blepharoplasty has limited efficacy in natural periorbital rejuvenation for severe lateral hooding of the upper eyelids, as well as often producing a 'surprised look'. Subbrow excision is a popular method in East Asia for the correction of eyelid drooping, especially on the lateral side as periorbital rejuvenation. However, medial upper eyelid skin redundancy often tends to be undercorrected. Here, we present a few cases of revisional blepharoplasty, especially for medial crease formation, to improve aesthetic results. METHODS: Five patients, for a total of 10 eyelids, who underwent revisional blepharoplasty from January 2011 to January 2015 after a previous subbrow excision, were included. Patients were dissatisfied with uncorrected excessive skin on the medial part of the upper eyelid after a previous subbrow excision; thus, they underwent revisional blepharoplasty for medial crease formation. RESULTS: During the follow-up period, patients were aesthetically satisfied with the postoperative results. No patients suffered from any complications during the follow-up period. CONCLUSIONS: After a previous unfavorable subbrow excision, medial crease formation, via a very minimally invasive technique, could be a favorable option to improve patient satisfaction without postoperative complication or discomfort.