Cochlear electrode array misplacement into the superior semicircular canal: a case report and literature review / 临床耳鼻咽喉头颈外科杂志

Electrode array misplacement is a rare complication of cochlear implant. This article reports an 11-year-old boy who was mistakenly implanted the cochlear electrode array into the superior semicircular canal during the initial cochlear implant. After the diagnosis was confirmed, he underwent a second cochlear implant and the electrode array were successfully implanted into the cochlea. This article conducted a systematic review of the literature on electrode array misplacement, and the causes of electrode array misplacement were analyzed from different implantation position.

Diagnóstico precoz de la estrechez del maxilar superior en la dentición mixta / Early diagnosis of the maxillary´s narrowness in the mixed dentition

Las compresiones del maxilar superior son alteraciones transversales por discrepancia óseo-dentaria. .En la dentición mixta temprana puede establecerse la estrechez mediante índices que relacionan el tamaño dental con el ancho transversal del arco dentario. Se analizaron 33 modelos superiores de niños en el tercer período de desarrollo clínico según Barnett. Se estableció la estrechez realizando el análisis métrico del arco dental mediante el índice de Pont. Se describió la anomalía de posición anterior según las siguientes variables: A) Apiñamiento dentario: 1-Escalón de los dientes anterosuperiores; 2-Rotación mesial de los cuatro incisivos; 3-Rotación mesial de los incisivos centrales y rotación distal de los incisivos laterales y 4-Rotación distal de los incisivos centrales. B) Ausencia de apiñamiento: 1-Reabsorción atípica y 2- Ausencia de reabsorción atípica. Las anomalías de posición y/o reabsorciones atípicas anteriores en este período de desarrollo clínico se asocian a estrechez transversal del maxilar superior Siendo la malposición más frecuente la rotación mesial de los cuatro incisivos, siguiendo las reabsorciones atípicas y el escalón de los dientes anterosuperiores, luego la rotación mesial de los incisivos centrales y distal de los laterales y por último la rotación distal de los incisivos centrales (AU)

Inside the traverse alteration of the maxillary the compressions are described as uni or bilateral where an imbalance is settled down between the dental size and the size of the maxillary causing alterations in the position of the teeth. In the early mixed teething the narrowness of the maxillary can be settled by means of indexes that relate the dental size with the traverse width of the dental arch. Thirty models of the maxillary of children according to Barnett's third development period were analyzed. The metrical analysis of the dental arch form was carried out through Pont's index. The theoretic values were compared with the real ones establishing the deviations of the norm that is to say the narrow nest. Out of the 30 cases analyzed, 40% presented mesial rotation of the 4 incisors; 27% showed a stop of the front teeth; 27% atypical reabsorption; 20% mesial rotation of the central incisors and distal rotation of the lateral incisors and the 10% presented a distal rotation of the central incisors. With regard to the front atypical discrepancy 36.66% of the cases had a discrepancy above 6 mm and the 23.33% below 3 mm (AU)

Effect of central venous pressure waveforms on location of power PICC tip localization / 现代临床护理

Objective To explore the effect of central venous pressure waveforms on the location of power PICC tip. Methods From January 2015 to December 2015, we placed power PICC for 47 patients in our intensive care unit. The CVP waveforms were applied to detect any displacement into small thoracic veins after a four-step localization method. The position of the catheter tip was finally confirmed by X-ray inspection. Results Among the 47 cases undergoing PICC implantation, 45(95.75%) displayed a typical CVP waveform, with the catheter tip positions were located in the superior vena cava inferior segment, 1 (2.13%) displayed a typical CVP waveform, with the catheter tip was misplaced into axillary vein and retraced and 1(2.13%) did not display typical CVP waveforms and CVP value was negative, with the catheter tip was in left internal jugular vein. To locate the catheter tip position with CVP waveform and chest X-rang were 100.00%the same. Conclusions The central venous pressure waveform can be used to determine whether the catheter tip is located in the inferior segment of the superior vena cava or not immediately after the placement of a power PICC. However, chest X-ray inspection conformation is still needed.

Effect of central venous pressure waveforms on location of power PICC tip localization / 现代临床护理

Objective To explore the effect of central venous pressure waveforms on the location of power PICC tip. Methods From January 2015 to December 2015, we placed power PICC for 47 patients in our intensive care unit. The CVP waveforms were applied to detect any displacement into small thoracic veins after a four-step localization method. The position of the catheter tip was finally confirmed by X-ray inspection. Results Among the 47 cases undergoing PICC implantation, 45(95.75%) displayed a typical CVP waveform, with the catheter tip positions were located in the superior vena cava inferior segment, 1 (2.13%) displayed a typical CVP waveform, with the catheter tip was misplaced into axillary vein and retraced and 1(2.13%) did not display typical CVP waveforms and CVP value was negative, with the catheter tip was in left internal jugular vein. To locate the catheter tip position with CVP waveform and chest X-rang were 100.00%the same. Conclusions The central venous pressure waveform can be used to determine whether the catheter tip is located in the inferior segment of the superior vena cava or not immediately after the placement of a power PICC. However, chest X-ray inspection conformation is still needed.

Clinical analysis of peripherally inserted central catheters guided by B-ultrasound / 局解手术学杂志

Objective To analyze and summarize the clinical effect of peripherally inserted central catheters (PICC) guided by B-ultrasound,and to discuss the catheterization skills of PICC guided by B ultrasound.Methods Retrospectively analyzed the clinical data of 102 patients recieved PICC guided by ultrasound in neurosurgery department of Chongqing emergency medical center from January 2016 to May 2017.The success rate of one-time puncture, the success rate of one-time catheter delivery and the number of complications were analyzed, and the causes and treatment methods of complications were analyzed.Results Of the 102 cases,94 cases were successfully punctured in one time,6 cases were punctured twice,and 2 cases were punctured more than 2 times.The one-time puncture success rate was 92.16%.Catheter misplacement occurred in 5 patients,and postoperative complications occurred in 2 patients.Conclusion Mastering the related angiotomy and imaging knowledge of PICC and using the B-ultrasound guidance system to insert the catheter can improve the success rate of catheterization and reduce the postoperative complications.

Effects of palm pressing PICC and mandible-pressing-on-shoulder on PICC′s misplacement in jugular veins / 现代临床护理

Objective To study effects of palm pressing peripherally inserted untral catheter(PICC) and mandible-pressing-on-shoulder on PICC′s misplacement in jugular veins during intubation. Methods Seventy-six patients undergoing intubation with PICC were randomized into observation group and control group equally by random digital table. The palm pressing PICC method was used in the observation group and the mandible-pressing-on-shoulder method was used in the control group. The two groups were compared in terms of the incidence of PICC misplacement. Result The misplacement rate of PICC in the experiment group was significantly lower than that in control group (P<0.01). Conclusion Palm pressing method is much effective in prevention of PICC misplacement in jugular veins and worth promoting especially in hospitals of basic level.

A Case of Iliopsoas Abscess and Cerebellum Abscess Caused by Misplacement of Central Venous Catheter / General Medicine

A 64-year-old female was admitted due to iliopsoas abscess caused by misplacement of a central venous catheter (CVC) into the ascending lumbar vein (ALV). Despite removing the CVC and administering an antimicrobial agent, her general condition did not improve. Therefore, we performed a contrast-enhanced head computed tomography (CT) scan. The CT scan revealed a cerebellum abscess. Surgical cerebellum abscess drainage was thus performed urgently. We recommend using anteroposterior radiographs, J-guide wire catheter and ultrasound guidance to prevent misplacement. If misplacement of the CVC is suspected, it should be removed and a CT scan performed without hesitation as soon as possible.

Assessment of femoral central venous catheter misplacement in the ascending lumbar vein / 日本プライマリ・ケア連合学会誌

<b>Introduction</b> : Catheter which strays in the ascending lumbar vein during femoral vein catheterization can cause complications such as retroperitoneal hematoma. However, not much is known of this phenomenon.<br><b>Methods</b> : We retrospectively studied 107 patients who had indwelling femoral vein catheter in our hospital between March 2013 and April 2011.<br><b>Results</b> : The catheter went straying in the ascending lumbar vein 11/110 times (10.0%) , 5/34 times (14.7%) on the left side, and 6/76 times (7.9%) on the right side. The possibility of the catheter straying was maximum when the catheter was displaced laterally or raised sharply towards the caudal side, as seen through abdominal radiographic examination.<br><b>Conclusion</b> : Femoral central venous catheter misplacement in the ascending lumbar veins is fairly common. Tests such as additional abdominal CT or radiographs should be conducted if misplacement is suspected.

Risk factors and early indicators for misplacement of subclavian vein catheter into ipsilateral internal jugular vein / 中华临床营养杂志

Objective To identify the risk factors and early indicators for misplacement of subclavian vein catheter into ipsilateral internal jugular vein.Methods From August 2008 to July 2009,subclavian vein catheterization was successfully performed with Seldinger method in 167 patients in Department of General Surgery,Xuanwu Hospital of Capital Medical University.The paraeentesis side,pameentesis site,direction of puncture needle.and the perceptions of both patients and operators during catheter placement were recorded.The correlation of these factors,age,and gender with the misplacement of subclavian vein catheter into internal jugular vein was analyzed.Results Sixteen patients(9.58%)experienced misplacement of subclavian vein catheter into ipsilateral internal jugnlar vein,which was not significantly correlated with age(P=0.375),gender(P=0.259),paraeentesis side (P=0.175),or paracentesis site(P=0.061).Misplacement of subclavian vein catheter into internal jugular vein was significantly more frequent when the direction of puncture needle was toward the midpoint of suprasternal fossa and laryngeal prominence(P=0.002).When the paracentesis site was located at a point at the junction of medial one-third and lateral two-tllirds of the clavicle.it was more frequent that the puncture needle was toward the midpoint of suprasternal fossa andlaryngeal prominence(P=0.010).There were more misplacement events when the patients feel ears pain(P=0.000)and when the operator felt resistance when inserting gnidewire during catheter placement(P=0.000).Conclusions Misplacement of subclavian vein catheter into ipsilateral internal jugnlar vein occurs more frequently when the direction of puncture needle is towards the midpoint between suprasternal fossa and laryngeal prominence.Patients feel ears pain and operators feel resistance when inserting guidewire during catheter placement are early indicators of misplacement.

Intercostal misplacement of a thoracic epidural catheter: A case report / 대한마취과학회지

Epidural block is useful for chronic pain and thoracic surgery. However, there are several complications, which include vessels or dural puncture, pleural puncture, misplacement of epidural catheter and trauma to the spinal cord. We report a case of intercostal misplacement of an epidural catheter in a 66-year-old patient who scheduled for left thoracotomy.

Inadvertent Placement of Epidural Catheter in the Extra-epidural Space: Two case reports / 대한마취과학회지

Although epidural block is a well-established anesthetic method, we often experience a failed epidural block. The success rate of epidural block is dependent on the accurate identification of the epidural space and successful location of the catheter within the epidural space. Rarely, it is missed to identify the epidural space with a loss of resistance method due to a variable anatomy of the epidural structure. Occasionally, an epidural catheter may pass into the extra-epidural space. We report 2 cases of misplacement of an epidural catheter in the extra-epidural space. These cases highlights the need for careful identification of the epidural space during epidural puncture and confirming the location for successful placement of the catheter within the epidural space by using a test block with a test dose of the local anesthetic drug after epidural catheterization.

Misplaced IUD / 대한산부인과학회잡지

OBJECTIVE: To study intrauterine or extrauterine misplacement of intrauterine devices in respect to their usage in diagnosis and therapy via retrospective analysis. METHODS: Data from 1993 to 2000 on a total of 32 patients from seven Catholic University branch hospitals who had been admitted to treat IUDs which had misplaced to intrauterine or extrauterine locations were analyzed for usage in a retrospective study. RESULTS: The data for intrauterine and extrauterine misplacement revealed no significant difference between from the statistical average in relation to age, parity and duration of insertion. In terms of removal method, all 15 patients with extrauterine misplacement underwent surgical extraction by open or laparascopic method under general anesthesia, but those patients with intrauterine misplacement had their device removed after cervical dilatation with a laminaria using local anesthesia. Concerning diagnosis, 81.2% of extrauterine misplacement were diagnosed using x-ray while 58% of intrauterine misplacement were diagnosed using vaginal US. The result of the Fisher's exact test showed a significant difference (p=0.043) in the rate of diagnosis for intrauterine and extrauterine misplacement of IUDs. Also, the results of multi-variable analysis performed for logistical regression analysis showed that intrauterine misplacement occurred 1.23 times more frequently than extrauterine misplacement. CONCLUSION: Further studies are required on a broader patient population, on more types of IUDs and with time variables taken into account. Despite more research, prevention of complications such as misplacement remains the most appealing situation, being influenced by such factors as technical skill of the physician inserting the IUD, appropriate duration of insertion and proper patient education.

Peutz-Jeghers Syndrome with Extensive Epithelial Misplacements and Adenomatous and Carcinomatous Transformation: A case report

Peutz-Jeghers syndrome is an autosomal dominant disease characterized by gastrointestinal ployposis and mucocutaneous melanin pigmentation involving the lip, oral mucosa, digits, palms and soles. The polyps are almost hamartomatous. The relationship of gastrointestinal carcinoma and the Peutz-Jeghers syndrome has been discussed for many years. The question is unsettled whether gastrointestinal carcinoma arise in hamartomatous polyps itself. Recently, there are a few reports that adenomatous and carcinomatous changes were superimposed upon the background of the hamartoma. Occasionally epithelial misplacement of the epithelium is found in the small intestinal polyps. Since the epithelial misplacement may involve submucosa, muscularis propria and serosa, a difficulty of histopathologic differential diagnosis between the epithelial misplacement and invasive adenocarcinoma cause overdiagnosis of cancer in the gastrointestinal polyps of Peutz-Jeghers syndrome. We present a case of Peutz-Jeghers syndrome of 39-year-old woman with multiple gastrointestinal polyps, two of which showed extensive epithelial misplacement even into the pancreas and another one at the colon showed carcinomatous change at the tip portion. Areas of hamartoma, adenoma and in situ carcinoma were noted in this colonic hamartomatous polyp. This case support that adenoma and carcinomatous changes may evolve directly within a hamartomaous polyp itself.