ABSTRACT
The purpose of this report is to promote early recognition, expeditious evaluation, and judicious management of acute external laryngeal trauma. A retrospective chart review was performed of 112 cases that were managed at a Medical College of Georgia tertiary care hospital by the senior author (E.S.P.). Patients were classified by the time of their presentation, the severity of their injury, and the treatment protocol followed. The clinical outcomes of airway, voice quality, and deglutition were retrospectively reviewed. For voice outcomes, in the delayed treatment group, only 27.7% of patients had a good result, as compared to a 78.3% good result in the early treatment group. Similar differences were demonstrated regarding the airway. In the delayed treatment group, only 73.3% had good airway function, as compared to 93.3% who had good airway function in the early treatment group. Ninety-nine percent of all patients had a good result for deglutition. We conclude that expeditious diagnosis and intervention reduce the incidence of suboptimal clinical outcomes, and with timely and appropriate application of diagnostic and management protocols, the majority of patients will be successfully decannulated (97%) with functional speech (100%) and normal deglutition (99%).
Subject(s)
Larynx/injuries , Neck Injuries/diagnosis , Neck Injuries/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Airway Obstruction/etiology , Airway Obstruction/prevention & control , Child , Child, Preschool , Deglutition Disorders/etiology , Deglutition Disorders/prevention & control , Female , Humans , Male , Middle Aged , Neck Injuries/complications , Retrospective Studies , Time Factors , Tracheotomy , Treatment Outcome , Voice Disorders/etiology , Voice Disorders/prevention & controlABSTRACT
Intraoperative complications of 175 cementless revision total hip arthroplasties done at four institutions using a porous-coated, uncemented, distally slotted, fluted femoral stem were reviewed. Three types of complications were recorded: eccentric reaming, femoral perforation, and femoral fracture. Intraoperative complications occurred in 16 patients (9.1%). There was no statistically significant association between complication rate and type of surgical approach, stem length, stem diameter, or host bone quality. This complication rate is comparable to or lower than that reported with the use of similar uncemented long femoral revision stems.
Subject(s)
Arthroplasty, Replacement, Hip , Hip Prosthesis , Intraoperative Complications , Adult , Aged , Aged, 80 and over , Chi-Square Distribution , Coated Materials, Biocompatible , Female , Humans , Male , Middle Aged , Prosthesis Design , Prosthesis Failure , ReoperationABSTRACT
Carotid artery pseudoaneurysms are detected most commonly after acute traumatic injuries to the head and neck. Pseudoaneurysms of the carotid artery are rare after blunt trauma. The most common site of injury occurs in the internal carotid artery with greater than 70 per cent of those injuries resulting from motor vehicle collisions. We report a case of external carotid artery pseudoaneurysm secondary to chronic arterial trauma. The patient presented with a one-week history of left ear pain and a pulsatile left neck mass. Radiologic studies revealed a 2.8-cm neck mass compatible with a pseudoaneurysm of the external carotid artery. Primary repair of the aneurysm was performed. Exploration of the pseudoaneurysm cavity at the time of surgery revealed a fracture of the hyoid bone. We believe this to be the contributing factor to the formation of a pseudoaneurysm in this patient. This is the first reported case of external carotid pseudoaneurysm caused by chronic arterial injury secondary to hyoid bone fracture.
