ABSTRACT
BACKGROUND: A 38-year-old male with no medical history complains about hemoptysis, chest pain, dyspnea on exertion and a cough. He has a history of occasional smoking, but had quitted smoking 1 year previously. There is a normal saturation and normal spirometry. Clinical examination and auscultation are also normal. Because of these complaints CT scan of the thorax was performed. For further diagnostic workup bronchoscopy was performed afterwards.
ABSTRACT
Most cases of primary spontaneous pneumothorax are thought to be caused by air leaks at so-called "emphysema-like changes" or in areas of pleural porosity at the surface of the lung. Environmental pressure swings may cause air leaks as a result of transpulmonary pressure changes across areas of trapped gas in the distal lung. This is the first report of music as a specific form of air pressure change causing pneumothorax (five episodes in four patients). While rupture of the interface between the alveolar space and pleural cavity in these patients may be linked to the mechanical effects of acute transpulmonary pressure differences caused by exposure to sound energy in association with some form of distal air trapping, we speculate that repetitive pressure changes in the high energy-low frequency range of the sound exposures is more likely to be responsible. Exposure to loud music should be included as a precipitating factor in the history of patients with spontaneous pneumothorax.
Subject(s)
Music , Noise/adverse effects , Pneumothorax/etiology , Adult , Humans , Male , PressureSubject(s)
Chondroma/diagnosis , Neoplasm Recurrence, Local/diagnosis , Tracheal Neoplasms/diagnosis , Adult , Asthma/complications , Bronchoscopy , Chondroma/complications , Chondroma/surgery , Humans , Male , Neoplasm Recurrence, Local/surgery , Otologic Surgical Procedures/methods , Surgical Flaps , Tomography, X-Ray Computed , Tracheal Neoplasms/complications , Tracheal Neoplasms/surgerySubject(s)
Pleural Diseases/diagnosis , Pulmonary Emphysema/diagnosis , Subcutaneous Emphysema/diagnosis , Adult , Humans , Male , ThoracoscopyABSTRACT
Our preliminary experience with the bronchoscopic application of cryotherapy using rapid decompression of liquid nitrous oxide as cooling agent is reported. Seventeen applications through rigid bronchoscopy in twelve patients were performed. A single cryotherapy session was successful in the debulking of obstructive malignant lesions of the central airways in five patients (four non-small cell carcinoma, one renal cell cancer metastasis), and in the treatment of a capillary haemangioma (one patient). Two sessions were successful in the treatment of a metastatic melanoma (one patient) and benign granulation tissue (one patient). Cryotherapy was also successful in the treatment of early bronchial cancer (carcinoma in situ) in four patients, requiring repetitive sessions in two. There were no complications or side-effects. These preliminary findings confirm the safety and efficacy of bronchoscopic cryotherapy in a variety of airway lesions.
