RESUMO
We describe a four-year-old boy of Indian descent who had elective adenotonsillectomy for chronic sore throat and partial airway obstruction. About 10 minutes into the procedure, the patient suddenly developed cardiac asystole. After prolonged cardiac resuscitation, recovery was achieved. No permanent neurologic deficits resulted. The child was later found to have a strong family history of Duchenne's muscular dystrophy (DMD) and an elevated serum creatine kinase level documented since shortly after birth. We reviewed several case reports substantiating the risk for cardiac arrest during general anesthesia in DMD patients, and we concluded that DMD is a little-known risk for cardiac arrest during general anesthesia. The otolaryngologist must be aware of this potential complication, because tonsillectomy and adenoidectomy are commonly indicated for children at an age when DMD may be subclinical.
Assuntos
Tonsila Faríngea/cirurgia , Parada Cardíaca/etiologia , Distrofias Musculares/complicações , Tonsila Palatina/cirurgia , Adenoidectomia , Obstrução das Vias Respiratórias , Anestesia Geral/efeitos adversos , Pré-Escolar , Creatina Quinase/análise , Creatina Quinase/sangue , Humanos , Hiperpotassemia/complicações , Hiperpotassemia/metabolismo , Complicações Intraoperatórias , Masculino , Distrofias Musculares/sangue , Distrofias Musculares/metabolismo , TonsilectomiaRESUMO
We present the case of a 37-year-old man with plasma cell granuloma affecting the middle ear and mastoid. At magnetic resonance imaging scan, the lesion appeared as a homogeneously enhancing mass of soft tissue replacing the majority of the mastoid bone and causing vascular compression. After surgical resection, microscopic examination showed predominantly plasmacytes, and histochemical studies confirmed a polyclonal origin consistent with nonneoplastic plasma cell granuloma. We believe this is the first case report of plasma cell granuloma affecting the middle ear and mastoid.
