RESUMO
Blunt trauma to the anterior neck has been known to cause upper-airway obstruction requiring emergency tracheostomy. We report the case of a 26-year-old man who sustained blunt trauma to the anterior neck in whom upper-airway obstruction developed. Although computed tomography of the neck revealed a thyroid cartilage fracture and a retropharyngeal hematoma, fiberoptic examination of the larynx identified vocal cord paralysis as the primary cause of his upper-airway obstruction. Emergency tracheostomy was performed, and the patient recovered uneventfully. A Medline search of the literature for the past 3 years failed to identify any individual case reports of bilateral vocal cord paralysis secondary to blunt anterior neck trauma.
Assuntos
Lesões do Pescoço , Paralisia das Pregas Vocais/etiologia , Ferimentos não Penetrantes/complicações , Adulto , Obstrução das Vias Respiratórias/etiologia , Ciclismo/lesões , Criança , Fraturas de Cartilagem/complicações , Humanos , Masculino , Cartilagem Tireóidea/lesõesRESUMO
Endoscopic sinus surgery has gained acceptance in the otolaryngologic community as an effective and safe method of treating inflammatory disease of the paranasal sinuses. At our institution, partial endoscopic middle turbinectomy has become a standard component of the procedure and our experience is reported. Middle turbinectomy enhances surgical exposure, specific anatomic anomalies are more completely corrected, and subpopulations of patients at risk for failure because of their underlying disease enjoy decreased rates of synechiae formation and closure of the middle meatus antrostomy when followed over time. Photodocumentation of the surgical technique and a discussion regarding the impact of middle turbinectomy on normal nasal physiology are presented. It is reported that the procedure is safe, and no complications directly attributable to middle turbinectomy (including atrophic rhinitis) are reported in a series of 298 patients.
Assuntos
Endoscopia , Sinusite/cirurgia , Conchas Nasais/cirurgia , Seguimentos , Humanos , Obstrução Nasal/etiologia , Doenças Nasais/etiologia , Complicações Pós-Operatórias/etiologia , Ventilação Pulmonar/fisiologia , Aderências Teciduais/etiologia , Falha de TratamentoRESUMO
A series of 145 patients with chronic sinusitis were treated with functional endoscopic sinus surgery. Patency of the middle meatus was evaluated by actuarial life-table methods. After 24 months' follow-up, the overall patency rate of endoscopic middle meatotomy was 94.08%. Questionnaire data indicated that 91.8% of these patients were improved or asymptomatic. This preliminary study indicates that the patency rate of middle meatal antrostomy appears to be greater than that of inferior meatal antrostomy when compared to literature controls, and that a high percentage of these patients are improved by this surgery.
Assuntos
Endoscopia , Seios Paranasais/cirurgia , Sinusite/cirurgia , Análise Atuarial , Adolescente , Adulto , Idoso , Perda Sanguínea Cirúrgica , Criança , Pré-Escolar , Doença Crônica , Seguimentos , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Prognóstico , Procedimentos Cirúrgicos Operatórios/métodosRESUMO
Two hundred patients with chronic sinusitis were operated on using functional endoscopic sinus surgery (FESS) techniques. These patients were followed closely over 3 years. Patency of the endoscopic middle meatotomy was recorded using actuarial life-table methods. The overall patency rate of the endoscopic middle meatotomy was 93.55%, and the actuarial patency rate at 36 months was 87.47%. The presence of seasonal allergy with nasal polyps was the most important variable in predicting closure. Middle turbinectomy was the most important variable in predicting patency. Symptoms were evaluated by questionnaire at 1 year. Questionnaire data indicate that 96% of these patients are improved or asymptomatic.
