1/32. An unusual case of stridor due to osteophytes of the cervical spine: (Forestier's disease).Stridor is a noisy breathing caused by compromised airway in the larynx and trachea. The causes can either be due to intrinsic or extrinsic compression. Stridor resulting from extrinsic compression due to anterior cervical osteophytes is rare. We report an unusual case of acute stridor due to an osteophytic mass in the cervical vertebrae resulting in a mechanical upper airway obstruction. The underlying pathology was Forestier's disease or diffuse idiopathic skeletal hyperostosis (DISH). Stridor is a rare manifestation of DISH and it certainly represents the most life-threatening one. Only a few cases have been reported in the English literature and are mainly secondary to impaired function of the vocal folds, or postcricoid ulceration and oedema. We present such a case, in that stridor was the result of direct airway obstruction by the osteophytic mass and an emergency tracheostomy had to be performed to establish an airway.- - - - - - - - - - ranking = 1keywords = compression (Clic here for more details about this article) |
2/32. Stridor in a 6-week-old infant caused by right aortic arch with aberrant left subclavian artery.BACKGROUND: Persistent infant stridor, seal-like cough, and difficulty feeding can be the initial signs of right aortic arch with an aberrant left subclavian artery. This congenital cardiovascular abnormality results in the development of a vascular ring that encircles the trachea and esophagus. methods: A case report is presented that describes the evaluation and care of a 6-week-old male infant whose condition was diagnosed as right aortic arch and aberrant left subclavian artery after he was brought to the family practice clinic with a history of persistent stridor. This case report involved a patient seen in the author's outpatient clinic during a well-child check. Data were obtained from the patient's medical record and review of his radiologic diagnostic tests. medline and Index Medicus literature searches were conducted for the years 1966 to the present, using the key words "stridor" and "vascular ring," with cross-references for earlier articles. RESULTS AND CONCLUSIONS: Persistent or recurrent stridor associated with feeding difficulties should prompt an investigation for a vascular ring. In general, an anteroposterior and lateral neck radiograph and a posteroanterior and lateral chest radiograph are usually the initial diagnostic tests to evaluate stridor. Persistent stridor and new-onset regurgitation of formula in a 6-week-old infant prompted an escalation of the patient's workup to include a barium swallow, which subsequently showed compression of the esophagus caused by a vascular ring. In some cases direct observation with a laryngoscope or bronchoscope might be necessary to determine the cause of stridor. Indications for hospitalization of patients with stridor include stridor at rest, dyspnea, actual or suspected epiglottis, repeatedly awakening from sleep with stridor, a history of rapid progression of symptoms, toxic appearance, and apneic or cyanotic episodes. The primary care provider should be familiar with the evaluation and management for patients with the complaint of persistent or recurrent stridor.- - - - - - - - - - ranking = 0.5keywords = compression (Clic here for more details about this article) |
3/32. Occipital condyle fracture with peripheral neurological deficit.A 24-year-old woman sustained a type III Anderson and Montesano fracture in a road traffic accident. Acute respiratory stridor, multiple cranial nerve palsies and right upper limb neurological deficits associated with a C1 to T2 extradural haematoma were unique features of this case. The patient made a full and uncomplicated recovery with conservative management.- - - - - - - - - - ranking = 0.022417965734495keywords = fracture (Clic here for more details about this article) |
4/32. Achalasia presenting as acute airway obstruction.Achalasia presenting as acute airway obstruction is an uncommon complication. We report the case of an elderly woman with previously undiagnosed achalasia who presented with acute respiratory distress due to megaesophagus. Emergency endotracheal intubation and insertion of a catheter into the esophagus, with continuous aspiration was required. Upon introduction of the esophageal catheter an abruptand audible air decompression occurred, with marked improvement of the clinical picture. Endoscopic injection of botulinum toxin was chosen as the definitive treatment with good clinical result. The pathophysiology of the phenomenon of esophageal blowing in achalasia is unclear, but different hypothetical mechanisms have been suggested. One postulated mechanism is an increase in upper esophageal sphincter (UES) residual pressure or abnormal UES relaxation with swallowing in achalasia patients. We reviewed the UES manometric findings in 50 achalasia patients and compared it with measurement performed in 45 healthy controls. We did not find any abnormalities in UES function in any of our achalasia patients group, or in the case under study. An alternative hypothesis postulates that airway compromise in patients with achalasia results from the loss UES belch reflex (abnormal UES relaxation during esophageal air distension), and in fact, an abnormal UES belch reflex was evidenced in our case.- - - - - - - - - - ranking = 0.5keywords = compression (Clic here for more details about this article) |
5/32. Compression of the trachea by the innominate artery in a 2-month-old child.SUMMARY. We utilized improved methods for assessing airway structure and function to define the clinical significance of the innominate artery syndrome. Both infant pulmonary function tests (IPFT) and noninvasive controlled ventilation computed tomography (CVCT) were used, along with traditional diagnostic techniques in a 2-month-old child with compression of the trachea by the innominate artery. These tests provided objective documentation of functional impairment before surgery and improvement postoperatively. These tests should aid in the understanding of this controversial syndrome and help to further define treatment options.- - - - - - - - - - ranking = 0.5keywords = compression (Clic here for more details about this article) |
6/32. Surgical correction of postpneumonectomy stridor by saline breast implantation.Postpneumonectomy syndrome is a rare complication of pneumonectomy and is characterized by progressive dyspnea, stridor, and repeated chest infections. It is caused by displacement and rotation of the mediastinal structures into the pneumonectomy space, producing compression and malacic changes in the trachea and remaining bronchus. We report the successful long-term results of mediastinal correction, cardiopexy and plombage with saline breast prostheses in a 59-year-old man after right pneumonectomy for carcinoma of the lung.- - - - - - - - - - ranking = 0.5keywords = compression (Clic here for more details about this article) |
7/32. Laryngeal lymphatic malformation in a newborn.Stridor in a neonate evokes a series of prompt evaluations to determine the etiology. Common etiologies include inherent structural defects (such as laryngomalacia), vocal fold paralysis, acquired infectious etiologies, or extrinsic compressions. We report a neonate with a lymphatic malformation (lymphangioma) initially confined to the larynx that presented with stridor and progressive respiratory failure. Only seven other cases have been reported to present with lymphatic malformation confined solely to the larynx. There are several different modalities available to treat this condition, but recurrences are common. The presentation and management are discussed below. physicians should be aware that stridor in a neonate can result from this unusual intrinsic obstruction of the larynx.- - - - - - - - - - ranking = 0.5keywords = compression (Clic here for more details about this article) |
8/32. Innominate artery compression of the trachea: an unusual cause of apnea in a 12-year-old boy.Innominate artery compression of the trachea is a common cause of airway obstruction in infants and young children. The clinical significance of this lesion, even when compression is documented endoscopically or radiographically, is controversial. Obstructive respiratory symptoms occur in only a fraction of such cases, and symptomatic patients are most commonly detected in the first year of life. We present a case of a 12-year-old boy with a chief complaint of progressive stridor and apnea who was diagnosed with symptomatic innominate artery compression of the trachea. We reviewed the literature regarding the pathology, diagnosis, and treatment of this condition.- - - - - - - - - - ranking = 3.5keywords = compression (Clic here for more details about this article) |
9/32. Mediastinal compression secondary to supraglottitis: a case report.Potential fascial spaces of the neck communicate inferiorly with the mediastinum and thus provide a route for spread of infections. It is very uncommon for supraglottitis to spread to one of these spaces. In this rare case, this infection not only involved the parapharyngeal space but also followed the anatomic path down to the mediastinum. The resulting mediastinal edema increased the intrathoracic pressure and thus upset the hemodynamic. Despite being in critical condition due to pulmonary edema and hypotension, the patient recovered without the use of aggressive surgical measures recommended for such cases.- - - - - - - - - - ranking = 2keywords = compression (Clic here for more details about this article) |
10/32. Rings, slings and other vascular abnormalities. Ultrafast computed tomography and magnetic resonance angiography in pediatric cardiology.Ultrafast CT and MR angiography are noninvasive, accurate and robust techniques for preoperative diagnosis and planning of congenital heart disease and vascular abnormalities in pediatric patients. While they seem to be equivalent to conventional catheter angiocardiography for detecting vascular abnormalities, they are more accurate for the diagnosis of potentially life-threatening complications, such as tracheal, bronchial or esophageal compression. The value of ultrafast CT and MR angiography is demonstrated in 22 pediatric patients with vascular rings, slings and other vascular abnormalities.- - - - - - - - - - ranking = 0.5keywords = compression (Clic here for more details about this article) |
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