Cases reported "Laryngeal Edema"

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1/12. Laryngeal and other otolaryngologic manifestations of Crohn's disease.

    Laryngeal and other otolaryngologic manifestations of Crohn's disease are uncommon and may be subtle. Crohn's disease is a well-known inflammatory bowel disease of unknown etiology marked by relapsing and remitting granulomatous inflammation of the alimentary tract. Extraintestinal manifestations of Crohn's disease may appear anytime during the course of the disease process and may be the initial symptom. Findings are nonspecific, primarily edema and ulcerations, and may be confused with a multitude of other disease processes. awareness of these manifestations in the head and neck will prevent misdiagnosis or a delay in diagnosis.
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2/12. angiotensin-converting enzyme inhibitors and angiotensin ii receptor antagonists.

    The use of angiotensin-converting enzyme inhibitors (ACEIs) has been implicated in many cases of angioedema, but, given the potential mechanism of this complication, it was not expected to be caused by angiotensin ii receptor blockers (ARBs). However, in the past few years, scattered reports of angioedema associated with ARBs have appeared in the medical literature. We performed a retrospective chart review from January 1, 1998, through June 30, 2003, and a review of the literature. During this time, we managed head and neck angioedema induced by ACEIs (n = 27) and ARBs (n = 4) in 31 patients. All of them had significant mucosal swelling, and in some of them dyspnea and dysphagia coexisted. The most frequently involved areas were the oral tongue (13 cases), uvula and soft palate (5 cases), and larynx, mouth floor, and lips (3 cases each). angioedema may be a more common complication of ACEI and/or ARB use than originally thought. This complication may occur after long-term use of these drugs. We advise that ARBs not be prescribed to patients with a history of angioedema, particularly that due to the use of ACEIs.
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3/12. airway obstruction following carotid endarterectomy.

    Upper airway obstruction after carotid endarterectomy is a rare but potentially fatal complication of carotid endarterectomy. Upper airway obstruction is also a well recognized complication after neck surgery involving the thyroid gland and cervical spine. The airway obstruction usually develops slowly over a few hours and the onset is unpredictable. We report a patient who developed upper airway obstruction 16 hours following carotid endarterectomy. She required re-intubation in the intensive care unit (ICU). Fibreoptic assessment demonstrated severe supraglottic and glottic oedema. tracheostomy was performed on day 2 postoperatively. Serial fibreoptic assessment of the upper airway showed gradual resolution of glottic edema and decanulation was successful on day 43.
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4/12. laryngeal edema induced by neck dissection and catheter thrombosis.

    PURPOSE: There are many possible causes of airway edema in a patient being treated for squamous cell carcinoma of the head and neck. The differential diagnosis includes radiation changes, anaphylaxis, and venous or lymphatic obstruction secondary to mechanical compromise resulting from infection, recurrent tumor, or anatomic distortion. methods: A 60-year-old man underwent partial glossectomy and right radical neck dissection for squamous cell carcinoma of the tongue. He subsequently required insertion of a Hickman catheter for administration of chemotherapy to treat recurrent disease. Edema of the left neck, shoulder, and arm was noted to accompany the onset of laryngeal obstruction secondary to supraglottic edema. RESULTS: Catheter-induced thrombosis of the left brachycephalic vein obstructed the only residual jugular vein and was responsible for the sudden airway obstruction. CONCLUSION: Acute laryngeal edema may be caused by obstruction of venous outflow. Invasive catheters should be placed with caution in patients who have undergone surgical sacrifice of the contralateral internal jugular vein.
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keywords = neck
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5/12. Cricothyroidotomy: a short-term measure for elective ventilation in a patient with challenging neck anatomy.

    Cricothyroidotomy is a well established technique of airway management in emergency situations where translaryngeal intubation cannot be achieved. This case report describes a case where cricothyroidotomy was used for elective ventilation for short period of 48 hours in a patient who had a vocal cord palsy, supraglottic oedema and inflammation. Surgical tracheostomy was considered the preferred option, but this was deemed impossible due to the challenging neck anatomy in this case.
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6/12. Hashimoto's thyroiditis presenting with severe pressure symptoms--a case report.

    A extremely rare case of Hashimoto's thyroiditis presenting with pressure symptoms is described herein. A 50 year old Japanese woman was referred to our department with swelling of the anterior neck, facial edema and recent heavy snoring. Oto-rhinolaryngological examinations revealed no movement of the bilateral vocal cords, severe laryngeal edema and diffuse edema of the tongue and pharynx. These findings had apparently been induced by compression of the bilateral recurrent nerves and internal jugular veins by an enlarged thyroid gland. The results of thyroid function and autoimmune tests were compatible with a diagnosis of Hashimoto's disease and thus, total thyroidectomy with a tracheostomy was performed uneventfully. The resected specimen weighed 168 grams and was confirmed histologically to be Hashimoto's disease. Following her operation, all the above symptoms disappeared and 4 months later, the patient is well and asymptomatic.
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7/12. Chemodectoma of the larynx. A clinico-pathological study.

    The present case report is concerned with a clinico-pathological study, including ultrastructural investigation, of a rare and uncommon laryngeal tumour, a chemodectoma, in a 62 year old patient. There have been 23 cases of laryngeal chemodectomas reported in the literature, and only three of them, including our own report, were investigated by electron microscopy. The tumours arise from the superior and inferior larynegeal nonchromaffin paraganglia or possibly from Kultschitzky-cells of the normal bronchial mucosa. Ultrastructurally they have all the characteristics of apudomas whose parent cells (APUD-cells), usually show endocrine function and probably have their origin in the neural crest. The tumours show an aggressive type of behaviour, despite usually benign histological features when compared to chemodectomas at other sites in the head and neck region. Surgery is thus the therapy of choice.
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8/12. Laryngeal oedema from a neck haematoma. A complication of internal jugular vein cannulation.

    Laryngeal oedema occurred after formation of a neck haematoma after attempted internal jugular vein cannulation. This resulted in complete respiratory obstruction and respiratory arrest and it was impossible to ventilate her lungs manually or intubate her trachea. Oxygenation of the patient was only possible using transtracheal ventilation.
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9/12. sleep apnea syndrome after irradiation of the neck.

    After irradiation of the neck for a squamous cell carcinoma of the tonsillar pillar and vocal cord, a 71-year-old man presented with a rapidly progressive sleep apnea syndrome. Previous reports describe the condition of patients with obstructive sleep apnea that developed after neck irradiation and secondary to supraglottic edema. Our patient had an obstructive component to his apnea similar to that described in previous cases, but, in addition, he had hypothyroidism. myxedema is a well-described cause of both obstructive and central apnea. We believe both contributed to his condition. He was successfully treated by placement of a tracheostomy and by thyroid supplementation. In patients who present with sleep apnea after neck irradiation, especially with acute or severe symptoms, the differential diagnosis should include both a central cause from hypothyroidism as well as a peripheral obstructive cause from laryngeal edema.
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10/12. Retropharyngeal pseudomasses.

    The false impression of a retropharyngeal mass on lateral radiographs of the neck is not uncommon, particularly in the pediatric patient. With careful attention to radiographic technique, positioning of the patient, and the proper timing with regard to respiration, the diagnosis of a "pseudomass" can be avoided.
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