Cases reported "Laryngostenosis"

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1/117. epidermolysis bullosa associated with laryngeal stenosis.

    A boy with epidermolysis bullosa developed progressive laryngeal obstruction after age six months, with tracheotomy necessary at age three years. By eight years, the larynx was completely occluded by web and scar. Stenosis recurred repeatedly over the next seven years, three to six months after each corrective procedure, but laryngeal patency has been better-maintained since age 15. Laryngeal stenosis, presumably secondary to epithelial detachment, although a rare complication of epidermolysis bullosa, can be serious and life-threatening.
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ranking = 1
keywords = obstruction
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2/117. Noninvasive positive-pressure ventilation facilitates tracheal extubation after laryngotracheal reconstruction in children.

    Tracheal extubation after laryngotracheal reconstruction in children may be complicated by postoperative tracheal edema and pulmonary dysfunction. The replacement of a tracheal tube in this situation may exacerbate the existing injury to the tracheal mucosa, complicating subsequent attempts at tracheal extubation. We present two cases where noninvasive positive-pressure ventilation was employed to treat partial airway obstruction and respiratory failure in two children following laryngotracheal reconstruction. Noninvasive positive-pressure ventilation served as a bridge between mechanical ventilation via a tracheal tube and spontaneous breathing, providing airway stenting and ventilatory support while tracheal edema and pulmonary dysfunction were resolved. Under appropriate conditions, noninvasive positive-pressure ventilation may be useful in the management of these patients.
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ranking = 54.228043527239
keywords = airway obstruction, airway, obstruction
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3/117. Sequestrated tubular duplication of the colon with congenital subglottic stenosis.

    A 6-year-old male presenting with features of intestinal obstruction because of a sequestrated tubular duplication of the colon is reported. The patient also had congenital subglottic stenosis, an association not yet reported with any type of gut duplication. Complete excision of the duplication was done with preservation of vascularity of the adjacent normal colon. The relevant literature is reviewed briefly.
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ranking = 1
keywords = obstruction
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4/117. Congenital laryngeal webs: surgical management and clinical embryology.

    Laryngeal webs are uncommon congenital anomalies. The formation of a laryngeal web represents anomalous embryologic development of the larynx. The extent of airway involvement varies which ultimately affects surgical management. A series of five congenital laryngeal webs each with subglottic involvement is reported. One patient also had a ventral laryngeal cleft. All patients ultimately required open laryngeal reconstruction, either laryngotracheal reconstruction (LTR) or thyrotomy (laryngofissure) and silastic keel, to correct the defect and all were decannulated. Findings at surgery correlate with recent descriptions of embryonic laryngeal development though the actual mechanism by which webs develop remains unknown. The findings suggest that congenital glottic webs require accurate endoscopic diagnosis and open airway reconstruction for definitive treatment.
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ranking = 25.625200563341
keywords = airway
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5/117. Cicatricial pemphigoid with an upper airway lesion.

    Cicatricial pemphigoid is an unusual mucocutaneous disease that is characterized by subepidermal blister formation involving the oral and conjunctival membranes. The oral lesions are expressed as erythema and induration and have rarely been associated with upper airway obstruction. We report the case of a patient with dyspnea and an abnormal flow-volume loop who was found to have subglottic compromise due to cicatricial pemphigoid. Immunosuppressive therapy improved his symptoms and air flow.
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ranking = 92.66584437225
keywords = airway obstruction, airway, obstruction
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6/117. Supracricoid partial laryngectomy for severe laryngeal stenosis.

    We report 2 cases in which supracricoid partial laryngectomy and cricohyoidoepiglottopexy were used to restore the airway in cases of severe associated glottic and supraglottic laryngeal stenosis.
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ranking = 12.81260028167
keywords = airway
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7/117. Subglottic stenosis associated with transesophageal echocardiography.

    Transesophageal echocardiography (TEE) is used extensively to assess cardiac function and anatomical relationships in both adults and children. Although considered a noninvasive procedure, TEE in infants and small children may result in airway complications. A patient who developed subglottic stenosis after the use of TEE during a cardiac procedure is reported.
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ranking = 12.81260028167
keywords = airway
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8/117. Evaluating laryngotracheal stenosis in a canine model with virtual bronchoscopy.

    We performed a prospective masked animal study to determine whether virtual bronchoscopy, a noninvasive computed tomography technique, can accurately measure upper airway stenosis. Virtual bronchoscopy creates a 3-dimensional endoscopic image from spiral computed tomography data. Laryngotracheal stenosis was endoscopically induced in 18 dogs. The excised larynges were examined by endoscopy, virtual bronchoscopy, and macrodissection. Measurements were made of the anteroposterior (A-P) diameter, the left-right (L-R) diameter, the full length of stenosis in the sagittal plane, and the length of the tightest stenotic segment. Each measurement method was performed independently. All investigators were unaware of measurements made by others. The measurements obtained through virtual bronchoscopy and actual endoscopy were compared to those made at dissection by interclass correlation coefficients (ICCs). endoscopy was better than virtual bronchoscopy in measuring the A-P diameter (ICC = .79, p < .0001; ICC = .42, p = .01). Both were equally effective in measuring the L-R diameter (ICC = .53, p = .0062; ICC = .52, p = .0064). The endoscopes could not assess the full length of the stenosis, whereas virtual bronchoscopy measured it fairly accurately (ICC = .72, p = .0001). Virtual bronchoscopy relatively accurately measured the length of the tightest stenotic segment (ICC = .68, p = .0002), whereas endoscopy produced measurements in only 11 of 18 larynges, and the measurements were less accurate (ICC = .45, p = .0068). Virtual bronchoscopy can provide good measurements of stenotic lesions in the airway. It is more accurate than actual endoscopy in determining the length of stenosis. It may therefore be useful as an adjunct imaging method in preoperative planning for reconstructive surgery.
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ranking = 25.625200563341
keywords = airway
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9/117. Laryngotracheal reconstruction and the hidden airway lesion.

    OBJECTIVE: Single-stage laryngotracheal reconstruction (SSLTR) is an increasingly common technique to achieve decannulation of patients with laryngotracheal stenosis. In a proportion of cases airway distress on extubation may be attributed to a dynamic second airway lesion not diagnosed before surgery. Our aim is to describe our recent experience with these frustrating patients. methods: Between July 1997 and July 1999 we prospectively followed patients who underwent SSLTR and experienced difficulty after extubation owing to an unsuspected second airway lesion. RESULTS: During this 24-month period we performed 80 SSLTRs. In six surgeries performed on five patients, a second airway lesion complicated extubation. In five patients the second lesion was not diagnosed before surgery because there was significant airway stenosis and tracheotomy. The sixth patient was transferred to our care intubated. In all cases the airway surgery for the dominant lesion was technically successful, but revealed a second dynamic lesion. There were three cases of tracheomalacia, two cases of laryngomalacia, and one case of arytenoid prolapse. All patients required intervention. tracheotomy was required in four patients. CONCLUSIONS: Failure to achieve extubation after SSLTR may be caused by a dynamic second airway lesion that was previously disguised by a more dominant airway lesion. Surgical repair of the dominant lesion will allow manifestation of the dynamic lesion due to the Bernoulli effect. The combination of a tracheotomy and a dominant airway lesion limits airflow and potentially disguises the situation.
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ranking = 166.56380366171
keywords = airway
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10/117. Malignant laryngotracheal obstruction: a way to treat serial stenoses of the upper airways.

    BACKGROUND: Six patients known to have inoperable esophageal carcinoma presented with stridor due to both malignant tracheal stenosis (n = 6) and bilateral vocal cord paralysis. Two patients also had respiratory-digestive fistula. methods: Patency was restored by endotracheal stenting plus unilateral cordectomy. Four patients had immediate relief. Two patients required enlargement of the cord incision. One of them declined reoperation and underwent tracheotomy. RESULTS: Stent function was uneventful. There was no dislodgement or mucous impaction. fistula seal was complete. There was no aspiration through the new-shaped glottic orifice. Peak expiratory flow increased from 24.4% /- 9.7% predicted normal before to 40.5% /- 13.7% after the procedure, whereas the dyspnea score decreased from 74.2 /- 12.7 to 24.2 /- 14.0. CONCLUSIONS: Restoration of airway continuity in serial laryngotracheal stenoses using a combined approach is a feasible technique in end-stage cancer patients. It effectively relieves respiratory distress and ensures voice preservation. In addition, it may avoid the risks of tracheotomy.
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ranking = 68.063001408352
keywords = airway, obstruction
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