Cases reported "Papilloma"

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1/74. choroid plexus papilloma. I. Proof of cerebrospinal fluid overproduction.

    Utilizing a ventricular perfusion technique, the rate of CSF formation was determined in a 2-year-old child before and after removal of a 74 g choroid plexus papilloma from the left lateral ventricle. Preoperatively, the CSF formation rate was 1.05 /- SD 0.01 ml/min (1,656 ml/day). Postoperatively, the CSF formation rate was reduced fivefold to 0.20 /- SD 0.01 ml/min (288 ml/day). Whereas these data are regarded as conclusive evidence of CSF overproduction by a choroid plexus papilloma, the pathogenesis of generalized ventricular enlargement in this case was due to part to obstruction of the subarachnoid pathways.
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ranking = 1
keywords = obstruction
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2/74. acromegaly and papillomatosis: difficult intubation and use of the airway exchange catheter.

    We describe the anaesthetic management of a patient with acromegaly scheduled for transsphenoidal resection of a pituitary tumour who was found at intubation to have coexisting laryngeal papillomatosis. Oral intubation was impossible using both direct and fibreoptic techniques. Nasal fibreoptic intubation was successful but precluded the transsphenoidal approach to surgery. A Cook Airway Exchange Catheter [Cook (UK) Ltd, Monroe House, Letchworth SG6 1LN] was used with a Negus bronchoscope to convert to oral intubation and allow completion of surgery without resort to tracheostomy.
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ranking = 8.0156366594006
keywords = airway
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3/74. Inspiratory pressure threshold training for glottal airway limitation in laryngeal papilloma.

    A single-subject design was used to determine if inspiratory pressure threshold training increases inspiratory muscle strength and reduces the sensation of dyspnea during exercise and speech. The subject was a 23-year-old female with congenital juvenile papilloma which has been in remission for 10 years. A 4-week inspiratory muscle training program was implemented using an inspiratory pressure threshold trainer. The pressure threshold of the trainer was set by the experimenter. The pressure threshold setting of the trainer was based on a percentage of the subject's maximum inspiratory pressure measured prior to training. The average range of the pressure threshold was 40 to 70 cmH2O. In order for inspiratory air to flow, the subject generated inspiratory pressure, independent of airflow rate. Maximum inspiratory pressure (MIP) was the dependent variable used as the index of inspiratory muscle strength. exercise dyspnea was a dependent variable rated by the subject during a progressive treadmill test. dyspnea associated with speech was rated following production of a comfortable and loud speech task. MIP increased by 57% following the training program with a 2-scale point reduction in the perception of dyspnea during exercise. dyspnea during loud speech decreased from moderate to mild. The changes in dyspnea, both during exercise and speech, are directly related to inspiratory muscle strengthening. The results suggest that inspiratory muscle training may improve respiratory related function in patients with restrictive upper airway disorders.
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ranking = 10.019545824251
keywords = airway
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4/74. Laryngeal papillomatosis presenting as acute airway obstruction in a child.

    Upper airway obstruction, regardless of cause, can masquerade or be misdiagnosed as lower airway disease in children. In such cases, therapeutic trials of antibiotics, bronchodilators, and over-the-counter medications for symptom relief routinely fail; however, the original diagnosis often goes unchallenged. If the obstructive process is progressive, then acute occlusion of the airway may occur, rapidly leading to suffocation and death if resuscitation is unsuccessful. Outlined in this report is the case of a young female with a history of asthma, poorly responsive to outpatient treatment, who presented with respiratory arrest. The cause of the respiratory collapse was later identified as a large laryngeal papilloma, a condition rarely encountered by emergency physicians.
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ranking = 88.050151115172
keywords = airway obstruction, airway, obstruction
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5/74. Recurrent lacrimal sac papilloma: case report.

    Tumors of the lacrimal sac are rare. Benign papillomas comprise approximately 40% of all neoplasms of the lacrimal drainage system. They often present insidiously with symptoms of dacryostenosis or dacryocystitis. Recurrent bouts of dacryocystitis and nasolacrimal duct obstruction were reported in a 35-year-old man over a period of 13 years. A medial canthal mass was noted in the 6th year after the onset of symptoms. A tumor was discovered incidentally during surgical intervention for presumed dacryostenosis. Surgical removal of the tumor and dacryocystorhinostomy were performed. The histopathologic report turned out to be benign papiloma. Local recurrences occurred during the follow-up period. In addition to surgical excision, we applied cryotherapy and CO2 laser to prevent further recurrence. This case we presented the characteristic recurrence of lacrimal sac papilloma and implied the possibility of tumor occurrence in a patient with recurrent dacryocystitis. We must bear in mind that a recurrent dacryocystitis may be a presentation of a lacrimal sac tumor, because early diagnosis and aggressive treatment can prevent recurrence and result in a cure.
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ranking = 1
keywords = obstruction
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6/74. The association of laryngoceles with ventricular phonation.

    Laryngoceles represent dilatations of the laryngeal saccule that may extend internally into the airway, or externally through the thyrohyoid membrane. Unilateral laryngoceles are uncommon clinical entities and bilateral laryngoceles are rare. Certain activities like glass blowing and playing a wind instrument are associated with laryngocele development, as is laryngeal carcinoma in the ventricular area. This case describes development of bilateral laryngoceles in a patient who chronically uses ventricular phonation during speech. The pathogenesis involves repetitive elevation of intralaryngeal pressure during false vocal cord approximation, exposing the ventricles to abnormally high air pressures. The pathogenesis in this case, as well as in laryngoceles associated with occupational or anatomic risk factors, is discussed.
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ranking = 2.0039091648501
keywords = airway
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7/74. Laryngeal papillomatosis with airway obstruction in an infant.

    Laryngeal papillomatosis in infants and children is a benign condition, but the location and a marked tendency for recurrence makes the disease both dangerous and troublesome. This case report deals with a little girl who had suffered hoarseness and wheezing since she was born. The diagnosis of laryngeal papillomatosis was made when she was 17 months old. By that time, the tumour had reached a size that necessitated a tracheotomy to secure the airway. The symptoms and differential diagnoses are discussed, and it is stressed that chronic hoarseness and wheezing sounds in infants and children should make a doctor suspect laryngeal papillomatosis. Laser treatment and anaesthetic management of small children with a compromised airway are discussed. As tracheal intubations and tracheotomy increase the risk of the disease spreading to the trachea and bronchi, an example is given of treating laryngeal papillomatosis with potassium titanyl phosphate (KTP) laser, using a laryngeal mask as an airway to avoid tracheal intubation. Whether this procedure can reduce the need to perform a tracheotomy in some of these small patients remains to be seen.
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ranking = 73.245593722928
keywords = airway obstruction, airway, obstruction
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8/74. Successful treatment of severe respiratory papillomatosis with intravenous cidofovir and interferon alpha-2b.

    In contrast to uncomplicated juvenile laryngeal papillomas which may regress spontaneously, papillomatosis involving pulmonary parenchyma is associated with a poor outcome. This report represents the case of a 34 yr-old female in whom respiratory papillomatosis resulted in voice problems and recurrent pneumonias due to bronchial obstruction. A computed tomographic scan of the chest showed worsening bilateral round cavitating consolidations. bronchoscopy revealed polypoid lesions of the right vocal cord and the midtrachea which were confirmed as squamous papillomatosis by histology. Interferon (IFN)alpha-2b treatment was inefficient as was cidofovir monotherapy on a maintenance basis. Six months of IFN-alpha-2b and cidofovir in combination led to a complete macroscopic disappearance of the laryngeal lesions and to an impressive regression of the tracheal papillomas and of the intrapulmonary consolidations. These data provide support that severe respiratory papillomatosis can be safely treated by interferon alpha-2b and cidofovir in combination. Probably the same mechanisms as in ribavirin plus interferon alpha-2b, in the treatment of patients with chronic hepatitis c, are responsible for the therapeutic success in this case.
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ranking = 1
keywords = obstruction
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9/74. Respiratory papillomatosis: a rare cause of collapse in a young adult presenting to the emergency department.

    Treating patients with rapidly deteriorating respiratory compromise in the emergency room is difficult and stressful. The patient in front of you is rapidly progressing towards total cardiorespiratory collapse and you may have no idea why. A case is reported of an adult presenting with impending cardiorespiratory collapse attributed to asthma who actually had upper airway obstruction caused by laryngeal papillomata. This case report reinforces the importance of airway assessment, gives an overview of respiratory papillomatosis, and reiterates both the non-surgical and surgical approach to the difficult airway.
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ranking = 20.816284886795
keywords = airway obstruction, airway, obstruction
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10/74. adenocarcinoma in biliary papillomatosis.

    A patient with multicentric biliary papillomatosis associated with invasive adenocarcinoma of the bile duct is reported. This case documents the progression to malignancy of a lesion generally thought to be benign. It serves to alert clinicians to a rare but important cause of recurrent biliary obstruction. The literature on this entity is reviewed.
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ranking = 1
keywords = obstruction
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