Cases reported "Respiratory Sounds"

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1/22. anesthesia of CO2 laser surgery in a patient with Hunter syndrome: case report.

    Hunter syndrome (mucopolysaccharidosis, type II; MPS II) is one of a heterogeneous group of recessively inherited mucopolysaccharide storage diseases. patients with mucopolysaccharidosis show progressive involvement and derangement of many organs, especially upper airway anomalies, which are the major cause of perioperative death. In recent years, a CO2 laser is often applied to upper airway lesions. A 16-year-old patient suffering from Hunter syndrome was scheduled for CO2 laser surgery because of sleep apnea and respiratory stridor. Otolaryngological examination revealed bulging of the bilateral false cord with stenosis of the glottis. We adopted sevoflurane mask induction and high-frequency jet ventilation to overcome the perioperative airway problems. The anesthetic course was uneventful, and the patient was discharged 2 days after the operation.
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ranking = 1
keywords = stenosis
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2/22. Upper airway obstruction due to rhinoscleroma: case report.

    rhinoscleroma is a very rare cause of upper airway obstruction with only isolated reports in the literature of rhinoscleroma with isolated tracheal obstruction. The course is usually chronic with the presentation most often being non-specific. We report a 54-year-old woman with progressive shortness of breath and wheezing over 7 years' duration. She was diagnosed and treated as bronchial asthma without improvement in her symptoms. At the time of referral to our institution, her flow-volume loop revealed fixed upper airway obstruction. Her chest radiography and other laboratory tests were normal. bronchoscopy revealed a 70-80% irregular concentric stenosis of the trachea beginning immediately below the vocal cords and extending 4 cm distally. biopsy showed characteristic Mikulicz histiocytes containing numerous gram-negative intracellular coccobacilli consistent with a diagnosis of rhinoscleroma. The patient was treated with laser resection of the stenosis followed by a course of ciprofloxcin and trimethoprim-sulfamethoxazole. She has remained asymptomatic over a year follow-up period and repeated biopsies have shown no evidence of recurrence.
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ranking = 2
keywords = stenosis
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3/22. Respiratory arrest after successful neodymium:yttrium-aluminum-garnet laser treatment of subglottic tracheal stenosis.

    IMPLICATIONS: We describe a patient who developed respiratory arrest 4 h after successful laser treatment of tracheal stenosis. Respiratory arrest was caused, presumably, by airway narrowing due to delayed tissue edema secondary to thermal injury by deep penetration of the laser beam.
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ranking = 2127.4908806365
keywords = tracheal stenosis, stenosis
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4/22. Stridor: unusual presentation of multiple myeloma.

    We present a patient with multiple myeloma whose only presenting symptom was stridor caused by a subglottic stenosis. biopsy suggested the presence of amyloid which prompted immunological investigations that showed hypogammaglobulinaemia and the presence of Bence Jones proteinuria at 0.93 g/24 hours. Further investigation demonstrated a 15 per cent plasma cell infiltrate into the bone marrow and a lytic lesion in the mid-shaft of the right femur. Chemotherapy and localized radiotherapy were commenced. This is a most unusual presentation of multiple myeloma and shows that immunoglobulin profiles should be properly investigated in such cases.
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ranking = 1
keywords = stenosis
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5/22. A case of idiopathic tracheal stenosis.

    Idiopathic tracheal stenosis (ITS) is an extremely rare disease. We report the case of a 32-year-old woman with ITS. She had no history of previous surgery, endotracheal intubation, neck trauma, granulomatous disease, or any other severe respiratory tract infections. She presented with progressive dyspnea on effort and had been treated for bronchial asthma for 3 years. Chest radiography and laboratory examinations revealed no abnormalities. bronchoscopy demonstrated almost circumferential tracheal stenosis extending for 10 mm from about 20 mm below the vocal cords. Luminal diameter was about 4 mm at the narrowest. Bronchoscopic biopsy revealed increased fibrous tissue and chronic inflammatory cell infiltration (nonspecific inflammatory tissue). These finding are compatible with idiopathic stenosis as reported by Grillo et al. After tracheostomy, the patient was treated by tracheal segmental resection (two rings) with end-to-end anastomosis of the cartilaginous trachea. Symptoms of tracheal stenosis were completely relieved and no recurrence has been observed as of 3 years postoperatively.
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ranking = 2979.4872328911
keywords = tracheal stenosis, stenosis
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6/22. Ectopic subglottic thymic cyst: a rare cause of congenital stridor.

    We describe the case of a 10-day-old boy who was brought to the hospital with stridor and respiratory distress. He was diagnosed with stenosis caused by a subglottic cyst. After the cyst was removed endoscopically, the patient's symptoms resolved. pathology identified the cyst as ectopic thymic tissue. This case is noteworthy because we believe it represents the first reported instance of ectopic thymic tissue in the subglottis.
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ranking = 1
keywords = stenosis
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7/22. Functional stridor diagnosed by the anaesthetist.

    While stridor is an ominous sign implying severe airway stenosis, not all stridor has an organic aetiology. We present two cases of functional stridor in which the diagnosis was made by the anaesthetist. As experts in the management of difficult airways, anaesthetists should be aware of this clinical entity. Recurrent episodes present as aphonia, dysphonia, dyspnoea, apnoea or unconsciousness. Stridor is usually inspiratory. Flow volume loops show a pattern of variable extrathoracic obstruction with diminished peak inspiratory flow. Awake fibreoptic laryngobronchoscopy reveals normal airway anatomy, intense adduction of false and true vocal cords during inspiration and normal vocal cord motion on expiration. Treatment of functional stridor is supportive. The diagnosis of functional stridor demands exclusion of life-threatening airway stenosis of organic aetiology. A high index of suspicion for this clinical entity will reduce the incidence of unnecessary interventions such as tracheal intubation and tracheostomy.
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ranking = 2
keywords = stenosis
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8/22. Tracheal stent in the treatment of tracheal stenosis.

    The use of airway stents for the treatment of benign airway stenosis is increasingly advocated. However, the long-term safety and efficiency of these devices has not been established. We present a case of tracheal stenosis. which persisted despite open surgical and laser correction. The patient required tracheal stent insertion and is currently well with no respiratory difficulty. The use of metallic or silicon intraluminal stent remains appropriate in cases in which there is defined and relative short-term end point of treatment.
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ranking = 2128.4908806365
keywords = tracheal stenosis, stenosis
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9/22. Postoperative tracheal rupture in a patient with a difficult airway.

    PURPOSE: Tracheal rupture is an uncommon and potentially life-threatening event. This report presents a case of postoperative tracheal rupture in a patient with a known difficult airway presenting to a rural hospital. CLINICAL FEATURES: A 29-yr-old man presented to a rural hospital with sudden onset neck pain and progressive dyspnea. Five days earlier the patient had undergone tracheal resection for tracheal stenosis related to prolonged intubation. The patient informed the emergency room staff that the attending anesthesiologist had made note of a "difficult airway". The community hospital had neither a portable storage unit for difficult airway management nor a bronchoscope available. In the presence of a general surgeon, an initial attempt at an awake intubation was unsuccessful. During this time the patient developed massive subcutaneous emphysema obliterating surgical landmarks and causing stridor. A modified rapid sequence intubation was performed. intubation was successful using a Jackson-wisconsin #3 straight blade and styletted endotracheal tube. The patient was transferred to a tertiary care centre where he underwent a primary repair of the trachea. CONCLUSION: Management of tracheal rupture in the patient with a difficult airway is a challenging problem, especially, in a rural hospital. This case highlights the need for skilled staff and resources to manage a difficult airway in the emergency room.
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ranking = 425.4981761273
keywords = tracheal stenosis, stenosis
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10/22. Collapse of a new type of self-expanding metallic tracheal stent.

    Alveolus TB-STS is a new self-expanding, completely polyurethane-covered, metallic stent which has been designed to be successfully used even in the treatment of non-neoplastic airway strictures as it is supposed to be removable. We recently observed the collapse of an Alveolus tracheal stent, causing dyspnea and hemopthysis, in a 63-yr-old female patient with post-intubation tracheal stenosis. Such a complication, which to our knowledge has never been previously reported with metallic stent use, forced us to remove the stent.
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ranking = 425.4981761273
keywords = tracheal stenosis, stenosis
(Clic here for more details about this article)
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