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Oropharyngeal stenosis in patient with oral submucous fibrosis: a case report with 8-year follow-up.BMC Oral Health Jun 2024Oral submucous fibrosis (OSF) is a chronic, progressive condition affecting the oral mucosa associated with areca nut consumption. It leads to restricted tongue...
Oral submucous fibrosis (OSF) is a chronic, progressive condition affecting the oral mucosa associated with areca nut consumption. It leads to restricted tongue movement, loss of papillae, blanching and stiffening of the mucosa, difficulty in opening the mouth, and challenges in eating due to inflammation and fibrosis. This report presents a rare case of oropharyngeal stenosis secondary to OSF in a 43-year-old male with a history of chewing betel nut. A surgical procedure similar to Uvulopalatopharyngoplasty was performed to excise the submucous oropharyngeal stenosis and to reconstruct the uvula, palatoglossal arch, and palatopharyngeal arch. At 8 years postoperatively, the patient exhibited a normal mouth opening and oropharyngeal aperture.
Topics: Humans; Male; Oral Submucous Fibrosis; Adult; Areca; Constriction, Pathologic; Follow-Up Studies; Oropharynx; Uvula
PubMed: 38872152
DOI: 10.1186/s12903-024-04467-4 -
Endoscopy Dec 2023
Topics: Humans; Hypopharynx; Constriction, Pathologic; Endoscopy; Iatrogenic Disease; Magnetic Phenomena
PubMed: 36894138
DOI: 10.1055/a-2029-6340 -
Otolaryngology--head and Neck Surgery :... Jun 2024Endoscopy is routinely used to diagnose obstructive airway diseases. Currently, endoscopy is only a visualization technique and does not allow quantification of airspace...
OBJECTIVE
Endoscopy is routinely used to diagnose obstructive airway diseases. Currently, endoscopy is only a visualization technique and does not allow quantification of airspace cross-sectional areas (CSAs). This pilot study tested the hypothesis that CSAs can be accurately estimated from depth maps created from virtual endoscopy videos.
STUDY DESIGN
Cross-sectional.
SETTING
Academic tertiary medical center.
METHODS
Virtual endoscopy and depth map videos of the nasal cavity were digitally created based on anatomically accurate three-dimensional (3D) models built from computed tomography scans of 30 subjects. A software tool was developed to outline the airway perimeter and estimate the airspace CSA from the depth maps. Two otolaryngologists used the software tool to estimate the nasopharynx CSA and the nasal valve minimal CSA (mCSA) in the left and right nasal cavities. Model validation statistics were performed.
RESULTS
Nasopharynx CSA had a median percent error of 3.7% to 4.6% when compared to the true values measured in the 3D models. Nasal valve mCSA had a median percent error of 22.7% to 33.6% relative to the true values. Raters successfully used the software tool to identify subjects with nasal valve stenosis (ie, mCSA < 0.20 cm) with a sensitivity of 83.3%, specificity ≥ 90.7%, and classification accuracy ≥ 90.0%. Interrater and intrarater agreements were high.
CONCLUSION
This study demonstrates that airway CSAs in 3D models can be accurately estimated from depth maps. The development of artificial intelligence algorithms to compute depth maps may soon allow the quantification of airspace CSAs from clinical endoscopies.
Topics: Humans; Nasal Cavity; Pilot Projects; Endoscopy; Male; Cross-Sectional Studies; Female; Imaging, Three-Dimensional; Proof of Concept Study; Adult; Tomography, X-Ray Computed; Middle Aged; Software; Nasopharynx
PubMed: 38329226
DOI: 10.1002/ohn.669 -
Archivos Argentinos de Pediatria Feb 2024The bilateral presentation of peritonsillar abscess is uncommon. Its management is controversial and it has been argued whether a quinsy tonsillectomy or an interval...
The bilateral presentation of peritonsillar abscess is uncommon. Its management is controversial and it has been argued whether a quinsy tonsillectomy or an interval tonsillectomy should be performed. Here we describe the case of a 14-year-old boy with sore throat, trismus, and fever. He had bilateral tonsillar hypertrophy, convex arches, and soft palate edema. Computed tomography: bilateral tonsillar hypertrophy, with post-contrast enhancement, both with collection, edema with moderate pharyngeal stenosis. The patient was hospitalized for intravenous therapy and tonsillectomy with bilateral drainage resulting in a complete resolution of his condition and discharge at 48 hours. In the presence of a peritonsillar abscess, an unsuspected contralateral abscess should be considered. It should be diagnosed and managed adequately to prevent complications. Quinsy tonsillectomy could be safe and should be considered in patients who will undergo anesthesia for abscess drainage. The final decision should be made for each patient on an individual basis.
Topics: Male; Humans; Adolescent; Peritonsillar Abscess; Tonsillectomy; Pharyngitis; Hypertrophy; Edema
PubMed: 37382552
DOI: 10.5546/aap.2023-03034.eng -
Head & Neck Apr 2024There is a lack of consensus regarding the effectiveness of salivary bypass tubes during total pharyngectomy reconstruction to prevent pharyngocutaneous fistula or...
BACKGROUND
There is a lack of consensus regarding the effectiveness of salivary bypass tubes during total pharyngectomy reconstruction to prevent pharyngocutaneous fistula or pharyngoesophageal stricture.
METHODS
Our study examined tubed free flap reconstruction outcomes for total pharyngectomy defects over 11 years at a single tertiary referral center. We compared postoperative fistula and stricture rates between two groups: those with salivary bypass tubes inserted during reconstruction and those without.
RESULTS
Among 36 patients, 26 had radial forearm, and 10 had anterolateral thigh free flap reconstruction. 53% received salivary bypass tubes. However, the tubes did not significantly reduce the relative risks of fistula or stricture. Notably, neck dissection during total pharyngectomy was associated with increased fistula incidence. Minor salivary bypass tube-related complications affected 21% of subjects.
CONCLUSION
The role of salivary bypass tubes in total pharyngectomy reconstruction remains uncertain.
Topics: Humans; Pharyngectomy; Constriction, Pathologic; Retrospective Studies; Plastic Surgery Procedures; Cutaneous Fistula; Postoperative Complications; Laryngectomy; Free Tissue Flaps
PubMed: 38165002
DOI: 10.1002/hed.27610 -
The Laryngoscope Feb 2024In this report, we present a 55-year-old female with cervical stenosis that underwent C5-C7 anterior cervical discectomy and fusion surgery complicated by hardware...
In this report, we present a 55-year-old female with cervical stenosis that underwent C5-C7 anterior cervical discectomy and fusion surgery complicated by hardware failure requiring removal. One screw remained after transcervical hardware removal due to operative difficulty with the risk of exposing the hypopharyngeal submucosal space. The retained screw caused the patient significant discomfort and dysphagia prompting a transoral attempt at removal. Using a hypopharynx blade on an oral retractor for access, the single-port surgical robot successfully removed the foreign body from the distal hypopharynx. In this case, a single-port surgical robot expanded access to the inferior hypopharynx. Laryngoscope, 134:588-591, 2024.
Topics: Female; Humans; Middle Aged; Robotics; Hypopharynx; Robotic Surgical Procedures; Laryngoscopes
PubMed: 37439371
DOI: 10.1002/lary.30882 -
Endoscopy Dec 2023
Topics: Humans; Constriction, Pathologic; Endoscopes; Esophageal Neoplasms; Endoscopic Mucosal Resection; Treatment Outcome; Esophageal Stenosis
PubMed: 36049765
DOI: 10.1055/a-1899-8441 -
The Journal of Laryngology and Otology Jun 2024This paper reports the innovative use of a modified nasopharyngeal airway device as a temporary stent in patients with laryngotracheal stenosis. It also discusses the...
BACKGROUND
This paper reports the innovative use of a modified nasopharyngeal airway device as a temporary stent in patients with laryngotracheal stenosis. It also discusses the technique of endoscopic stent placement, and our experience in terms of the indications and suitability.
METHOD
The nasopharyngeal airway device was modified to use as an airway stent by trimming it to the desired length. Next, the stent was inserted endoscopically and anchored using a novel approach.
RESULTS
The surgery was performed successfully without complications. The patients had full use of their voice while the stent was in situ. No significant granulation tissue was observed.
CONCLUSION
This paper demonstrates the feasibility of using a nasopharyngeal airway device as a temporary stent to prevent restenosis in cases where the patients have a strong demand for phonation. The modified nasopharyngeal airway device is potentially very promising, but cases must be selected carefully to avoid compromising efficacy and safety.
Topics: Humans; Stents; Tracheal Stenosis; Laryngostenosis; Male; Adult; Female; Nasopharynx; Treatment Outcome; Middle Aged; Feasibility Studies; Endoscopy
PubMed: 37926907
DOI: 10.1017/S0022215123001858