The Annals of otology, rhinology, and laryngology
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Ann. Otol. Rhinol. Laryngol. · Oct 2018
Review Case ReportsGrill-Cleaning Wire Brush Bristle Ingestion: Case Series and Review of the Literature.
The authors report a small case series of an unusual ingested foreign body, wire brush bristles, whose small size can present a challenge for endoscopic removal. The authors describe transnasal endoscopic removal and provide a literature review. ⋯ Case Series, IV.
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Ann. Otol. Rhinol. Laryngol. · Oct 2018
Multicenter StudyPapillary-Type Carcinoma of the Thyroglossal Duct Cyst: The Case for Conservative Management.
Thyroglossal duct cyst (TGDC) is the most common congenital neck mass, presenting in up to 7% of the population. TGDC carcinoma is much less common, occurring in roughly 1% of patients diagnosed with TGDC. The vast majority of these tumors are papillary-type thyroid cancer. Given its rarity, there is wide variation in management recommendations for this disease. Extent of surgical management and need for adjuvant therapy including radioactive iodine ablation (RAI) are particularly debated, with some authors arguing aggressive therapy including RAI for any patients who undergo concurrent thyroidectomy with the Sistrunk procedure for TGDC carcinoma. We present a series of patients treated for TGDC carcinoma at our institutions and discuss our management algorithm. ⋯ Thyroglossal duct cyst carcinoma is uncommon and management is controversial. In low-risk patients (single tumor focus, negative margins, normal preoperative neck/thyroid imaging, no extension of TGDC carcinoma beyond the cyst wall), the Sistrunk procedure alone with observation of the thyroid may be sufficient. In this patient population, RAI is unlikely to be of any substantial benefit.
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Ann. Otol. Rhinol. Laryngol. · Aug 2018
ReviewProlonged Intubation Injuries of the Larynx: Endoscopic Diagnosis, Classification, And Treatment.
Laryngeal trauma from prolonged endotracheal intubation occurs in patients of all ages. Most changes are superficial and heal quickly. ⋯ This classification has required introduction of new descriptive terminology: "tongues of granulation tissue," "ulcerated troughs," "healed furrows," and "healed fibrous nodule." During intubation the degree of injury can be precisely assessed under general anesthesia by using telescopes for image magnification, thus assisting adecision whether to continue intubation orperform tracheotomy to minimize long-term morbidity. Changes that are found after extubation result from granulation tissue, ulceration, ora combination of both and have been illustrated on flow charts; a knowledge and understanding of these sequelae allows them to be identified by both indirect and direct laryngoscopy so that treatment can be planned.
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Ann. Otol. Rhinol. Laryngol. · Sep 2017
Case ReportsSurgical Management of Supraglottic Stenosis Using Intubationless Optiflow.
Airway management during endoscopic surgical treatment of supraglottic and pharyngeal stenosis is often challenging and can be accomplished by various means, including tracheostomy, jet ventilation, or direct laryngoscopy. We describe CO2 laser excision of supraglottic-pharyngeal stenosis using intubationless Optiflow high-flow nasal cannula (HFNC). ⋯ Optiflow is an important new tool in the management of severe supraglottic stenosis. It provides sufficient oxygenation to perform extended apneic surgery and improves endoscopic surgical access in a limited airway.
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Ann. Otol. Rhinol. Laryngol. · Jul 2017
Self-extubation Laryngeal Injuries at an Academic Tertiary Care Center: A Retrospective Pilot Study.
The purpose of this study is to identify laryngeal symptoms and injuries in self-extubated patients. ⋯ This study demonstrates that the majority of self-extubated patients have laryngeal symptoms and clinical findings. A comprehensive, multidisciplinary evaluation is warranted for self-extubations.