1/57. Cyanoacrylate tissue adhesive augmented tenoplasty: a new surgical procedure for bilateral severe chemical eye burns.PURPOSE: To report on cyanoacrylate tissue adhesive augmented tenoplasty, a new surgical procedure for bilateral severe chemical eye injuries. methods: A 26-year-old man presented with bilateral severe (grade IV) chemical burns involving the eye, periorbital tissues, face, and neck. Despite adequate medical therapy, corneal, limbal, and scleral ulceration progressed in both eyes. Secondary pseudomonas keratitis necessitated therapeutic penetrating keratoplasty in the right eye. Tenoplasty and glued-on rigid gas permeable contact lens were unsuccessful to arrest progression of corneolimboscleral ulceration in the left eye. We applied n-butyl cyanoacrylate tissue adhesive directly on the ulcerating corneal, limbal, and scleral surface to augment tenoplasty. RESULTS: The left ocular surface healed with resultant massive fibrous tissue proliferation and symblepharon on the nasal side. Ocular surface rehabilitation resulted in a vascularized leukomatous corneal opacity with upper temporal clear cornea. The patient achieved visual acuity of 6/36 in the left eye. CONCLUSION: We suggest that cyanoacrylate tissue adhesive-augmented tenoplasty can be undertaken to preserve ocular integrity and retain visual potential in a severe chemical eye injury.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
2/57. Medication-induced oesophageal injury leading to broncho-oesophageal fistula.Medication-induced oesophageal injury is one of the least recognised side-effects of oral medication and, in contrast to other oesophageal pathologies, is rarely considered in the differential diagnosis of chest pain. We describe a case of medication-induced oesophageal injury with a rare complication in which the diagnosis was not considered until the characteristic features were demonstrated at endoscopy.- - - - - - - - - - ranking = 0.092340914074952keywords = chest (Clic here for more details about this article) |
3/57. colon interposition in a patient with total postcricoid stenosis after caustic ingestion and preservation of full laryngeal function.Caustic burns of the upper aerodigestive tract continue to be a significant clinical problem. However, the available literature uncommonly mentions changes affecting the larynx. We could find only one publication in which four cases of high hypopharyngeal stenosis were described in detail and where the functional outcome of the laryngeal function was stated as partially saved. We describe here a case of total retrocricoid stenosis in a 28-year-old woman that was caused by lye ingestion. A life-saving gastroesophagectomy was performed by the Department of general surgery. Reconstruction of the esophagus was carried out with mobilized right colon, which was meticulously sutured circumferentially behind the arytenoids and on the prevertebral fascia. The anatomy of the larynx and its nerve supply were scrupulously maintained intact. We believe that our patient's rehabilitation was due mainly to an intensive 18-month program of care, following which all laryngeal functions recovered with normal voice and swallowing patterns.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
4/57. Successful treatments of lung injury and skin burn due to hydrofluoric acid exposure.Recent growth in the electronics and chemical industries has brought about a progressive increase in the use of hydrofluoric acid (HF), along with the concomitant risk of acute poisoning among HF workers. We report severe cases of inhalation exposure and skin injury which were successfully treated by administering a 5% calcium gluconate solution with a nebulizer and applying 2.5% calcium gluconate jelly, respectively. Case 1: A 52-year old worker used HF for surface treatment after welding stainless steel, and was hospitalized with rapid onset of severe dyspnea. On admission to the critical care medical center he had widespread wheezing and crackles in his lungs. Chest radiograph showed a fine diffuse veiling over both lower pulmonary fields. Severe hypocalcemia with high concentrations of F in serum and urine were disclosed. He was immediately given 5% calcium gluconate solution by intermittent positive-pressure breathing (IPPB), utilizing a nebulizer. On the 21st hospital day, chest film and CT scan did not demonstrate any abnormality. He was discharged very much improved on the 22nd hospital day. Case 2: A 35-year old worker at an electronics factory was admitted to his local hospital with severe skin burn on his face and neck after exposure to 100% HF. Treatment began with immediate copious washing with water for 20 min. calcium gluconate 2.5% gel (HF burn jelly) was applied to the area as a first-aid measure. Persistent high concentrations of serum and urinary F were disclosed for 2 weeks. After treatment with applications of HF burn jelly, he was confirmed as being completely recovered. The present cases and a review of published data suggest that an adequate method of emergency treatment for accidental HF poisoning is necessary.- - - - - - - - - - ranking = 0.092340914074952keywords = chest (Clic here for more details about this article) |
5/57. Reinforcement of laryngeal mask airway cuff position with endotracheal tube cuff for airway control in a patient with altered upper airway anatomy.Implications: This case report suggests that the laryngeal mask airway (LMA) cuff position may not be optimal in some difficult airway situations in which the anatomical position of the larynx is altered. Reinforcement of the LMA cuff position by an additional cuff on the dorsal side of the LMA cuff may prove helpful. In this case, in which a difficult airway was anticipated, a nasopharyngeal tube cuff placed behind the standard LMA cuff helped relieve upper airway obstruction.- - - - - - - - - - ranking = 5keywords = upper (Clic here for more details about this article) |
6/57. Upper aerodigestive tract burn: a case report of firework injury.The case of a 46 year-old German man with upper aerodigestive burn by firework was reported. He presented with the symptoms and signs of upper airway obstruction. tracheostomy was done and direct laryngoscopy with microscopic examination revealed swelling and denudation of the mucosa of the oral cavity and supraglottic area. Intravenous steroids and antibiotics were administrated for treatment. It is suggested that proper management needs an understanding of the mechanism and effect of the corrosive agent. Careful airway management resulted in a good outcome in this patient.- - - - - - - - - - ranking = 2keywords = upper (Clic here for more details about this article) |
7/57. Cololaryngostomy procedure in caustic esophageal burns.The study presented herein was undertaken to report an original case of cololaryngostomy operation in caustic esophageal burns. Cololaryngostomy application to a chronic caustic esophageal burn case is reported with a detailed literature review of the topic. For the first time in the world, the larynx was used for the integrity of the gastrointestinal system by applying a cololaryngostomy procedure as it was found to be the only intact and reliable tissue in the operation. The patient started to gain weight in a 3-month period. Oral nutrition and speech were also achieved. Caustic injury to the upper aerodigestive system with scarring of the pharynx, hypopharynx and esophagus is an important reconstructive problem. In reconstruction, the aim should be the supplementation of both oral nutrition and speech.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
8/57. Visual rehabilitation after severe alkali injury with piggyback hyper O2 contact lenses.PURPOSE: To report successful visual rehabilitation following severe bilateral alkali injury using piggyback hyperoxygen-transmissible (hyper O2) contact lenses. methods: Case report and literature review. RESULTS: More than 15 years after a severe bilateral alkali injury, multiple surgical procedures including repeat bilateral penetrating keratoplasty, severe tear deficiency, and chronic ocular surface disruption, the patient achieved 20/30 best-corrected vision through the simultaneous use of a hyper O2 rigid gas permeable contact lens over a hyper O2 soft contact lens in his right eye. The patient has tolerated this piggyback combination without any adverse reactions or complications, and his corneal graft remains clear and healthy. CONCLUSION: Visual rehabilitation for conditions that compromise the ocular surface can be accomplished by utilizing newer soft and rigid contact lens materials that facilitate oxygen transmission, thereby promoting epithelial healing and improving safety in extended wear situations. These newer materials may potentially reduce complications previously associated with extended wear therapeutic lenses.- - - - - - - - - - ranking = 0.57826322133026keywords = back (Clic here for more details about this article) |
9/57. Chemical burn caused by povidone-iodine alcohol solution--a case report.Burns associated with chemical disinfectants for skin preparation are rare. skin irritation and maceration associated with pressure factors may contribute to its occurrence. We report a 24-year-old female with thyroid tumor who was admitted for subtotal thyroidectomy. After anesthetic induction, the patient was placed in the supine position with the trunk elevated to 20 degree. The skin over the anterior neck was sterilized with 10% povidone-iodine (PI) alcohol solution. After a 3-hour surgery, the patient complained of burning pain over the back at the recovery room. physical examination revealed a 9 x 11 cm area of skin lesion partially thickened amid on the middle of the back suggestive of chemical burn. After conservative treatment, she was discharged uneventfully 4 days later. Upon follow-up, the wound was seen to heal with minimal scarring within 3 weeks.- - - - - - - - - - ranking = 0.19275440711009keywords = back (Clic here for more details about this article) |
10/57. An unusual cause of burn injury: fig leaf decoction used as a remedy for a dermatitis of unknown etiology.Medicinal plant extracts are commonly used worldwide. Their use relies mostly on historical and anecdotal evidence and might be so hazardous. Phytophotodermatitis is a well-known entity that is caused by the sequential exposure to certain species of plants containing furocoumarins and then to sunlight. In this article, superficial burn lesions caused by fig leaf decoction that was applied to a patient's both upper extremity as a remedy for a dermatitis of unknown etiology is reported. Direct sun exposure is an essential component of phytophotodermatitis. All reported cases to date have in common that patients are exposed to direct sunlight or to artificial UVA lights (like solarium) of varying durations. In our case neither direct sun exposure, other than inevitable indoor UVA influence, nor blister formation was present. The etiologic factors, symptoms, signs, course, and treatment alternatives for phytophotodermatitis are also reviewed briefly.- - - - - - - - - - ranking = 1keywords = upper (Clic here for more details about this article) |
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