1/5. leeches in the larynx.This is a report of four patients who inhaled leeches. They presented with severe attacks of inspiratory stridor, difficulty in breathing and spitting blood. Indirect laryngoscopy revealed a dark greenish living foreign body in the larynx in each case. laryngoscopy was performed with local anaesthesia in two of the cases and general anaesthesia was used in the other two. The leeches were removed with forceps.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/5. maxillary artery embolisation in the management of epistaxis.Serious consideration needs to be given to the importance of early embolisation of the maxillary artery in severe and refractory epistaxis. This is particularly true in the young fit person with traumatic epistaxis and in the elderly person who is unfit for general anaesthesia. Embolisation is now a safe and reliable technique. Six patients were embolised. In the two institutions from 1999 - 2000. All responded well to embolisation without complication. This paper describes the technique used in our hospitals and suggests that with the advent of platinum coils and pre embolisation arteriography, the chances of cerebrovascular accident is very small.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
3/5. moyamoya disease complicated by life-threatening epistaxis: first report of a case.OBJECTIVE: Subacute haemorrhage is a common emergency in otorhinolaryngology. Rapid evaluation of the aetiology and localization is a precondition for suitable treatment. We demonstrate a rare case of primarily intractable epistaxis associated with occlusion of the circle of willis (moyamoya disease). PATIENT: A 38-year-old man presented with a 24-h history of recurrent epistaxis. Anamnesis revealed long-term anticoagulation after heart valve transplantation and arterial hypertension. RESULTS: As a result of several re-bleedings after anterior nasal packing, a re-packing was followed by surgical treatment under general anaesthesia. Four days after discharge the patient presented to the intensive care unit with severe re-bleeding. After removal of a temporary Bellocq packing, interdisciplinary treatment was necessary. Emergency angiography revealed advanced moyamoya disease, with occlusion of both internal carotid arteries. The cerebral blood supply was sustained by an excessive collateral network originating from external carotid anastomoses. This complicated the endovascular treatment, which consisted of embolization of the infraorbital and maxillar arteries with liquid material and coils flanked by Bellocq packing. The patient was doing well at follow-up after 12 months. CONCLUSION: epistaxis complicating moyamoya disease is rare, and endovascular treatment is difficult due to the high risk of cerebral embolism. Malformations of the cerebral arteries should be considered in the differential diagnosis of intractable epistaxis.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
4/5. Large central osteoma of the maxillary antrum.The aim of this report is to describe a case presenting with complaints of orbital pain, altered facial sensation, nasal obstruction and unilateral spontaneous nose bleeding. Panoramic radiography and computerized tomography disclosed a large pedunculated heterogeneous mineral opacity with two impacted molar teeth invading the maxillary sinus. The patient was operated on under general anaesthesia. Microscopic examination of the surgical specimen revealed relatively dense, compact bone with sparse marrow tissue that was diagnosed as osteoma. Clinical characteristics and biological behaviour of this lesion were evaluated with special regard to the reliability of imaging modalities and surgical procedures.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |
5/5. Intranasal use of QuickClot in a patient with uncontrollable epistaxis.A 60-year-old man who presented with nasopharyngitis developed uncontrollable epistaxis following a punch biopsy of the nasopharynx. QuickClot was successfully used to arrest the haemorrhage under general anaesthesia after the usual methods employed to secure haemostasis failed. The haemostatic plug was successfully removed a week later after control of the infection. This case represents the first reported intranasal use of QuickClot. We describe our experience and a literature review on this haemostatic agent.- - - - - - - - - - ranking = 0.5keywords = anaesthesia (Clic here for more details about this article) |