1/5. Tonsillolith. Case report and review of the literature.Large oropharyngeal concretions--giant tonsillolith--are not very common. Over the last few years only some 50 cases have been reported in the literature. Many tonsilloliths, especially small concretions, are asymptomatic; large concretions, on the contrary, may produce several symptoms. The case is described of a 56-year-old female complaining of dysphagia, odynophagia, sore throat, right otalgia and swelling in right tonsillar fossa. Routine panoramic radiography revealed a radio-opaque area in right tonsil region. Computed tomography of oropharynx was performed and axial slices revealed a calcified cylindrical lesion in posterior pharyngeal region, between palatoglossus and palatopharyngeus muscles. The tonsillolith was easily excised under local anaesthesia. The post-operative course was good with no recurrence. Microscopic examination of the specimen revealed necrotic debris, "ghost" cells, calcifications and inflammatory cells, confirming the diagnosis of tonsillolith. Authors stress that large tonsillar concretions are uncommon, and may be difficult to diagnose since the tonsillolith can also be mistaken for other anatomic and pathologic structures in the oropharyngeal area.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
2/5. Late congenital syphilis of the larynx and pharynx presenting at endotracheal intubation.The case of a 73-year-old lady with late congenital pharyngo-laryngeal syphilis is presented. Its finding was at a potentially difficult intubation during the induction of general anaesthesia. She was asymptomatic; there was no evidence of active disease on either clinical examination or serology and no treatment was required. However, it is important to differentiate this condition from others which may require treatment.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
3/5. Changing Mallampati score during labour.We present the case of a changing Mallampati score during the course of labour in a healthy primigravida. On admission to hospital, the airway was assessed as Mallampati class I-II. At 5 cm cervical dilation, the woman began to bear down strenuously and continued this despite being advised of the inherent hazard. At 8 cm dilation, Caesarean delivery was contemplated because of fetal heart rate decelerations. Repeat airway evaluation revealed marked oedema of the lower pharynx giving rise to a Mallampati score of III-IV. Improvement of the fetal heart rate tracing permitted vaginal delivery under local infiltration. Postpartum, the Mallampati score was still III-IV. However, 12 hr later it had returned to the admission classification of I-II. We recommend that, in addition to the usual airway evaluation on admission, the assessment be repeated in the obstetric patient before induction of general anaesthesia.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
4/5. A wooden foreign body in the neck.foreign bodies in the throat and/or neck are uncommon and transpharyngeal impaction of a wooden foreign body in the neck without vascular injury is very rare. The patient presented in this communication, reported to our center five days after severe physical assault with a pharyngocutaneous fistula in the left side of the neck. Clinical examination and x-rays were unremarkable. Conservative treatment led to healing of the fistula and he was discharged. Two weeks later he was readmitted with an abscess in the right supraclavicular region. Exploration under general anaesthesia revealed a 7 cm long wooden fragment of a spear in the abscess cavity. The fragment was removed. After several days' antibiotic treatment, he recovered fully and was discharged.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |
5/5. angiomyoma of the retropharyngeal space.We encountered a 59-year-old man with angiomyoma of the retropharyngeal space. He had been referred to our hospital because of a six-month history of a sensation of a narrowed pharynx. A smooth-surfaced tumour arising from the posterior wall in the hypopharynx was observed by indirect laryngoscopy. Radiographical imaging revealed a solitary tumour with homogenous contents in the retropharyngeal space. The tumour was successfully removed via a lateral pharyngotomy approach under general anaesthesia. Histopathologically, the tumour was composed of numerous veins with thick muscular walls. To the best of our knowledge, this is the first report of an angiomyoma arising in the retropharyngeal space.- - - - - - - - - - ranking = 1keywords = anaesthesia (Clic here for more details about this article) |