1/7. Laryngeal diversion and tracheotracheal speech fistula for chronic aspiration.Intractable aspiration is a life-threatening problem and often requires a procedure for blocking or separating the larynx from the bronchial tree. The disadvantage of these techniques is a compromise of phonation. We report the use of a speech fistula after laryngotracheal diversion to restore voice. It allows for the definitive treatment of aspiration, while maintaining the use of the vocal folds for phonation.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
2/7. Unsuspected foreign body aspiration.Aspiration of foreign bodies is a serious complication that may occur during the course of dental treatment. A case report of a 60-year-old man with recurrent pneumonia is presented. One year after the onset of his initial symptoms, a hard substance that made a complete mold of the bronchial tree at the inferior right lobe was extracted with a rigid bronchoscopy. This green material of elastic consistency was dental impression material (polyvinylsiloxane). On careful questioning, the patient indicated that he had dental impressions taken 2 months before the onset of the symptoms. Surgery was indicated and lobectomy of the inferior right lobe was performed without incident. To avoid this complication, some preventive precautions such as identifying high-risk patients; using rubber dam; tethering any small instrument with a ligature; placing a gauze screen to protect the oropharynx in sedated patients; and using custom impression trays to minimize the amount of impression material required have been suggested. In case of a suspected aspiration, the patient must be referred to appropriate medical care.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
3/7. An unusual way of tracheal stoma cleaning could end up with foreign body aspiration in a laryngectomized patient.We report a case of a laryngectomized patient who accidentally aspirated a wooden stick through his tracheal stoma in highly unusual circumstances. He was in a habit of cleaning secretions of upper airway with a wooden stick covered with cotton on the tip soaked in olive oil, via tracheostomy. After applying topical aerolized lidocaine spray through the tracheostomy stoma a flexible video-brochoscopy was performed and a tree twig over 11 cm in length was removed. The patient's symptoms were resolved by a bronchoscopy. With experience and availability of accessories, the removal of the foreign body using flexible bronchoscope under local anesthesia can be performed safely and successfully. This case suggests that the physicians and otolaryngologists should educate their laryngectomized patients about stomal care and discuss any potential life-threatening situation they might encounter.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
4/7. diagnosis of occult meat aspiration by fiberoptic bronchoscopy.Cytologic examination of bronchial washings from a patient with a persistent localized pulmonary infiltrate revealed large numbers of striated muscle fibers. The patient died shortly after bronchoscopy, and postmortem examination provided evidence of recurrent aspiration pneumonias. Since skeletal muscle fibers are not likely to enter the tracheobronchial tree from any endogenous source, it is proposed that this unusual cytologic finding is virtually diagnostic of recent food aspiration.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
5/7. Pulmonary aspiration presenting with generalised convulsions.Foreign body in the tracheobronchial tree is a relatively infrequent, but, potentially fatal event, requiring rapid and expert intervention. The symptoms and signs may be mistaken for asthma and pneumonia, - or, as in the case described, with grand mal epileptiform seizures. This emphasises the need to take a thorough case history, and to have a high index of suspicion in a case presenting with convulsion associated with cough, wheezing or respiratory distress.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
6/7. laryngectomy for chronic aspiration.Most laryngectomies are performed for neoplastic disease. Recently, the authors have managed four patients with chronic aspiration who ultimately required laryngectomy to control leakage of food and saliva into the tracheobronchial tree. Various surgical procedures have been devised to conserve the larynx and protect the lower airway. Although potentially reversible, these procedures are fraught with complications, and the patients seldom recover sufficiently to justify repair of the larynx. The authors feel that those patients with poor prognoses, associated medical problems, and evidence of impaired wound healing should undergo laryngectomy. This approach removes doubt about the cause of the aspiration and spares the patients additional surgical procedures should a more conservative approach fail.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |
7/7. Severe barium sulfate aspirationinto the lung: clinical presentation, prognosis and therapy.Aspiration of large amounts of barium sulfate is a rare incident during radiographic contrast procedures. Here we describe two patients, who developed acute dyspnea after aspiration of significant amounts of barium into the lung during an upper gastrointestinal radiographic contrast study. The regions of the lung involved depended on the position of the patients during and after aspiration. Arterial blood gas analysis revealed hypoxemia due to alveolar shunt with V/Q distribution disturbances. bronchoscopy was performed to extract the contrast medium from the tracheobronchial tree. The patients could be discharged a few days later with normal lung function. Long-term prognosis is generally excellent due to the inert character of barium sulfate, even though impressive radiographic findings remain.- - - - - - - - - - ranking = 1keywords = tree (Clic here for more details about this article) |