1临床资料患者,男,52岁,因“间断吐血2天”于2022-02-28夜间急诊收入我科。患者2d前晨起咳嗽后痰中带血,无法明确回答是否误卡异物,否认外伤史。既往患高血压15年,间断口服硝苯地平缓释片,血压控制在145/95 mm Hg;高血脂15年,间断口服...1临床资料患者,男,52岁,因“间断吐血2天”于2022-02-28夜间急诊收入我科。患者2d前晨起咳嗽后痰中带血,无法明确回答是否误卡异物,否认外伤史。既往患高血压15年,间断口服硝苯地平缓释片,血压控制在145/95 mm Hg;高血脂15年,间断口服辛伐他汀片,血脂控制正常。展开更多
Background: Lipoma is a very rare benign tumour of upper aero-digestive tract with less than 115 cases described in the English-literature. They account for approximately 1% of benign tumours of the larynx and oro/hyp...Background: Lipoma is a very rare benign tumour of upper aero-digestive tract with less than 115 cases described in the English-literature. They account for approximately 1% of benign tumours of the larynx and oro/hypopharynx. The symptoms are variable including progressive horseness, dysphagia and even severe dyspnea which can sometimes be life-threatening. The clinical presentation of lipoma is important particularly during the induction of general anesthesia, for they can cause unpredictable airway obstruction. Surgery is the treatment of choice which includes endoscopic techniques, microscopic laryngeal surgery and external surgical approach (cervicotomy). However, a standard surgical management for large lipomas of the epiglottis has not been present yet. In this article, we present a case report of a huge lipoma of the epiglottis successfully treated with tracheotomy and external surgical approach—cervicotomy with hyoidthyroidpexy without sacrificing any laryngeal structure. Case Presentation: We present a case of a 54-year-old female with a huge lipoma on the lingual surface of the epiglottis that extends upwards to the level of the left aryepiglottic fold narrowing the pyriform sinus, making impossible for our anesthesiologist the glottic visualization and the orotracheal intubation. Following a tracheotomy, the endoscopic and microscopic surgery approach was inadequate to manipulate the epiglottic lipoma. Instead, we performed macroscopic external surgery (cervicotomy with hyoidthyroidpexy) in which the epiglottic lipoma was pulled into the endolaryngeal window with forceps and then dissected from the surrounding tissues “in toto”. Conclusion: Despite epiglottic lipomas are rare and benign, they are important because of being potential cause of laryngeal obstruction. Surgery is the treatment of choice and different procedures are able to manage it. The external surgery approach—cervicotomy with hyoidthyroidpexy after tracheotomy enabled the huge lipoma to be extirpated without leaving any remnants or causing excessive laryngeal damage.展开更多
Introduction: The main signs and symptoms of ankyloglossia with deviation of the epiglottis and larynx (ADEL) are sleep disorders caused by respiratory restraint. The author contrived the surgical procedure of correct...Introduction: The main signs and symptoms of ankyloglossia with deviation of the epiglottis and larynx (ADEL) are sleep disorders caused by respiratory restraint. The author contrived the surgical procedure of correction of the glosso-larynx (CGL) and expansion of the vestibular oris (EVO) for the cure of ADEL. CGL increases vital capacity (VC) and forced expiratory volume in 1 second (1% FEV). EVO reduces nasal airflow resistance. The most important component of nasal airflow resistance is the nasal valve. Purpose: Our purpose was to measure how wide the nares were dilated after EVO. Method: The width of the nares, height of the nose, length of the philtrum and width of the lip were measured in patients who had signs and symptoms of ADEL, before and after EVO. Result: Significant increases were observed in the width of the nares, height of the nose and length of the lip after EVO. Conclusion: This study confirmed that the nares dilate after EVO. Not only the amelioration of nasal respiration by EVO increases immunity, but also aesthetic effects are obtained after EVO.展开更多
Weights of curetted adenoid were measured and were compared with both weights of tonsils and the rate of adenoidectomy among the tonsillectomized cases. This study included 603 patients whose adenoids were curetted du...Weights of curetted adenoid were measured and were compared with both weights of tonsils and the rate of adenoidectomy among the tonsillectomized cases. This study included 603 patients whose adenoids were curetted during the 11-year period. 90% of patients were 2 to 9 years old. The rate of curetted adenoid vegetation among the tonsillec-tomized cases was 80% among patients from 1 to 6 years old and 70% among patients of 7 and 8 years old. The rate remarkably decreased from 9 years of age. The average weight of the curetted adenoids in each age group ranged from 0.7 g to 1.9 g. There was no statistical correlation in the distribution of the average weight of the curetted adenoids between males and females as well as between the weight of the tonsils and the weight of the curetted adenoids. A hypothesis on the cause of adenoid hypertrophy was presented in this study.展开更多
文摘Background: Lipoma is a very rare benign tumour of upper aero-digestive tract with less than 115 cases described in the English-literature. They account for approximately 1% of benign tumours of the larynx and oro/hypopharynx. The symptoms are variable including progressive horseness, dysphagia and even severe dyspnea which can sometimes be life-threatening. The clinical presentation of lipoma is important particularly during the induction of general anesthesia, for they can cause unpredictable airway obstruction. Surgery is the treatment of choice which includes endoscopic techniques, microscopic laryngeal surgery and external surgical approach (cervicotomy). However, a standard surgical management for large lipomas of the epiglottis has not been present yet. In this article, we present a case report of a huge lipoma of the epiglottis successfully treated with tracheotomy and external surgical approach—cervicotomy with hyoidthyroidpexy without sacrificing any laryngeal structure. Case Presentation: We present a case of a 54-year-old female with a huge lipoma on the lingual surface of the epiglottis that extends upwards to the level of the left aryepiglottic fold narrowing the pyriform sinus, making impossible for our anesthesiologist the glottic visualization and the orotracheal intubation. Following a tracheotomy, the endoscopic and microscopic surgery approach was inadequate to manipulate the epiglottic lipoma. Instead, we performed macroscopic external surgery (cervicotomy with hyoidthyroidpexy) in which the epiglottic lipoma was pulled into the endolaryngeal window with forceps and then dissected from the surrounding tissues “in toto”. Conclusion: Despite epiglottic lipomas are rare and benign, they are important because of being potential cause of laryngeal obstruction. Surgery is the treatment of choice and different procedures are able to manage it. The external surgery approach—cervicotomy with hyoidthyroidpexy after tracheotomy enabled the huge lipoma to be extirpated without leaving any remnants or causing excessive laryngeal damage.
文摘Introduction: The main signs and symptoms of ankyloglossia with deviation of the epiglottis and larynx (ADEL) are sleep disorders caused by respiratory restraint. The author contrived the surgical procedure of correction of the glosso-larynx (CGL) and expansion of the vestibular oris (EVO) for the cure of ADEL. CGL increases vital capacity (VC) and forced expiratory volume in 1 second (1% FEV). EVO reduces nasal airflow resistance. The most important component of nasal airflow resistance is the nasal valve. Purpose: Our purpose was to measure how wide the nares were dilated after EVO. Method: The width of the nares, height of the nose, length of the philtrum and width of the lip were measured in patients who had signs and symptoms of ADEL, before and after EVO. Result: Significant increases were observed in the width of the nares, height of the nose and length of the lip after EVO. Conclusion: This study confirmed that the nares dilate after EVO. Not only the amelioration of nasal respiration by EVO increases immunity, but also aesthetic effects are obtained after EVO.
文摘Weights of curetted adenoid were measured and were compared with both weights of tonsils and the rate of adenoidectomy among the tonsillectomized cases. This study included 603 patients whose adenoids were curetted during the 11-year period. 90% of patients were 2 to 9 years old. The rate of curetted adenoid vegetation among the tonsillec-tomized cases was 80% among patients from 1 to 6 years old and 70% among patients of 7 and 8 years old. The rate remarkably decreased from 9 years of age. The average weight of the curetted adenoids in each age group ranged from 0.7 g to 1.9 g. There was no statistical correlation in the distribution of the average weight of the curetted adenoids between males and females as well as between the weight of the tonsils and the weight of the curetted adenoids. A hypothesis on the cause of adenoid hypertrophy was presented in this study.
