• Title/Summary/Keyword: Airway injuries

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Spontaneously Healed Thyroid Cartilage Fracture with Displacement: Report of a Case (전위를 동반한 갑상연골 골절의 자연 치유 치험 1례)

  • Ryu, Hyun-Ho;Lee, Byung-Kook;Jeung, Kyung-Woon
    • Journal of Trauma and Injury
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    • v.23 no.1
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    • pp.53-55
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    • 2010
  • A thyroid cartilage fracture is a rare entity and can be overlooked easily. Such cases are difficult to diagnose, and assessment and treatment guidelines are difficult to determine. CT of the neck region may be useful when acute airway intervention is not required or when more information regarding the neck's anatomy is required for management decisions. We describe a case of a thyroid cartilage fracture with displacement. In the emergency department (ED), neck CT and fiberoptic nasopharyngoscopy were used to assess the status of the patient's (a male) vocal chords immediately. He remained unable to phonate continuously. After an immediate assessment, we decided to use steroid and conservative therapy. The patient had a good recovery and was without symptoms one month after injury. There is no question that early surgical repair of neck injuries affords the best results for airway and voice patency in most cases however, we suspect that surgical repair is not needed in all cases. Early recognition and an accurate therapy plan for a thyroid fracture with displacement are essential. Therefore, the emergency physician's immediate and careful decision based on endoscopy and neck CT is important for the patient's long-term recovery.

A Case of Thyroid Cartilage Fracture with Vocal Cord Paralysis (갑상연골 골절로 인한 성대마비의 치험례)

  • 조진규;차창일;안회영;조중생;홍남표
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.14.2-14
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    • 1983
  • Complications and sequelae of the laryngeal trauma are respiratory difficulties, edema or swelling, cellulitis or abscess, fistula, perichondrium and chondritis, chronic laryngeal stenosis, vocal cord paralysis, decannulation difficulty, and impaired voice production etc. Generally, the treatment of laryngeal injuries consists of initial tracheostomy for adequate airway and later surgical intervention for its complications and sequelae. Recently, authors experienced a case of closed laryngeal injury with thyroid cartilage fracture, left vocal cord paralysis, swallowing difficulty and right clavicular fracture owing to automobile accident. With reconstructive surgery for thyroid cartilage fracture, we established an adequate airway, improved swallowing function and better voice production.

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THE SUPERFICIAL AND DEEP SPREADING PATHWAYS OF INFECTION OF THE MAXILLOFACEAL AND NECK AREA: REPORTS OF 2 CASES (두경부 감염의 천층 및 심층부로의 확산 경로: 증례 보고)

  • Lee, Jung-Gyo;Choi, Byung-Jun;Kim, Yeo-Gap;Lee, Baek-Soo;Kwon, Yong-Dae;Kim, Young-Ran
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.32 no.1
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    • pp.62-67
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    • 2010
  • The spreading pathways which is the cause of infection on head and neck area are submandibular space, masticatory space, parapharyngeal space, retropharyngeal space, carotid sheath and mediastinum, etc. If spread to parapharyngeal area involving airway, such infection can be life-threatening by airway obstruction, or can cause vascular injury followed by hemorrhage, nerve injuries. Also, if spread to superficially, necrotizing fasciitis and many complications may occur including gangrene of skin. The key to successful treatment of infection on head and neck area is recognition of spreading pathways, early diagnosis and following therapeutic management. Our department present two cases, one is infection progressed superficially to suprasternal space, another is spreading deep according to parapharyngeal space, subclavian space and carotid sheath followed by airway obstruction, and obtained significant results with surgical incision and drainage, administration of selected antibiotics, continuous post-operative treatment. We report these 2 cases with literatures review.

An effective emergency care of a person from water submersion (익수사고자에 대한 효과적인 응급처치 방법)

  • Oh, Yong-Gyo;Park, Hyoung-Sun
    • The Korean Journal of Emergency Medical Services
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    • v.2 no.1
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    • pp.26-35
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    • 1998
  • This study was to exhibit the effective emergency care method for the drowning and non-drowning who are reached two-thousand peoples every year in our country. For investigate the effective emergency care, this study was discussed as follows ; Pathophysiology of the water submersion, Fresh-water & sea-water drowning, Factors affecting survival, and Prehospital management. The conclusions from this study were summarized as follows; 1. Remove the patient from the water. If you suspect neck or spinal injuries, Always support the head and neck level with the back and, begin rescue breathing. 2. Maintain the airway and support ventilation in the water use the jaw-thrust technique to avoid farther injury to the neck or spine. We might encounter more resistance to ventilations than you expect because of water in the airway. Once you have determined that there are no foreign objects in the airway, apply ventilations with more force; adjust ventilations until you see the patient's chest rise and fall but not until you see gastric distention. Do not attempt to remove water from the patient's lungs or stomach. 3. If there is no pulse, begin CPR. 4. Administer high-flow supplemental oxygen; suction as needed. 5. Once the patient is breathing and has a pulse, assess for hemorrhage; control any serious bleeding that you find. 6. Cover the patient to conserve body heat, Handle the patient very gently, and, Transport the patient as quickly as possible to Emergency Department, Continuing resuscitative measures during transport. If the patient have the hypothermia, follow hypothermia management.

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Bronchial Mucoepidermoid Carcinoma - 1 Case Report - (기관지 점막표피종 치험 -1례 보고-)

  • Byeon, Hyeong-Seop;An, Byeong-Hui;Lee, Dong-Jun
    • Journal of Chest Surgery
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    • v.21 no.5
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    • pp.941-947
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    • 1988
  • The mucoepidermoid carcinoma of the bronchus is very rare neoplasm. The histological appearance is an intimate mixture of mucous-producing cell and epidermoid cell. The malignant potency of the tumor was determined by histologic pattern. Bronchoplasty techniques represent the ideal form of excisional therapy for benign endobronchial tumor as well as tumors of low-grade malignant potential, such as bronchial adenoma, and for repair of traumatic airway injuries and benign stricture and selected group of patients with carcinoma of the lung. We experienced a case of-low-grade mucoepidermoid carcinoma in a patient of 21-year old male who has been suffered from hemoptysis episodes for several years. The sleeve resection of left main bronchus and left lower lobectomy due to bronchiectatic change were carried out. The patient are being followed up without specific problem.

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Vacuum-assisted Closure Therapy for Treating Patients with Severe Subcutaneous Emphysema (피하기종의 Vacuum-assisted Closure Therapy)

  • Oh, Tak-hyuk;Lee, Sang Cjeol;Lee, Deok Heon;Cho, Joon Yong
    • Journal of Trauma and Injury
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    • v.28 no.4
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    • pp.276-279
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    • 2015
  • Subcutaneous emphysema is a benign condition following trauma (pneumothorax and oropharyngeal), cervical or thoracic procedures, and mediastinal infection. However, severe subcutaneous emphysema may be related to serious complications such as respiratory failure, airway compromise, and tension- related phenomena. Many alternative therapies have been tried to treat patients with this condition. We report our experience with vacuum-assisted closure therapy for treating patients with severe subcutaneous emphysema.

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A CASE OF PALATAL GUNSHOT WOUND OPERATED BY LANGENBECK METHOD (Langenbeck씨 수술법에 의한 구개총상치험례)

  • Yu, Gwang-Hui;Sim, Yeong-Seop;Yong, Ho-Taek
    • The Journal of the Korean dental association
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    • v.13 no.7
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    • pp.629-632
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    • 1975
  • The clinical investigation and operation procedure were described on the gunshot wound which involved on soft, hard palate and nasal cavity. The patient, 19 years old, female, admitted in Han Yang Medical Center with clinical diagnosis of maxillofacial injuries on Nov. 1973. No Significant signs include of airway obstruction, Oro-nasal bleeding were revealed only exception of rupture and perforation on the soft, hard palate. For closure and reduction of destructed palatal wound, operation was done in out patient dental clinic under local anesthesia by means of Langenbeck method. And to control of post-operative inflammation and reactive swelling, administration of accurate antibiotics and physical therapy were performed for 5 days after operation. On the 10th day after administration, patient was discharged with satisfactory result of operation.

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Dexamethasone treatment for bilateral lingual nerve injury following orotracheal intubation

  • Kim, Saeyoung;Chung, Seung-Yeon;Youn, Si-Jeong;Jeon, Younghoon
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.18 no.2
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    • pp.115-117
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    • 2018
  • Lingual nerve injury is a rare complication of general anesthesia. The causes of lingual nerve injury following general anesthesia are multifactorial; possible mechanisms may include difficult laryngoscopy, prolonged anterior mandibular displacement, improper placement of the oropharyngeal airway, macroglossia and tongue compression. In this report, we have described a case of bilateral lingual nerve injury that was associated with orotracheal intubation for open reduction and internal fixation of the left distal radius fracture in a 61-year-old woman. In this case, early treatment with dexamethasone effectively aided the recovery of the injured lingual nerve.

Monitoring and Interpretation of Mechanical Ventilator Waveform in the Neuro-Intensive Care Unit (신경계 중환자실에서 기계호흡 그래프 파형 감시와 분석)

  • Park, Jin
    • Journal of Neurocritical Care
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    • v.11 no.2
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    • pp.63-70
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    • 2018
  • Management of mechanical ventilation is essential for patients with neuro-critical illnesses who may also have impairment of airways, lungs, respiratory muscles, and respiratory drive. However, balancing the approach to mechanical ventilation in the intensive care unit (ICU) with the need to prevent additional lung and brain injury, is challenging to intensivists. Lung protective ventilation strategies should be modified and applied to neuro-critically ill patients to maintain normocapnia and proper positive end expiratory pressure in the setting of neurological closed monitoring. Understanding the various parameters and graphic waveforms of the mechanical ventilator can provide information about the respiratory target, including appropriate tidal volume, airway pressure, and synchrony between patient and ventilator, especially in patients with neurological dysfunction due to irregularity of spontaneous respiration. Several types of asynchrony occur during mechanical ventilation, including trigger, flow, and termination asynchrony. This review aims to present the basic interpretation of mechanical ventilator waveforms and utilization of waveforms in various clinical situations in the neuro-ICU.

Pneumoparotitis

  • House, Laura Kathryn;Lewis, Andrea Furr
    • Clinical and Experimental Emergency Medicine
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    • v.5 no.4
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    • pp.282-285
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    • 2018
  • The objective is to review a case of pneumoparotitis and to discuss how knowledge of this unique presentation is important when making differential diagnoses in emergency medicine. A patient with recurrent subcutaneous emphysema of the head and neck is reviewed. Stenson's duct demonstrated purulent discharge. Physical examination revealed palpable crepitance of the head and neck. Fiberoptic laryngoscopy and barium esophagram were normal. Computed tomography demonstrated left pneumoparotitis and subcutaneous emphysema from the scalp to the clavicles. This is an unusual presentation of pneumoparotitis and malingering. Emergency physicians should be aware of pneumoparotitis and its presentation when creating a differential diagnosis for pneumomediastinum, which includes more life-threatening diagnoses such as airway or esophageal injuries.