RESUMEN
BACKGROUND: Some children are dependent on a tracheostomy for many years. As they grow, larger tracheostomy tubes may be required. Although tables of sizes of tracheas exist for different age groups, they are estimations of normal and may not be accurate for atypical cases. Chest radiographs and computed tomograms (CT) have been used experimentally to estimate tracheal sizes, but are not in regular use. METHOD: High-resolution diagnostic ultrasound imaging was used to estimate the internal and external transverse tracheal diameter, and the depth of the trachea from the skin surface. This allowed selection of the correct standard pattern tracheostomy tube, or the construction of a custom-made tube preoperatively. RESULTS: Four children with various abnormalities who were being considered for replacement tracheostomies were scanned. In one, diagnostic ultrasound confirmed that a new larger fenestrated tube could be placed, which subsequently improved vocalisation and respiration. In the other three, the scan showed there was no space to allow a larger tube to be placed. The standard tables were not suitable for any of these patients. CONCLUSION: High-resolution ultrasound has a role in the non-invasive measurement of the size of the tube needed for specialised operations in children.
Asunto(s)
Tráquea/diagnóstico por imagen , Traqueostomía/instrumentación , Anomalías Múltiples , Adolescente , Quemaduras Químicas/terapia , Niño , Diseño de Equipo , Cara/anomalías , Humanos , Masculino , Músculos del Cuello/diagnóstico por imagen , Paraplejía/terapia , Cuidados Preoperatorios , Respiración , Piel/diagnóstico por imagen , Habla/fisiología , Traumatismos de la Médula Espinal/terapia , Propiedades de Superficie , Glándula Tiroides/diagnóstico por imagen , Tráquea/lesiones , UltrasonografíaAsunto(s)
Bronquios/cirugía , Enfermedades Bronquiales/cirugía , Tecnología de Fibra Óptica , Anciano , Broncoscopía , Humanos , Masculino , SucciónRESUMEN
We present two cases of histologically confirmed intracerebral metastases from oral squamous cell carcinoma (SCC). This site of distant spread has not to our knowledge previously been reported. The only common feature in all these cases was the long period over which the patients had untreated primary disease (12--24 months). Both patients developed symptoms from their cerebral deposit within a short time of diagnosis and treatment of the primary disease. They died rapidly of their cerebral metastases despite extensive and effective treatment of the primary site and regional lymph nodes. We recommend that a magnetic resonance (MR) scan of the brain is considered for patients who present with long-standing untreated primary oral SCC.
Asunto(s)
Neoplasias Encefálicas/secundario , Carcinoma de Células Escamosas/secundario , Neoplasias de la Boca/patología , Resultado Fatal , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Palatinas/patología , Paladar Blando/patología , Neoplasias de la Lengua/patologíaRESUMEN
We describe a technique of percutaneous miniplate osteosynthesis of the zygoma, using the transbuccal approach. It can be used in conjunction with an extraoral approach, or in isolation. Excellent access was achieved to the posterior zygomatic buttress and arch of zygoma, and the infraorbital rim. No complications developed in the two cases presented. This technique is a useful addition to the armamentarium of maxillofacial surgeons.
Asunto(s)
Fijación Interna de Fracturas/métodos , Fracturas Conminutas/cirugía , Fracturas Cigomáticas/cirugía , Adulto , Placas Óseas , Femenino , Fijación Interna de Fracturas/instrumentación , Humanos , MasculinoRESUMEN
A young woman developed an unusual adenocarcinoma in each submandibular salivary gland at an interval of 30 months. This presentation has not been described previously. The possible etiology for this and treatment options are discussed. The choice of diagnostic imaging (ultrasound versus magnetic resonance imaging) is highlighted. As a result of regular follow-ups using diagnostic ultrasound, a second tumor was observed to reach a dimension of 8 mm in less than 6 months. This is probably the first report documenting the extent of initial growth of this rare tumor.
Asunto(s)
Adenocarcinoma/patología , Neoplasias Primarias Secundarias/patología , Neoplasias de la Glándula Submandibular/patología , Adenocarcinoma/diagnóstico por imagen , Adulto , Resultado Fatal , Femenino , Humanos , Imagen por Resonancia Magnética , Metástasis de la Neoplasia , Neoplasias Primarias Secundarias/diagnóstico por imagen , Neoplasias de la Glándula Submandibular/diagnóstico por imagen , UltrasonografíaRESUMEN
Peritonsillar abscess is a rare presentation of squamous cell carcinoma of the tonsil. We report two cases illustrating the need to be aware of the possibility and reinforcing the need to send all excised tissue for histopathological diagnosis.
Asunto(s)
Carcinoma de Células Escamosas/diagnóstico , Absceso Peritonsilar/diagnóstico , Neoplasias Tonsilares/diagnóstico , Adulto , Carcinoma de Células Escamosas/patología , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Tonsilares/patologíaRESUMEN
Tongue piercing remains popular. A variety of complications have been reported, including life-threatening infection, airway problems and damaged teeth or mucosal surfaces. A patient who collapsed after continuous profuse bleeding following tongue piercing is presented. It is recommended that piercing practitioners be licensed and inspected. A list of written post piercing instructions for customers is included on how to deal with, or who to contact regarding potential complications including haemorrhage.
Asunto(s)
Técnicas Cosméticas/efectos adversos , Cuerpos Extraños/complicaciones , Choque Hemorrágico/etiología , Lengua/lesiones , Adulto , Femenino , Humanos , Hemorragia Bucal/complicaciones , Hemorragia Bucal/etiologíaRESUMEN
Two patients with metastatic squamous cell carcinoma are presented. Both were initially clinically diagnosed as branchial cysts. The importance of a full examination of the upper aerodigestive tract, and fine needle aspiration cytology is emphasised to avoid the possibility of excision as a branchial cyst, which could lead to tumour dissemination.
Asunto(s)
Branquioma/diagnóstico , Carcinoma de Células Escamosas/secundario , Neoplasias de Cabeza y Cuello/diagnóstico , Metástasis Linfática/diagnóstico , Adulto , Biopsia con Aguja , Carcinoma de Células Escamosas/diagnóstico , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The aneurysmal bone cyst is an uncommon lesion of the jaws. Cases involving the maxilla have been reported infrequently. Despite uncertainty as to the aetiology of the aneurysmal bone cyst, it is regarded as a benign lesion. Conservative surgical treatment with regular postoperative follow-up is recommended. The case described here presented with tooth mobility resulting from extensive root resorption. A review of the literature reveals that significant root resorption is not a commonly reported feature of aneurysmal bone cysts. For the present case we interpret the evidence as supporting a diagnosis of idiopathic root resorption complicated by the formation of a aneurysmal bone cyst.