RESUMEN
Laryngotracheobronchitis is a common, typically self-limiting viral infection. However, severe laryngotracheobronchitis can require urgent intubation to prevent imminent airway obstruction. The concurrent inflammation and urgency make laryngeal trauma more likely. We report two cases of children who underwent emergent intubation for acute respiratory distress due to viral laryngotracheobronchitis and subsequently developed anterior laryngeal webs. Both underwent laryngoplasty with keel placement, with resolution of their laryngeal webs. These cases describe pediatric laryngeal web formation as a rare complication of traumatic intubation and a novel technique for endoscopic keel placement.
Asunto(s)
Crup , Enfermedades de la Laringe , Laringoplastia , Niño , Glotis , Humanos , Lactante , Intubación Intratraqueal/efectos adversos , Enfermedades de la Laringe/etiología , Enfermedades de la Laringe/cirugíaRESUMEN
As the treatment of hematopoietic cancers evolves, otolaryngologists will see a higher incidence of opportunistic infections. We discuss a case of invasive fungal disease that invaded the larynx, pharynx, trachea, and pulmonary parenchyma after chemotherapy. The patient, a 46-year-old woman, presented 1 week after undergoing induction chemotherapy. Her initial symptoms were odynophagia and dysphagia. Despite encouraging findings on physical examination, her health rapidly declined and she required an urgent tracheotomy and multiple operations to address spreading necrosis. Because of her inability to heal, she was not a candidate for laryngectomy, so she was treated with conservative management. The patient was then lost to follow-up, but she returned 5 months later with laryngeal destruction and a complete laryngotracheal separation. While noninvasive fungal laryngitis is routinely encountered, its invasive counterpart is rare. The literature demonstrates that some cases completely resolve with medical therapy alone but that surgery is necessary in others. We recommend surgical debridement of all necrotic tissue.
Asunto(s)
Infecciones por Bacterias Grampositivas/complicaciones , Huésped Inmunocomprometido/inmunología , Infecciones Fúngicas Invasoras/complicaciones , Laringitis/complicaciones , Absceso Pulmonar/complicaciones , Faringitis/complicaciones , Antibacterianos/uso terapéutico , Antifúngicos/uso terapéutico , Aspergilosis/complicaciones , Aspergilosis/inmunología , Aspergilosis/terapia , Candidiasis/complicaciones , Candidiasis/inmunología , Candidiasis/terapia , Coinfección/complicaciones , Coinfección/inmunología , Coinfección/terapia , Infecciones por Corynebacterium/complicaciones , Infecciones por Corynebacterium/inmunología , Infecciones por Corynebacterium/terapia , Desbridamiento , Trastornos de Deglución/etiología , Disfonía/etiología , Femenino , Infecciones por Bacterias Grampositivas/inmunología , Infecciones por Bacterias Grampositivas/terapia , Humanos , Quimioterapia de Inducción/efectos adversos , Infecciones Fúngicas Invasoras/inmunología , Infecciones Fúngicas Invasoras/terapia , Laringitis/inmunología , Laringitis/terapia , Leucemia Mieloide Aguda/complicaciones , Leucemia Mieloide Aguda/tratamiento farmacológico , Absceso Pulmonar/inmunología , Absceso Pulmonar/terapia , Persona de Mediana Edad , Síndromes Mielodisplásicos/complicaciones , Síndromes Mielodisplásicos/tratamiento farmacológico , Faringitis/inmunología , Faringitis/terapia , Tomografía Computarizada por Rayos X , TraqueotomíaAsunto(s)
Oído Interno/patología , Pérdida Auditiva Sensorineural/etiología , Pérdida Auditiva Súbita/etiología , Hemorragia/complicaciones , Anciano , Humanos , Leucemia Mielomonocítica Crónica/complicaciones , Imagen por Resonancia Magnética , Masculino , Potenciales Vestibulares Miogénicos EvocadosRESUMEN
BACKGROUND: We report the first report of an expansile crista galli (CG) mucocele treated surgically by an endoscopic endonasal approach. Only 1 other case of a CG mucocele has been previously reported in the literature. This was treated by a craniotomy approach. CASE REPORT: We describe the technique employed in endoscopic marsupialization. We also discuss relevant CG anatomy, pneumatization patterns, surgical approaches, and its potential to cause disease, including CG sinusitis and mucocele formation. CONCLUSION: We present this case to highlight that the growing experience with endoscopic techniques offer us less morbid and more functional alternatives to a variety of lesions that were once tackled by neurosurgical or external approaches. In the contemporary era, the indications for open approaches and craniotomy for frontal sinus and CG lesions is likely limited. We recommend these patients undergo careful evaluation by a surgeon experienced in advanced endoscopic techniques before being advised to undergo open or craniotomy techniques.