RESUMO
Tumors of the trachea are rare, especially schwannoma. We diagnosed a 27-year-old man with schwannoma of the trachea after he was admitted to our hospital with complaints of progressive dyspnea and wheezing. He was treated as having bronchial asthma initially, but his signs and symptoms did not improve with conventional therapy. Flexible fiberscopy revealed the presence of a submucosal tumor in the subglottic area. Tracheal tomography, computed tomography (CT) and magnetic resonance imaging (MRI) revealed the presence of a mass in the trachea that extended from the cricoid cartilage level to the second tracheal ring. After tracheostomy, we removed the tumor from a tracheostoma upwards to the larynx without a laryngofissure, using forceps and scissors usually used for laryngomicrosurgery and endoscopes usually used for sinus surgery. No complications developed during or after the procedure. To our knowledge, this is the first report of the removal of a tracheal schwannoma by this technique.
Assuntos
Neurilemoma/cirurgia , Neoplasias da Traqueia/cirurgia , Adulto , Biópsia por Agulha Fina , Cartilagem Cricoide/cirurgia , Humanos , Laringoscopia , Imageamento por Ressonância Magnética , Masculino , Neurilemoma/complicações , Neurilemoma/diagnóstico , Tomografia Computadorizada por Raios X , Neoplasias da Traqueia/complicações , Neoplasias da Traqueia/diagnóstico , Estenose Traqueal/etiologia , Estenose Traqueal/prevenção & controle , Traqueostomia/métodosRESUMO
This study examined 53 patients (74 ears) with acute sensorineural hearing impairment due to rifles. After patients were admitted, 16 were treated by steroid alone and 37 by steroid and PGE1 through intravenous drip injection. The therapeutic ratio was 19% and the recovery ratio 66% with no significant difference seen between treatment types in hearing improvement. Forty-two patients were treated within 7 days of injury and 32 8 or more days after injury. The therapeutic ratio was 21% and the recovery ratio 78% among patients treated sooner and a significant difference was seen between in hearing improvement early and later (8 or more days) treatment. We studied average hearing improvement between pre- and post treatment across the frequency spectrum. The average hearing improvement of 500 Hz and 1 kHz was significantly high compared to that of 8 kHz. This suggests that impairment of middle-pitched tones is improved more easily than high-pitch tones in hearing injuries due to rifles, and that early treatment after injury is extremely important.