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INTRODUCTION: Tracheal bronchus is a rare anomaly in which an accessory bronchial branch originates superior to the tracheal bifurcation. It is usually incidentally found in patients with recurrent chest infection, persistent stridor and less commonly due to foreign body aspiration. PRESENTATION OF CASE: A 6-year-old medically and surgically free boy presented to the Emergency Department with severe shortness of breath. The patient was initially saturating well, but then suddenly worsened and was rushed for intubation. The patient was taken to the operating room for direct laryngobronchoscopy to retrieve the foreign body obstructing the airway. The foreign body was successfully retrieved, and the presence of a tracheal bronchus was confirmed. DISCUSSION: The presence of tracheal bronchus has its implications on airway management. CONCLUSION: Knowledge about tracheal bronchus is of great importance to the otolaryngologist and anesthetist to maintain the airway.
RESUMEN
BACKGROUND: Lobular capillary hemangiomas (LCH) are acquired benign vascular lesions of the skin and mucous membranes mostly affecting the head and neck region. Involvement of the nasal cavity is extremely rare and can manifest as epistaxis and nasal obstruction. CASE SERIES: In this case series, we present five cases of intranasal LCH. Three cases are of pregnant women that presented with epistaxis and nasal obstruction. The first was surgically treated during her pregnancy with preoperative embolization of the tumor for vascular control, while the other two patients were treated after delivery. The two other cases are of a post trauma pediatric patient, and an elderly lady with multiple co-morbidities, both presenting with recurrent nose bleeds and nasal obstruction. Surgical excision was performed with no complications observed post-operatively. DISCUSSION: The etiology of LCH is unknown, but certain predisposing factors have been associated with the development of LCH and include pregnancy and trauma. The anterior portion of the nasal septal mucosa and the tip of the inferior turbinate are commonly involved sites. Computed tomography scans and histopathology are used to diagnose LCH. Treatment is surgical excision with or without pre-operative embolization. CONCLUSION: LCH are rare tumors of the nasal cavity. Treatment of these lesions is surgical with or without preoperative vascular control.
RESUMEN
BACKGROUND: Approximately 3-6% of the general population have carpal tunnel syndrome (CTS). CTS is more prevalent among people with occupations that involve repetitive and forceful maneuvers, such as dentists. It is important to identify risk factors for these symptoms and to understand the impact they may have on clinical practice. OBJECTIVES: Measure the prevalence of CTS-symptoms and identify factors associated with CTS. DESIGN: Cross-sectional. SETTING: Dentists working in Riyadh. SUBJECTS AND METHODS: In-person interviews from 15 July to 10 September 2017 of subjects obtained using random cluster sampling. MAIN OUTCOME MEASURES: Prevalence of CTS-related symptoms among dentists. SAMPLE SIZE: 223 dentists (134 males and 89 females). RESULTS: The prevalence of CTS-related symptoms among dentists working in Riyadh was 30.5% (95% CI 0.25 to 0.36). Female dentists had a significantly greater risk of having CTS symptoms than male dentists (OR 2.13; 95% CI 1.09-4.17). Obese dentists were also more likely to complain of CTS symptoms than dentists within normal weight limits (OR 3.66; 95% CI 1.55-8.64). Left-hand dominance was strongly associated with CTS symptoms, with an estimated OR of 6.28 (95% CI 1.24-31.90). However, there was no relationship between CTS symptoms and age, marital status, history of smoking, exercise, dental specialty, occupation period, or having other educational degrees. CONCLUSION: Thirty percent of dentists working in Riyadh had experienced severe or mild symptoms related to CTS. Several risk factors for CTS have been identified. Future research could explore the reasons behind these risk factors to identify and implement prevention measures. LIMITATIONS: Cannot be generalized to the whole of Saudi Arabia, or the region. Larger controlled studies are needed to further identify the risk factors associated with CTS among dentists. In addition, since the Boston Carpal Tunnel Questionnaire was used, the self-reporting nature of the study might be affected by external bias. CONFLICT OF INTEREST: None.