RESUMEN
Stellate ganglion block (SGB) is utilized in the diagnosis and management of various vascular disorders and sympathetically mediated pain in upper extremity, head and neck. The stellate ganglion lies medial to the scalene muscles, lateral to longus coli muscle, esophagus, trachea and recurrent laryngeal nerve, anterior to C7 transverse process and prevertebral fascia, superior to the subclavian artery and posterior to vertebral vessels. Consequently, inadvertent placement of the needle tip into these soft tissues and vessels occur with blind technique. Henceforth, various interventional modalities are being used for SGB, these have been reviewed in this paper. Various techniques of SGB have been described, and vary from the use of standard blind technique to the use of fluoroscopy, computerized tomography, magnetic resonance imaging, and radio nucleotide tracers. However, these techniques may not be practical in a clinical setting, insofar as they are time consuming, costly, and may involve radiation exposure. The use of fluoroscopy does not visualize the blood vessels close to the stellate ganglion. Ultrasounds are the alternative. They help in visualization of soft tissues to prevent complications and help in deposition of drug subfascially, under direct visual control.
Asunto(s)
Anestésicos Locales/administración & dosificación , Bloqueo Nervioso Autónomo/métodos , Ganglio Estrellado , Ultrasonografía Intervencional/métodos , Fluoroscopía/métodos , Humanos , Imagen por Resonancia Magnética/métodos , Dolor/diagnóstico , Dolor/tratamiento farmacológico , Tomografía Computarizada por Rayos X/métodos , Enfermedades Vasculares/diagnóstico , Enfermedades Vasculares/tratamiento farmacológicoRESUMEN
Laryngeal foreign bodies are not uncommon. A common difficulty encountered is a delay in diagnosis. The clinical features of a laryngeal foreign body may simulate asthma in an adult. The differentiation is necessary in the initial stages as the laryngeal foreign body can lead to sudden death due to airway obstruction. Sudden onset of wheeze in a non-asthmatic patient should arouse its suspicion. A case is reported where patient was transferred to respiratory intensive care unit for respiratory distress with wheeze which was later diagnosed as foreign body larynx.
Asunto(s)
Dentaduras , Cuerpos Extraños/diagnóstico , Laringe , Adulto , Femenino , Cuerpos Extraños/cirugía , Humanos , Traqueostomía , Pliegues VocalesRESUMEN
Branchio-oto-renal syndrome (Melnick-Fraser syndrome) is a rare autosomal dominant disorder characterized by syndromic association of branchial cysts or fistulae along with external, middle & inner ear malformations and renal anomalies. Authors are reporting a 19 year male patient, who presented with profound deafness & low set "lop-ear" with right sided preauricular pit. USG abdomen revealed agenesis of the left kidney.