Novel use of a suction-irrigation device to remove impacted blood clot from the airway.

OBJECTIVES: We sought to describe the novel use of a suction-irrigation device to remove a large blood clot that was causing critical obstruction of the trachea and main stem bronchi in our patient. METHODS: A large-bore suction-irrigation device designed for use in gynecologic cases was adapted for use in removal of an obstructing blood clot in the face of patient decompensation after several unsuccessful attempts at removal with standard otolaryngological instruments. RESULTS: The tracheal obstruction and the significant bronchial obstructions were successfully removed with the suction-irrigation device. The patient's ventilatory status quickly stabilized. He was extubated the following day and discharged home. CONCLUSIONS: The suction-irrigation device proved highly successful in removing a large blood clot from the airway. A similarly designed device made specifically for the airway could prove useful in similar cases in the future.

Original report of bilateral carotid body tumors with 2 rare concomitant anatomic findings, an ectopic parathyroid gland and cervical thymus, with literature review.

BACKGROUND: Carotid body tumors are uncommon neoplasms with unique epidemiology and management demands. Cervical embryology is complex. Developmental abnormalities can result in ectopic displacement of native tissues. METHODS: We present the case of a 21-year-old female with bilateral carotid body paragangliomas who presented to our clinic seeking excision of the symptomatic right-sided tumor. RESULTS: The patient was successfully treated with surgical excision. Two rare anatomic variants were identified in her surgical specimen: a carotid sheath parathyroid gland and ectopic thymus tissue. CONCLUSIONS: This patient represents an unreported combination of pathologic and anatomic phenomena. The paraganglioma resulted from a familial genetic mutation that is well studied in this patient's ethnic population (Dutch), and the literature on this topic is reviewed herein. The 2 anatomic variants likely represent a single, embryologic glitch that will carry no physiologic sequelae. The clinical application of this ectopic anatomy and the common embryologic origins are discussed.