Operational Consideration for Definitive Airway Management in the Austere Setting: A Case Report.

In modern and asymmetric conflicts, traumatic airway obstruction caused by penetrating injury to the face and neck anatomy is the second leading cause of preventable mortality. Definitive airway management in the emergency setting is most commonly accomplished by endotracheal intubation. When this fails or is not possible, a surgical airway, usually cricothyrotomy, is indicated. The clinical choice for establishing a definitive airway in the austere setting is impacted by operational factors such as a mass casualty incident or availability and type of casualty evacuation. This is a case report of a patient with severe cervicofacial injuries with imminent airway compromise in the setting of a mass casualty incident, without possibility of sedation and mechanical ventilation during his evacuation. The authors seek to highlight the considerations and lessons learned for emergency cricothyrotomy.

Osteochondrolipoma of the submandibular region: a case report and review of the literature.

Lipoma is an extremely common and ubiquitous benign soft tissue tumor composed of mature adipose tissue, with frequent differentiation towards other mesenchymal elements such as blood vessels, fibrous tissue, or muscle. They are typically slow-growing, encapsulated, superficial or deep, and have a wide range in size depending on their location. The presence of cartilage or bone is very rare, with most reported cases in the head and neck area. We report the case of an osteochondrolipoma of the submandibular region with associated benign bone marrow elements, with a review of the literature and discussion of the differential diagnosis.

Iatrogenic post-intubation tracheal rupture treated conservatively without intubation: a case report.

BACKGROUND: Tracheal rupture is a rare but life-threatening complication that most commonly occurrs after blunt trauma to the chest, but which may also complicate tracheal intubation. We report a case of post-intubation tracheal rupture after cataract surgery under general anesthesia treated conservatively. CASE PRESENTATION: Four hours after extubation, a 67 year-old woman developed subcutaneous emphysema of the facial, bilateral laterocervical and upper anterior chest. Tracheobronchial fiberendoscopy showed a posterior tracheal transmural rupture 4 cm long located 2.5 cm above the carina that opened in inspiration. The location of the lesion and features of the patient favoured conservative treatment with antibiotic cover. The patient made a full and uncomplicated recovery and was discharged fourteen days after the original injury. CONCLUSION: Two therapeutic strategies are currently employed for post-intubation tracheal rupture: a non-surgical strategy for small injuries and a surgical strategy for larger injuries. This case report presented the non-surgical therapeutic strategy of a large tracheal injury.