Anterior-commissure laryngoscope extraction of esophageal coins in children using an apnea technique.

This is a case series with chart review of 59 consecutive pediatric patients with a diagnosis of cervical esophageal coin who underwent anterior-commissure laryngoscope (ACLA) extraction during apnea. The purpose of this study was (1) to evaluate the efficacy and safety of coin extraction and (2) to analyze foreign body features and intraoperative physiological parameters (apnea time, O2 saturation and end-tidal CO2 (ETCO2) of apnea, minimum O2 during procedure, and heart rate). The technique was completed in 94.9% of the sample. The mean of the length of apnea was 57.7 ± 25.2 seconds. The median minimum O2 saturation was 99.5% (minimum = 93, maximum = 100), and the median of the ETCO2 at the end of the procedure was 35.7 ± 4.8 mm Hg. Heart rates remained at baseline values during the procedure (P < .001). This technique represents an efficient and secure modality for treatment. If successful, the patient can be safely discharged after clearance from anesthesia and a swallowing trial.

Synovial sarcoma of the hypopharynx in pregnancy.

Synovial sarcomas of the hypopharynx are a rare form of soft tissue sarcomas. In the head and neck, they are most commonly found on the pharyngeal wall in areas that do not have synovial cells. We review a case of a 23 year-old pregnant female who presented to our hospital with acute airway obstruction due to a large hypopharynx lesion. She underwent emergency tracheotomy and tumor debulking. Pathology revealed synovial sarcoma. After the procedure the patient went into labor delivering a 29 weeks premature child. Six weeks after being discharged from the hospital the patient had a partial pharyngectomy performed to excise the remnant base of the tumor. She has had no recurrence at the 30-month post-operative period.