Uvular necrosis as an unusual complication of bronchoscopy via the nasal approach.

Bronchoscopy can cause post-procedural throat discomfort due to oropharyngeal irritation. We report a rare complication of bronchoscopy that resulted in similar symptoms. A 30-year-old man complained of severe throat discomfort a day after bronchoscopy. Examination revealed a swollen, elongated uvula. The lower half of the uvula was completely white, consistent with uvular necrosis. He was managed conservatively with topical lidocaine and antihistamines. At a follow-up examination 2 weeks later his symptoms had substantially improved and the necrosed uvula had separated, leaving a shortened uvula with an irregular border. Simple precautions taken during bronchoscopy can avoid this rare complication that causes persistent symptoms.

Postoperative uvular necrosis: A case series and literature review.

OBJECTIVES/HYPOTHESIS: Postoperative uvular necrosis is rare, but can be distressing to the patient when it unexpectedly occurs. Little has been published regarding its predisposing factors and pathophysiology. The purpose of this comprehensive review was to compile cases of postoperative uvular necrosis and identify risk factors and potential causes for this complication. STUDY DESIGN: Retrospective case series. METHODS: The study was performed at an academic tertiary care referral center. Clinical records from four patients treated for postoperative uvular necrosis from 2008 to 2018 were reviewed. A comprehensive literature review was also performed. The MEDLINE, Embase, and Scopus databases were searched, as well as the grey literature. All case reports and literature reviews in the English literature from 1978 to 2018 were systematically identified for review. RESULTS: Four cases of postoperative uvular necrosis diagnosed clinically at our institution were included. The comprehensive literature review identified 26 reports and seven case series, totaling 53 cases of this complication. Use of suction was reported in 19 cases, and six cases reported no use of suction. Ninety-four percent of cases were treated conservatively, whereas 6% underwent excision. Ninety-one percent resolved within 14 days. CONCLUSIONS: Impingement with various devices and vascular trauma from suction each likely play a role in postoperative uvular necrosis. Male oropharyngeal anatomy may be a risk factor, but neither the type of instrumentation nor the type of procedure seem to predict this complication. Proper positioning of the patient and instruments and minimizing suction force help prevent uvular injury. LEVEL OF EVIDENCE: NA Laryngoscope, 130:880-885, 2020.

Unusual case of soft palate and uvula haematoma in a patient on anticoagulant drugs.

A 91-year-old Caucasian man on warfarin for atrial fibrillation presented in view of sudden-onset haemoptysis with fresh bleeding with clots immediately after having eaten a piping-hot traditional cheesecake (pastizz) and burning the soft-palate of his mouth. The haemoptysis had resolved by the time that the patient had arrived to hospital. On examination, a 2 cm by 2 cm dark red, solitary mass could be seen just anterior to the uvula. This was not causing any pain or discomfort to the patient. Blood results were mostly unremarkable except for a raised international normalised ratio (INR) of 3.53. The patient was administered 5 mg vitamin K orally in attempt to lower the INR level and warfarin was subsequently omitted for 7 days. He was also prescribed oral steroids on discharge. The lesion resolved in 7 days and warfarin was restarted then with no further consequences.

Uvular necrosis after orotracheal intubation.

Most complications from general anesthesia are thought to be minor and require no specific treatment. Throat pain after general anesthesia is a relatively common complaint. However, uvular necrosis is an unusual complication after intubation that has been rarely reported. We describe a case of a 22-year-old man who presented with uvular necrosis 4 days after undergoing general anesthesia.

[Swollen and elongated uvula after general anaesthesia]. / Uvula-Schwellung und -Elongation nach Intubationsnarkose.

Localized pathological changes of the uvular are rare but potentially life-threatening complications after general anaesthesia with endotracheal intubation. A case of postoperative swollen and elongated uvula after general anaesthesia in a prone position is presented. A mechanical trauma seems to be the most likely etiology.

Uvular necrosis following diagnostic gastroscopy.

Uvular necrosis is an extremely rare complication of gastroscopy. We describe the fifth published case of uvular necrosis following an uncomplicated diagnostic gastroscopy in a young man. Presentation with severe sore throat and inability to swallow saliva occurred within 24 hours of gastroscopy and resolved with conservative treatment.

An Uncommon Complication with a Supraglottic Airway: The King LT.

General anesthesia was administered in an 18-year-old man for removal of hardware from his right knee using a King Laryngeal Tube supraglottic airway. An hour after extubation, he reported inability to swallow with no respiratory distress. Examination showed an edematous uvula, which took 3 days to subside with anti-inflammatory medication. During the positioning of the King Laryngeal Tube, it was pulled back to ensure adequate ventilation. The inflated cuff could have dragged the uvula and folded it on itself, leading to venous congestion and edema.

Body piercing involving oral sites.

The authors present a case report on body piercing involving oral sites. Common locations and types of oral jewelry and piercing techniques are discussed. Oral considerations of intraoral piercing are emphasized.

Strangulation of the uvula by hair wrapping.

A 13-month-old male presented with a hair wrapped around his uvula. The entwined hair subsequently caused autoamputation of the distal uvula. Although a non-accidental etiology has been suggested for some cases of hair strangulation of appendages, this case indicates accidental strangulation of body parts is possible.

Conditions of the uvula: a 14 years experience.

OBJECTIVE: A retrospective study to find out the aetiology, symptomatology and management of elongated and enlarged uvulae. MATERIALS AND METHODS: Examination of files of 375 patients seen in the period 1983-1997. RESULTS: Trauma constituted a big proportion of patients seen. However, papillomas, solitary infections, allergy, simple symptomatic elongation, squamous cell carcinoma as well as asympomatic elongation were seen. The symptomatology varied between simple irritation in the throat to vomiting, pain and dysphagia. CONCLUSION: Enlarged or elongated uvulae are rare but solitary involvement of uvula because of variety of causes occur.

Oropharyngeal trauma during routine ear, nose and throat procedures.

A prospective study of 122 adults undergoing routine ear, nose and throat (ENT) operations over a three-month period was carried out to determine the cause of oropharyngeal trauma seen in some patients. Those having tonsillar or palatal surgery were excluded from the study. Forty-five (36.9 per cent) patients complained of a mild sore throat post-operatively and six (4.9 per cent) of a severe sore throat. Five of these (4 per cent) had evidence of injury to the uvula and soft palate which delayed their discharge from hospital. No single cause of trauma was identified but possible factors included the use of laryngeal masks (two cases), throat packs (two cases) and blind suctioning with a plastic Yankauer sucker (one case). There is a relatively high risk of oropharyngeal trauma during routine otolaryngological procedures and we recommend that care should be taken to prevent this common cause of significant post-operative morbidity.

Uvular injury during the perioperative period in patients undergoing general anesthesia.

OBJECTIVE: The purpose of this study was to evaluate the incidence and causes of uvular injury in the patients that received general anesthesia in the perioperative period. STUDY DESIGN: A 4-year retrospective review of cases of uvular injury and their resolution was conducted in adult patients who received general anesthesia at our institution. METHODS: An extensive review was conducted of the quality assurance (QA) database maintained by the Department of Anesthesiology at our tertiary academic medical center. The database was searched for cases of uvular injury that occurred in adult patients undergoing general anesthesia that between January 2007 and December 2010. The medical records of identified patients were then obtained to evaluate the presentation, treatment and ultimate resolution of injury. RESULTS: Ten cases of uvular injury were reported in the 28,788 general anesthetics conducted over a 3-year period in adult patients. This correlates to an incidence of 0.034%. Uvular injury occurred in mostly male patients (80%) during elective cases in the supine position. All cases were associated with endotracheal intubation. Additional objects, such as gastric tubes and esophageal temperature probes, were placed in the pharynx of 80% of these patients. Urologic procedures were associated with 50% of reported cases. Treatment ranged from observation to medical therapy. There were no permanent symptoms in any of the patients. CONCLUSION: Uvular injury is a relatively rare complication that occurs in patients during the perioperative period who receive general anesthesia. While endotracheal intubation is closely associated with this type of injury, further study is required to elucidate the mechanism and other associated etiologic factors.

Papiloma en úvula / Uvula papiloma

Presentamos el caso de un paciente con sensación de cuerpo extraño en la garganta y finalmente diagnosticado de papiloma invertido y papiloma escamoso de úvula. Tras la cirugía la evolución fue favorable (AU)

The present is a case of a patient with a foreign body sensation in the throat and final diagnosis of inverting papilloma and squamous papilloma of uvula. After surgery, the evolution was successful (AU)

Treatment of an enlarged uvula.

We report a case of enlarged uvula (5.5cm) that caused difficulty in swallowing and speech after it had been damaged by intubation or suction of the throat. Medical treatment failed, so 4.5cm was resected by diathermy. The patient made an uneventful recovery.

Lesions of the cerebellar nodulus and uvula impair downward pursuit.

We studied sinusoidal (SIN) and step-ramp (SR) pursuit in two rhesus monkeys, before and after surgical lesions of the cerebellar nodulus and uvula (Nod/Uv). Eye movements were recorded using the magnetic field scleral search coil method. Pursuit targets were generated by an LCD projector and back-projected onto a tangent screen in an otherwise dark room. After the Nod/Uv lesions, both monkeys showed a reduced eye velocity during downward pursuit (SIN: 42% decrease in M1, 91% decrease in M2; SR: 37% decrease in M1, 85% decrease in M2). For SR, the decrease was seen only for the closed-loop response; initial eye acceleration did not change (P>0.05). Upward pursuit gains increased for SIN (M1: 9%, M2: 11%); they decreased for SR (M1: 27%, M2: 18%), but to a lesser degree than for downward pursuit. Horizontal pursuit was little changed in M1 but was reduced in one direction in M2, the animal with the larger lesion. The deficit in downward tracking was limited to foveal pursuit; ocular following of random-dot stimuli was retained, even when the target subtended only several degrees. Our findings support a critical role for the Nod/Uv in vertical pursuit, particularly for sustained downward pursuit. Finally, in both monkeys, the lesion increased spontaneous upward ocular drift in the dark (mean prelesion, 1.43 degrees/s; postlesion, 5.92 degrees/s), suggesting a role for the Nod/Uv in holding the eyes still and in the genesis of downbeat nystagmus.

A bizarre penetrating head wound with intraoral communication. Report of a case.

A case of a transcervical-intraoral penetrating foreign body in a 49-year-old man is presented. This is of interest because of the unusual mechanism of this potentially fatal injury, including the oral cavity, and because of the absence of serious neurologic sequelae.