Surgical Management of Dysphagia Due to Anterior Cervical Osteophytes.

PURPOSE: The present study was performed to share personal experiences and to discuss the advantages and disadvantages of anterior cervical osteophytes surgical procedures. METHODS: The operative records of anterior cervical osteophytes patients who did not benefit from conventional treatments and underwent osteophytectomy were analyzed retrospectively. Transoral and transcervical anterolateral methods were applied, considering both the localization of the osteophyte and the patient's preference. RESULTS: Five patients were operated with the transcervical anterolateral method, and 3 patients were operated with the transoral procedure. Those using the transcervical method were likely to encounter complications, however, being comfortable for patients. Although the transoral procedure is much safer, the patients may face postoperative pain, long healing time, and morbidities as hematoma, cervical instability, and infection after surgery. CONCLUSIONS: Both transcervical and transoral methods will improve the functional swallowing pathologies and decrease aspiration-penetration. Transoral approach is not recommended due to slow healing times and postoperative pain, although it creates easier access to the spine.

Noninvasive Treatment of Acquired Subglottic Stenosis.

A 23-day-old infant referred to the neonatal intensive care unit with difficulty breathing and inspiratory stridor increasing with exercise. Medical history included a cardiothoracic surgery for transposition of the great arteries, patent ductus arteriosus, atrial septal defect, and a history of intensive care unit from surgery. Flexible fiberoptic transnasal laryngoscopy revealed subglottic stenosis that was probably caused by prolonged intubation with a higher airway pressure. Computed tomographic scan of the neck showed a tiny stenosis without cartilage deformity and limited in subglottic region. Tracheotomy and external open surgery was found risky for sternal wound infection or mediastinitis as the neonate had newly thoracotomy. The patient had a balloon dilation under general anesthesia without intubation. Presenting symptoms of the neonate were fully improved with balloon dilation.