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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Cervical median corpectomy as an alternative to laminoplasty and laminectomy has been suggested as an effective treatment for cervical spondylotic myelopathy (CSM) in cases of multisegmental spondylotic stenosis. We report on our experience with this procedure with particular reference to neurological outcome and complications. Median corpectomy was performed in 17 cases (3 female, 14 male; mean age 59 yrs, (41-80 yrs.) with cervical myelopathy (CM) and radiologically diagnosed multisegmental spondylotic stenosis and spinal cord compression seen on MRI. The degree of stenosis was determined by means of the modified Pavlov's index (ratio between spinal canal width at the level of the intervertebral disc and the diameter of the vertebral body itself). 3/17 patients suffered from acute, 4/17 from subacute and 10/17 from chronic CM. Single level corpectomy was performed in 9 cases, one and a half vertebrae were removed in 2 cases and dual level corpectomy was performed in the remaining 6 cases. All patients received an autologous bone graft and AO - anterior plate stabilization or were stabilized as described by Morscher. Postoperative follow - up was possible in 16/17 cases over a mean time of 13.5 months. Myelopathy was graded according to Nurick's scale. Postoperatively, 12% with chronic CM improved by two grades, 38% (2 pts, with acute, 3 with subacute and 1 with chronic CM) improved by one grade. The other patients remained stable, none showed worsening of their myelopathy. Paresis improved in 92%, sensory deficits in 69%, spasticity in 73%, pain in 60%, and vegetative disturbances in 100% of all patients presenting these preoperative symptoms respectively. One patient died due to esophageal perforation and subsequent lethal mediastinitis caused by screw loosening 4 months following surgery and after initial neurological improvement. 4 other patients experienced screw loosening, three with acataposis, one remained clinically asymptomatic with concomitant graft displacement in two of these. One patient had to be re-operated due to a hematoma at the iliac crest and 2 suffered from a pelvic fracture of the spina iliaca at the site of graft removal. With respect to the neurological improvement, especially to the motor function and spasticity, median corpectomy can be regarded as an effective procedure in selected cases with cervical myelopathy, even when treatment related complications are taken into consideration.
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PMID:Median corpectomy in cervical spondylotic multisegmental stenosis. 877 71

An 8(10)/(12) year old girl with infantile cerebral paresis (ICP), severe mental retardation and seizure disorder was admitted to the intensive care unit (ICU) with clinical signs of aspiration and died ten days later. Final diagnosis was esophagobronchial fistula caused by a foreign body in the esophagus provoking aspiration pneumonia, mediastinitis and respiratory distress syndrome (ARDS). The foreign body was found to be part of a plastic toy. The clinical relevance of aspiration in mentally retarded children and the peculiar nature of the foreign body impacted in the esophagus in this case are discussed. We conclude that in cases of aspiration pneumonia in mentally retarded children the presence of unusual foreign bodies should be suspected.
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PMID:An esophagobronchial fistula caused by an unusual foreign body in the esophagus leading to mediastinitis with fatal outcome. 1650 9

The aim of the present report is to review the complications of the deep neck infections and their surgical treatment in the Institute for the last 5 years. From 1999 to 2003 29 patients with deep cervical infections were treated surgically. Twelve of the patients had submandibular abscess, 10 cases were with parapharyngeal abscess, 3 with Ludwig's angina, 1 with mastoiditis with exteriorization in the neck and 3 with neck phlegmonas. The infections were most frequently oftonsillar and dental origin. The following complications were observed: 6 cases with acute obstruction of the upper airways treated with tracheostomy; 2 cases with sepsis; 2 with descending mediastinitis; and 1 with acute hemorrhage of stress ulcers of the stomach. Three cases of deep cervical infections, complicated with mediastinitis, sepsis, VII and XI cranial nerves paresis, hemorrhages from the gastrointestinal tract are cited. The third case is interesting with the multiple complications including hemorrhage from stress ulcers of the stomach, which could not be managed endoscopically because of the compression due to hypopharingeal edema leading to laparotomy, gastrotomy and suture of 3 stress ulcers. Later, the development of mechanical ileus based on adhesions was treated with ileostomy and laparostomy. The great importance of the early surgical treatment of neck infections, the use of antibiotics covering both aerobic and anaerobic bacterial spectrum and the good coordination between otolaryngologists, surgeons, anestesists and microbiologists is stressed in conclusion.
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PMID:[Surgical complications of the deep infections of the neck]. 1869 31

Deep infections of the neck are potentially life-threatening for their descending spread along cervical fascia planes towards the mediastinum and development of sepsis after thrombophlebitis of the internal jugular vein. The aim of the present report is to review the complications of the deep neck infections and their surgical treatment for the period of the last 5 years. From 1999 to 2003 29 patients with deep cervical infections were treated surgically. Twelve of the patients had submandibular abscess, 10 cases were with parapharyngeal abscess, 3 with Ludwig's angina, 1 with mastoiditis with exteriorization in the neck and 3 with neck phlegmonas. The infections were most frequently of tonsillar and dental origin. The following complications were observed: 6 cases with acute obstruction of the upper airways treated with tracheostomy; 2 cases with sepsis; 2 with descending mediastinitis; and 1 with acute hemorrhage of stress ulcer of the stomach treated with laparotomy and laparostomy. Combined surgical and massive antibiotic treatment according to the bacteriological findings was carried out. Cervical incisions, jugulotomy and thoracotomy were performed in cases with descending mrdiastinitis. Permanent suction drainage and lavage of the abscess cavities were used. In cervical phlegmonas the surgical wounds were left open against anaerobic infection. Three cases of deep cervical infections, complicated with mediastinitis, sepsis, VII and XI cranial nerves paresis, hemorrhages from the gastrointestinal tract are cited. The third case is interesting with the multiple complications of the deep neck infection--stress ulcer of the stomach, which could not be managed endoscopically because of the compression due to hypopharingeal edema, sepsis, tracheal stenosis. All the patients but one recovered after the treatment. One of them with cervical phlegmona died out of heart arrest in the operating theater after urgent intubation and tracheotomy for airway obstruction. The great importance of the early surgical treatment of neck infections, the use of antibiotics covering both aerobic and anaerobic bacterial spectrum and the good coordination between otolaryngologists, surgeons, reanimators and microbiologists is stressed in conclusion.
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PMID:[Complications of the deep infections of the neck]. 1878 14