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Query: UMLS:C0262471 (ENT)
 5,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Apertura pyriformis stenosis in the newborn. Respiratory distress in the newborn can have a variety of aetiologies, the best known of which are cardiac and pulmonary diseases. Major nasal airway obstruction is probably often overlooked when acute desaturation of the neonate requires reanimation procedures, although it is well established that the baby is an obligate nose breather at birth. Nasal airway stenosis or atresia could account for a number of unexplained deaths in the delivery room. In the differential diagnosis of major nasal airway obstruction in the newborn, choanal atresia is by far the most common aetiology. However, a few cases of pyriform aperture stenosis have been reported. One child presenting this pathology was recently treated at the Brussels University Children's Hospital. Unexpectedly, the baby survived until 3 months without any medical support but had severe feeding problems. The diagnosis was confirmed by naso-sinusal CT scan. Surgery was performed at 4 months through an unusual endonasal approach which seems to be less traumatic than the classical sublabial approach. The post-operative course was satisfactory. The 9-month-old patient does not now show residual breathing problems. The presentation will focus on this unusual case.
B-ENT 2006
PMID:Apertura pyriformis stenosis in the newborn. 1667 45

Always ask about hoarseness and quality of voice in a history of any child presenting with cough or asthma-like symptoms. Children presenting with what appears to be an acute onset of hoarseness, without any physical signs of airways obstruction, should be reviewed after two weeks. If there is chronic hoarseness, referral to an ENT specialist should be considered with a view to laryngoscopy. If the child develops clinical signs of acute airway obstruction such as stridor or respiratory distress, prompt paediatric review is indicated. When referring, it is important to emphasise whether or not there is chronic hoarseness in order to differentiate the diagnosis from croup. Juvenile Laryngeal Papillomatosis may present with cough, pneumonia, dysphagia, or stridor, as well as hoarseness. These patients are often misdiagnosed as having asthma or allergies.
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PMID:Juvenile laryngeal papillomatosis. 1670 72

Congenital dacryocystocele (CDC) is recognised as a cause of nasal airway obstruction or respiratory distress in newborns. CDC is caused by the distal obstruction of the lachrymal duct and presents as a cystic formation in the inferior meatus. We discuss five cases of dacryocystocele, together with surgical management and outcome. Endoscopic endonasal marsupialisation and appropriate postoperative care resulted in definitive recovery for all patients. In newborns or infants with nasal obstruction, CDC should be considered in the differential diagnosis, and prompt endoscopic endonasal marsupialisation is mandatory.
B-ENT 2008
PMID:Congenital dacryocystocele: five clinical cases. 1894 60

A dacryocystocele refers to a sterile cystic dilatation of the lacrimal sac resulting from a complete obstruction of the lacrimal pathway above and below the lacrimal sac. In most cases, it is a congenital disorder that typically occurs in neonates. It is characterized by a bluish cystic swelling just below the medial canthus accompanied by epiphora. In some cases, there is also an intranasal expansion beneath the inferior turbinate. When this expansion is large and bilateral, it can lead to respiratory distress in neonates since they are obligate nasal breathers. Although congenital dacryocystoceles may resolve with conservative measures, many become infected and require systemic antibiotic treatment, and most require early surgical intervention. Herein, the authors report a rare case of dacryocystocele in an adult that was successfully managed with an endonasal endoscopic dacryocystorhinostomy. The pre-operative images and the intra-operative findings are shown, and the available literature is reviewed.
B-ENT 2009
PMID:Endonasal endoscopic dacryocystorhinostomy for a primary dacryocystocele in an adult. 1990 56

We treated a 41-year-old man who presented with dysphagia, fever and respiratory distress. Magnetic resonance imaging (MRI) showed a large retropharyngeal abscess (RPA) extending to the C5-6 level, C5-6 spondylodiscitis and a spinal epidural abscess. The RPA was drained surgically under emergency conditions. Because the tuberculin skin test was positive, the patient underwent a triple anti-tuberculous drugs regimen. After six months of drug therapy, the epidural abscess was completely resolved. One of the most important aetiologies of RPA is thought to be tuberculous spondylodiscitis, and cervical vertebrae should be scanned thoroughly with pre-operative MRI.
B-ENT 2010
PMID:Retropharyngeal abscess presenting with acute respiratory distress in a case of cervical spondylodiscitis. 2042 84

Congenital nasal aperture stenosis is an unusual cause of upper airway obstruction among neonates, and rarely presents as unilateral. Most commonly presents as choanal atresia. A CT evaluation is essential to confirm the diagnosis. Both surgical and conservative management can be applied, based on the severity of the associated clinical presentation; however, the very rare unilateral condition is usually treated conservatively. We present a case of a 30-day-old male baby (second twin, preterm 29 weeks pregnancy, and birth weight 1.070 kg) with difficult breathing since birth. The baby was referred for an ENT consultation. He was on a nasal cannula, not in respiratory distress, with no stridor, nor tachypnea. There were decreased breathing sounds in the left nostril. Nasogastric tubes size 8 French (Fr) and 6 Fr could not be introduced through the left nostril, which looked obstructed more anteriorly.
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PMID:Congenital unilateral nasal aperture stenosis. 2084 22

Upper airway obstruction is defined as blockage of any portion of the airway above the thoracic inlet. Stridor, suprasternal retractions, and change of voice are the sentinel signs of upper airway obstruction. Most of the common causes among children presenting to emergency department are of acute infectious etiology. Among these, croup is the commonest while diphteria remains the most serious life-threatening cause. Recent reports indicate that bacterial tracheitis has become increasingly common. In ER evaluation the key clinical data in determining the cause and the site of obstruction are the onset, presence of fever, character of the stridor, retractions, the voice and the ability to handle secretions. After assessment of the severity of respiratory distress and resuscitative or supportive therapy including oxygen and emergent airway, specific treatment is directed at underlying etiology. All patients with audible stridor require early endotracheal intubation/tracheostomy. In croup the mainstay of treatment are cold humidified oxygen, budesonide nebulization ( in mild cases), Dexamethasone 0.6 mg/kg iv or im (in moderate and severe cases), and Adrenaline 5 ml 1:1000 (5 mg) solution as nebulization ( in severe cases). In diphtheria, early tracheostomy, anti-diphtheric serum and injectable penicillin are critical. Bacterial Tracheitis and Retropharyngeal abscess need early administration of injectable Cloxacillin, Amikacin and Clindamycin. ENT consultation should be obtained for early surgical drainage of retropharyngeal abscess. Angioneurotic edema is treated with subcutaneous adrenaline (1:1000, 0.01 ml/kg); hydrocortisone 10 mg/kg IV and antihistamines. Patients with severe obstruction and those with endotracheal tube/ trachesotomy should be transferred to PICU.
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PMID:Acute upper airway obstruction. 2155 8

Foreign body in the bronchus is one of the life saving emergency in the ENT department. Most patients of foreign body bronchus are kids. Common presentation is respiratory distress or noisy respiration of sudden onset. Proper clinical examination and suspicion needed for proper diagnosis. In this report, 52 cases of foreign body bronchus were included. All patients underwent straight x-ray chest after taking proper history and while aroused suspicion. All of them received antibiotic and steroid. Foreign body was removed by rigid bronchoscope, flexible bronchoscope and by rigid telescope along with rigid bronchoscope. Most foreign bodies lodged in the left bronchus. Only one patient had died in the process for anaesthetic hazards.
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PMID:Foreign bodies in bronchus--2 years experience at IPGME&R, Kolkata. 2336 44

Up to 80% of all cases of pulmonary-renal syndrome are due to systemic vasculitis associated with antibodies to neutrophil cytoplasm (ANCA). Most patients die within the first year after the onset of the disease but adequate immunosuppressive therapy ensures the 5-year survival rate of 65-75%. We obtained clinical and morphological data for 34 patients with ANCA-associated vasculitis affecting lungs and kidneys treated at S. P. Botkin Hospital in 1994-2012. 16 patients presented with granulomatous polyangiitis (Wegener 's granulomatosis), 11 with microscopic polyangiitis, and 7 with eosinophilicpolyangiitis (Churg-Strauss syndrome). We made the definitive diagnosis in 79% of the cases. Pulmonary lesions were largely in the form offocal, nodular and infiltrative changes, one third of the patients suffered blood spitting/pulmonary hemorrhage and 15% respiratory distress. Most patients had renal dysfunction (16% required emergency hemodialysis), lesions of ENT skin, joints, peripheral nervous system, and eyes. Therapy with corticosteroids and cytostatics increased the total and renal survival rate up to 91 and 82% respectively despite unfavourable prognostic factors in most patients. Duration of observation was 32.5 [0.1;129] months, the survival rate depended on the severity of lung lesions whereas renal problems had no appreciable effect on life prognosis.
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PMID:[ANCA-associated vasculitis affecting lungs and kidneys: clinical and morphological characteristic, treatment, outcomes]. 2443 68

Teratoma is the most common germ cell tumour in childhood. Teratoma typically arises in the sacrococcygeal region, gonads and mediastinum. The head and neck region is seldom involved. Teratomas of the neck region represent one of the most unusual causes of respiratory distress during the neonatal period. We present a case of an immature teratoma in the parapharyngeal space presenting with airway obstruction in an infant. Surgeons should consider the possibility of immature teratoma in the head and neck region in the differential diagnosis of respiratory distress in an infant, even if the patient does not have an external deformity.
B-ENT 2014
PMID:Immature teratoma of the parapharyngeal space presenting with airway obstruction in an infant. 2476 32


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