Foreign body lodgement in the larynx is a rare situation. Our review of the literature revealed no living foreign body in larynx except for laryngeal leeches and anisakiasis. In this article, we report a patient with unusual laryngeal foreign body lodgement: a bee which presented with sudden odynophagia and stinging sensation in throat. The bee was detected on the laryngeal mucosa in indirect laryngoscopic examination and removed immediately under general anesthesia in apneic period. In this case report, we describe the importance of detailed anamnesis and laryngeal examination even if the patient has no severe symptoms.
ÖZAmaç: Bu çalışmada burunda yabancı cisim tanısı konulan hastaların klinik belirtileri ve tedavi protokolleri araştırıldı. Hastalar ve Yöntemler:Kasım 2008 -Temmuz 2013 tarihleri arasında burunda yabancı cisim tanısı konulan ve tedavisi yapılan 130 hasta (72 erkek, 58 kadın; ort. yaş 3.65±2.31 yıl; dağılım 15 ay-72 yıl) geriye dönük olarak değerlendirildi. Hastaların yaş ve cinsiyeti, yabancı cismin türü, hangi tarafta olduğu, belirti ve semptomları, tedavi uygulamaları ve sonuçları kaydedildi. Bulgular:Hastaların büyük bir çoğunluğu 2-5 yaş arasındaki çocuklardı (n=113, %86.9). En fazla görülen yabancı cisimler; küçük plastik oyuncak parçaları (%43.8) fındık, ceviz, mısır ve fasulye gibi tohum taneleri (%29.2) idi. Hastaların 74'ünde (%56.9) sağ, 54'ünde (%41.6) sol nazal pasajda ve ikisinde (%1.5) ise her iki burun deliğinde yabancı cisim izlendi. Hastaların %92.3'ü ilk 24 saat içerisinde kliniğimize başvurdu.Sonuç: Buruna yabancı cisim kaçması kulak burun boğaz hastalıkları acilinde sık karşılaşılan bir durumdur. Genellikle hayati bir risk oluşturmayan bu durum uzun dönemde çeşitli komplikasyonlara yol açabileceğinden acil müdahale gerektirir. Çocuk bakımından sorumlu ebeveyn ve bakıcılar buruna kaçabilecek cisimlerin çocukların ulaşabileceği yerlerde bulundurmamaları ve buruna yabancı cisim kaçması durumlarında hekime başvurmaları konusunda bilinçlendirilmelidir.Anahtar Sözcükler: Yabancı cisim; burun boşluğu; rinolit. ABSTRACT Objectives:This study aims to investigate clinical manifestations and treatment protocols in patients with a diagnosis of nasal foreign bodies. Patients and Methods:We retrospectively evaluated 130 patients (72 males, 58 females; mean age 3.65±2.31 years; range 15 month to 72 years) who were diagnosed with nasal foreign bodies and received treatment between November 2008 and July 2013. Age and sex of the patients, type of foreign body, side of presentation, signs and symptoms, management practices, and outcomes were recorded. Results:Most of the patients were children between the ages of 2 and 5 (n=113, 86.9%). The most common foreign bodies were small plastic toys (43.8%), nut, walnut, corn, bean and the other seed grains (29.2%). Foreign bodies were detected in the right nasal passage in 74 patients (56.9%), left nasal passage in 54 patients (41.6%) and both nostrils in two patients (1.5%). Of the patients, 92.3% were admitted to our clinic within 24 hours. Conclusion:Nasal foreign bodies are frequent encountered in the emergency setting of ear, nose, and throat diseases. Although they are not life-threatening conditions, they require urgent intervention, as they may lead to several complications in the long-term. Parents and caregivers of children should keep objects which can be put into the nose away and be instructed that they should consult a physician in case of nasal foreign bodies.
The purpose of this study was to evaluate the efficacy of transoral or transnasal endoscopic-guided adenoidectomy compared with endoscopic nasopharyngeal inspection at the end of curettage adenoidectomy. A prospective case series of patients who had adenoidectomy. A total of 27 girls and 34 boys (age range 2.5-18 years) in whom adenoidectomy with or without tonsillectomy procedure was planned were included in the study. The cases were divided into three groups. Group 1 Transoral endoscopic-guided adenoidectomy performed patients. Group 2 Transnasal endoscopic-guided adenoidectomy performed patients. Group 3 Transnasal endoscopic nasopharyngeal exploration performed at the end of the conventional curettage adenoidectomy. The study was completed on 61 children. Mean age and sex frequency were not significant different between the groups. Mean operative time were 11.6 ± 2.9, 15.6 ± 4.4 and 9.7 ± 2 min, respectively (p > 0.05). On the other hand, significant differences were observed in operative time between group 1 and group 2 (p < 0.05), and between group 2 and group 3 (p < 0.05). Transnasal endoscopic examination at the end of curettage adenoidectomy is an appropriate method to assess the residual adenoid tissue after conventional curettage adenoidectomy. Also, operative time of this method is shorter than transoral or transnasal endoscopic-guided adenoidectomy. We recommend transnasal endoscopic inspection in all patients after conventional curettage adenoidectomy.
Objective: Tracheotomy is one of the oldest surgical procedures. Pediatric tracheotomy indications have changed in recent decades. Currently, tracheotomy is performed because of prolonged intubation, upper airway obstruction, neuromuscular, and craniofacial anomalies instead of acute airway infections. This study aims to present our experience regarding indications and complications of tracheotomy in pediatric patients. Methods:We retrospectively evaluated 17 pediatric patients who underwent tracheotomy because of prolonged intubation, increased pulmonary secretions, and upper respiratory tract obstruction from June 2010 to June 2015. The patients' age, gender, tracheotomy indications, duration of intubation, complications, and actual clinical condition were recorded.Results: Tracheotomy was performed on 17 pediatric patients in our clinic. Discharged patients were followed with a 3-month routine check. Six patients (35.29%) had died because of a primary disease during follow-up, and one (5.88%) of them was a one-day-old newborn who had anomalies that were incompatible with life. In one patient, emergency tracheotomy was performed because of a tracheal trauma. None of the patients has been decannulated except one (5.88%). One (5.88%) patient had an accidental decannulation, while another had bleeding in the operation field. The total minor complication rate was 11.76%, and no major complication was observed. Two (11.76%) of the discharged patients underwent re-operation for widening of the tracheotomy stoma during their routine visit. Conclusion:Currently, tracheotomy in pediatric patients is mostly performed for prolonged intubation and upper respiratory tract obstruction for which intubation is not possible. Tracheotomy enables the discharge of these patients after training their families. Keywords
ÖZETEpidermoid kistler derinin en sık görülen kistleridir. Dermoid ve epidermoid kistlerin baş ve boyun bölgesinde görülme sıklığı %1.6-6.9 arasında değiş-mektedir. Konjenital epidermoid kistlerin etyolojisi tam olarak aydınlatılmamıştır. En çok kabul gören teoriye göre birinci ve ikinci brankial arkusların kapanması sırasında sıkışan embriyojenik epitelyal doku artıklarından oluştuğu ileri sürülmektedir. Epidermoid kistler klinik olarak boyun orta hatta yavaş büyüyen asemptomatik kitleler olarak belirirler. Epidermoid kistler genellikle küçüktürler ve nadiren 5 cm üzerinde boyutlara ulaşırlar. Tedavisi kistin cerrahi olarak tamamen çıkartılmasıdır. Kistin ağız tabanı ile ilişkisine göre eksternal veya internal cerrahi yaklaşım seçilir. Burada, boyunda submental şiş-lik olarak ortaya çıkan dev epidermoid kist literatür eşliğinde tartışılmıştır. Anahtar Sözcükler Epidermoid kist, boyun, cerrahi ABSTRACTEpidermoid cysts are the most common skin cysts. The incidence of epidermoid and dermoid cysts range between 1.6-6.9% in head and neck region. The etiology of congenital epidermoid cysts are not fully understood. According to commonly accepted theory, they originate from embryonic remnants of epithelium that was trapped during the fusion of first and second branchial arches. Epidermoid cysts clinically appea as a slowly growing asymptomatic masses at the midline of the neck. They are usually small and rarely reach above 5 cm in size. Treatment of epidermoid cyst is total surgical excision. The surgical approach is choose as an external or internal one according to relationship of the cyst with the floor of the mouth. Herein, a giant epidermoid cyst emerged as a submental swelling in the neck is discussed in the light of the literature.
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