Ingested foreign body is one of the most frequently encountered emergencies in otolaryngology practice. Many of these foreign bodies get lodged in the upper digestive tract and can be removed endoscopically. Few of these foreign bodies can perforate the upper digestive tract and an even smaller number of these can migrate extraluminally. Although, a migrating foreign body can remain quiescent, they can cause life-threatening suppurative or vascular complications; hence, location and removal is essential. Here we report two cases of extraluminal migration of foreign body which was removed by neck exploration.
The surgical treatment of oral cavity cancers can be influenced by post-operative complications. Identification of risk factors based on clinical characteristics may assist in therapeutic planning and thereby helps in reducing complications. Here, an attempt is made to identify the factors associated with post-operative complications (complications developing within 1 month of surgery) in patients undergoing primary oral cancer surgery. Six hundred seventy-six consecutive patients who underwent primary surgery for oral cancer from December 2007 to May 2010 were prospectively evaluated. The risk factors that predict for post-operative complications were analyzed. There was one mortality and 15% (103 patients) had post-operative complications. The complications included metabolic complications, primary site problems, donor site problems, and systemic complications. Fifteen factors were found statistically significant for the development of post-operative complications by univariate analysis. On multivariate analysis, three of the 15 factors, i.e., presence of COPD, full thickness wide excision, and increased duration of surgery were found to be independently associated with the development of post-operative complications. Presence of COPD, full thickness wide excision, and increased duration of surgery were identified as independent risk factors for post-operative complications in primary oral cancer surgery. The development of complications invariably resulted in increased hospital stay. Hence, the prompt recognition of risk factors for complications based on pre-operative clinical characteristics plus the identification of the risks associated with the surgical procedure can help in determining the appropriate therapeutic planning to prevent complications and in achieving cost effectiveness.
of extraluminal foreign body impaction. The patient had a foreign body at the cricopharynx which was removed endoscopically and the check X-ray showed a remnant foreign body which was again confirmed by CT scan neck. A lateral pharyngotomy and neck exploration was carried out, which concluded it as vertical ossification of cricoid lamina and not remnant foreign body. CASE REPORTA 40-year-old gentleman presented in our department with the complaint of accidental ingestion of fish bone (head part of fish) 2 days back and thereafter persistent foreign body sensation throat. On examination his general condition was satisfactory. Vital parameters were well maintained. Throat examination was normal. Indirect laryngoscopy showed pooling of saliva in both pyriform fossae but no foreign body. Neck movements were painless but laryngeal crepitus was absent. Systemic examination was essentially normal.In view of the positive clinical history, persistent symptoms and clinical examination findings, an X-ray of the soft tissue neck lateral view was taken. It showed an irregular shaped radiopaque foreign body at the level of C5-C6 with no significant prevertebral widening or air shadow or air fluid level (Fig. 1). An emergency hyopharyngoscopy was done under local anesthesia. The foreign body was found at the cricopharyngeal level and the surrounding mucosa was found inflamed. It was removed endoscopically and was a 1.5 cm sized, irregular shaped fish bone broken into ABSTRACTOssification of airway cartilages on plain X-ray film may masquerade as a foreign body in the digestive tract in some patients with a history of foreign body ingestion. This process may cause confusion to the clinician, who then has to rely on other investigations and explorative surgery to exclude the possibility of an impacted or extraluminally migrated foreign body. Here we present a pitfall in the diagnosis of extraluminal foreign body impaction secondary to vertical ossification of cricoid lamina, which resulted in an explorative surgery.
Schwannomas are benign, solitary, and well-differentiated tumors originating from Schwann cells. They may originate from any of the peripheral, cranial, or autonomic nerves of the body with the exception of the olfactory and the optic nerves. Schwannomas arising from the cervical sympathetic chain are very rare. Only < 65 cases have been reported in the literature to date. Here we report a case of cervical sympathetic chain schwannoma in a 41-year-old lady presenting as a parapharyngeal mass which was excised by a transcervical approach without any postoperative Horner's syndrome.
Drug-induced airway hematoma is a very rare condition. The incidence of hemorrhage with anticoagulants is 6.8%. We hereby present the case reports of two such cases. Both patients presented with dysphagia and throat pain. One was on warfarin and the other was on aspirin. Examination revealed laryngeal and retropharyngeal hematoma respectively. Discontinuation of drugs and reversal of anticoagulation improved the symptoms. In the second case, retropharyngeal hematoma was drained. These cases highlight the importance of suspecting this entity in patients on drugs, especially anticoagulants who present with upper aerodigestive tract symptoms. Timely intervention and reversal of coagulopathy can save the patients. How to cite this article Divya GM, Dahiya V, Ramachandran K, Muhammed F. Drug-induced Airway Hematoma. Int J Head Neck Surg 2015;6(4):187-189.
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