Post-Thyroidectomy Laryngeal Diplegia in Mali: What Therapeutic Challenge? by Kone Fatogoma Issa in Experiments in Rhinology & Otolaryngology
Post-thyroidectomy laryngeal diplegia is the most common and most feared complication [1]. It occurs following a recurrent nerve lesion in 26 to 59% of cases [1,2]. Tracheotomy was considered until 1922 as the only reference treatment [3,4]. Therapeutic approaches have evolved over time, ranging from convention altranslaryngeal or extralaryngeal therapy to endoscopic laser approaches [5]. These endoscopic methods emphasized endoscopicary tenoidectomy and posterior transverse cordotomy [4,6]. Laser transverse posterior cordotomy has proved its efficacy, illustrated by the work of Denis and Kashima and Laccoureye & Merite Drancy [4,7].
A case report of open reduction, internal fixation and platting of clavicle f...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Tips and tricks to site and maintain nerve cathetersAmit Pawa
This lecture was given on Friday 13th September 2019 at the annual congress of the European Society of Regional Anaesthesia in Bilbao and Spain. The talk was also contributed to by the Twitter Community. Strategies and techniques to site, secure and maintain perineural nerve catheters is discussed
A case report of open reduction, internal fixation and platting of clavicle f...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Tips and tricks to site and maintain nerve cathetersAmit Pawa
This lecture was given on Friday 13th September 2019 at the annual congress of the European Society of Regional Anaesthesia in Bilbao and Spain. The talk was also contributed to by the Twitter Community. Strategies and techniques to site, secure and maintain perineural nerve catheters is discussed
Management Outcomes of Post-Thyroidectomy Bilateral Recurrent Laryngeal Nerve Paralysis at National Hospital Abuja by Olusesi Abiodun Daud in Experiments in Rhinology & Otolaryngology
Bilateral recurrent laryngeal paralysis is an uncommon complication of total or subtotal thyroidectomy, observed in approximately 0.4 per cent of cases. This paralysis could be temporary or permanent. An audit of 5 cases referred to the ENT Department of National Hospital Abuja, between January 2010 and July 2017 is presented. All cases were referred already on tracheostomy tubes and were females aged 11 to 59 years. 4 of the cases had external arytenoidectomy, bilateral in 2 cases, and unilateral in 2 cases. 4 out of the 5 cases were successfully decannulated. The preferred approach to cases of post-thyroidectomy bilateral recurrent laryngeal nerve paralysis referred to ENT Specialists in resource-poor economy like ours is not very clear from existing literature and we discuss our adopted protocol for management of such cases in this case series.
https://crimsonpublishers.com/ero/fulltext/ERO.000511.php
Percutaneous Endovascular Retrieval of Intravascular foreign body in pediatri...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Endoscopic techniques have been widely adopted in sinus and skull base surgery replacing the traditional intracranial/extracranial approaches. However, one of the most common complication is an iatrogenic Cerebrospinal Fluid (CSF) leak, which places the patient at risk for meningitis, pneumocephalus and brain herniation. The instant intraoperative CSF leak diagnosis and consequent repair is crucial to avoid these complications. Traditionally, intrathecal fl uorescein injection was utilized to aid in the diagnosis. However, this technique is not FDA approved and encompasses major drawbacks (seizure, lower extremity paresis, cranial nerve palsies and patient discomfort).The purpose of this case series is to introduce a new diagnostic paradigm using topical fl uorescein strips “FLUORETS”. It has shown promising prospects due to its safety, accuracy and sensitivity in identifying CSF leaks.
Peripheral Nerve Catheters - an introductionAmit Pawa
In November 2019 Dr Pawa Delivered a Lecture to the South Thames Acute Pain Group, in Cobham, Just outside London, on Peripheral Nerve Catheters. This was meant to serve as an introduction to the subject and to outline some of the challenges and difficulties he had instituting these at his own trust.
An Extremely Rare Case of the Traumatic Spinal Epidural Hematoma in a Child: ...CrimsonPublishersTNN
An Extremely Rare Case of the Traumatic Spinal Epidural Hematoma in a Child: Case Report and Review of the Literature by Ivan Domazet in Techniques in Neurosurgery & Neurology
Suboccipital lymphadenectomy for patients with occipital squamous cell carcin...Dr./ Ihab Samy
F. Fouad Saleep(1), I. Fayek(1), I. Farahat(2)
(1)National Cancer Institute - Cairo University, Surgical Oncology Department, Cairo, Egypt.
(2)National Cancer Institute - Cairo University, Pathology Department, Cairo, Egypt.
Poster presentation No.3224 at the 17th European Cancer Organization conference ECCO 17, Amsterdam-Netherlands, September 2013.
Laparoscopic Gynecologic Surgery Under Regional Neuraxial Anaesthesia: the be...semualkaira
At present, most laparoscopic
interventions are performed under general anesthesia. In literature
we have few retrospective studies, with few cases, that show just
minor laparoscopic proceduresperformed under regional anesthesia.
Management Outcomes of Post-Thyroidectomy Bilateral Recurrent Laryngeal Nerve Paralysis at National Hospital Abuja by Olusesi Abiodun Daud in Experiments in Rhinology & Otolaryngology
Bilateral recurrent laryngeal paralysis is an uncommon complication of total or subtotal thyroidectomy, observed in approximately 0.4 per cent of cases. This paralysis could be temporary or permanent. An audit of 5 cases referred to the ENT Department of National Hospital Abuja, between January 2010 and July 2017 is presented. All cases were referred already on tracheostomy tubes and were females aged 11 to 59 years. 4 of the cases had external arytenoidectomy, bilateral in 2 cases, and unilateral in 2 cases. 4 out of the 5 cases were successfully decannulated. The preferred approach to cases of post-thyroidectomy bilateral recurrent laryngeal nerve paralysis referred to ENT Specialists in resource-poor economy like ours is not very clear from existing literature and we discuss our adopted protocol for management of such cases in this case series.
https://crimsonpublishers.com/ero/fulltext/ERO.000511.php
Percutaneous Endovascular Retrieval of Intravascular foreign body in pediatri...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Endoscopic techniques have been widely adopted in sinus and skull base surgery replacing the traditional intracranial/extracranial approaches. However, one of the most common complication is an iatrogenic Cerebrospinal Fluid (CSF) leak, which places the patient at risk for meningitis, pneumocephalus and brain herniation. The instant intraoperative CSF leak diagnosis and consequent repair is crucial to avoid these complications. Traditionally, intrathecal fl uorescein injection was utilized to aid in the diagnosis. However, this technique is not FDA approved and encompasses major drawbacks (seizure, lower extremity paresis, cranial nerve palsies and patient discomfort).The purpose of this case series is to introduce a new diagnostic paradigm using topical fl uorescein strips “FLUORETS”. It has shown promising prospects due to its safety, accuracy and sensitivity in identifying CSF leaks.
Peripheral Nerve Catheters - an introductionAmit Pawa
In November 2019 Dr Pawa Delivered a Lecture to the South Thames Acute Pain Group, in Cobham, Just outside London, on Peripheral Nerve Catheters. This was meant to serve as an introduction to the subject and to outline some of the challenges and difficulties he had instituting these at his own trust.
An Extremely Rare Case of the Traumatic Spinal Epidural Hematoma in a Child: ...CrimsonPublishersTNN
An Extremely Rare Case of the Traumatic Spinal Epidural Hematoma in a Child: Case Report and Review of the Literature by Ivan Domazet in Techniques in Neurosurgery & Neurology
Suboccipital lymphadenectomy for patients with occipital squamous cell carcin...Dr./ Ihab Samy
F. Fouad Saleep(1), I. Fayek(1), I. Farahat(2)
(1)National Cancer Institute - Cairo University, Surgical Oncology Department, Cairo, Egypt.
(2)National Cancer Institute - Cairo University, Pathology Department, Cairo, Egypt.
Poster presentation No.3224 at the 17th European Cancer Organization conference ECCO 17, Amsterdam-Netherlands, September 2013.
Laparoscopic Gynecologic Surgery Under Regional Neuraxial Anaesthesia: the be...semualkaira
At present, most laparoscopic
interventions are performed under general anesthesia. In literature
we have few retrospective studies, with few cases, that show just
minor laparoscopic proceduresperformed under regional anesthesia.
Laparoscopic Gynecologic Surgery Under Regional Neuraxial Anaesthesia: the be...semualkaira
At present, most laparoscopic
interventions are performed under general anesthesia. In literature
we have few retrospective studies, with few cases, that show just
minor laparoscopic proceduresperformed under regional anesthesia.
Bilateral vocal fold paralysis is a rare condition. The commonest cause identified is mostly iatrogenic. It can be extremely debilitating for the patient who usually suffers from severe breathlessness on slightest exertion. Many of them requires a tracheostomy to maintain airway. The treatment of bilateral vocal cord palsy is a balance between phonation, airway and swallowing. Several surgical modalities have been described for cases which doesn't improve with conservative management. However transoral CO2 laser endoscopic arytenoidectomy has become the standard of management today for this condition. CO2 laser is arguably the most appropriate tool for cordectomy with the advantage of increased precision, better hemostasis and minimal tissue handling. We describe the procedure of posterior cordectomy with partial arytenoidectomy using transoral CO2 laser in two patients who were successfully managed for this condition in our centre.
Management of iatrogenic bilateral vocal cord paralysis by endoscopic transor...Apollo Hospitals
Bilateral vocal fold paralysis is a rare condition. The commonest cause identified is mostly iatrogenic. It can be extremely debilitating for the patient who usually suffers from severe breathlessness on slightest exertion. Many of them requires a tracheostomy to maintain airway. The treatment of bilateral vocal cord palsy is a balance between phonation, airway and swallowing. Several surgical modalities have been described for cases which doesn’t improve with conservative management. However transoral CO2 laser endoscopic aryte-noidectomy has become the standard of management today for this condition. CO2 laser is arguably the most appropriate tool for cordectomy with the advantage of increased pre-cision, better hemostasis and minimal tissue handling. We describe the procedure of posterior cordectomy with partial arytenoidectomy using transoral CO2 laser in two pa-
tients who were successfully managed for this condition in our centre.
Thermal Ablation of Renal Tumors under Ultrasound Guidance and Conscious Seda...asclepiuspdfs
Purpose: Computed tomography (CT) guidance and general anesthesia have recently been recommended as the approach of choice for percutaneous ablation of small renal cell carcinoma (RCC), whereas ultrasound (US) guidance and conscious sedation have been tagged as inadequate. Aim of the study was to assess the safety and effectiveness of percutaneous thermal ablation of small RCC under ultrasound (US)-guidance and conscious sedation. Methods: The records of 74 patients with small RCC (≤5 cm), who underwent US-guided thermal ablation under conscious sedation were retrospectively reviewed. Conscious sedation was usually induced by means of intravenous bolus of midazolam 50–100 μg/kg plus continuous infusion of a 25 μg/mL solution of remifentanil at a rate of 0.05 μg/kg/min. Technical success, technical efficacy, local tumor progression (LTP), primary and secondary efficacy rates, complication rate, and 1-, 3-, and 5-year survival rates were analyzed.
Clinical Experience in Maxillary and Mandibular division block for Trigeminal...iosrphr_editor
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
Mid Term Functional Results Following Surgical Treatment of Recto-Urinary Fistulas Post Prostate Cancer Treatment by Pierre Etienne Theveniaud in Experimental Techniques in Urology & Nephrology
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Background: Perforated tympanic membrane and middle ear infection are among common complications treated by tympanoplasty. This study was aimed to compare the effects of underlay and overlay tympanoplasty on the improvement of hearing and tympanic membrane landmarks and post-operative complications as well.
This study was performed Department of Otor hinolaryngology, Jubilee Mission Medical College, thrissur, Kerala for a period of 2 years commencing from December 2012 to November 2014. To review our experience with deep neck space infections and to study changing trends. The objectives were to study clinical presentation, etiology, associated systemic diseases, bacteriology, radiology, management and outcome of deep neck space infections.40 Patients coming from both urban and rural areas irrespective of age and sex admitted in department of ENT with deep neck space infections which was confirmed either clinically or radiologically. Superficial skin abscesses and abscesses due to infections of external neck injuries were excluded from the study \r\n.
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The Mastoid Compartment of Middle Ear Cleft-A Clinic Pathological Study in Patients with Chronic Otitis Media-Mucosal Type by George MV in Experiments in Rhinology & Otolaryngology
https://crimsonpublishers.com/ero/fulltext/ERO.000525.php
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Health Education on prevention of hypertensionRadhika kulvi
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2. How to cite this article: Kone F I, and Mohamed A K. Post-Thyroidectomy Laryngeal Diplegia in Mali: What Therapeutic Challenge?. Exp Rhinol Otolaryngol.
1(2). ERO.000508. 2017. DOI: 10.31031/ERO.2017.01.000508
Experiments in Rhinology & Otolaryngology
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Table 1: Status preoperative of patients.
Patients Age /year Sex Etiology of Immobility Delay in Month Since Immobility
Tracheotomy
Yes No
Patient 1 45 F Post-thyroidectomy 60 month yes -
Patient2 45 F Post-thyroidectomy 12 month yes -
Patient 3 45 F Post-thyroidectomy 12 month yes -
Patient 4 42 F Post-thyroidectomy Less than one week yes -
Patient 5 38 F Post-thyroidectomy Less than one week yes -
Patient 6 30 F Post-thyroidectomy Less than one week yes -
Patient 7 40 F Post-thyroidectomy Less than one week yes -
Patient 8 23 F Post-thyroidectomy 12 month yes -
Patient 9 18 M Post-thyroidectomy 12 month yes -
F: Female M: Male
Table 2: Status peroperative and postoperative of patients.
Patients Type of Cordotomy
Peroperatory
Complications
Postoperatory
Complication
Failure
Latest News in
Months
State in the Latest
News
Patient 1 CTP Hemorrhage Neant no 10 month good
Patient 2 CTP Hemorrhage Neant no 12 month good
Patient 3 CTP Hemorrhage Neant no 12 month good
Patient 4 CTP Hemorrhage Neant no 11 month good
Patient 5 CTP Hemorrhage Neant no 13 month good
Patient 6 CTP Hemorrhage Neant no 14 month good
Patient 7 CTP Hemorrhage Neant no 12 month good
Patient 8 CTP Hemorrhage Neant no 14 month good
Patient 9 CTP Hemorrhage Neant yes 11 month
Good after surgical
recovery
Table 3: Postoperative glottic pathway surveillance.
Patients
Surveillance Glotticpathway
3 Months 6 Months 9 Months 12 Months 14 Months
Patient 1 Good Good Good Good Good
Patient 2 Good Good Good Good Good
Patient 3 Good Good Good Good Good
Patient 4 Good Good Good Good Good
Patient 5 Good Good Good Good Good
Patient 6 Good Good Good Good Good
Patient 7 Good Good Good Good Good
Patient 8 Good Good Good Good Good
Patient 9 Dyspnea to Exercise surgery Good Good Good Good
3. How to cite this article: Kone F I, and Mohamed A K. Post-Thyroidectomy Laryngeal Diplegia in Mali: What Therapeutic Challenge?. Exp Rhinol Otolaryngol.
1(2). ERO.000508. 2017. DOI: 10.31031/ERO.2017.01.000508
3/3
Exp Rhinol OtolaryngolExperiments in Rhinology & Otolaryngology
Discussion
The modesty of our technical platform has constituted in our
case some difficulties as much surgical as in peroperative. The
surgical decision less than one week for four patients explains
recurrent nerve section on peroperative. This section was brought
in operating report. Strobo scopy and electromyography are
essentials; They make it possible to make the positive diagnosis
of what is neurogenic by involvement of the recurrent nerves
[1]. In other cases any information were not provided on the
status of recurrent nerve, therapeutic abstention was the rule to
nine months. No nerve recovery was noted in our patients. The
therapeutic abstention of nine months in search of a nerve recovery
is necessary to resort to alaryngealen largement treatment [8].
The mean duration of immobility was 10+ or -11.6 years in the
Nawkaseries [9]. Dispenza [10] has observed a period of 6-12
months with endoscopic controls to objectify recovery.
In per operative the haunting was the haemorrhage due to an
absence of simultaneous method of hemostasis, like the laser who
can make at the same time the notch and hemostasis. Hemostasis
was obtained by the application of xylocaine naphazoline 5%
on the notch part. Some authors have emphasized the value of
preoperative tracheotomy [5,11] for other sit is not necessary in
the laser era [8]. Tracheotomy was realized in all our patients as in
Francesco Dispenza’s serie [10]. In our study, the tracheotomy have
permitted to raise dyspnea. In contrast to Lichtenberger’sapproach
who combining the endo-external method, the absence of oedema
and hemostasis have prevented tracheotomy in some cases [12].
The endoscopic posterior partial cordotomy with the micro
instruments was our treatment of choice. Endoscopic laser is the
treatment of choice and should be offered as the first-line treatment
[8]. In a context of sub-medicalization and the absence of the laser,
the partial posterior cordotomy was realized with laryngeal micro-
instruments (tongs - Scissors). Usage of those cold instruments has
been reported by Lichtenberger [12]. Arytenoid perichondritis,
stenosis, carbonization, granuloma formation and delayed healing
were mentioned as complications by the authors [3,13]. The
absence of oedema and granuloma in our serieis the fact of using
corticosteroids. This absence of complications was noted by
Lichtenberger [12]. We have removed the cannula of tracheotomy
after ten days post operation for seven of our patients. One case of
failure during the first decanulation was notified. Another surgery
permetted to remove that canula. The failure of decanulation found
in our serie is shared by the literature [14,15]. The dysphonia was
the only after-effect for all the patients; which deduced that our
notch was bilateral. An improvement of the quality of the voice was
observed in the series where the notch was unilateral [8,16]. Any
notion of effort dyspnea wasn’t found after a follow-up from 10 to
14 months as in the series of B. Hammami with a set back of 27
months [8].
Conclusion
The management of post-thyroidectomy laryngeal diplegiaen
counters many problems in our region. The usage of endoscopic
micro instruments enabled us to obtain promoters results with
haemorrhage as the only minimal intraoperative complication.
This alternative may allow in our context to reintegrate socially
of our patients by removing them from a tracheotomy previously
considered as definitive.
References
1. Baujat B, Delbove H, Wagner I, Fugain C, Corbierre S, et al. (2001)
Immobilité laryngée post-thyroïdectomie. Ann Chir 126(2): 104-110.
2. Sapundzhiev N, Lichtenberger G, EckelH E, Zenev I, Toohill RJ, et al.
(2008) Surgery of adultnilateral vocal fold paralysis in adduction:
history and trends. Eur Arch Otorhinolaryngol 265(12): 1501-1514.
3. Cheung EJ, McGinn J (2007) The surgical treatment of bilateral vocal fold
impairment. Operative Techniques in Otolaryngology 18(2): 144-155.
4. Gorphe P, Hartl D, Primov-Fever A, Hans S, Crevier-BuchmanL, et al.
(2013) Endoscopic laser medial arytenoidectomy for treatment of
bilateral vocal fold paralysis. Eur Arch Otorhinolaryngol 270(5): 1701-
1705.
5. Pia F, Pisani P, Aluffi P (1999) CO2
laser posterior ventriculocordectomy
for the treatment of bilaterall vocal cordparalysis. Euch Arch
Otorhinolaryngol 256(8): 403-406.
6. Kashima H, Dennis DP (1989) Carbondioxide laser posterior
cordectomie for treatment of bilateral cordparalysis. Ann Otol Rhinol
98(12): 930-934.
7. Drancy A, Laccourreye E, Brasnu D (1992) Posterior partial cordectomy
with CO2
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