2,996 research outputs found
Pierre Robin sequence in association with tracheoesophageal fistula and esophageal atresia
The first symptom of esophageal atresia and tracheoesophageal fistula is the inability to eat and respiratory distress after feeding. The coexistence of Pierre Robin Sequence (PRS) with esophageal atresia and tracheoesophageal fistula is a rare clinical condition. In infants with PRS, evaluation of respiratory and nutritional problems is important. The coexistence of esophageal atresia and tracheoesophageal fistula leads to increased nutritional and respiratory problems. Problems that may occur in the airways may occur late. In this case report, we aimed to present a case of neonatal infant with rare esophageal atresia, tracheoesophageal fistula, and PRS
Overview of 100 patients with voice prosthesis after total laryngectomy--experience of single institution [Pregled 100 bolesnika sa govornom protezom nakon totalne laringektomije]
Surgical procedures, especially total laryngectomy, used for treatment of advanced laryngeal carcinoma, have a profound adverse effect on the patient's physical, functional, and emotional health, and almost always decrease quality of life. There are three main types of voice rehabilitation after surgery. They are: esophageal speech techniques, the use of artificial larynx devices and tracheoesophageal puncture with the insertion of various types of voice prostheses. Voice prosthesis was inserted in 100 patients in the ENT Department, University Hospital Center Zagreb, from January 2004 until February 2011, and 91 of these patients were included in our study. The prosthesis was inserted secondary at 71 patients, while in other 20 it was inserted primary, i.e. immediately after laryngectomy as a part of the same procedure. Voice rehabilitation was initiated 10th day after primary insertion and 1st-3rd day after secondary insertion. The postoperative voice quality was compared with a five degree scale, which was taken from Hilger's retrospective study (2000). The rehabilitation was successful in 75.8% of our patients. Early complication rate was 4.4%, and 10.9% of patients had late complications. Statistical analysis didn't show significant differences regarding the complications rate and success rate of rehabilitation between groups of patients, formed according to age, irradiation status and timing of prosthesis insertion
Gross E esophageal atresia with unique course
The patient was a 15 months-old boy who had been diagnosed CHARGE syndrome, which is a multiple congenital anomaly syndrome caused by mutations in the CHD7 gene. Mechanical ventilation management was initiated 2 hours after birth for dysphagia and respiratory failure, and tracheotomy was performed 3 months after birth for dysphagia and failed extubation. He was repeatedly hospitalized due to pneuomoniae. Approximately 1 year after birth, the boy had two consecutive episodes of sudden ventilatory insufficiency while replacing the tracheotomy cannula. A bronchoscopic examination under general anesthesia revealed a tracheoesophageal fistula directly below the tracheostomy. The patient was diagnosed with Gross E esophageal atresia, and we speculated that the cannula migrated to the esophagus via the fistula during tracheostomy cannula replacement. Gross E esophageal atresia is a rare disease. Its diagnosis is often delayed, and it is discovered by recurrent pneumonia in many cases. A tracheoesophageal fistula may also be found in children with deformities of the respiratory system. Furthermore, tracheoesophageal fistulae are often found in the neck. Therefore, when sudden ventilatory insufficiency occurs in a child with a tracheostomy after replacing the tracheostomy cannula, caution must be exercised since the cannula may have migrated to the esophagus via a fistula
Insertion of Provox®2 voice prosthesis using the anterograde technique immediately after the secondary tracheoesophageal puncture
Insertion of a voice prosthesis through the tracheoesophageal puncture (TEP) is one way to restore the voice after total laryngectomy. The second generation Provox voice prosthesis is presently one of the most popular devices. Although TEP can be done primarily, there are many centres that prefer it to be done at a second stage for various reasons. However, secondary TEP for retrograde replacement of prosthesis can be difficult and general anaesthesia is very often necessary. Moreover, the presence of neck stiffness and fibrosis from the surgery or previous radiotherapy could affect the neck extension for proper positioning of the trocar. Similarly, it is difficult to insert the prosthesis if there is stenosis at the pharyngoesophageal segment. We describe a technique in which creation of secondary TEP and insertion of Provox2 is done with local anaesthesia under the same setting. The procedure is well tolerated and can be safely performed on an out-patient basis.published_or_final_versio
Compromised ventilation caused by tracheoesophageal fistula and gastrointestinal endoscope undergoing removal of disk battery on esophagus in pediatric patient -A case report-
Ingestion of disk batteries may have serious complications such as esophageal burn, perforation, and tracheoesophageal fistula, particularly when the battery is caught in the esophagus. Proper placement of the tracheal tube is critical when tracheoesophageal fistula was occurred from esophageal impaction the battery. Endoscopy of upper gastrointestinal tract in infants and children is an important and effective tool for the diagnosis and treatment of foreign body ingestion. But upper gastrointestinal endoscopy in infant and children has very high risk of tracheal compression and airway compromise. We present a case of ventilatory compromise during insertion of the upper gastrointestinal endoscopy in 16-month-old child with tracheoesophageal fistula secondary to disk battery ingestion
Esophageal Atresia: Postoperative Complications and Involved Factors
Introduction: Esophageal atresia (EA) is a relatively common congenital anomaly. Following the increase in the survival rate of neonates with appropriate surgical procedures, timely diagnosis and treatment of surgical complications are essential.
Materials and Methods: After getting ethical approval, all the patients who underwent surgery for EA at Tabriz Children's Hospital were contacted, and in case of any long-term complications, parents were invited to visit the hospital.
Results: Fifty-five children, including 31 boys and 24 girls, with a mean birth weight of 2734.63±566.21 grams and an APGAR score of 8.75±0.96, participated in this study. The most common type of EA was type C (87.3%). Respiratory disorders (47.3%) and marked anastomotic stenosis (21.8%) are the most common complications following surgery. Anastomotic stenosis was associated with suture tension, tracheal intubation >5 days, and birth weight<2,500 grams.
Conclusion: In the postoperative phase of EA surgery, respiratory disorders are a common complication. Anastomotic stenosis is the second most common complication. It is associated with suture tension, tracheal intubation for more than five days, birth weight less than 2,500 grams, Gastroesophageal reflux into the esophagus, and leakage from anastomosis. There is a need for future multi-center studies to provide more reliable evidenc
The surgical approach of late-onset tracheoesophageal fistula in a tracheostomized COVID-19 patient
In the COVID-19 era the tracheal complications due to prolonged mechanical ventilation have significantly increased. Acquired tracheoesophageal fistula is one of those in ventilated COVID-19 patients. Thus, the knowledge of their management in such fragile patient is crucial. We report a case of tracheoesophageal fistula in a 56-year-old female under prolonged mechanical ventilation for COVID-19 bilateral pneumonia and discuss its management. A surgical approach was proposed. By a collar-shaped transverse cervicotomic access, we transected the trachea at level of fistula en-bloc with the tracheostoma. The esophageal lesion was longitudinally repaired in two-layers. Protective left strap muscle was sandwiched between esophagus and trachea. The tracheal end-to-end anastomosis was completed without a re-tracheostoma. Even if surgical approach of tracheoesophageal fistula in COVID-19 patients has not been tested before, surgery remains the treatment of choice according to the multidisciplinary board
THE PREVALENCE OF BIRTH DEFECTS AMONG NON-HISPANIC ASIANS AND AMERICAN INDIANS/ALASKA NATIVES IN TEXAS, 1999-2015
Background: Birth defects are disproportionately higher among certain race/ethnic groups. We examined how birth defects prevalence differs among the less studied non-Hispanic (NH) Asian and any American Indian/Alaska Native (AI/AN) populations, relative to NH Whites. Methods: Data were obtained from the Texas Birth Defect Registry from 1999 to 2015 for infants born to Texas-resident mothers who were NH White, NH Asian, or AI/AN. This covers a livebirth population of 2.6 million. Prevalence ratios were calculated for NH Asians and AI/ANs (relative to NH Whites) for 44 birth defects using Poisson regression and were adjusted for maternal age. Results: After adjustment, there were 34 statistically significant prevalence ratios. Among NH Asians, 23 defects had a lower adjusted prevalence ratio (aPR) and 3 defects had a higher aPR. AI/ANs had 2 defects with a significantly lower aPR and 6 with a higher aPR. Conclusions: NH Asians generally have a lower prevalence for birth defects while AI/ANs have a higher prevalence compared to NH Whites. These findings update the limited previous literature on this topic and also warrant additional research among larger populations in order to identify the true association of these understudied race/ethnic groups
Surgical Approaches to Congenital Anomalies of Esophagus
With prevalence of about 1 in 3000 live births, pediatric surgeons commonly deal with esophageal abnormalities, which may provide substantial clinical complications. Surprisingly, the embryologic processes underlying esophageal atresia (EA) with or without tracheoesophageal fistula (TEF), one of the hallmark disease entities of pediatric surgery, have only lately been largely uncovered. When it comes to the treatment of congenital esophageal abnormalities, notably esophageal atresia and tracheoesophageal fistula, surgical methods are essential. In order to address the anatomical abnormalities and restore normal function, surgical correction is often necessary in the care of congenital esophageal anomalies, including esophageal atresia and tracheoesophageal fistula. In this review we are going to cover surgical approaches to repair those malformations, long-term outcomes, and latest developments in esophageal surgical approaches
- …