Back pain with erectile dysfunction

A 42-year-old male was referred to our pain clinic with back pain. Four years ago, he was treated for back pain caused by falling down injury. He also complained of erectile dysfunction, which was regarded as having psychologic origin at other departments. He had grade IV leg weakness and left lower thoracic paravertebral tenderness. Thoracic CT, plane X-ray and whole body bone scan revealed normal findings. After diagnostic medial branch block at lower thoracic vertebra, pain was subsided partially, but erectile dysfunction persisted. Due to persistent symptoms, we ordered MRI, and the extramedullary mass at T9 level was found. He had undergone neurosurgical operation for tumor removal, and pathologic finding was Schwannoma. After the operation his symptoms improved completely. Although erectile dysfunctions are presumed to have psychologic origin frequently, we report a patient whose symptoms were from the spinal cord tumor.ope

An assessment of oropharyngeal airway position using a fibreoptic bronchoscope

Selecting the appropriate oropharyngeal airway for safe and effective airway management is important in clinical practice. In this prospective observational study, we examined the position of the distal end of oropharyngeal airways using a fibreoptic bronchoscope. We enrolled 149 adults (72 men and 77 women). The correct airway size was determined by inserting four adult sizes Guedel airway (Hudson RCI; Teleflex Medical, Research Triangle, Park, NC, USA) (sizes 8, 9, 10 and 11) sequentially in anaesthetised patients. The ‘best fit’ airway was size 10 in 45 (62%) men, and size 9 in 58 (75%) women. However, when these airways were inserted, the distal end of the airway either touched or passed beyond the epiglottis tip in 20 (27%) men and six (8%) women, respectively. When a size-9 airway was inserted in men and a size-8 airway inserted in women, the distal ends were obstructed by the tongue in three (2%) patients. In conclusion, a size-9 airway in men and a size-8 airway in women are the most acceptable sizes for adults of average height.ope