To the Editor: We read with interest the report by Arndt et aLl Recurarization appears to occur frequently and we would like to provide two further reports. Patient #1 sustained a gunshot to her neck causing an intimal flap injury to the carotid artery. During stent placement under conscious sedation an intracranial AV fistula was discovered during arteriography. Subsequently, invasive radiolog...

The anesthetic management of patients with facial trauma that directly or indirectly involves the airway can be challenging. We present this image that represents a 22-yrold female patient who suffered a penetrating stiletto shoe injury to the left eye incurred during an altercation. She arrived at the emergency department with the heel still embedded in the eye and the sole covering most of th...

STUDY OBJECTIVE To describe our systematic approach to securing the airway in patients with laryngeal tumors, developed over a 10-year period. DESIGN Retrospective analysis. SETTING University-affiliated veterans administration medical center. PATIENTS Eight hundred one patients presenting for laryngeal tumor surgery in a 10-year period, 285 of whom underwent tracheostomy (25 with local a...

Bilateral vocal cord paralysis is a rare and preventable complication of anterior cervical discectomy and fusion. Herein, we report a fatal case of bilateral vocal cord paralysis after anterior cervical discectomy and fusion (ACD/F). A 65-year-old man with cervical spine trauma and anterior cord syndrome, following car overturn presented to our emergency department. The patient had C6-T10 prola...

Anesthetic management of anterior mediastinal masses (AMM) is challenging. We describe the successful anesthetic management of two patients with AMM in which dexmedetomidine was used at supra-sedative doses. Our first case was a 41-year-old man who presented with a 10 9 9 9 11 cm AMM, a pericardial effusion, compression of the right atrium, and superior vena cava syndrome. He had severe obstruc...

While stridor is an ominous sign implying severe airway stenosis, not all stridor has an organic aetiology. We present two cases of functional stridor in which the diagnosis was made by the anaesthetist. As experts in the management of difficult airways, anaesthetists should be aware of this clinical entity. Recurrent episodes present as aphonia, dysphonia, dyspnoea, apnoea or unconsciousness. ...

FIBROSING mediastinitis is a rare disease characterized by an abnormal proliferation of fibrous tissue and acellular collagen within the mediastinum. Most cases of fibrosing mediastinitis in the United States are caused by an exaggerated granulomatous immunologic response to Histoplasma capsulatum infection. However, other possible etiologic conditions include tuberculosis, mediastinal malignan...

  Introduction: Tracheal stenosis is normally caused by trauma, infection, benign and malignant tumors, prolonged intubation or tracheostomy. The best treatment for tracheal stenosis is resection and anastomosis of trachea. Yet the major surgical complication of tracheal surgery is postoperative stenosis. The goal of this paper is to study the result of tracheal stenting as a replacement therap...

BACKGROUND Orthopaedic surgeons frequently encounter patients with ankylosing spondylitis who would benefit from various types of lower limb operations; however, some of these patients present challenges for anesthesiologists. CASE DESCRIPTION We report the case of a 65-year-old patient with a fractured femoral component 30 years after a cemented THA. The patient had severe tracheal stenosis ...

Pediatric laryngotracheal injuries as a result of blunt neck trauma are exceedingly rare, but they have the potential for fatal consequences if not identified and managed appropriately. Two cases on the spectrum of laryngotracheal trauma are presented followed by an overview of pediatric laryngotracheal trauma with a focus on acute airway management. Special considerations must be taken into ac...