Phlegmon refers to a spreading diffuse inflammation of connective tissue with formation of an exudate or pus. Phlegmonous infections may affect any region of the gastrointestinal tract. The stomach is the region most frequently involved; infections at other sites have been but rarely reported. Acute phlegmonous esophagitis is a very rare disease involving both the submucosal and muscular layers of the esophagus, with sparing of the mucosal layer. Acute esophageal esophagitis is commonly associated with acute phlegmonous gastritis; any association with a deep neck infection is very rare. We report herein a case of acute phlegmonous esophagitis developing as a complication of a retropharyngeal abscess treated via incision and drainage and prescription of longterm antibiotics. Thus, we did not perform esophageal surgery. We also review the relevant literature. (J Clinical Otolaryngol 2018;29:119-122)
Objectives/Hypothesis In this study, we compared the effects of propofol and dexmedetomidine on the upper airway collapse pattern and cardiopulmonary parameters of patients with obstructive sleep apnea (OSA) undergoing drug‐induced sleep endoscopy (DISE). Study Design Prospective, single center, observational study Materials and Methods The 50 patients with OSA underwent 30 minutes of DISE on 2 different days, the first time with propofol target‐controlled infusion (TCI) and the second time with dexmedetomidine TCI. Both the characteristics of upper airway obstruction and cardiopulmonary parameters in response to the depth of sedation achieved with each drug were evaluated. Results The results obtained with propofol and dexmedetomidine DISE were in excellent agreement for all sites of obstruction irrespective of the depth of sedation. Although partial or total obstruction at all areas was consistently observed using both drugs, the degree of upper airway narrowing was slightly lower with dexmedetomidine than with propofol. However, the percentage of patients with a greater than 20% change in blood pressure and heart rate compared to baseline was significantly higher in response to propofol than to dexmedetomidine ( P = 0.003 and P < 0.001, respectively). Minimal oxygen saturation was significantly lower in DISE with propofol than with dexmedetomidine ( P = 0.004). The percentage of patients with oxygen saturation less than 90% or 80% during DISE was significantly higher in response to propofol than to dexmedetomidine ( P = 0.032 and P < 0.001, respectively). Conclusion The DISE findings achieved with propofol and dexmedetomidine were in excellent agreement. However, during DISE, dexmedetomidine provided greater hemodynamic stability and less respiratory depression than propofol. Level of Evidence 4. Laryngoscope , 126:763–767, 2016
The “nasal swell body” (NSB) or septal turbinate is a distinct structure of the anterior nasal septum that is observed on endoscopic and radiographic examination. It is primarily a glandular rather than a venous formation that is comprised of septal cartilage, bone, and thick mucosal lining. It is commonly found in patients with symptoms of chronic sinusitis and allergic rhinitis, and is linked to septal deviation. Space occupying lesions of the septum such as tumors, mucoceles, and pneumatization of the septum can lead to anatomical and functional disorders such as nasal obstruction and sinusitis, while more serious clinical conditions can develop when these lesions are combined with the NSB. Recently, there has been emphasis on the functional aspects of the NSB. It is especially being emphasized for clinicians to pay attention to the NSB and its connection with the stuffy nose. We report an interesting case of the NSB combined with pneumatization of the perpendicular plate of the ethmoid bone causing severe nasal obstruction and repetitive sinusitis along with a literature review.
Cholesterol granulomas are inflammatory deposits commonly found in the mastoid antrum and air cells of temporal bone. They rarely occur in the nose. Here, we report an extremely rare case of cholesterol granuloma in the nasal septum, and include a short literature review. The clinical characteristics, pathology, and surgical treatment are also discussed.
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