PubMed · 13172319
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L M BOSCH DEL MARCO, J A FOLLE. 1953. [Enterogenous cyst].. https://pubmed.ncbi.nlm.nih.gov/13172319/
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Subglottic cysts are rare and may cause airway obstruction. Most cases are acquired secondary to endotracheal intubation, even short-term, particularly in the premature neonate. Complete tracheal rings are rare anomalies associated with tracheal stenosis. To our knowledge, the two have not been reported coexisting. A 16-month-old ex-premature boy was found unresponsive, with his tracheostomy tube dislodged. Tracheomalacia, subglottic stenosis, and a laryngeal cyst had been diagnosed shortly after birth, and the cyst was surgically treated at that time. At autopsy, a complete tracheal ring was noted in the subglottic region, above the tracheostomy site, and the tracheal diameter was markedly decreased in this area. In addition, multiloculated cysts were present at that level, arising from both anterolateral tracheal walls. These completely occluded the airway. To our knowledge, this is the first case of a combination of tracheal ring anomaly and subglottic cysts. Pediatric pathologists must be aware of iatrogenic lesions associated with care of the premature neonate, particularly as the age of viability continues to decrease.
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OBJECTIVE: To evaluate the benefits, as well as the possible complications, of the use of diathermy scissors in parotid gland surgery. DESIGN: Prospective study of the surgical procedures of the diathermy scissors and a retrospective comparison with a conventionally treated control group concerning cut-closure time. SETTING: Tertiary care referral academic center. PATIENTS: Prospective examination of 30 unselected patients undergoing superficial (n=23) or subtotal/total (n=10) parotidectomies performed with diathermy scissors. Indications were benign tumors (n=18), malignant tumors (n=12), and cystic lesions (n=3). In a control group (n=50), 36 superficial and 21 subtotal/total parotidectomies were performed. RESULTS: The use of diathermy scissors reduces the need to frequently change dissecting and coagulating surgical instruments. The scissors reduce intraoperative bleeding and therefore improve visualization and orientation in the surgical field. Postoperative bleeding or seroma and Frey syndrome were not observed. In 1 case, a salivary fistula was present for 3 weeks. Three cases of transient facial weakness occurred, all of which completely resolved by 6 months after surgery. In the control group, the cut-closure time ranged from 50 to 120 minutes (average, 87.6 minutes) during superficial parotidectomy; it ranged from 80 to 160 minutes (average, 130.0 minutes) during subtotal and total parotidectomy. In comparison, in the study group, the average time gain was 16 minutes during superficial parotidectomy when diathermy scissors were used, a statistically significant difference (P=.03). During subtotal and total parotidectomy with diathermy scissors, the average time gain was 19.3 minutes and was statistically not significant (P=.23). CONCLUSIONS: The results of the present study show that diathermy scissors are very well suited for most of the surgical steps in parotid gland surgery. They provide an elegant, safe, and fast surgical procedure, especially in the hands of an experienced surgeon.