[Anesthesia for maxillofacial, ear, nose and throat surgery, otorhinolaryngology in ophthalmic procedures. 2. Specific aspects of otorhinolaryngology in ophthalmic procedures].
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BACKGROUND: Airbags are successful in avoiding or in reducing serious injuries caused by motor vehicle accidents. On the other hand airbag deployment has led to a new kind of injuries. Only a few publications about that item exist. The experiences made with two patients after airbag deployment are described. The relevant literature is discussed. PATIENTS: Two patients after airbag injuries were examined. The face of the first patient hit a regularly expanding airbag. Afterwards his nose was obviously deformed. In the other case both front airbags of a car burst triggered by a frontal crash. The symptoms of this patient were painful itching skinlesions in his face, unilateral hearing loss and tinnitus. RESULTS: The first described patient had a clinical and radiological provable fracture of his nasal bone with a frontal impression. The facial skin of the other patient was etched by the filling gas of the airbags. He was also suffering from an acoustic trauma. These cases are compared to other cases found in the literature. CONCLUSIONS: Oto-rhino-laryngological injuries can be caused by airbag deployment, especially by bursting airbags. Beside of outward injuries like dermatological hurts and fractures of the facial skeleton also more serious and life-threatening traumata can occur with damage of the cervical spine and upper airway. Moreover otologic handicaps like temporary or permanent hearing loss, tinnitus, vertigo, otalgia and tympanic membrane perforations are possible consequences.
Hyalinosis cutis et mucosae (HCM) is a rare autosomal recessive disease of unknown aetiology and pathogenesis. In the skin and mucous membranes there is characteristically a deposition of hyaline-like material in the papillary dermis, around the small blood vessels and around skin appendages. Besides the manifold skin lesions, the mucous membranes affected are found in the nasal and oral cavities, pharynx and larynx. The latter causes the most characteristic symptom, namely, hoarseness, from birth. The lesions of the vessel walls are the most significant histopathological alterations. Ultrastructurally, massive deposits of amorphous, hyaline-like material in the dermis, reduction in number and size of the collagen fibrils and, finally, thickening of the basal laminae could be observed. The findings suggest an abnormal production of noncollagenous proteins as well as the alteration of the lysosomal systems of fibroblasts, endothelial cells and pericytes in the pathogenesis of hyalinosis.
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