B-ENT
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Foreign bodies within the parotid gland retained after trauma are rarely observed, due in part to ease of detection. Few, however, particularly wooden foreign bodies, may not be identified clinically and radiologically. ⋯ Any suspicion of a residual foreign body after penetrating parotid gland trauma can be clarified with a detailed radiological examination, which may provide further guidance for treatment. The treatment modality of parotid foreign bodies is early surgical exploration, and in delayed cases, superficial parotidectomy may be needed.
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New entities, such as 'subclinical' over- and undersubstitution, are easily diagnosed after thyroid surgery due to improved testing methods, and the incidence of thyroidectomy with lifelong hormone substitution is increasing. Thus, there is a need to review conventional replacement therapy after thyroid surgery. We investigated the adequacy of our thyroid hormone replacement therapy for three months after total-, subtotal-, and hemithyroidectomy using an upper reference limit of thyrotropin (TSH) of 4.6 mU/L. ⋯ To avoid over- and undersubstitution after thyroidectomy, an optimal replacement therapy dose is necessary. A small majority of our preoperatively euthyroid patients received adequate therapy. Endocrinological follow-up six weeks after surgery revealed the need for L-T4 dose adjustments, especially in preoperatively hyperthyroid patients. When the extent of resection was similar for hyperthyroid and euthyroid patients, the same initial dose of L-T4 was justified.
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Various approaches and techniques are used in discontinuing tracheostomy in children. The variability in the use of resources is considerable. The objective of the study was to assess decannulation in children attending our ENT department. ⋯ They had downsizing, then capping of the tracheostomy as a functional trial. One child failed decannulation and another needed a second trial for successful decannulation. The individualization of tracheostomy decannulation is necessary in children.
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Stridor is the sound caused by abnormal air passage into the lungs and can exist in different degrees and be caused by obstruction located anywhere in the extra-thoracic (nose, pharynx, larynx, trachea) or intra-thoracic airway (tracheobronchial tree). Stridor may be congenital or acquired, acute, intermittent or chronic. Laryngotracheal inflammation (croup) is the most common cause of acute stridor. ⋯ Following this procedure, a place in the intensive care unit should be available for those cases presenting with stridor in which a definite diagnosis could not yet be established. Although important, pre-endoscopy assessment including history, physical examination and radiological examination, is only a guide to the type and degree of pathology found during endoscopy. About 1 out of 10 infants are found to have lesions in more than one anatomical site of the upper aerodigestive tract.
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We present two cases of blunt external trauma to the trachea. The first was a 19-year-old man who had suffered rupture of the first tracheal ring as a consequence of attempting suicide by hanging from a cable. The second was an 11-year-old boy who fell from a bicycle and struck his neck against the handlebars. ⋯ Both cases were treated by primary repair. A surgical exploration is essential in the case of subcutaneous emphysema, even if no respiratory distress is present and a radiological evaluation is negative. Follow up, according to the extent and type of injury, is recommended to prevent post traumatic stenosis of the trachea.