BACKGROUND A fish spike stuck in the throat is a common ear,nose,and throat(ENT)emergency.However,it is very rare for a fish spike to reach the thyroid tissue through the throat,which is very dangerous and can lead to...BACKGROUND A fish spike stuck in the throat is a common ear,nose,and throat(ENT)emergency.However,it is very rare for a fish spike to reach the thyroid tissue through the throat,which is very dangerous and can lead to pharyngeal fistula,cervical abscess,mediastinal abscess,and thyroid abscess.Proper and timely management can help reduce complications,especially in elderly patients.CASE SUMMARY In the case presented here,the causative factor was dentures,but improper management aggravated the condition.In the case presented here,an elderly woman with a history of accidentally swallowing fish bones for 20 d had a sensation of foreign bodies in her throat.Eventually,computed tomography(CT)of the neck showed that the left side of the thyroid gland had a dense shadow in the form of a stripe.CONCLUSION If a fishbone foreign body is not visible during endoscopic examination but the patient has significant symptoms,the surgeon should be aware that the fishbone may be lodged in the thyroid.To avoid a misdiagnosis,ultrasound,CT,and other tests can be used to clarify the diagnosis.T The first step in treating a fish bone in the thyroid gland is to determine the position of the foreign body and the extent of the infection,and to develop a personalized surgical plan for its removal.At the same time,scientific information should be made available to the general public so that people know that if a fish bone is accidentally lodged,they should not force it to be swallowed or be spit out by inducing vomiting,which are incorrect methods and may aggravate the condition or even cause it to migrate outside the cavity,leading to serious complications,as in this reported case.展开更多
BACKGROUND A“cannot intubate,cannot oxygenate(CICO)”situation is a life-threatening condition that requires emergent management to establish a route for oxygenation to prevent oxygen desaturation.In this paper,we de...BACKGROUND A“cannot intubate,cannot oxygenate(CICO)”situation is a life-threatening condition that requires emergent management to establish a route for oxygenation to prevent oxygen desaturation.In this paper,we describe airway management in a patient with an extended parotid tumor that invaded the airways during CICO using the endotracheal tube tip in the pharynx(TTIP)technique.CASE SUMMARY A 43-year-old man was diagnosed with parotid tumor for>10 years.Computed tomography and nasopharyngeal fiberoptic examination revealed a substantial mass from the right parotid region with a deep extension through the lateral pharyngeal region to the retropharyngeal region and obliteration of the nasopharynx to the oropharynx.Tumor excision was arranged.However,we encountered CICO during anesthesia induction.An endotracheal tube was used as an emergency supraglottic airway device(TTIP)to ventilate the patient in a CICO situation where other tools such as laryngeal mask airway or mask ventilation were not suitable for this complicated and difficult airway.The patient did not experience desaturation despite sudden loss of definite airway.During tracheostomy,the pulse oximetry remained 100%with our technique of ventilating the patient.The arterial blood gas analysis revealed PaCO_(2)35.7 mmHg and PaO2242.5 mmHg upon 50%oxygenation afterward.CONCLUSION Using an endotracheal tube as a supraglottic airway device,patients may have increased survival without experiencing life-threatening desaturation.展开更多
This article deals with a treatment of acute diseases of pharynx and larynx with bloodpricking therapy, in this treatment, a group of 79 patients accepted the treatment with this therapy.The therapy contains mainly tw...This article deals with a treatment of acute diseases of pharynx and larynx with bloodpricking therapy, in this treatment, a group of 79 patients accepted the treatment with this therapy.The therapy contains mainly two methods: Acupoint pricking and local scattered pricking. A good result is achieved. It proves that blood-pricking method can replace the antibiotics and alleviate the sufferer’s pain and economic burden. It is simple and easy to carry out, thus it can be spread extensively.展开更多
BACKGROUND Effective bowel cleansing is essential for a successful colonoscopy.Laxatives,such as polyethylene glycol,are commonly used for bowel preparation.Vomiting is a frequent complication during bowel preparation...BACKGROUND Effective bowel cleansing is essential for a successful colonoscopy.Laxatives,such as polyethylene glycol,are commonly used for bowel preparation.Vomiting is a frequent complication during bowel preparation,and forceful vomiting can potentially lead to esophageal perforation,as reported in several previous cases.However,pharyngeal perforation during bowel preparation has not been previously documented.Here,we present a case of pharyngeal perforation induced by forceful vomiting during bowel preparation.CASE SUMMARY A 38-year-old man with a history of hypertension,dyslipidemia,diabetes mellitus,and end-stage renal disease on hemodialysis was admitted for evaluation of recurrent abdominal pain.The patient complained of sudden pain in the neck,throat,and anterior chest following forceful vomiting during bowel preparation.Physical examination revealed crepitus under the skin of the neck and anterior chest on palpation,and upper gastrointestinal endoscopy revealed pharyngeal perforation.The perforation site was located above the upper esophageal sphincter,which distinguished it from Boerhaave’s syndrome.Conservative medical management was chosen after consultation with a thoracic surgeon and an otolaryngologist,considering the patient's mild symptoms,stable vital signs,and the small size of the lesion;the perforation resolved without endoscopic or surgical intervention.The patient was discharged from hospital two weeks after the perforation.CONCLUSION Despite its rarity,pharyngeal perforation should be considered a potential complication of bowel preparation for colonoscopy.展开更多
目的:观察中医“三联疗法”治疗中风后假性球麻痹吞咽障碍的临床疗效。方法:将80例中风后假性球麻痹吞咽障碍患者按照随机数字表法分为观察组和对照组,每组各40例。两组患者均给予常规西药治疗,对照组给予康复功能训练,观察组在对照组...目的:观察中医“三联疗法”治疗中风后假性球麻痹吞咽障碍的临床疗效。方法:将80例中风后假性球麻痹吞咽障碍患者按照随机数字表法分为观察组和对照组,每组各40例。两组患者均给予常规西药治疗,对照组给予康复功能训练,观察组在对照组治疗的基础上采用中医“三联疗法”,包括舌根透针法、穴位贴敷、冰片柠檬冰棒咽部冷刺激等。比较两组患者的临床疗效及治疗前后日常生活活动能力(activities of daily living,ADL)评分、标准吞咽功能评定量表(standardized swallowing assessment,SSA)评分、美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)评分、血清前白蛋白水平。结果:观察组有效率为95.0%,对照组有效率为75.0%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后SSA评分低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后ADL评分高于本组治疗前,且治疗后观察组高于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后NIHSS评分低于本组治疗前,血清前白蛋白水平高于本组治疗前,治疗后观察组NIHSS评分低于对照组,血清前白蛋白水平高于对照组,差异均有统计学意义(P<0.05)。结论:中医“三联疗法”治疗中风后假性球麻痹吞咽障碍,可改善患者的临床症状及营养状况,提高其生活质量,促进神经功能的恢复。展开更多
OBJECTIVE To systematically assess the efficacy and safety of acupuncture in treating acute tonsillitis,providing a reference for clinical decision-making.METHODS We searched PubMed,CENTRAL,Embase,Web of Science,China...OBJECTIVE To systematically assess the efficacy and safety of acupuncture in treating acute tonsillitis,providing a reference for clinical decision-making.METHODS We searched PubMed,CENTRAL,Embase,Web of Science,China National Knowledge Infrastruc⁃ture,China Biomedical,clinical research registra⁃tion platforms,grey literature,and the reference lists of the selected studies from inception to Oct.30,2022.The risk of bias assessment used Rev⁃Man.Meta-analysis was performed using STATA with Hedges′g value.In addition,we performed subgroup analysis,meta-regression,and publica⁃tion bias detection with Harbord′s and Egger′s tests.RESULTS We included 19 randomized controlled trials comprising 1701 patients,of which 1 study was assessed high risk of bias.The primary outcome,the response rate,revealed that acupuncture was more effective than antibi⁃otics.The secondary outcomes showed that the difference in the reduction of the VAS scores,sore throat time,and white blood cell counts was statistically significant with acupuncture compared to antibiotics.However,the difference in modulat⁃ing neutrophil percentage and C-reactive protein was not statistically significant.Besides,acupuncture treatments showed a lower incidence of adverse events than antibiotics.CONCLUSION Acupuncture therapy on acute tonsillitis is safe,and the response rate is superior to antibiotics.For alleviating sore throat symptoms,shortening sore throat time,and improving immune in fl am mation index,acupuncture has positive signi fi cance.Nevertheless,because of the limitations of this study,our conclusions should be inter⁃preted with caution.Future efforts still need more high-quality trials to improve the methodology and reporting quality.展开更多
文摘BACKGROUND A fish spike stuck in the throat is a common ear,nose,and throat(ENT)emergency.However,it is very rare for a fish spike to reach the thyroid tissue through the throat,which is very dangerous and can lead to pharyngeal fistula,cervical abscess,mediastinal abscess,and thyroid abscess.Proper and timely management can help reduce complications,especially in elderly patients.CASE SUMMARY In the case presented here,the causative factor was dentures,but improper management aggravated the condition.In the case presented here,an elderly woman with a history of accidentally swallowing fish bones for 20 d had a sensation of foreign bodies in her throat.Eventually,computed tomography(CT)of the neck showed that the left side of the thyroid gland had a dense shadow in the form of a stripe.CONCLUSION If a fishbone foreign body is not visible during endoscopic examination but the patient has significant symptoms,the surgeon should be aware that the fishbone may be lodged in the thyroid.To avoid a misdiagnosis,ultrasound,CT,and other tests can be used to clarify the diagnosis.T The first step in treating a fish bone in the thyroid gland is to determine the position of the foreign body and the extent of the infection,and to develop a personalized surgical plan for its removal.At the same time,scientific information should be made available to the general public so that people know that if a fish bone is accidentally lodged,they should not force it to be swallowed or be spit out by inducing vomiting,which are incorrect methods and may aggravate the condition or even cause it to migrate outside the cavity,leading to serious complications,as in this reported case.
文摘BACKGROUND A“cannot intubate,cannot oxygenate(CICO)”situation is a life-threatening condition that requires emergent management to establish a route for oxygenation to prevent oxygen desaturation.In this paper,we describe airway management in a patient with an extended parotid tumor that invaded the airways during CICO using the endotracheal tube tip in the pharynx(TTIP)technique.CASE SUMMARY A 43-year-old man was diagnosed with parotid tumor for>10 years.Computed tomography and nasopharyngeal fiberoptic examination revealed a substantial mass from the right parotid region with a deep extension through the lateral pharyngeal region to the retropharyngeal region and obliteration of the nasopharynx to the oropharynx.Tumor excision was arranged.However,we encountered CICO during anesthesia induction.An endotracheal tube was used as an emergency supraglottic airway device(TTIP)to ventilate the patient in a CICO situation where other tools such as laryngeal mask airway or mask ventilation were not suitable for this complicated and difficult airway.The patient did not experience desaturation despite sudden loss of definite airway.During tracheostomy,the pulse oximetry remained 100%with our technique of ventilating the patient.The arterial blood gas analysis revealed PaCO_(2)35.7 mmHg and PaO2242.5 mmHg upon 50%oxygenation afterward.CONCLUSION Using an endotracheal tube as a supraglottic airway device,patients may have increased survival without experiencing life-threatening desaturation.
文摘This article deals with a treatment of acute diseases of pharynx and larynx with bloodpricking therapy, in this treatment, a group of 79 patients accepted the treatment with this therapy.The therapy contains mainly two methods: Acupoint pricking and local scattered pricking. A good result is achieved. It proves that blood-pricking method can replace the antibiotics and alleviate the sufferer’s pain and economic burden. It is simple and easy to carry out, thus it can be spread extensively.
文摘BACKGROUND Effective bowel cleansing is essential for a successful colonoscopy.Laxatives,such as polyethylene glycol,are commonly used for bowel preparation.Vomiting is a frequent complication during bowel preparation,and forceful vomiting can potentially lead to esophageal perforation,as reported in several previous cases.However,pharyngeal perforation during bowel preparation has not been previously documented.Here,we present a case of pharyngeal perforation induced by forceful vomiting during bowel preparation.CASE SUMMARY A 38-year-old man with a history of hypertension,dyslipidemia,diabetes mellitus,and end-stage renal disease on hemodialysis was admitted for evaluation of recurrent abdominal pain.The patient complained of sudden pain in the neck,throat,and anterior chest following forceful vomiting during bowel preparation.Physical examination revealed crepitus under the skin of the neck and anterior chest on palpation,and upper gastrointestinal endoscopy revealed pharyngeal perforation.The perforation site was located above the upper esophageal sphincter,which distinguished it from Boerhaave’s syndrome.Conservative medical management was chosen after consultation with a thoracic surgeon and an otolaryngologist,considering the patient's mild symptoms,stable vital signs,and the small size of the lesion;the perforation resolved without endoscopic or surgical intervention.The patient was discharged from hospital two weeks after the perforation.CONCLUSION Despite its rarity,pharyngeal perforation should be considered a potential complication of bowel preparation for colonoscopy.
文摘目的:观察中医“三联疗法”治疗中风后假性球麻痹吞咽障碍的临床疗效。方法:将80例中风后假性球麻痹吞咽障碍患者按照随机数字表法分为观察组和对照组,每组各40例。两组患者均给予常规西药治疗,对照组给予康复功能训练,观察组在对照组治疗的基础上采用中医“三联疗法”,包括舌根透针法、穴位贴敷、冰片柠檬冰棒咽部冷刺激等。比较两组患者的临床疗效及治疗前后日常生活活动能力(activities of daily living,ADL)评分、标准吞咽功能评定量表(standardized swallowing assessment,SSA)评分、美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)评分、血清前白蛋白水平。结果:观察组有效率为95.0%,对照组有效率为75.0%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后SSA评分低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后ADL评分高于本组治疗前,且治疗后观察组高于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后NIHSS评分低于本组治疗前,血清前白蛋白水平高于本组治疗前,治疗后观察组NIHSS评分低于对照组,血清前白蛋白水平高于对照组,差异均有统计学意义(P<0.05)。结论:中医“三联疗法”治疗中风后假性球麻痹吞咽障碍,可改善患者的临床症状及营养状况,提高其生活质量,促进神经功能的恢复。
文摘OBJECTIVE To systematically assess the efficacy and safety of acupuncture in treating acute tonsillitis,providing a reference for clinical decision-making.METHODS We searched PubMed,CENTRAL,Embase,Web of Science,China National Knowledge Infrastruc⁃ture,China Biomedical,clinical research registra⁃tion platforms,grey literature,and the reference lists of the selected studies from inception to Oct.30,2022.The risk of bias assessment used Rev⁃Man.Meta-analysis was performed using STATA with Hedges′g value.In addition,we performed subgroup analysis,meta-regression,and publica⁃tion bias detection with Harbord′s and Egger′s tests.RESULTS We included 19 randomized controlled trials comprising 1701 patients,of which 1 study was assessed high risk of bias.The primary outcome,the response rate,revealed that acupuncture was more effective than antibi⁃otics.The secondary outcomes showed that the difference in the reduction of the VAS scores,sore throat time,and white blood cell counts was statistically significant with acupuncture compared to antibiotics.However,the difference in modulat⁃ing neutrophil percentage and C-reactive protein was not statistically significant.Besides,acupuncture treatments showed a lower incidence of adverse events than antibiotics.CONCLUSION Acupuncture therapy on acute tonsillitis is safe,and the response rate is superior to antibiotics.For alleviating sore throat symptoms,shortening sore throat time,and improving immune in fl am mation index,acupuncture has positive signi fi cance.Nevertheless,because of the limitations of this study,our conclusions should be inter⁃preted with caution.Future efforts still need more high-quality trials to improve the methodology and reporting quality.
