7^th International Conference on Telemedicine, eHealth & Health Informatics November 16-17, 2018 | Mercure Albert Park | Melbourne, Australia

Biography:

Lauren Styan is an Ear Nose and Throat Principle House Officer currently working at Ipswich Hospital, Australia.

 

Abstract:

Introduction: The differential diagnosis of upper airway obstruction in adults is broad, including infection, foreign body aspiration, trauma, allergic reaction, malignancy and systemic disease. Upper airway obstruction secondary to laryngeal myxedema is a rare complication of severe hypothyroidism. There is limited literature to guide diagnosis and management, with only a small number of case reports available. We report the case of a patient with acute upper airway obstruction secondary to laryngeal myxedema, resulting in supraglottic oedema and bilateral vocal cord palsy. A review of the literature regarding the presentation, diagnosis and management of this rare, but life threatening condition is presented.

 

Case Presentation: A 54-year-old male presented to the emergency department with a 2 weeks history of progressive shortness of breath, productive cough and dysphonia. His past medical history was significant for hypertension, hypothyroidism and severe obstructive sleep apnea. He had self-ceased his antihypertensive and thyroxin two weeks prior. On initial evaluation the patient was in respiratory distress with significant stridor. Flexible nasendoscopy demonstrated diffuse edema of the supraglottis, with bilateral vocal cord palsy. His acute upper airway obstruction was managed with urgent fiber-optic intubation and subsequent tracheostomy. Laboratory studies revealed profound hypothyroidism and hyponatremia. The patient was admitted to the intensive care unit and commenced on thyroid replacement therapy and glucocorticoids. His bilateral vocal cord palsy and laryngeal edema resolved and he was successfully decannulated 4 weeks later.

 

Conclusion: Laryngeal myxedema is uncommon, but should be considered in patients presenting with upper airway obstruction and hypothyroidism. To our knowledge this is the only case reported in the literature in which laryngeal myxedema has resulted in bilateral vocal cord palsy. This case report and review of the literature suggests that, with appropriate airway management and treatment of underlying hypothyroidism, laryngeal myxedema is reversible and resolves over the course of two to four weeks.

 

Biography:

Amarendra Singh has completed his Master’s degree in ENT from Mahatma Gandhi Mission Medical College, Mumbai, India. He has completed his Fellowship in the Skull Base Surgery from Grouppo Otologico Piacenza, Italy in 2016. He has worked for 30 months as the Senior Resident in the Department of ENT at Heritage Institute of Medical Science, Varanasi. He has set up his own ENT center, Kashi ENT Center, Varanasi.

 

Abstract:

Olfactory neuroblastoma is an uncommon malignant nasal tumor originating from the olfactory neurosurgical cells of nasal cavity. OAN represents less than 5% of all sinonasal malignancies. The incidence of this tumor has a nominal distribution with peak at 20 and 50 year of age, respectively. OAN is also as anesthesia neuroblastoma or neuroendocrine carcinoma. A 50 year old male presented with mass in nasal cavity with intermittent epistaxis, which was treated by combined surgical excision and RT.

 

Biography:

Lucy Huang is a Surgical Resident Medical Officer at Flinders Medical Center with a particular interest in Otorhinolaryngology Head and Neck Surgery. She has completed her Internship at Lyell McEwin Hospital and is completing two years of Surgical Residency at Flinders Medical Centre. She is actively involved in clinical audits and multiple research projects with the Department of Otolaryngology Head and Neck Surgery.

 

Abstract:

Background: Trans nasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) is an anesthetic technique that allows for prolonged apnoeic oxygenation without intubation. THRIVE is often conducted in patients with normal BMI and mild systemic disease. However, it is unclear if patients with an increased BMI or significant comorbidities are able to safely undergo upper airway ENT procedure with THRIVE.

 

Method: A case note review of all ENT upper airway surgery conducted at Flinders Medical Centre and Flinders Private Hospital with the use of THRIVE and optiflow was conducted. Factors extracted from the case notes were: age, BMI, ASA, smoking status, reflux disease, presence of respiratory and cardiac disease. Analysis utilized non-parametric tests and odds ratios.

 

Result: THRIVE was used with the following upper airway procedures (n=56): micro laryngoscopy with biopsy and/or injection laryngoplasty (n=20), micro laryngoscopy with KTP laser use (n=12), panendoscopy with biopsy (n=11), esophageal dilatation (n=2), subglottic stenosis dilatation (n=10) and stapling of pharyngeal pouch (n=1). Rescue ventilation was required in 21.4% of cases (n=12). THRIVE related complications were reported in 1.8% of cases (1/56). Weight and BMI were associated with rescue ventilation (Mann Whitney U Tests; weight p=0.022, BMI p=0.045). A weight >100 kg or BMI >30 were 5.7 times more likely to require rescue ventilation (Fisher Exact Test p=0.028 and p=0.021). Gender was also associated with rescue ventilation (Pearson Chi-Square r=-0.319, p=0.017), with 75% being male. No other factors reported an association with rescue ventilation.

 

Conclusion: This case series demonstrates that THRIVE can be safely used for a variety of ENT upper airway procedures. However, there is a higher likelihood of rescue ventilation if patient is >100 kg or has BMI >30. Continued investigation with a larger dataset is recommended.

 

Biography:

Lauren Styan is an Ear Nose and Throat Principle House Officer currently working at Ipswich Hospital, Australia.

Abstract:

Introduction & Aim: Tonsillectomy is one of the most commonly performed procedures in children, typically for the management of sleep disordered breathing and/or recurrent tonsillitis. Intracapsular coblation tonsillectomy is an emerging technique that has become popular due to its reported reductions in postoperative pain when compared to other methods. We aimed to investigate the outcomes of children undergoing intracapsular coblation tonsillectomy for management of sleep disordered breathing in our department.

 

Method: 44 pediatric patients undergoing intracapsular coblation tonsillectomy (with or without adenoidectomy) for the management of sleep disordered breathing were recruited. Post-operative pain levels, diet, analgesia requirement, return to normal activity and complication rates were collected. Validated self-reported T-14 pediatric throat disorders outcome tools were completed by parent’s pre and post-operatively to assess for resolution of sleep disordered breathing symptoms. The outcomes were compared to a cohort of pediatric patients undergoing bipolar tonsillectomy.

 

Result: Coblation tonsillectomy was associated with significantly less postoperative pain (P<0.0001), earlier return to normal diet (P=0.008) and activity (P=0.013) and reduced analgesia requirement (P=0.001). There was no statistically significant difference in the rates of post-tonsillectomy hemorrhage between the two groups (P=0.109). Sleep disordered breathing outcomes have been excellent, with significant improvements in parent reported symptoms at three week postoperative follow-up (mean total T-14 score (/70) 23.9 preoperative, 2.4 three weeks postoperative, P<0.0001). Only a portion of the cohort has reached 12-month follow-up, however at this early stage there have been no reported recurrence of symptoms and no requirement for revision tonsil surgery.

 

Conclusion: Children with sleep disordered breathing undergoing intracapsular coblation tonsillectomy have less postoperative pain and faster recovery, when compared to bipolar tonsillectomy. Effective reduction of sleep disordered breathing symptoms is also demonstrated. Further studies are required to determine the long-term outcomes and also investigate the utility of this method for the management of recurrent tonsillitis

Biography:

Mikyung Ye has completed her PhD at the age of 36years from Kyungpook National University and postdoctoral studies from University of Tennessee Health Science Center. She is the director of Public Relations of Korean Society of Otorhinolaryngology Head and Neck Sugery. She has published more than 100 papers in reputed journals and has been serving as an editorial board member of repute.

 

 

Abstract:

Gastroesophageal reflux disease (GERD) is related to lifestyles including eating habits. Patients with GERD often report decreased taste sensitivity when eating. Some patients  remark that food does not smell or taste the same. We aimed to investigate the effect of GERD on smell and taste functions. Four hundred eighty seven patients with taste disturbance who visited smell and taste clinic from 2010 to 2016 were evaluated. A questionnaire, which included questions regarding demographic information, taste and smell symptoms, taste preferences, and gastrointestinal symptoms was conducted. Diagnosis of GERD was based on the Korean version of GER questionnaires and/or esophagogastroduodenoscopy (EGD), 24hours PH monitoring. Olfactory testing was performed using the Korean version of sniffin’ sticks test. Whole mouth taste test was performed with successive solutions of sucrose, sodium chloride, citric acid, and quinine hydrochloride. The electrical taste thresholds were measured using an electrogustometer for four different sites in the oral cavity. One hundred ninety patients were diagnosed with GERD. Taste threshold and gastrointestinal symptom severity were significantly correlated. However, olfactory function test score was not significantly correlated with gastrointestinal symptom severity and with EGD findings. The patients with GERD showed higher taste preferences to salty, sour, and spicy food than without GERD group. Abnormalities in taste function were correlated with gastrointestinal symptom severity. Awareness of this high prevalence of GERD among patients with taste disturbance may help to better manage the taste disorder.

 

Biography:

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Biography:

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