Airway management in the patients who receive transmaxillary approach for resection of giant pituitary tumor presents a clinical challenge to the anesthesiologists. Oral or nasal route for tracheal intubation can inte...Airway management in the patients who receive transmaxillary approach for resection of giant pituitary tumor presents a clinical challenge to the anesthesiologists. Oral or nasal route for tracheal intubation can interfere with surgical procedures. This report describes submental tracheal intubation for airway management in a patient who underwent resection of recurrent giant pituitary tumor via transmaxillary approach. Submental tracheal intubation is an adaptable and safe alternative technology for airway management during operation.展开更多
Securing a definitive airway in patients who require surgical fixation of complex maxillofacial fractures is an integral part of their perioperative management. For the ease of surgical access, an orotracheal tube is ...Securing a definitive airway in patients who require surgical fixation of complex maxillofacial fractures is an integral part of their perioperative management. For the ease of surgical access, an orotracheal tube is usually not preferred by surgeons. The presence of a base of skull or nasal bone fractures would also contraindicate nasotracheal intubation. Therefore, a tracheostomy may be the only option left to secure the airway in these patients who require surgical fixation. Submental intubation has been used as a safe and effective alternative method in patients who require intubation for maxillofacial reconstruction since it was first reported by Hernandez Altemir F in 1986. Many modifications to the original technique have been documented over the years, but there has been no consensus to support the use of a single method or device. In this case report, we described our experience with submental intubation using an LMAFastrachTM endotracheal tube (ETT) to facilitate the surgical fixation of bilateral Le Fort II fractures. We conclude that the LMAFastrachTM ETT is a suitable device for submental intubation. This technique should be included in airway workshops and courses for anaesthesia residents as it is a simple yet secure alternative to tracheostomy in the intraoperative airway management of maxillofacial trauma.展开更多
Chronic peripheral lymphadenopathy in adults is an indication of pathology of which tuberculosis is the commonest in the developing countries. Presented is a 36-year-old with a huge chronic Submental lymphadenopathy i...Chronic peripheral lymphadenopathy in adults is an indication of pathology of which tuberculosis is the commonest in the developing countries. Presented is a 36-year-old with a huge chronic Submental lymphadenopathy in a seronegative patient of 7 years duration. Histology revealed non-caseating tuberculosis. Tuberculosis should be considered in Submental lymphadenopathy. Despite the long duration, the absence of cold abscess, and or sinus formation may be an indication of the non-caseating tuberculous lymphadenopathy.展开更多
Background:Excess submental fat(SMF)is a common facial aesthetic concern,and assessment scales play a crucial role in its evaluation.Existing SMF scales are based on Caucasian populations,although genetic background s...Background:Excess submental fat(SMF)is a common facial aesthetic concern,and assessment scales play a crucial role in its evaluation.Existing SMF scales are based on Caucasian populations,although genetic background significantly influences SMF distribution.Therefore,this study aimed to develop and validate a 5-point Chinese version of the Clinician-Reported Submental Fat Rating Scale(CR-SMFRS).Methods:The study included 150 volunteers,and captured photographs from the frontal,oblique,and lateral views were combined for each participant.A 5-point scale with descriptive criteria was primarily designed.Internal validation involved three experienced plastic surgeons,while external validation was conducted on 50 live volunteers by six additional raters.Intra-and inter-rater reliability were assessed.Results:A 5-point grading system with descriptive criteria was developed and validated as the Chinese CR-SMFRS.Internal validation demonstrated a good intra-and inter-rater consistency.During external validation,intraclass correlation coefficient values for each rater exceeded 0.850,indicating high intra-rater consistency.Moreover,the inter-rater reliability showed good consistency.Conclusion:The Chinese version of the SMF rating scale is a reliable tool for clinical use.展开更多
Objective: To explore the feasibility of the submental island flap in the repair of hypopharyngeal defects.Methods: We collected wet specimens of fresh cadaveric heads from the Han Chinese adult population for applied...Objective: To explore the feasibility of the submental island flap in the repair of hypopharyngeal defects.Methods: We collected wet specimens of fresh cadaveric heads from the Han Chinese adult population for applied anatomy of the submental island flap, and followed five patients with pyriform sinus carcinoma after reconstruction surgery using submental island flaps.Results: We found that the average length and width of the submental island flaps were (65.20 ± 11.69) mm and (46.70 ± 6.59) mm, respectively.The skin flap in all five patients survived after surgery, and tracheal tubes and gastric tubes were removed 7-36 days after surgery.Patients were followed up for 24-42 months, pharyngeal flaps grew well, and speech and swallowing functions were satisfactory.Conclusion: The submental island flap is a preferred material for the repair of hypopharyngeal defects after hypopharyngeal carcinoma resection, because of good blood supply, easy harvesting, and high survival rate.展开更多
Objective:The submental flap can be utilized for soft tissue reconstruction in oral cavity malignancies because due to its close approximation to the surgical site,fewer donor site morbidity and the cost effectiveness...Objective:The submental flap can be utilized for soft tissue reconstruction in oral cavity malignancies because due to its close approximation to the surgical site,fewer donor site morbidity and the cost effectiveness of the procedure.Methods:A total of 30 patients with squamous cell carcinoma of the oral cavity were included in the study from July 2012 to August 2015 in a tertiary care referral hospital.Patients with clinical staging Ⅰ/Ⅱ/Ⅲ (T1/T2/T3,N0) oral malignancy were included in the study.Patients with nodal metastasis irrespective of the stage of disease and patients with chronic medical illness/revision cases were excluded from the study.Submental island flap was utilized for the reconstruction of the soft tissue defect in each patient.Patients were followed at monthly interval till 6 months in the postoperative period.Results:The buccal mucosa (12 patients),tongue (10 patients) and floor of mouth (8 patients) were the subsites in the oral cavity.Partial and complete skin necrosis was found in 4 and 2 patients respectively.Postoperative chemoradiation was required in 5 patients.None of the patients had loco regional recurrence till 6 months of follow-up.Conclusion:The submental island flap is considered to be the reliable option for the soft tissue reconstruction in oral cancer because of dependent vascular pedicle,less donor site morbidity and the lower cost compared to the free flaps,often preferred in patients with a lower socioeconomic condition.展开更多
Head and neck lipomas are fairly common but their presentation in areas like submandibular, submental and sublingual regions are rarely seen. Lipomas are generally asymptomatic and gradually progressive in size, causi...Head and neck lipomas are fairly common but their presentation in areas like submandibular, submental and sublingual regions are rarely seen. Lipomas are generally asymptomatic and gradually progressive in size, causing aesthetic and functional deficits. Surgical excision remains the mainstay of treatment. Radiological investigations like CECT and MRI play a critical role in diagnosis and management of these lesions. We describe a case of a giant lipoma involving the sublingual, submandibular and submental region, and its management.展开更多
文摘Airway management in the patients who receive transmaxillary approach for resection of giant pituitary tumor presents a clinical challenge to the anesthesiologists. Oral or nasal route for tracheal intubation can interfere with surgical procedures. This report describes submental tracheal intubation for airway management in a patient who underwent resection of recurrent giant pituitary tumor via transmaxillary approach. Submental tracheal intubation is an adaptable and safe alternative technology for airway management during operation.
文摘Securing a definitive airway in patients who require surgical fixation of complex maxillofacial fractures is an integral part of their perioperative management. For the ease of surgical access, an orotracheal tube is usually not preferred by surgeons. The presence of a base of skull or nasal bone fractures would also contraindicate nasotracheal intubation. Therefore, a tracheostomy may be the only option left to secure the airway in these patients who require surgical fixation. Submental intubation has been used as a safe and effective alternative method in patients who require intubation for maxillofacial reconstruction since it was first reported by Hernandez Altemir F in 1986. Many modifications to the original technique have been documented over the years, but there has been no consensus to support the use of a single method or device. In this case report, we described our experience with submental intubation using an LMAFastrachTM endotracheal tube (ETT) to facilitate the surgical fixation of bilateral Le Fort II fractures. We conclude that the LMAFastrachTM ETT is a suitable device for submental intubation. This technique should be included in airway workshops and courses for anaesthesia residents as it is a simple yet secure alternative to tracheostomy in the intraoperative airway management of maxillofacial trauma.
文摘Chronic peripheral lymphadenopathy in adults is an indication of pathology of which tuberculosis is the commonest in the developing countries. Presented is a 36-year-old with a huge chronic Submental lymphadenopathy in a seronegative patient of 7 years duration. Histology revealed non-caseating tuberculosis. Tuberculosis should be considered in Submental lymphadenopathy. Despite the long duration, the absence of cold abscess, and or sinus formation may be an indication of the non-caseating tuberculous lymphadenopathy.
基金supported by the National High Level Hospital Clinical Research Funding(grant no.2022-PUMCH-A-208).
文摘Background:Excess submental fat(SMF)is a common facial aesthetic concern,and assessment scales play a crucial role in its evaluation.Existing SMF scales are based on Caucasian populations,although genetic background significantly influences SMF distribution.Therefore,this study aimed to develop and validate a 5-point Chinese version of the Clinician-Reported Submental Fat Rating Scale(CR-SMFRS).Methods:The study included 150 volunteers,and captured photographs from the frontal,oblique,and lateral views were combined for each participant.A 5-point scale with descriptive criteria was primarily designed.Internal validation involved three experienced plastic surgeons,while external validation was conducted on 50 live volunteers by six additional raters.Intra-and inter-rater reliability were assessed.Results:A 5-point grading system with descriptive criteria was developed and validated as the Chinese CR-SMFRS.Internal validation demonstrated a good intra-and inter-rater consistency.During external validation,intraclass correlation coefficient values for each rater exceeded 0.850,indicating high intra-rater consistency.Moreover,the inter-rater reliability showed good consistency.Conclusion:The Chinese version of the SMF rating scale is a reliable tool for clinical use.
文摘Objective: To explore the feasibility of the submental island flap in the repair of hypopharyngeal defects.Methods: We collected wet specimens of fresh cadaveric heads from the Han Chinese adult population for applied anatomy of the submental island flap, and followed five patients with pyriform sinus carcinoma after reconstruction surgery using submental island flaps.Results: We found that the average length and width of the submental island flaps were (65.20 ± 11.69) mm and (46.70 ± 6.59) mm, respectively.The skin flap in all five patients survived after surgery, and tracheal tubes and gastric tubes were removed 7-36 days after surgery.Patients were followed up for 24-42 months, pharyngeal flaps grew well, and speech and swallowing functions were satisfactory.Conclusion: The submental island flap is a preferred material for the repair of hypopharyngeal defects after hypopharyngeal carcinoma resection, because of good blood supply, easy harvesting, and high survival rate.
文摘Objective:The submental flap can be utilized for soft tissue reconstruction in oral cavity malignancies because due to its close approximation to the surgical site,fewer donor site morbidity and the cost effectiveness of the procedure.Methods:A total of 30 patients with squamous cell carcinoma of the oral cavity were included in the study from July 2012 to August 2015 in a tertiary care referral hospital.Patients with clinical staging Ⅰ/Ⅱ/Ⅲ (T1/T2/T3,N0) oral malignancy were included in the study.Patients with nodal metastasis irrespective of the stage of disease and patients with chronic medical illness/revision cases were excluded from the study.Submental island flap was utilized for the reconstruction of the soft tissue defect in each patient.Patients were followed at monthly interval till 6 months in the postoperative period.Results:The buccal mucosa (12 patients),tongue (10 patients) and floor of mouth (8 patients) were the subsites in the oral cavity.Partial and complete skin necrosis was found in 4 and 2 patients respectively.Postoperative chemoradiation was required in 5 patients.None of the patients had loco regional recurrence till 6 months of follow-up.Conclusion:The submental island flap is considered to be the reliable option for the soft tissue reconstruction in oral cancer because of dependent vascular pedicle,less donor site morbidity and the lower cost compared to the free flaps,often preferred in patients with a lower socioeconomic condition.
文摘Head and neck lipomas are fairly common but their presentation in areas like submandibular, submental and sublingual regions are rarely seen. Lipomas are generally asymptomatic and gradually progressive in size, causing aesthetic and functional deficits. Surgical excision remains the mainstay of treatment. Radiological investigations like CECT and MRI play a critical role in diagnosis and management of these lesions. We describe a case of a giant lipoma involving the sublingual, submandibular and submental region, and its management.
