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Facial and Periorbital emphysemas Following a Violent Sneezing: An Atypical Clinical Situation

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第3期11卷 136-142页

作者： Adèle-Rose Ngo Nyeki Caroline Mvilongo Esthelle Minka Ngom Valentin Fokouo Roger Meva’a Léonel Atanga Yannick Mossus Claudine Nkidiaka Luc Meka Abakar Taimou Serge Abogo David Mindja Olive Ngaba Godefroy Koki Francois Djomou Richard Njock ENT Ophthalmology and Stomatology Department Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Essos Hospital Center Yaoundé Cameroon Central Hospital of Yaoundé Yaoundé Cameroon ENT Department Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Douala General Hospital Douala Cameroon Bertoua Regional Hospital Bertoua Cameroon

Introduction: Facial emphysema is the presence of air in the subcutaneous tissues of the facial region. They can be clinically recognized by the crackling sensation felt when the affected area is palpated. Observation: The authors describe left orbito-facial emphysema that occurred after a violent sneezing episode in a 36-year-old patient. He had significant edema of the left facial and ipsilateral periorbital region associated with major emphysema and complete closure of the left eye. Nasal cavities endoscopy revealed inflammation of the distal orifice of the nasolacrimal duct. The clinical ophthalmologic examination performed in emergency showed left chemosis, slight ocular hypertonia of mechanical origin, and a slight decrease in visual acuity. Pupillary reflexes and retinography were normal. A craniofacial computed tomography (CT) revealed a significant left orbital emphysema, a fracture of the left medial orbital wall (ethmoidal lamina papyracea) with intraconal fat incarceration without entrapment of the medial rectus and significant air infiltration of all the left hemifacial soft tissues. A broad-spectrum antibiotic and anti-inflammatory treatment were instituted, as well as practical advice to prevent a recurrence. We observed progressive resorption of the edema with a return to the normal of the soft tissues and the palpebral cleft in 15 days. Conclusion: These atypical cases can be serious. It is essential to exclude signs of visual deficit and ocular compression. Multidisciplinary management is important.

关键词： Sneezing Orbital Fracture emphysema Pneumorbitia

Destroyed Lung Syndrome: A Review of 31 Published Cases

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Open Journal of Respiratory Diseases 2022年第2期12卷 37-43页

作者： John Osarenkhoe Henry Aiwuyo Ogbomo Aisosa Umuerri Ejiroghene Department of Medicine Igbinedion University Teaching Hospital Okada Nigeria Department of Medicine Chevron Hospital Warri Nigeria Cardiology Unit Department of Medicine University of Benin Teaching Hospital Benin Nigeria Department of Medicine Delta State University Delta Nigeria

Background: Destroyed lung is a lung condition commonly caused by tuberculosis. Other causes include bronchiectasis, aspergilloma, emphysema, etc. It is characterized by extensive lung destruction and reduced lung function. Chest X-ray, chest CT, bronchography, and ventilation-perfusion ratio scan are the commonest radiologic diagnostic tools. Treatment of choice may include pneumonectomy. The study aims to highlight the common causes of destroyed lung and the major presenting complaints based on age, sex and affected lungs. Method: Published cases from English medical journals were evaluated and analyzed. Results: 31 published cases on destroyed lung were reviewed. 58.1% showed that the left lung was the most commonly affected lung. The condition was more common in males (71%). Based on our review, the commonest causes are pneumonia and tuberculosis at 25.9% and 22.8%, respectively. Conclusion: Pneumonia and Tuberculosis seem to be the commonest causes of destroyed lung based on our review, with left sided affectation being more predominant.

关键词： Destroyed Lung Tuberculosis Bronchiectasis Aspergilloma emphysema

Pneumomediastinum, pneumorachis, subcutaneous emphysema: An unusual complication of leukemia in a child

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World Journal of Clinical Cases 2013年第7期1卷 224-226页

作者： Hakim Irfan Showkat Aleem Jan Arif Hussain Sarmast Gull Mohammad Bhat Basharat Mujtaba Jan Yasir Bashir Department of Internal Medicine Sheri-Kashmir Institute of Medical Sciences

Pneumorrhachis(PR), or epidural emphysema, denotes the presence of air in the spinal epidural space. It can be associated with a variety of etiologies, including trauma; recent iatrogenic manipulations during surgical, anesthesiological and diagnostic interventions;malignancy and its associated therapy. It usually represents an asymptomatic epiphenomenon but also can be symptomatic by itself, as well as by its underlying pathology, and rarely can be fatal. The pathogenesis and etiology of PR are varied and can sometimes be a diagnostic challenge. As such, there are no standard guidelines for the management of symptomatic PR and its treatment is often individualized. Here, we present a case of a 14-year-old boy treated for leukemia who developed this complication and whether chemotherapy related or not, it proved to be fatal for him. To our knowledge, this is the first case in the literature of this complication with acute lymphoblastic leukemia.

关键词： Pneumomediastinum Leukemia Pneumorachis Subcutaneous emphysema Chemotherapy

Subcutaneous emphysema Is Iatrogenic Complication in Dental Surgery

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Open Journal of Stomatology 2015年第8期5卷 217-225页

作者： Yara Mahfouz Maen Mahfouz Dental Department Al Zafer Hospital Najran Saudi Arabia Department of Orthodontics and Pediatric Dentistry Arab American University Jenin Palestine

Subcutaneous emphysema in the head and neck is a well known clinical condition. It is an uncommon clinical complication of dental treatment caused by forceful injection of air into the loose connective tissue below the dermal layer. The trapped air is often limited by subcutaneous space in the head and neck. This paper presents a clinical case in which subcutaneous emphysema developed immediately during surgical extraction of third molar.

关键词： Subcutaneous emphysema Surgical Complication

Spontaneous Subcutaneous emphysema with Pneumo-Mediastinum: A Case Report

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Case Reports in Clinical Medicine 2017年第11期6卷 285-290页

作者： Anwar Ali Jamali Ghulam Mustafa Jamali Niaz Hussain Jamali Department of Medicine Peoples University of Medical & Health Sciences Nawabshah Pakistan Department of Physiology Peoples University of Medical and Health Sciences Nawabshah Pakistan

Aim: To report a rare case of Spontaneous subcutaneous emphysema and pneumo-mediastinum Introduction: Spontaneous subcutaneous emphysema and pneumo-mediastinum may be defined as the presence of free gas or air in the subcutaneous tissue or mediastinal structures without an apparent precipitating cause. It most commonly occurs in adolescent in good physical health group devoid of severe existing lung pathology. Case Report: In our case, a middle aged married housewife was referred to Department of Medicine, Peoples Medical University Hospital Nawabshah, Sindh, Pakistan, by her local GP for the worsening of her condition due to development of acute neck pain, difficulty in breathing, eating and swallowing (mainly for solid foods) with swelling of neck. She was not complaining of any respiratory symptoms. The chest and neck radiographs showed subcutaneous emphysema and pneumo-mediastinum, there was no any evidence of air leakage from esophagus. She was subsequently put on free fluids, light diet, antibiotics, analgesia and other supportive measures along with close observation. After three days of admission, her clinical symptoms were alleviated to a great extent. She was discharged well from hospital after four days. Conclusion: Spontaneous subcutaneous emphysema with pneumo-mediastinum is medical and surgical emergency. Diagnosis may be made by routine chest X-rays and CT scan of the chest. Prompt diagnosis and immediate management may affect the morbidity and mortality outcomes in this condition.

关键词： Spontaneous Subcutaneous emphysema Pneumo-Mediastinum

Subcutaneous emphysema Caused by Sodium Hypochlorite plus RC-Prep

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Open Journal of Stomatology 2014年第12期4卷 527-532页

作者： Masayuki Tokuda Yoshiko Kawakami Yoko Morimoto-Yamashita Mitsuo Torii Department of Restorative Dentistry and Endodontology Graduate School of Medical and Dental Sciences Kagoshima University Kagoshima Japan

Introduction: “RC-Prep”, a chemo-mechanical preparation for root canals, includes EDTA and urea peroxide as ingredients. For lubrication and its chelating effect, RC-Prep is useful as an adjunct in root canal enlargement. Furthermore, its cleaning action, due to its foaming properties in combi-nation with sodium hypochlorite, can be useful in root canal treatment in many situations. Methods: In a case of upper gingiva swelling, we used sodium hypochlorite with RC-Prep in the treatment of an infected root canal of the left maxillary premolar at the first visit. Within 2 min after use, the patient’s face became swollen. We kept the root canal open, and conducted a CT scan to investigate. Results: We diagnosed subcutaneous emphysema and prescribed 1 week of pain killers and antibiotics. The pain and swelling in the face finally resolved at 11 days after the incident. Conclusions: The cause of the emphysema was considered to have been the use of a sodium hypo-chlorite solution after using RC-Prep for an opened root apex.

关键词： Subcutaneous emphysema Hypochlorite RC-Prep Endodontic Treatment

Investigation of the Effects of emphysema and Influenza on Alveolar Sacs Closure through CFD Simulation

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Journal of Biomedical Science and Engineering 2016年第6期9卷 287-297页

作者： Parya Aghasafari Israr B. M. Ibrahim Ramana M. Pidaparti College of Engineering University of Georgia Athens GA USA

emphysema and influenza directly affect alveolar sacs and cause problems in lung performance during the breathing cycle. In this study, the effects of emphysema and Influenza on alveolar sac’s air flow characteristics are investigated through Computational Fluid Dynamics (CFD) simulation. Both normal and Emphysemic alveolar sac models with varying collapsed volumes resulting from influenza virus replication were developed. Maximum, area average pressure, and wall shear stress (WSS) in collapsed and open alveolar sacs models were compared. It was found that a collapse at half of the volume at the bottom of the alveolar sacs’ models would cause a decrease in average and maximum pressure values and yield higher WSS values for fluid flow during the breathing cycle. On the other hand, a quarter volume collapse at the bottom and side of the model resulted in higher values for average and maximum pressure and WSS. Additionally, results also showed that a combination of alveolar sacs closure and emphysema would generally lead to an increase in fluid pressure and average WSS during breathing. Maximum WSS was observed during exhalation and maximum WSS decrease occurred during inhalation. Findings are in good agreement with previous studies and suggest that emphysema and influenza virus affect fluid flow and may contribute to alveolar sac closure. However, more realistic simulations should include the fluid-solid interaction studies.

关键词： emphysema Influenza Wall Shear Stress (WSS)

Vitamin A,Vitamin E,Lutein and β-Carotene in Lung Tissues from Subjects with Chronic Obstructive Pulmonary Disease and emphysema

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Open Journal of Respiratory Diseases 2013年第2期3卷 44-51页

作者： Michael W.Schaffer Somdutta Sinha Roy Shyamali Mukherjee Salil K.Das Department of Biochemistry and Cancer Biology Meharry Medical CollegeNashvilleUSA

Vitamin A (VA) and its active metabolites play an essential role in lung airway function. Patients with moderate to severe chronic obstructive pulmonary disease (COPD) have a lower serum retinol concentration, and improvement of their 1-second Forced Expiratory Volume (FEV1) is achieved with VA supplementation. In order to test our hypothesis that the VA signaling pathway is compromised in COPD, we obtained 20 lung samples from COPD patients differing in the degree of emphysema as judged by their FEV% values. All were smokers or were exposed to secondhand smoke. Levels of VA (retinol/retinyl ester), tocopherols and carotenoids (lutein, beta-carotene) in these samples were determined using HPLC. Additional analytes beside VA were included for their known roles as antioxidants and modulators of VA-action. VA levels (retinol/retinyl ester) decreased significantly with the increase in severity of emphysema. Among other analytes, α-tocopherol levels fell by 25.8% in the severe emphysema group in comparison to the mild emphysema group, and lutein levels similarly decreased in severe compared to moderate emphysema groups. However, beta-carotene levels remained unchanged. Thus there is a significant linear correlation between lung VA-levels and the severity of emphysema. There was also a significant reduction in the levels of α-, δ-tocopherol and lutein in the severe emphysema group of COPD patients who either smoked or were exposed to smoke.

关键词： COPD β-Carotene emphysema Lutein Vitamin A Vitamin E HPLC

Classification of emphysema Subtypes: Comparative Assessment of Local Binary Patterns and Related Texture Features

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Advances in Computed Tomography 2015年第3期4卷 47-55页

作者： Mizuho Nishio Hisanobu Koyama Yoshiharu Ohno Kazuro Sugimura Division of Functional and Diagnostic Imaging Research Department of Radiology Kobe University Graduate School of Medicine Kobe Japan Advanced Biomedical Imaging Research Center Kobe University Graduate School of Medicine Kobe Japan Division of Radiology Department of Radiology Kobe University Graduate School of Medicine Kobe Japan

The purpose of this study was to assess usefulness of local binary patterns (LBP) and related texture features, namely completed local binary patterns (CLBP) and local ternary patterns (LTP), for the classification of emphysema subtypes on low-dose CT images. Fifty patients (34 men and 16 women;age, 67.5 ± 10.1 years) who underwent low-dose CT (60 mAs) were included. They were comprised of 17 never smokers, 13 smokers without COPD, and 20 smokers with COPD. By consensus reading of low-dose CT images from these patients, two radiologists selected 3681 nonoverlapping regions of interest (ROIs) and annotated them as one of the following three classes: normal tissue, centrilobular emphysema, and paraseptal emphysema. From these ROIs, histogram of CT densities, LBP, CLBP, and LTP were calculated, and the 3 types of texture histograms were concatenated with the CT density histogram. These 3 types of histograms (referred to as combined LBP, combined CLBP, and combined LTP) were used to classify ROI using linear support vector machine. For each type of the combined histogram, the accuracy of classification was determined by patient-based 10-fold cross validation. The best accuracy of combined LBP, combined CLBP, and combined LTP were 81.36%, 82.99%, and 83.29%, respectively. Compared to the classification accuracies obtained with combined LBP, those with combined LTP or combined CLBP were consistently improved. In conclusion, the results of this study suggest that, on low-dose CT, LTP and CLBP were more useful for the classification of emphysema subtypes than LBP.

关键词： emphysema COPD Texture Analysis Low-Dose CT