Clinicopathologic stage discrepancy in oral cavity SCC is a common phenomenon that is associated with a number of clinical factors and has survival implications.
Angioedema—nonpitting edema of the mucous membranes and skin—most commonly occurs
as a complication from the use of angiotensin-converting enzyme inhibitors. At
our institution, the otolaryngology department has incorporated the use of the
endotracheal tube cuff-leak test and bedside direct laryngoscopy to aid in
timing for extubation of angioedema patients. Prospective data collection of
patients presenting to the emergency department with angioedema was performed.
Of 76 patients with angioedema, 9 required fiberoptic intubation. Intubation was
performed at a median of 73 hours (range, 44-118). An endotracheal tube
cuff-leak test was performed in 7 patients prior to extubation, and bedside
direct laryngoscopy was also performed in 3 of these 7 patients to document
resolution of laryngeal edema. The use of the endotracheal tube cuff-leak test
and bedside direct laryngoscopy is an easy and inexpensive method to help
determine eligibility for extubation in patients intubated for angioedema.
The results suggest an aggressive approach to sinusitis complicated by subdural collections with a select role for conservative management in treatment of extradural collections.
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