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  1. Article ; Online: Surgical treatment of bronchial asthma by resection of the laryngeal nerve.

    Kurbon, Ubaidullo / Dodariyon, Hamza / Davlatov, Abdumalik / Janobilova, Sitora / Therwath, Amu / Mirshahi, Massoud

    BMC surgery

    2015  Volume 15, Page(s) 109

    Abstract: ... Our aim was to show that surgical treatment of chronic bronchial asthma by unilateral resection ... and/or uncontrolled bronchial asthma in settings with limited access to drug treatment. ... cure asphyxias in chronic bronchial asthma without affecting cough reflex,respiratory control and ...

    Abstract Background: Management of asthma in chronically affected patients is a serious health problem. Our aim was to show that surgical treatment of chronic bronchial asthma by unilateral resection of the internal branch of the superior laryngeal nerve (ib-SLN) is an adequateand lasting remedial response.
    Patients and methods: In a retrospective study, 41 (26 male and 15 female) patients with bronchial chronic asthma were treated surgically during the period between 2005 and 2013. It consisted of a unilateral resection of the ib-SLN under optical zoom, on patients placed in supinator position. 35 patients (24 male and 11 female) who were un-operated were included as a control.
    Results: In all patients, medication was reduced progressively. When the results were compared with the control group, it was seen that in 26% of the patients, both forced expiratory volume (FEV) and peak expiratory flow (PEF) increased significantly (p <05) and only modestly in 53.6% of patients (FEV, p <05 and PEF, p <05). In the remaining 20% of patients, these parameters remained however unchanged. Overall, in 80% of patients unilateral resection of the ib-SLN gave satisfactory results because it shortened the intervals and duration of asthmatic attacks, rendering thereby a reduction in medication.
    Conclusion: This minimal-invasive method helped prevent/cure asphyxias in chronic bronchial asthma without affecting cough reflex,respiratory control and phonation and it helped patients avoid severe crisis. This approach is of interest for patients with severe and/or uncontrolled bronchial asthma in settings with limited access to drug treatment.
    MeSH term(s) Adult ; Aged ; Asthma/physiopathology ; Asthma/surgery ; Chronic Disease ; Female ; Forced Expiratory Volume ; Humans ; Laryngeal Nerves/surgery ; Male ; Middle Aged ; Minimally Invasive Surgical Procedures/methods ; Neurosurgical Procedures/methods ; Peak Expiratory Flow Rate ; Retrospective Studies ; Treatment Outcome ; Young Adult
    Language English
    Publishing date 2015-10-08
    Publishing country England
    Document type Journal Article
    ZDB-ID 2050442-1
    ISSN 1471-2482 ; 1471-2482
    ISSN (online) 1471-2482
    ISSN 1471-2482
    DOI 10.1186/s12893-015-0093-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Surgical aspects of 175 mediastinal goiters.

    Vadasz, P / Kotsis, L

    European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery

    1998  Volume 14, Issue 4, Page(s) 393–397

    Abstract: ... symptoms, among them, in five instances, the initial false, long-lasting diagnosis was bronchial asthma and ... complications occurred in 46 cases (26%) and laryngeal nerve palsy in 14 patients (8%). Tracheomalatia developed ... like symptoms, which may lead to late or misdiagnosis and deficient treatment. Once the diagnosis and ...

    Abstract Objective: Clinical picture and surgical management of 175 mediastinal goiters are discussed in this retrospective study.
    Method: Between 1979 and 1996, 175 patients with intrathoracic goiters were operated on at the Thoracic Surgical Clinic in Budapest. The majority of the goiters were cervicomediastinal (n = 138, 79%), past the level of aortic arch, and the others were complete aberrant lesions (n = 37, 21 %). Of the patients, 40% (n = 70) were symptom-free, in the others the clinical picture was dominated by compressive symptoms, among them, in five instances, the initial false, long-lasting diagnosis was bronchial asthma and, in four cases, vena cava superior syndrome caused by advanced inoperable malignancy. Twenty-two percent of patients (n = 39) were operated on previously for cervical struma. Eleven percent (n = 19) of the patients had hyperthyroid symptoms. In 124 cases the goiters were located in the anterior mediastinum. The majority (n = 96) of cervicomediastinal goiters (n = 138) could be removed through a cervical access, in the others an additional sternotomy (n = 31), or anterior thoracotomy (n = 11) were necessary. For resection of complete intrathoracic goiters (n = 37) standard thoracotomy (n = 30) or median sternotomy (n = 7) were used guided by retrotracheal or substernal position.
    Results: Hospital mortality was 1.1%. Minor complications occurred in 46 cases (26%) and laryngeal nerve palsy in 14 patients (8%). Tracheomalatia developed in 18 patients (10%) which were mainly solved by tracheal intubation for 4-6 days. Ninety-four percent (n = 165) of the lesions proved to be diffuse colloid or adenomatous goiters by histology and 10 were (mostly follicular type) carcinomas.
    Conclusions: Unrecognized mediastinal goiters can produce asthma like symptoms, which may lead to late or misdiagnosis and deficient treatment. Once the diagnosis and exact extent of mediastinal goiter is established, multimodal surgical approaches are indicated for its safe removal - before occurrence of compressive symptoms.
    MeSH term(s) Adenocarcinoma, Follicular/pathology ; Aorta, Thoracic/pathology ; Asthma/diagnosis ; Carcinoma, Papillary/pathology ; Diagnosis, Differential ; Female ; Goiter, Substernal/complications ; Goiter, Substernal/diagnosis ; Goiter, Substernal/pathology ; Goiter, Substernal/surgery ; Humans ; Hyperthyroidism/etiology ; Intubation, Intratracheal ; Male ; Mediastinal Neoplasms/diagnosis ; Mediastinum/pathology ; Middle Aged ; Postoperative Complications ; Retrospective Studies ; Sternum/surgery ; Superior Vena Cava Syndrome/diagnosis ; Survival Rate ; Thoracotomy/methods ; Thyroid Neoplasms/pathology ; Tracheal Diseases/etiology ; Tracheal Diseases/therapy ; Vocal Cord Paralysis/etiology
    Language English
    Publishing date 1998-10
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 639293-3
    ISSN 1873-734X ; 1010-7940 ; 1567-4258
    ISSN (online) 1873-734X
    ISSN 1010-7940 ; 1567-4258
    DOI 10.1016/s1010-7940(98)00204-8
    Database MEDical Literature Analysis and Retrieval System OnLINE

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