Thyroid Cartilage Research Articles

Comparative Outcome of Short Proximal Femoral Nail Versus Proximal Femoral Locking Compression Plate in the Management of Unstable Trochanteric Fractures

Introduction: Trochanteric fractures are mostly due to RTA and falls. Unstable trochanteric fractures include those with a reverse oblique fracture line, intertrochanteric comminution, big posteromedial fragment, subtrochanteric extension, a broken greater trochanter and lateral cortex breach. As per the AO Classification of intertrochanteric fractures, AO31-2.2, AO31-2.3, AO31-3.1, AO31-3.2 and AO31-3.3 fall under the category of unstable trochanteric fractures. Internal fixation is mandatory to provide early mobilization of patients with partial weight-bearing and prevent further compli&cations. Materials and Methods: 43 patients more than 18 years old with unstable trochanteric fractures, less than 3 weeks old trauma were included in the prospective study for 1 year period (1st June 2020 to 31st May 2021). 22 cases were treated with short Proximal Femoral Nail (PFN) and 21 cases were treated with Proximal Femoral Locking Compression Plate (PFLCP). Results: (P<0.05), mean duration of surgery, blood loss was less in the PFN group (67minutes; 80mL) than PFLCP group (99 minutes; 152 ml). Union and partial weight-bearing was seen earlier in PFN group (14.1weeks; 10.6weeks) than in PFLCP group (18.7 weeks; 15.8weeks) (P<0.05). Good-excellent outcome was seen in 100% cases in PFN group and 85.71% cases in PFLCP group. There were 3 cases of delayed union in PFLCP group and 1 in PFN group. 1 PFLCP case had malunion in varus deformity. Conclusion: Short PFN is the optimum implant in treatment of unstable trochanteric fractures as it is an intramedullary, load sharing device with short lever arm and hastens biological healing with early ambulation and minimal complications.

Primary papillary carcinoma in a thyroglossal duct cyst: A case report

Background: Thyroglossal duct cyst(TDC)is the most common congenital disorder of the thyroid gland. Seventy five percent of midline neck masses in children are (TDC). Occurrence of malignancy in (TDC) is very rare event, and include 1% of all cases of (TDC). Here in this report, we describe a rare case of primary papillary carcinoma which arises in a (TDC). Case report: Our case is a 42-year-old woman who presented with a hard painless solid and cystic mass in front of the neck above of thyroid cartilage. After initial physical examination and ultrasonography, the mass identified. Radiologist performed a core needle biopsy of the cyst and mass which show a papillary cell carcinoma. The patient underwent near total thyroidectomy, excision of lymph node and surgical excision of the thyroglossal duct cyst (the Sistrunk's procedure). Histopathology of the specimen revealed a thyroglossal duct cyst which showed a primary invasive papillary carcinoma that infiltrated the cyst wall. The thyroid gland was normal, cervical lymph node was not involved. Conclusions: Primary papillary carcinoma of thyroglossal duct cyst is a rare disease which presents in patients with cystic midline neck masses. Surgery and radical excision is the optimal patient management with radioactive iodine therapy which improve the survival.

325 Modified Abdominal Assess for Laparoscopic Cholecystectomy in Obese Population: Our Recommendation

Abstract Background and Aim Conventional Umbilical access can be time consuming, surgically challenging due to inadequate ‘Critical View of Safety’ and pneumoperitoneum maintenance for high BMI patients undergoing laparoscopic cholecystectomy (LC). Assess the feasibility, safety and outcome of our modified access for patients of BMI ≥30. Method and Technique Prospective study of consecutive patients undergoing LC in a large DGH (2007-2022) that included age, sex, BMI, ASA, grade of operation with stay and complications were analysed. Group A: Veress needle pneumoperitoneum through Palmer’s point. After 2 litre (minimum) insufflations, optical port introduced at intersection of two imaginary lines: a 15cm oblique line starting from where the right mid-clavicular line cuts the right lower costal margin and directed medially meeting the other vertical line running 3cm to the right of midline. Remaining ports standard. Group B (BMI <30): Conventional umbilicus entry. Results Group A: 543 with Female: Male 4:1 (436:107), Age 49* (16-82) years, BMI 36*(30-65), ASA 2 * (1-3), Grade 1 * (1-4), Operating time 50* (15-200) mins, PO stay 0* (0-15) day. One conversion, 2 bile leaks, 5 collections and 4 wound infections. Group B: 1168 with Female: Male 3:1 (861:307), Age 53* (16-89) years, BMI 26 * (17-29), ASA 2* (1-3), Grade 1* (1-4), Operating time 45 *(15-240) mins, PO stay 0* (0-12) day. Ten conversions, 3 bile leaks, 5 collections, 8 wound infections, and 6 wash outs. Conclusion Modified LC abdominal access for obese patients allows safe quick entry with excellent ‘Critical view of Safety’ for a good outcome. * Median

The Carotid-Hyoid Topography Is Variable.

Background and Objectives: The carotid bifurcation (CB) is presented in most anatomy textbooks as having a unique location at the upper margin of the thyroid cartilage. Although a number of case reports have provided evidence of the possibility of carotid artery location either lateral or medial to the greater hyoid horn, these reports have not established specific anatomic possibilities and prevalences. Materials and Methods: We retrospectively analysed a batch of 147 CT angiograms for 12 types of carotid-hyoid relationships and classified the bilateral combination possibilities of these types. Results: In 168/294 sides there were no carotid-hyoid relationships. Type I, external carotid artery (ECA) medial to the greater horn of the hyoid bone (GHHB), was observed in 0.34%; type II, internal carotid artery (ICA) medial to GHHB, in 0.34%; type III, ICA and ECA medial to GHHB, in 1.02%; type IV, common carotid artery (CCA) medial to GHHB, in 1.02%; type V, CB medial to GHHB, in 0.34%; type VI, ECA lateral to GHHB, in 20.41%; type VII, ICA lateral to GHHB, was not recorded; type VIII, ECA and ICA lateral to GHHB, in 3.74%; type IX, CCA lateral to GHHB, in 8.5%; type X, CB lateral to GHHB, in 6.46%; type XI, ECA lateral and ICA medial to GHHB, in 0.34%; and type XII, ICA lateral and ECA medial to GHHB, in 0.34%. Bilateral symmetry was found in 70.74% of cases, including the null types without carotid-hyoid relationships as well as types IV, VI, VIII, IX, and X. There was a highly significant association between the left and right variants of the carotid-hyoid relationship. Conclusions: Mechanical compression of the hyoid bone on the carotid arteries has various undesirable effects on the ICA and cerebral circulation. Underlying these are several variational anatomical patterns of carotid-hyoid relationships, which can be accurately documented on CT angiograms. A case-by-case anatomical study is better than assuming the carotid anatomy learned from textbooks.

Method for calculating the uplift capacity of a circular anchor plate at arbitrary depth in sand

Methods for calculating the uplift capacity of horizontal anchor plates have the problem of artificially distinguishing shallow and deep buried types in advance, but the classification standards differ greatly. Based on the application of digital photographic measurement technology in experiment, this paper focuses on a theoretical method for calculating the uplift capacity of horizontal anchor plate in sand at arbitrary depth without distinguishing shallow and deep burial types. The results show that the sliding surface in the soil extends to ground surface in approximately a straight oblique line at shallow burial depths, then gradually confined within the soil as a balloon shape as the burial depth increases, and further shrinks toward the anchor plate. This change of sliding surface has no absolute boundary but undergoes continuous evolution, and can be described by a morphological function of logarithmic spiral line, which is used to develop a unified mechanical model, and a theoretical method for calculating uplift capacity is deduced and established. The new mechanical model well reflects the continuous variation of the sliding surface, and comparison with other four methods on 8 experimental cases show that the new calculation method has good adaptability for different types of burial depths.

Combined genioplasty, chondrolaryngoplasty, and glottoplasty: A novel scarless procedure in facial feminization surgery

Facial feminization is a long process with multiple surgical steps that is known to improve quality of life in transgender patients. Visible scars are a frequent complaint by this community as it adds to the stigmatization in this population. Combined procedures have been shown to be effective, by reducing the number of hospitalizations and the total length of recovery periods. In this context, we propose a novel scarless procedure combining a chondrolaryngoplasty, a glottoplasty, and a genioplasty using solely a transoral approach. First, we perform a glottoplasty according to the technique described by Wendler et al. and then a contraction genioplasty. Finally, the thyroid cartilage is approached by a subplatysmal dissection, between the mandibular osteotomy fragments. For now, 15 patients have benefited from this procedure in our department. Preliminary results demonstrate that this is an easy and safe procedure with good esthetic results and good patient satisfaction.

Research on Dynamic Deformation Laws of Super High-Rise Buildings and Visualization Based on GB-RAR and LiDAR Technology

It is well-known that structures composed of super high-rise buildings accumulate damages gradually due to ultra-long loads, material aging, and component defects. Thus, the bearing capacity of the structures can be significantly decreased. In addition, these effects may cause inestimable life and property losses upon strong winds, earthquakes, and other heavy loads. Hence, it is necessary to develop real-time health monitoring methods for super high-rise buildings to deeply understand the running state during operation, timely discover potential safety potentials, and to provide reference data for reinforcement design. Along these lines, in this work, the built super high-rise buildings (Yunding Building) and super high-rise buildings (the Main Tower of the Shandong International Financial Center), under construction, were selected as the research objects. The overall dynamic deformation laws of super high-rise buildings were monitored by using ground-based real aperture radar (GB-RAR) technology for its advantages in non-contact measurement, remote monitoring, and real-time display of observation results. Denoising of the observation data was also carried out based on wavelet analysis. The visualization of the space state of the Yunding Building was realized based on handheld LiDAR technology. From the acquired results, it was demonstrated that the measuring accuracy of GB-RAR could reach the submillimeter level, while the noises under a natural state of wavelet analysis were eliminated well. The maximum deformation values of the Yunding Building and the Main Tower of Shandong International Financial Center under their natural state were 9.63 mm and 16.46 mm, respectively. Under sudden wind loads, the maximum deformation of the Yunding Building could be as high as 895.79 mm. The overall motion state switched between an S-shaped pattern, hyperbolic-type, and oblique line, presented the characteristics of nonlinear elastic deformation.

Socio-demographic and medico-legal study of hanging and strangulation deaths in South Kerala

Hanging is a quick and very effective method used to commit suicide. The ligature material used for hanging is one of the important factors that determine the type of ligature mark or the pressure abrasion. The study was carried out at the Department of Forensic Medicine and Toxicology, Govt. Medical College in Thiruvananthapuram. The demographic characteristics of victims of hanging and strangulation as well as medico-legal findings in such situations were the key variables of the study. There were total 75 asphyxial fatalities, out of which 70 were caused by hanging and 5 by strangulation, were examined. According to the study's findings, men and young people between the ages of 21 and 40 are more likely to die violently from asphyxia. Suicidal hanging was a prevalent method among the unemployed. In the married group, hanging and strangulation deaths are more common. In most cases, a current psychological issue was the cause of suicide. Ligature marks from hanging were usually clearly defined, higher than the thyroid cartilage, discontinuous, and free of internal neck injuries.

An effective salivation-facilitating method for COVID-19 testing: An experimental study.

Simple tools, such as antigen test kits, are readily available for determining coronavirus disease 2019 infection at hospitals and homes. However, it is challenging for elderly people who are prone to dry mouth and other diseases. The main objective of this study was to investigate whether the presence or consumption of a plum pickle can facilitate salivation during coronavirus disease 2019 testing. Twenty healthy adult women participated in the study. The participants were allocated to 2 groups: presentation and non-presentation (n = 10; with and without presentation of a plum pickle, respectively), and eating and non-eating (n = 10; with and without consumption of plum pickle, respectively). We recorded the number of saliva swallows in 1 minute under each condition, using a swallowing test device, which attached film sensors to the hyoid bone and thyroid cartilage. There was a significant difference in the number of swallows between the non-presentation and presentation groups ( P < .01, r = 0.89, Z = -2.82) as well as between the non-eating and eating groups ( P < .01, r = 0.85, Z = -2.68). The strength of 3 factors, namely: direct stimulation with citric acid, saliva buffer capacity, and motor learning, may have affected the results. Our study suggests that saliva collection using the plum pickle is an effective complementary method for facilitating salivation. This technique may be useful in avoiding the risk associated with citric acid intake and for efficient specimen collection during coronavirus disease 2019 testing. In the future, we need to verify this method in elderly participants in a clinical setting.

CT Findings in Laryngeal Trauma and the Clinical Implications.

Acute traumatic osseous and cartilaginous injuries to the larynx are rare injuries presenting to the emergency department. Despite the low reported incidence, laryngeal trauma carries ahigh morbidity and mortality. The purpose of this study is to identify fracture and soft tissue injury patterns in laryngeal trauma and explore associations with patient demographics, mechanisms of injury, urgent airway and surgical intervention. Aretrospective review of patients with laryngeal injury who underwent multidetector computed tomography (MDCT) imaging was performed. The CT findings of laryngeal and hyoid fracture location, fracture displacement, and soft tissue injuries were recorded. Clinical data including patient demographics, mechanisms of injury, frequency of airway and surgical intervention were also recorded. Correlation of imaging characteristics with patient demographics, mechanism of injury and interventions were assessed for statistical significance using χ2 and Fisher's exact tests. The median patient age was 40years old with astrong male predominance. The most common mechanisms of injury included motor vehicle collisions and penetrating gunshot wounds. Thyroid cartilage fractures were the most common fracture type. Findings of fracture displacement and airway hematoma had ahigher correlation with requiring urgent airway management. Radiologists' early recognition and prompt communication of laryngeal trauma to the clinical service is important to reduce associated morbidity and mortality. Displaced fractures and laryngeal hematomas should be promptly conveyed to the clinical service as they are associated with more complex injuries and higher rates of urgent airway management and surgical intervention.

First Experience of Single-Port Robotic Areolar Approach Thyroidectomy.

Various minimally invasive thyroidectomy. have been developed and actively used in several hospitals worldwide. Herein, we describe a newly developed minimally invasive thyroidectomy method that uses the da-Vinci SP and report the initial clinical. of singleport robotic areolar thyroidectomy (SPRA). A 3 cm semi-circular incision on the right areola and an 8 mm small incision on the left areola were created. A subcutaneous skin flap was created from the areola to the thyroid cartilage using hydro-dissection and an advanced bipolar device. The da-Vinci SP was docked through the right areolar incision. Twenty-one SPRA surgeries were performed between December 2022 and March 2023. The patient's medical records and surgery videos were reviewed. Lobectomy was performed in 17 patients, isthmectomy in 2 patients, and total thyroidectomy was performed in 2 patients. The mean flap time was 14.905 ± 4.206 min and the console time was 62.381 ± 17.119 min. The tumor size was 0.886 ± 0.649 cm and the number of retrieved lymph nodes was 3.765 ± 4.024 (range 0-12). No vocal cord palsy and hypoparathyroidism was observed. We successfully started the novel SPRA for the first time in the world. Compared to other robotic surgery. SPRA is minimally invasive and does not leave scars. This method uses a high-end single-port robotic device. However, more cases should be analyzed and comparative studies should be performed in the near future to evaluate the effectiveness of this technique.

Novel Finding: Hyo-mandibular Ligament- A Cadaveric Study

Abstract Background: Many anatomical variations have been described in the deep neck; several of these are associated with the hyolarynx complex, consisting of the styloid process, hyoid bone, stylohyoid ligament, and thyroid, cricoid, and arytenoid cartilages as well as their associated ligaments. Methodology: An anterolateral deep dissection of the neck was performed bilaterally in 37 donors. Results: A novel ligament was found to connect the lesser horns of the hyoid bone to the angle of the mandible bilaterally in seven body donors (a total of 14 sides). To the best of our knowledge, the presence or function of a ligament connecting the lesser horns of the hyoid bone to the mandible has never been previously described or reported. Due to its proximal and distal attachment sites, we have termed this finding a “hyomandibular ligament.” Conclusion: This unique finding is clinically relevant and may add insight into the structural and functional variations of the deep neck. Knowledge of this structure and similar anatomical variations may provide an explanation for idiopathic difficulties, chewing or swallowing as a by-product of limited hyoideal mobility.

Homicide by Hanging: a Comprehensive Review of Published Literature

Homicide by hanging is a rare incident and, in contrast to suicidal hanging cases, only limited number of homicidal hanging cases have been reported. This comprehensive review is conducted to summarize the published forensic pathology evidence in homicide by hanging. A systematic search in five journal databases resulted in 12 case reports. All articles passed the selection criteria and were appraised using JBI critical appraisal worksheet for case reports. Fourteen victims were reported which in most of the cases psychosocial background were reported. Household conflict was the common background. Reef knot was the majority knot being used. The autopsy findings vary in the studies, some of which reported intact larynx, thyroid, and hyoid cartilage. Only one case mentioned thyroid cartilage fracture. In addition to the ligature mark, other violence findings include bruises, abrasions, stab wounds, and sexual violence. Toxicological analysis was limited, only 3 case reports reported alcohol in the victim’s serum. There are no distinguishing features in the external or internal neck injuries attributable to homicidal hanging. A thorough autopsy and holistic approach should be considered. They are including demographic characteristics, location of the victim, social and psychiatric history, ligature’s characteristic, signs of violence and toxicological analysis.

МЕТОДИКА ПЕРЕСАДКИ КОМБИНИРОВАННОГО КОСТНО-НАДКОСТНИЧНОГО АУТОТРАНСПЛАНТАТА ДЛЯ УВЕЛИЧЕНИЯ ОБЪЕМА АЛЬВЕОЛЯРНОГО ГРЕБНЯ ПЕРЕД ДЕНТАЛЬНОЙ ИМПЛАНТАЦИЕЙ (КЛИНИЧЕСКИЙ СЛУЧАЙ)

One of the urgent problems of modern dentistry, and in particular implantology, is the prevention of bone tissue atrophy after removal of teeth from the area of bone periodontal pockets and inflammatory odontogenic neoplasms (radicular cysts), which must be replaced with osteoplastic preparations for the subsequent installation of implants in this area to replace missing teeth. his article is devoted to the description of a clinical case of applying the method of transplantation of a combined bone-periosteal autograft in a patient with atrophy of the alveolar process of the upper jaw in the vertical and vestibulo-oral directions in the zone of 22-24 teeth after removal of an extensive radicular cyst of the upper jaw from the 23rd tooth. The plasty of the alveolar process of the upper jaw before dental implantation was performed with a combined bone-periosteal autograft from the area of the external oblique line and the body of the lower jaw. The result of the operation was monitored using cone-beam computed tomography before, after the operation and 6 months after the manipulations to monitor the state of the bone tissue surrounding the implant and determine the density of bone structures. Before the operation, it was found that the density profile of the subsequent implantation zone was 1502 units palatally, 2014 units in the vestibular zone, and 1998 units in the 24 zone. 6 months after the operation, the density of bone structures was: palatal - 1563 units, vestibular in zone 2.2. teeth - 1358 units, in zone 2.4 teeth - 1603 units. The use of this original technique provides an increase in the efficiency of the implant installation in the area of the replaced bone defect.

Does low bone mineral density have an association with head and neck soft tissue calcifications?

To evaluate whether low bone mineral density (BMD) has an association with the presence of head and neck soft tissue calcifications (STC), aging, and impaired mandibular canal cortices visibility. Panoramic radiographs of 1000 women aged between 50 and 75years oldwere evaluated by two examiners to classify BMD using mandibular cortical index (C1- normal, C2-moderately eroded and C3-severely eroded), the presence of STC, and also the mandibular canal cortices visibility at the ramus region. Chi-square test evaluated the association between the variables (α = 5%). There was no association between bone loss and the presence of head and neck soft tissue calcifications, except for calcified thyroid cartilage, which was less visualized at C3 group than others (p < 0.05). Women aged 61 to 70years old presented higher bone loss than those between 50 and 60 (p < 0.05). The mandibular canal was more poorly visualized at C3 group than C1 and C2 (p < 0.05). In general, no association between BMD and the presence of STC was found. However, greater bone loss had a positive correlation with aging and impaired mandibular canal cortices visibility. No relationship between bone mineral density and the existence of soft tissue calcifications was found. Nevertheless, increased bone loss was positively associated with aging and a reduced mandibular canal cortices visibility. This finding highlights the clinical importance of considering bone density factors when planning treatment strategies for patients with related disorders.

Assessment of thyroid cartilage ossification pattern in cancer patients: A suggestion of active ossification by tumor progression.

Ossified cartilage is much more susceptible to cancer infiltration, but the reason remains unknown, and the relationship between the ossification pattern and cancer infiltration has not been studied. The presence of thyroid cartilage ossification, cancer infiltration, ossification pattern (usual: direction from inferior to superior; unusual: other than the usual pattern), and distance between cancer and ossified cartilage were evaluated in laryngectomy specimens. There were 28 and 27 cases of usual and unusual patterns, respectively. There was no association between ossification pattern and cancer infiltration. However, the distance between the ossified area and cancer cells was greater in the usual pattern than in the unusual pattern (p = 0.006). And the usual pattern was more frequently observed in cases with a distance >1 mm than in cases with cancer infiltration or a distance ≤1 mm (p = 0.004). These results suggest the possibility of an active ossification due to tumor progression.

Scalp acupuncture alleviates cerebral ischemic stroke-induced motor dysfunction in rats via regulating endoplasmic reticulum stress and ER-phagy

Cerebral ischemic stroke is a high-risk disease and imposes heavy burdens on patients in china. Acupuncture has been used for thousands of years to treat motor dysfunction, cognitive disorder and language barrier caused by cerebral ischemic stroke. Acupoint lines, vertex middle line and anterior oblique line of vertex temple, are always employed to treat cerebral ischemic stroke. However, the mechanism of the two acupoint lines in relieving cerebral ischemic stroke needs further exploration. In the present study, scalp acupuncture treatment alleviated the motor dysfunction, brain damage, and cell death induced by middle cerebral artery occlusion (MCAO) in rats. Proteomics analysis and ultrastructure observation indicated that endoplasmic reticulum and lysosomes might involve in the mechanism of the scalp acupuncture treatment in suppressing MCAO-triggered neural deficits. Effect of the scalp acupuncture treatment on ER stress was then investigated and found that the activation of ER stress mediators, including PERK, IRE1, and ATF6, was downregulated after the scalp acupuncture treatment. Co-localisation analysis of KDEL and CD63 showed that the engulfment of ER fragments by lysosomes was accelerated by the scalp acupuncture treatment. Moreover, expression of pro-apoptotic protein CHOP, phosphorylated-JNK, cleaved capases-3 and -9 also decreased after the scalp acupuncture. In conclusion, the present study showed that scalp acupuncture of vertex middle line and anterior oblique line of vertex temple may alleviate cerebral ischemic stroke by inhibiting ER stress-accelerated apoptosis.

Computed tomographic laryngotracheal dimensions in adult domestic rabbits (Oryctolagus cuniculus) are positively associated with body weight and the laryngotracheal lumen is narrowest at the level of the thyroid cartilage.

This retrospective study aimed to measure rabbit laryngotracheal dimensions at different locations on computed tomography (CT), assess the relationship of these measurements with rabbit body weight, determine the most common narrowest measurement and assess its relationship with endotracheal tube (ETT) size and body weight. 66 adult domestic rabbits (Oryctolagus cuniculus) of different breeds and body weights. CT laryngotracheal luminal height, width, and cross-sectional area measurements were made at the rostral thyroid cartilage at the level of the arytenoids, caudal thyroid cartilage/rostral cricoid cartilage, caudal cricoid cartilage/cranial trachea, and trachea at the level of the fifth cervical vertebra. The data for every measurement of luminal airway dimensions revealed robust positive associations with body weight (P < .001). The narrowest laryngotracheal measurement was the width at the level of the caudal thyroid cartilage/rostral cricoid cartilage, and the smallest cross-sectional area was at the rostral thyroid cartilage at the level of the arytenoids. There was a strong association between body weight and the likelihood of appropriate ETT fit. To have at least an 80% chance of appropriate ETT fit with a 2.0, 2.5, and 3.0 mm ETT, the rabbits' weight predicted by the model (lower 95% confidence limit) were at least 2.99 (2.72) kg, 5.24 (4.65) kg, and 5.80 (5.21) kg, respectively. The laryngotracheal lumen was narrowest at the level of the caudal thyroid cartilage in rabbits, which indicates this location may be the limiting factor in determining ETT size in rabbits.

Tracheotomy as a life-saving procedure - overview of the current knowledge

Tracheotomy as a life-saving procedure has been known for many thousands of years. Tracheotomy remains one of the most frequently performed surgical procedures in the course of acute respiratory failure. Tracheostomy is traditionally performed as an open surgical procedure, performed both in the operating room and at the patient's bedside. Before performing the procedure, the thyroid cartilage and soft tissues are palpated. Before the operation, the patient lies on his back with a roller placed under the shoulder blades and his head tilted back. Direct and indirect laryngotracheoscopy is performed, and in doubtful situations we use computed tomography.General indications for tracheostomy are acute respiratory failure with anticipated need for prolonged mechanical ventilation and inability to wean off from mechanical ventilation, upper airway obstruction, and profuse secretions. Tracheostomy may have a beneficial effect on refractory obstructive sleep apnea. The percentage of late complications after the procedure reaches even 65%. The aim of the article is to present information on tracheostomy: its techniques, indications, contraindications, possible complications and decannulation of the patient.

Evaluation of the Incidental Prevalence of Soft Tissue Calcifications in the Neck Region with Cone Beam Computed Tomography

Objective: The aim of this study was to retrospectively evaluate the incidental prevalence of heterotopic soft tissue calcifications in the neck region, on Cone Beam Computed Tomography (CBCT) images, and their relationship with age and sex.&#x0D; Methods: A total of 6620 CBCT images were examined. CBCT images of 503 patients aged between 20 and 86 years were included in the study. Patients were grouped into five age groups: 20-30 (N = 132), 31-40 (N = 68), 41-50 (N = 92), 51-60 (N = 104), and 61 and above (N = 107). The images were assessed according to the presence of lymph node calcification, carotid artery calcification, thyroid cartilage, and triticeous cartilage calcification in the neck region. Descriptive statistics, crosstabs, and chi-square tests were used for data analysis. The significance level was set to 0.05&#x0D; Results: At least one calcification was detected in 372 (73.9%) patients. The difference between the prevalence of each calcification according to age groups was statistically significant. A significant relationship was found between the presence of carotid artery calcification and the sex variable (p&lt; .05). The presence of other calcifications did not show statistically significant differences associated with sex (p&gt; .05).&#x0D; Conclusion: The results of this study showed a significant amount of soft tissue calcification in the neck region. The most common calcifications were thyroid cartilage calcifications, and the least common calcification was lymph node calcification.