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Epiglottic dysfunction after isocyanate inhalation exposure.

J H Sales1, K S Kennedy

  • 1Department of Otolarvngology-Head and Neck Surgery, Naval Hospital, Portsmouth, VA 23708-5000.

Archives of Otolaryngology--Head & Neck Surgery
|June 1, 1990
PubMed
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Environmental exposure can cause epiglottic dysfunction. This case highlights diphenylmethane diisocyanate inhalation leading to airway obstruction, successfully treated with epiglottectomy.

Area of Science:

  • Environmental Medicine
  • Pulmonology
  • Otolaryngology

Background:

  • Epiglottic dysfunction is commonly caused by trauma, infection, allergy, neoplasm, and neurologic disorders.
  • Environmental exposures are recognized causes of epiglottic dysfunction.

Observation:

  • A case of epiglottic dysfunction following inhalation exposure to diphenylmethane diisocyanate is presented.
  • The patient experienced persistent inspiratory airway obstruction.
  • Fiberoptic rhinolaryngoscopy and barium contrast cineradiography confirmed epiglottic obstruction of the glottic airway during inspiration.

Findings:

  • Histological examination revealed marked inflammatory changes in the epiglottis, including infiltrative patterns, fibrosis, edema, and reactive changes.
  • Total epiglottectomy resolved the patient's upper airway obstructive symptoms.

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Implications:

  • This case underscores isocyanate inhalation as a potential cause of epiglottic dysfunction.
  • Early diagnosis and intervention, including surgical management like epiglottectomy, can effectively treat this condition.
  • Awareness of occupational and environmental triggers is crucial for managing airway obstruction.