10259-NQPC-9 CONTROVERSY ON INVASIVE AIRWAY MANAGEMENT IN PATIENTS WITH BRAIN STEM MALIGNANT GLIOMA. Article Swipe
Kensuke Ikeda
,
Kuniaki Saito
,
Yuki Yamagishi
,
Nobuyoshi Sasaki
,
Keiichi Kobayashi
,
Hirofumi Nakatomi
,
Motoo Nagane
·
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1093/noajnl/vdad141.097
YOU?
·
· 2023
· Open Access
·
· DOI: https://doi.org/10.1093/noajnl/vdad141.097
INTRODUCTION The prognosis for patients with malignant gliomas of the brainstem is poor. As the tumor progresses into the medulla oblongata, the lower cranial nerves are affected, resulting in dysphagia and eventually respiratory paralysis. On the other hand, higher cerebral function is often preserved, making it a palliative medical issue whether to perform invasive procedures to secure the airway. We report here three characteristic cases treated at our hospital. CASE 1 A-60-year-old male patient with diffuse midline glioma of the medulla oblongata was admitted to our hospital for radiation therapy and concomitant temozolomide. His consciousness level was clear, but dysphagia was noted. Although he was at risk for aspiration and choking, he did not wish to undergo surgery to prevent aspiration. After treatment was started, he died of choking. CASE 2 A-50-year-old male patient with recurrent astrocytoma in the brainstem was admitted for bevacizumab monotherapy. Despite the treatment, his dysphagia gradually worsened, and he developed respiratory failure due to aspiration pneumonia, resulting in tracheal intubation. Subsequently, he underwent glottis closure, and as a result, he lost his speech but recurrence of aspiration pneumonia and choking were prevented. CASE 3 A-50-year-old male patient with cerebellar glioma invading brainstem was admitted due to aspiration pneumonia. He was disoriented and required heavy care. He did not wish to undergo surgery to prevent aspiration, but with antimicrobial therapy and frequent oral suctioning, his aspiration pneumonia was cured. DISCUSSION Although invasive procedures are generally avoided in terminal-stage cancer patients, anti-aspiration procedures such as tracheostomy and glottis closure may be considered for the conscious patients with malignant glioma in the brainstem. These procedures might be an option at the end of life to avoid painful death due to choking and to prevent deterioration of the patient's condition due to repeated aspiration pneumonia.
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- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1093/noajnl/vdad141.097
- https://academic.oup.com/noa/article-pdf/5/Supplement_5/v24/54205134/vdad141.097.pdf
- OA Status
- gold
- Cited By
- 1
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4389515974
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4389515974Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1093/noajnl/vdad141.097Digital Object Identifier
- Title
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10259-NQPC-9 CONTROVERSY ON INVASIVE AIRWAY MANAGEMENT IN PATIENTS WITH BRAIN STEM MALIGNANT GLIOMA.Work title
- Type
-
articleOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2023Year of publication
- Publication date
-
2023-12-01Full publication date if available
- Authors
-
Kensuke Ikeda, Kuniaki Saito, Yuki Yamagishi, Nobuyoshi Sasaki, Keiichi Kobayashi, Hirofumi Nakatomi, Motoo NaganeList of authors in order
- Landing page
-
https://doi.org/10.1093/noajnl/vdad141.097Publisher landing page
- PDF URL
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https://academic.oup.com/noa/article-pdf/5/Supplement_5/v24/54205134/vdad141.097.pdfDirect link to full text PDF
- Open access
-
YesWhether a free full text is available
- OA status
-
goldOpen access status per OpenAlex
- OA URL
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https://academic.oup.com/noa/article-pdf/5/Supplement_5/v24/54205134/vdad141.097.pdfDirect OA link when available
- Concepts
-
Medicine, Aspiration pneumonia, Dysphagia, Surgery, Pneumonia, Bulbar palsy, Glioma, Radiation therapy, Internal medicine, Cancer researchTop concepts (fields/topics) attached by OpenAlex
- Cited by
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1Total citation count in OpenAlex
- Citations by year (recent)
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2024: 1Per-year citation counts (last 5 years)
- Related works (count)
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10Other works algorithmically related by OpenAlex
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