Question

Dear Dr. XXXXXX: Your patient R was seen today in Otolaryngology consultation as part of an airway clearance prior to upcoming sclerotherapy. HISTORY OF PRESENT ILLNESS: R is a 51 year old female who presents to today's clinic visit due to history of cervicofacial venous malformation. R has involvement in the right cheek and submandibular regions with extension towards the floor of the mouth based on imaging. R previously has received care in Chicago. She has had four prior sclerotherapies, most recently in 2009. R reports that she tolerated these procedures well to her recollection. She did not require prolonged intubation following the procedures. In general R has no difficulty breathing. She is able to be active without distress. She sleeps well without snoring or apneic concems. She is able to eat and drink without concerns for dysphagia. R has recently been evaluated by Dr. XXXXX in the Vascular Anomalies Center. They are planning to perform sclerotherapy at our institution next week. REVIEW OF SYSTEMS: Has been reviewed with R via the sheet provided to her at clinic check in encompassing 14 systems and is otherwise negative. PAST MEDICAL HISTORY: left-sided cervicofacial venous malformation. PAST SURGICAL HISTORY: Sclerotherapy, most recently 2009. MEDICATIONS: None. ALLERGIES: No known drug allergies SOCIAL HISTORY: R does not smoke and is not exposed to those who do. PHYSICAL EXAMINATION: Pulse 58 beats per minute, oxygen saturation 100% on room air. Temperature 36.8 degrees C. She is not in any pain. Ris seated comfortably in the examination chair. She is breathing comfortably and quietly without stridor or stertor. There is venous malformation involving the left cheek and submandibular regions. Bilateral tympanic membranes and external auditory canals are clear. There is no effusion or otorrhea noted. Nasal passages are patent anteriorly. Septum is midline. Intraoral examination reveals symmetrical palate elevation. Uvula is midline. Tonsils are small. Tongue mobility is normal. Floor of mouth is soft. Dentition is in good repair. There is no evidence of any venous malformation within the oral cavity. Neck examination is otherwise normal with the exception of mild submandibular fullness. PROCEDURE: A flexible nasal endoscopy and laryngoscopy was performed at today's clinic as part of her airway evaluation. On examination, she was found to have patent nares and septum was midline. Choanae is patent. She has normal nasopharynx, normal hypopharynx, and normal laryngeal examination. There is normal vocal cord function bilaterally. There is no evidence of any venous malformation on flexible endoscopy. IMPRESSION: Venous malformation. RECOMMENDATIONS: Dr. XXXXXXXX and I reviewed our findings with R. R has venous malformation

Answer 1

1, Patient is going to appear for sclerotherpay. it is a kind of treatment that doctor inject the medicine into blood vessels that cause the blood vessels to shrink. this procedure is done with outsurgery only using injection. patient seen by the physiican for airway clearance that help decrease patient lung infection and improve lung function during surgery. minor surgical procures uses local anesthesia. it is good to evaluate the pulmonary status to tolerate the procedure with anetisthsia. it reduce the pulmonary complications if prior consultation is taken by otolaryngology consultation. patient medical diagnosis os cervicofacial venous malformation. it is low flow vascular anomalies that involve in cervicofacial structures frequently with involvement in head and neck.
2, Otolarngeology consultation is a medical specialist they focus on ear, nose, and throat care. they also involve in surgical procedures involved in ear, nose and throat. airway clearance evaluated by this specialist through assessment.
3, patient has a history of cervicofacial venous malformation.
Reive of the system:
pulse: 58b/m, o2 sat 100%, Temperature-36.8degree C. breathing - no stridor present, a venous malformation in the left cheek, and submandibular regions. Bilateral lymphatic membrane and external auditory canal-clear. no effusion. nasal passage- patent, septum-midline, symmetrical palate elevation.ovula-midline.tonsils-small.tongue mobility -normal. mouth floor-soft. dentition- good. venous malformaiton in the oral cavity - no, neck -normal.
4, the patient has less blood supply in the neck and face that affected her right cheek and major salivary glands located just below the floor of the mouth. lack of blood supply extended up to the floor of the mouth. the patient got the care of Chicago. she had four sclerotherapy medical procedures to correct the blood supply. she tolerated the procedure well at that time. patient not needed any continuous respiratory support she is not having any breathing difficulty. she is active and not distress. she sleeps well any disturbance and she is not having any trouble while swallowing.she evaluated by the doctor in the vascular anomalies center. planning to perform sclerotherapy in next week.