Foix-Chavany-Marie syndrome (FCMS), or bilateral anterior opercular syndrome, is a rare form of pseudobulbar palsy characterized by an automatic-voluntary dissociation of the facio-pharyngo-glosso-masticatory muscles. Although dysphagia is a major clinical feature of FCMS, few studies have described its longitudinal progression, particularly in the context of epileptic encephalopathy. This paper reports a 32-year-old male with long-standing Lennox-Gastaut syndrome secondary to childhood herpes simplex encephalitis who developed FCMS with rapidly progressive dysphagia. Brain magnetic resonance imaging revealed multifocal old infarcts involving the bilateral frontoparietal opercular regions on a background of chronic encephalomalacia. Clinically, the patient exhibited classic automatic-voluntary dissociation. Serial videofluoroscopic swallowing studies (VFSS) over two months revealed rapid deterioration, from selective penetration with preserved semisolid swallowing to universal silent aspiration across all consistencies. Unlike typical FCMS caused by acute bilateral ischemic stroke, this case suggests a cumulative, epileptic network-mediated mechanism. The VFSS findings support a functional decompensation model, in which exhaustion of the swallowing network reserve may lead to abrupt functional collapse without radiologic evidence of a new structural lesion. Serial VFSS provides critical functional insight into the disease progression in FCMS and may guide appropriate decisions regarding long-term enteral nutrition.

A 71-year-old man was referred for an anterior chest wall mass. Chest computed tomography (CT) and positron emission tomography-CT suggested a malignant tumor. Surgical biopsy through a vertical subxiphoid incision revealed an extra-gastrointestinal stromal tumor (EGIST). En bloc resection of the tumor, including partial resection of the sternum, costal cartilage, pericardium, diaphragm, and peritoneum, was performed. Pathologic evaluation revealed a negative resection margin and confirmed the tumor as an EGIST. On postoperative day 17, the patient was discharged without any complications. At the 2-week follow-up, the patient was doing well and was asymptomatic.
Aged ; Biopsy ; Costal Cartilage ; Diaphragm ; Electrons ; Follow-Up Studies ; Gastrointestinal Stromal Tumors ; Humans ; Pericardium ; Peritoneum ; Sternum ; Thoracic Wall* ; Thorax*

Extracorporeal membrane oxygenation (ECMO) has been used successfully in critically ill patients with traumatic lung injury and offers an additional treatment modality. ECMO is mainly used as a bridge treatment to delayed surgical management; however, only a few case reports have presented the successful application of ECMO as intraoperative support during the surgical repair of traumatic bronchial injury. A 38-year-old man visited our hospital after a blunt chest trauma. His chest imaging showed hemopneumothorax in the left hemithorax and a finding suspicious for left main bronchus rupture. Bronchoscopy was performed and confirmed a tear in the left main bronchus and a congenital tracheal bronchus. We decided to provide venovenous ECMO support during surgery for bronchial repair. We successfully performed main bronchial repair in this traumatic patient with a congenital tracheal bronchus. We suggest that venovenous ECMO offers a good option for the treatment of bronchial rupture when adequate ventilation is not possible.
Adult ; Bronchi ; Bronchoscopy ; Critical Illness ; Extracorporeal Membrane Oxygenation* ; Hemopneumothorax ; Humans ; Lung Injury ; Rupture* ; Tears ; Thorax ; Ventilation ; Wounds, Nonpenetrating

Extracorporeal membrane oxygenation (ECMO) has been used successfully in critically ill patients with traumatic lung injury and offers an additional treatment modality. ECMO is mainly used as a bridge treatment to delayed surgical management; however, only a few case reports have presented the successful application of ECMO as intraoperative support during the surgical repair of traumatic bronchial injury. A 38-year-old man visited our hospital after a blunt chest trauma. His chest imaging showed hemopneumothorax in the left hemithorax and a finding suspicious for left main bronchus rupture. Bronchoscopy was performed and confirmed a tear in the left main bronchus and a congenital tracheal bronchus. We decided to provide venovenous ECMO support during surgery for bronchial repair. We successfully performed main bronchial repair in this traumatic patient with a congenital tracheal bronchus. We suggest that venovenous ECMO offers a good option for the treatment of bronchial rupture when adequate ventilation is not possible.
Adult ; Bronchi ; Bronchoscopy ; Critical Illness ; Extracorporeal Membrane Oxygenation ; Hemopneumothorax ; Humans ; Lung Injury ; Rupture ; Tears ; Thorax ; Ventilation ; Wounds, Nonpenetrating