Foreign body airway obstruction causing a ball valve effect

A ball valving carcinoid tumour as a cause of post bronchoscopy chest pain

The ball valve effect occurs when an obstructing lesion allows inspiration of air, but opposes the egression of exhaled air, causing gas trapping. The phenomenon is commonly described secondary to bronchial foreign body inhalation. However, it is less well reported in other disease processes. We report a unique case of a carcinoid tumour causing ball valving following diagnostic bronchoscopy in a young patient. The procedure caused swelling and oedema around an isolated carcinoid tumour in the left main bronchus. An inspiratory chest X-ray was normal, complicating the diagnosis. At repeat bronchoscopy the tumour was cored with LASER.

An Elegant, Simple Solution to a Newly Described Phenomenon: Traumatic Nasomalar "Ball-valve" Fistula

Sequela of complex craniomaxillofacial trauma is common. We report a previously undocumented, highly unusual, postfacial trauma presentation of a "nasomalar ball-valve fistula." The clinical presentation was a sharp influx of air into the left malar subcutaneous space with each nasal inspiration, followed by near-complete deflation upon each expiration. We also report a very simple and elegant solution of using a nasal trumpet to completely resolve this problem without the need for additional operation. The final recovery was uneventful. We hope to make all facial surgeons aware of this diagnosis and to remind them to keep this simple device in their armamentarium to address similar issues.