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Cricothyroid membrane

Bozena Kosztyła-Hojna, Greta Berger, Maciej Zdrojkowski
Glottal insufficiency (GI) is a cause of breathy voice that can profoundly affect quality of voice. Main causes are unilateral vocal fold paralysis or endoscopic cordectomy for the early treatment of laryngeal cancer of the glottis. The main strategy in surgical treatment is type I medialization thyroplasty according to Isshiki with the use of implants e.g. silastic, hydroxyapatite, titanium, Gore-Tex or Montgomery. Other procedures are arytenoid adduction, the injection laryngoplasty via thyrohyoid and cricothyroid approach and laryngeal reinnervation...
April 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
T Nutbeam, R Clarke, T Luff, D Enki, D Gay
Emergency cricothyrotomy is a common feature in all difficult airway algorithms. It is the final step following a 'can't intubate, can't oxygenate' scenario. It is rarely performed and has a significant failure rate. There is variation in the reported size of the cricothyroid membrane, especially across population groups. Procedural failure may result from attempting to pass a device with too large an external diameter through the cricothyroid membrane. We aimed to determine the maximum height of the cricothyroid membrane in a UK trauma population...
May 2, 2017: Anaesthesia
Chiraag Talati, Cristian Arzola, Jose C A Carvalho
This article provides an overview of the use of ultrasonography in obstetric anesthesia. It discusses the indications, benefits, and techniques of using ultrasonography to optimize the delivery of anesthesia and provide safe and efficacious clinical care. More specifically, it discusses the use of ultrasonography to facilitate neuraxial anesthesia, abdominal field blocks, central and peripheral vascular access, as well as the assessment of the lung fields and gastric contents, and identification of the cricothyroid membrane...
March 2017: Anesthesiology Clinics
Kara Marie Hessel, Erich Wessel, Anthony Olinger, Barth W Wright
BACKGROUND: This study aimed to identify the Anterior and Posterior Extralaryngeal branches (AELB, PELB) of the Recurrent Laryngeal Nerve (RLN), measure these branches when present, and determine relationships between gender, sidedness and neck length. MATERIALS AND METHODS: Dissection was completed to level of the thyroid on 45 cadavers. The course of the RLN was then traced superiorly from its entry into the neck. Careful reflection of the thyroid and dissection of the lateral thyroid ligament permitted visualization of the full course of the nerve...
September 26, 2016: Folia Morphologica (Warsz)
Aude Lagier, Daphné Guenoun, Thierry Legou, Robert Espesser, Antoine Giovanni, Pierre Champsaur
INTRODUCTION: The objective of this paper was to identify the determining factors of the glottal prephonatory configuration from the point of view of the resulting muscular actions (i.e., arytenoids adduction, membranous vocal fold adduction, and tension). MATERIALS AND METHODS: 21 human non-embalmed excised larynges (12 females and 9 males) were studied. Experiment A (11 larynges) studied four conditions of adduction of the vocal folds and arytenoids. Experiment B (10 larynges) studied the effect of cricothyroid approximation on the vocal fold length and the cricothyroid angle...
September 6, 2016: Surgical and Radiologic Anatomy: SRA
Martin Krause, Bahareh Khatibi, Jacklynn F Sztain, Pariza Rahman, Anna B Shapiro, NavParkash S Sandhu
We describe a novel technique of real-time ultrasound-guided superior laryngeal nerve and translaryngeal blocks in 4 patients with anticipated difficult airways. All patients had altered neck anatomy, and 1 had a prior unsuccessful awake fiberoptic bronchoscopic intubation. For block performance, an 11-mm broadband curved array transducer with a scanning frequency between 8 and 5 MHz (Sonosite, Bothell, WA) was used for anatomical structure identification, needle guidance toward each superior laryngeal nerve and through the cricothyroid membrane, and deposition of local anesthetic in the appropriate location...
September 2016: Journal of Clinical Anesthesia
Adi Osman, Kok Meng Sum
Upper airway ultrasound is a valuable, non-invasive, simple, and portable point of care ultrasound (POCUS) for evaluation of airway management even in anatomy distorted by pathology or trauma. Ultrasound enables us to identify important sonoanatomy of the upper airway such as thyroid cartilage, epiglottis, cricoid cartilage, cricothyroid membrane, tracheal cartilages, and esophagus. Understanding this applied sonoanatomy facilitates clinician to use ultrasound in assessment of airway anatomy for difficult intubation, ETT and LMA placement and depth, assessment of airway size, ultrasound-guided invasive procedures such as percutaneous needle cricothyroidotomy and tracheostomy, prediction of postextubation stridor and left double-lumen bronchial tube size, and detecting upper airway pathologies...
2016: Journal of Intensive Care
A Zamfir-Chiru-Anton, D C Gheorghe
UNLABELLED: Respiratory obstruction and stridor in infants and children are not uncommon. A rare cause of these sometimes life-threatening symptoms is the congenital saccular cyst. OBJECTIVES: We present the case of a 5-year-old girl with a cervical tumor, which appeared after a laryngeal endoscopic surgery of a saccular cyst with two relapses and a particular local evolution of its recurrence through the cricothyroid membrane. MATERIAL AND METHOD: The patient data has been reviewed over the entire follow-up period and a thorough an analysis of her investigations and surgery was performed...
April 2016: Journal of Medicine and Life
M S Kristensen, W H Teoh, S S Rudolph
Inability to identify the cricothyroid membrane by inspection and palpation contributes substantially to the high failure rate of cricothyrotomy. This narrative review summarizes the current evidence for application of airway ultrasonography for identification of the cricothyroid membrane compared with the clinical techniques. We identified the best-documented techniques for bedside use, their success rates, and the necessary training for airway-ultrasound-naïve clinicians. After a short but structured training, the cricothyroid membrane can be identified using ultrasound in difficult patients by previously airway-ultrasound naïve anaesthetists with double the success rate of palpation...
September 2016: British Journal of Anaesthesia
Woosuk Chung, Byung Muk Kim, Sang-Il Park
When first introduced, percutaneous dilatational tracheostomy (PDT) was performed using a bronchoscope. The bronchoscope itself, however, has several disadvantages, including interruption of ventilation. Modifications of the standard PDT technique have suggested that PDT can be safely performed without a bronchoscope. However, the safety of these modifications is unclear and many modifications have yet to be widely adopted. This study retrospectively evaluated the safety of a simplified PDT technique using the Cook® Ciaglia Blue Rhino™ in 186 patients...
June 2016: Korean Journal of Anesthesiology
Paul J Zetlaoui, Dan Benhamou
No abstract text is available yet for this article.
June 2016: Anesthesiology
Christina S Boncyk, Kristopher M Schroeder, Brooke Anderson, Richard E Galgon
STUDY OBJECTIVE: The purpose of this study was to evaluate and compare hands-on gel phantom versus instructional video teaching methods to improve anesthesia residents and staff members' ability to correctly identify airway structures using ultrasound on a human volunteer. DESIGN: Randomized, controlled trial. SETTING: Simulation laboratory. STUDY SUBJECTS: Fifty-four anesthesiology resident and staff members (27 anesthesiologists and 27 anesthesiology residents) at the University of Wisconsin-Madison...
June 2016: Journal of Clinical Anesthesia
Kenneth N Hiller, Ron J Karni, Chunyun Cai, John B Holcomb, Carin A Hagberg
PURPOSE: The primary aim of this study was to compare the success rates of anesthesia providers vs trauma surgeons in their use of palpation to identify the cricothyroid membrane (CTM). The secondary aim was to explore whether prior training and experience performing surgical airways affected the success rates for identifying the CTM. METHODS: Four female adults participated in this prospective observational study. The participants had varying measurements of neck anatomy that were known or theorized to affect the accuracy of identifying the CTM location...
July 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
J Adam Law
No abstract text is available yet for this article.
July 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Moahmmed I Almohizea, Vyas M N Prasad, Raja Fakhoury, Benoit Bihin, Marc Remacle
UNLABELLED: Type I medialization thyroplasty (MT) was introduced by Isshiki more than 40 years ago. It is one of the most widely used surgical options to correct glottic insufficiency. Intraoperatively, the surgeon relies solely on perceptual subjective measures to help to achieve an optimal glottic closure by bringing the affected vocal fold closer to the midline in order to close the glottic gap. One of the challenges of MT is the persistence of symptoms due to incorrect choice of implant size...
September 2016: European Archives of Oto-rhino-laryngology
Behrad Ziapour
BACKGROUND: To describe the successful management of a patient with severe dyspnea and hypoxia due to tracheal stenosis by the application of a novel bridging technique-anterograde tracheal catheterization-prior to tracheostomy. CASE PRESENTATION: A 55-year-old woman entered the Emergency Department with severe dyspnea, tachypnea, and stridor and a pulse oximetry reading of 60 %. An attempt at intubation failed because of tracheal stenosis discovered 3-4 cm distal to the vocal cords, which had been formed as a complication of intubation the previous month...
April 26, 2016: Journal of Cardiothoracic Surgery
Lauren L Ritterhouse, Lori J Wirth, Gregory W Randolph, Peter M Sadow, Douglas S Ross, Whitney Liddy, Jochen K Lennerz
BACKGROUND: Aberrations involving the ROS1 gene have not been reported in thyroid cancer. Here, a case of ROS1-associated thyroid cancer with unique and aggressive characteristics is presented. PATIENT FINDINGS: A 24-year-old athlete presented with a 3.5 cm left paramedian upper neck mass. Open biopsy demonstrated a papillary thyroid carcinoma arising in the pyramidal lobe. Additional imaging revealed involvement of her cricothyroid membrane, thyroid laryngeal cartilage, and left vocal cord...
June 2016: Thyroid: Official Journal of the American Thyroid Association
M S Kristensen, W H Teoh, S S Rudolph, R Hesselfeldt, J Børglum, M F Tvede
We compared the transverse and longitudinal approaches to ultrasound-guided identification of the cricothyroid membrane, to determine which was faster and more successful. Forty-two anaesthetists received a one-hour structured training programme consisting of e-learning, a lecture and hands-on training, and then applied both techniques in a randomised, cross-over sequence to obese females with body mass index 39.0 - 43.9 kg.m(-2) . The mean (SD) time to identify the cricothyroid membrane was 24.0 (12.4) s using the transverse technique compared with 37...
June 2016: Anaesthesia
E D'heygere, T Vauterin, J W Casselman, R Kuhweide, C Dick
BACKGROUND: Congenital laryngeal cysts are a rare, but potentially fatal, cause of airway obstruction in infants and children. Most laryngeal cysts are acquired. Here, we describe a congenital laryngeal cyst, its treatment, and its presentation immediately after birth. CASE REPORT: A newborn child developed stridor very shortly after birth, due to a large, congenital saccular cyst. The diagnosis was based on a laryngoscopy and imaging studies, which detected an extralaryngeal extension through the cricothyroid membrane...
2015: B-ENT
Doron Sagiv, Ana Eyal, Jobran Mansour, Gabriel Nakache, Michael Wolf, Adi Primov-Fever
OBJECTIVE: The thyroid cartilage (TC) in men has a more prominent thyroid notch and a narrower interlaminae angle (ILA) as compared with women. Anatomy textbooks classically stipulate that the ILA is 90° in men and 120° in women. Our observation, based on thyroid chondroplasty operations, of a much narrower angle led to the current investigation. STUDY DESIGN: Cohort imaging study. SETTING: Tertiary academic referral center. SUBJECTS AND METHODS: Computed tomography angiography neck images of adult patients were studied...
April 2016: Otolaryngology—Head and Neck Surgery
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