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Cricothyroid membrane

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https://www.readbyqxmd.com/read/29661380/relationship-between-severe-obesity-and-depth-to-the-cricothyroid-membrane-in-third-trimester-non-labouring-parturients-a-prospective-observational-study
#1
K Gadd, K Wills, R Harle, N Terblanche
BACKGROUND: Severely obese parturients have increased 'cannot intubate, cannot oxygenate' risk during Caesarean section under general anaesthesia. Front-of-neck access (FONA) at the cricothyroid membrane (CTM) is definitive management; however, attempted FONA can fail. Point-of-care ultrasonography may provide useful information about CTM depth to aid FONA in obesity. This study determined the difference in CTM depth between severely obese and non-obese parturients, utilising ultrasonography...
May 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29587754/retrograde-intubation-in-a-dog-with-severe-temporomandibular-joint-ankylosis-case-report
#2
Verónica Vieitez, Luis Javier Ezquerra, Víctor López Rámis, Massimo Santella, Ignacio Álvarez Gómez de Segura
BACKGROUND: Orotracheal intubation in dogs is a common and easily-performed procedure that provides a patent airway during anaesthesia. In dogs with temporomandibular joint ankylosis or pseudo-ankylosis, airway management can be a challenging procedure since these dogs have a limited ability to open their mouth. Methods to provide safe, uneventful intubation in such patients may include minimally invasive techniques such as retrograde intubation using a guide wire and fibre-optic-aided laryngoscopy...
March 27, 2018: BMC Veterinary Research
https://www.readbyqxmd.com/read/29422029/ultrasound-guided-identification-of-the-cricothyroid-membrane-in-a-patient-with-a-difficult-airway-a-case-report
#3
Hiromu Okano, Kohji Uzawa, Kunitaro Watanabe, Akira Motoyasu, Joho Tokumine, Alan Kawarai Lefor, Tomoko Yorozu
BACKGROUND: Surgical cricothyroidotomy is considered to be the last resort for management of the difficult airway. A major point for a successful surgical cricothyroidotomy is to identify the location of the cricothyroid membrane. CASE PRESENTATION: We encountered a patient with progressive respiratory distress who was anticipated to have a difficult airway due to a large neck abscess. We prepared for both awake intubation and surgical cricothyroidotomy. The cricothyroid membrane could not be identified by palpation, but was readily identified using ultrasound...
February 8, 2018: BMC Emergency Medicine
https://www.readbyqxmd.com/read/29416237/front-of-neck-access-a-survey-among-anesthetists-and-surgeons
#4
Cyprian Mendonca, Imran Ahmad, Achuthapillai Sajayan, Rathinavel Shanmugam, Manu Sharma, Will Tosh, Emily Pallister, Peter K Kimani
Background and Aims: Emergency front of neck access (FONA) is the final step in a Can't Intubate-Can't Oxygenate (CICO) scenario. In view of maintaining simplicity and promoting standardized training, the 2015 Difficult Airway Society guidelines recommend surgical cricothyroidotomy using scalpel, bougie, and tube (SBT) as the preferred technique. Material and Methods: We undertook a survey over a 2-week period to evaluate the knowledge and training, preferred rescue technique, and confidence in performing the SBT technique...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/29391159/cricothyroid-membrane-puncture-guided-tracheostomy-a-new-technique-for-emergency-airway-access
#5
Youbai Chen, Yan Han, Meredith August, Nalton F Ferraro, Qixu Zhang, Haizhong Zhang
PURPOSE: We sought to compare cricothyroid membrane puncture-guided tracheostomy (CMPGT) with surgical cricothyroidotomy (SC) and percutaneous tracheostomy with Griggs' guidewire dilating forceps (GWDF) for establishing an emergency airway in a porcine model. We hypothesized that CMPGT would be associated with a shorter time to ventilation and more rapid restoration of oxygenation. MATERIALS AND METHODS: We implemented a small pilot animal study. Eighteen miniature pigs were randomly assigned to undergo CMPGT, SC, or GWDF...
January 9, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29349776/effect-of-palpable-vs-impalpable-cricothyroid-membranes-in-a-simulated-emergency-front-of-neck-access-scenario
#6
C F Pairaudeau, C Mendonca, C Hillermann, I Qazi, P A Baker, R E Hodgson, S Radhakrishna
The Difficult Airway Society 2015 guidelines recommend and describe in detail a surgical cricothyroidotomy technique for the can't intubate, can't oxygenate (CICO) scenario, but this can be technically challenging for anaesthetists with no surgical training. Following a structured training session, 104 anaesthetists took part individually in a simulated can't intubate, can't oxygenate event using simulation and airway models to evaluate how well they could perform these front-of-neck access techniques. Main outcomes measures were: ability to correctly perform the technical steps; procedural time; and success rate...
May 2018: Anaesthesia
https://www.readbyqxmd.com/read/29349733/point-of-care-ultrasound-pocus-of-the-upper-airway
#7
REVIEW
Kong Eric You-Ten, Naveed Siddiqui, Wendy H Teoh, Michael S Kristensen
Airway management is a critical skill in the practice of several medical specialities including anesthesia, emergency medicine, and critical care. Over the years mounting evidence has showed an increasing role of ultrasound (US) in airway management. The objective of this narrative review is to provide an overview of the indications for point-of-care ultrasound (POCUS) of the upper airway. The use of US to guide and assist clinical airway management has potential benefits for both provider and patient. Ultrasound can be utilized to determine airway size and predict the appropriate diameter of single-lumen endotracheal tubes (ETTs), double-lumen ETTs, and tracheostomy tubes...
April 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29328751/a-comparative-prospective-cohort-study-comparing-physical-exam-to-ultrasound-for-identifying-the-cricoid-cartilage
#8
Peter Williams, Abhay Umranikar
Applying cricoid pressure is a common practice when intubating patients thought to be at risk of pulmonary aspiration. Recently, the perceived benefits of applying cricoid pressure have been questioned. Prior research has shown that cricoid pressure is applied incorrectly and that palpation of adjacent anatomy of the cricothyroid membrane is also inaccurate. We compared physical palpation to ultrasound for identifying the location of the cricoid cartilage using a total of 50 assessments. The median distance to target was 10 mm...
September 2017: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29098260/-applications-of-ultrasound-guided-superior-laryngeal-nerve-block-and-cricothyroid-membrane-puncture-in-conscious-endotracheal-intubation
#9
Jun-An Wang, Yu Sun, Yan Huang, Hong Jiang
PURPOSE: To explore the clinical value of ultrasound-guided superior laryngeal nerve block and cricothyroid membrane puncture in conscious endotracheal intubation. METHODS: Thirty ASA classⅠorII patients scheduled for selective surgeries were randomly divided into 2 groups, Group U was ultrasound-guided group (n=15), group A was anatomical location group (n=15). Transnasal tracheal intubation was performed in all patients. In patient of group U, thyrohyoid membrane was shown hyperecho by ultrasound and echoless superior laryngeal artery passed across it...
June 2017: Shanghai Kou Qiang Yi Xue, Shanghai Journal of Stomatology
https://www.readbyqxmd.com/read/29066133/enhancement-of-cricothyroidotomy-education-using-a-novel-technique-cadaver-autografting
#10
Ryan F Coughlin, Iris Chandler, John C Binford, James W Bonz, David C Hile
BACKGROUND: Cricothyroidotomy is a lifesaving procedure required in up to 2% of emergent airways. Emergency medicine training programs frequently instruct this procedure via cadaver training, but cadaver cost and availability limit the opportunity for all trainees to perform the critical initial skin incision. Cadaver autografting is a novel way to simulate all steps of the procedure. OBJECTIVE: Our aim was to determine whether the technique of autografting cadaver tissue improves the experience of cricothyroidotomy simulation education for emergency medicine trainees...
December 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29063583/infrared-red-intubation-system-irris-guided-flexile-videoscope-assisted-difficult-airway-management
#11
M S Kristensen, E Fried, P Biro
BACKGROUND: Tracheal intubation with a flexible scope is a cornerstone technique in patients with severely difficult airways, but may fail. We report on a technique, Infrared Red Intubation System (IRRIS), that seems to facilitate the identification of the glottis. METHODS: The IRRIS is placed over the patient's cricothyroid membrane and emits blinking infrared light through the patient's skin into the subglottic space. When a flexible videoscope (one that does not filter infrared light) is introduced into the airway, it will display this as a blinking white light emerging from the glottis, retrograde transillumination, showing the pathway to the trachea...
January 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28988443/effects-of-supramaximal-balloon-dilatation-pressures-on-adult-cricoid-and-tracheal-cartilage-a-cadaveric-study
#12
Venkata S P B Durvasula, Sara C Shalin, Ozlem E Tulunay-Ugur, James Y Suen, Gresham T Richter
OBJECTIVES/HYPOTHESIS: Cricoid fracture is a serious concern for balloon dilatation in airway stenosis. Furthermore, there are no studies examining tracheal rupture in balloon dilatation of stenotic segments. The aim of this study was to evaluate the effect of supramaximal pressures of balloons on the cricoid and tracheal rings. STUDY DESIGN: Prospective cadaveric study. METHODS: Seven cadaveric laryngotracheal complexes of normal adults with intact cricothyroid membranes were acquired...
October 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28843218/clinicopathologic-findings-and-treatment-outcome-of-laryngectomized-patients-with-laryngeal-cancer-and-hypopharyngeal-cancer-an-experience-in-thailand
#13
Noppadol Larbcharoensub, Duangkamon Wattanatranon, Juvady Leopairut, Suwimon Suntisuktana, Boonsam Roongpupaht, Chalermchai Chintrakarn, Jumroon Tungkeeratichai, Phurich Praneetvatakul, Thongchai Bhongmakapat, Wichit Cheewaruangroj, Supawadee Prakunhungsit
Objective: To evaluate the clinicopathologic findings and treatment outcome in laryngectomized patients with laryngeal cancer and hypopharyngeal cancer. Materials and Methods: The authors retrospectively reviewed the medical records of 212 patients who had been newly diagnosed and treated with laryngectomy between January 2000 and December 2010. The age, gender, clinical manifestations, associated predisposing condition, tumor WHO grade, AJCC tumor stage, maximum tumor size, anatomical involvement, type of surgery, postoperative sequelae, treatment and therapeutic outcome were analyzed...
August 27, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28837293/-%C3%A2-golden-hour-%C3%A2-and-the-sellick-manoeuvre-in-emergency-care-we-must-not-throw-out-the-baby-with-the-bathwater
#14
Lukas Bürki, Bertrand Yersin
This article evaluates 3 controversial subjects of pre-hospital emergency care : 1) The concept of the « Golden hour » predicates an increased morbidity and mortality for injured patients, if pre-hospital care exceeds 1 hour. In the subgroup of patients presenting with severe hemorrhagic injuries or penetrating trauma to the torso, a transport of 60 minutes or less decreases mortality ; 2) The Sellick manoeuvre is used to decrease the risk of bronchoaspiration in patients undergoing an emergency intubation...
August 9, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28622494/laryngeal-neuropathy-in-adult-goats-with-copper-deficiency
#15
R F A Sousa, V M Almeida, J E Neto, C W A Nascimento, G X Medeiros, R M T Medeiros, F Riet-Correa, F S Mendonça
The aim of this study was to elucidate the cause of a neurological syndrome characterized by stridor in adult goats with clinical signs of copper deficiency. The main clinical signs consisted of apathy, emaciation, pale mucous membranes, mucous nasal discharge, dyspnea, severe achromotrichia, diffuse alopecia, torpor, ataxia, and stridor. When the goats were forced to move, the stridor increased. In a herd of 194 Toggenburg goats, 10 adult goats with clinical signs of copper deficiency were removed from the herd and divided into 2 groups: group 1, which consisted of 4 nannies and 1 buck with stridor, and group 2, which consisted of 4 nannies and 1 buck without stridor...
July 2017: Veterinary Pathology
https://www.readbyqxmd.com/read/28604085/tension-pneumothorax-after-percutaneous-tracheostomy
#16
Sarina Matsumura, Naotaka Kishimoto, Tomio Iseki, Yoshihiro Momota
A 76-year-old woman with right mandibular gingival cancer was scheduled for surgery. A percutaneous tracheostomy kit was used for tracheostomy under intravenous sedation. After puncturing the cricothyroid membrane, a dilator was inserted along a guidewire. Bucking was observed at the time of insertion of the dilator, despite intratracheal lidocaine spray applied before insertion. After that, the tracheostomy tube was inserted, but no capnographic waveforms appeared when the tube was connected to the anesthesia circuit...
December 0: Anesthesia Progress
https://www.readbyqxmd.com/read/28577552/determining-the-amount-of-training-needed-for-competency-of-anesthesia-trainees-in-ultrasonographic-identification-of-the-cricothyroid-membrane
#17
Katia F Oliveira, Cristian Arzola, Xiang Y Ye, Jefferson Clivatti, Naveed Siddiqui, Kong E You-Ten
BACKGROUND: Airway guidelines recommend the use of ultrasound to localize the cricothyroid membrane prior to airway manipulation in difficult airways. In this study, we aimed to determine the amount of training anesthesia trainees would need to achieve competence in bedside ultrasound to identify the cricothyroid membrane. METHODS: This is a prospective non-randomized cohort study in the Department of Anesthesia at Mount Sinai Hospital (Toronto, Ontario, Canada)...
June 2, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28530217/-phonosurgical-methods-of-treatment-in-unilateral-vocal-folds-paralysis
#18
REVIEW
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
https://www.readbyqxmd.com/read/28463474/the-height-of-the-cricothyroid-membrane-on-computed-tomography-scans-in-trauma-patients
#19
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...
August 2017: Anaesthesia
https://www.readbyqxmd.com/read/28131119/the-use-of-ultrasonography-in-obstetric-anesthesia
#20
REVIEW
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
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