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Flexible laryngoscopy

Bernar Tan Wen Sheng, Patrick Wong, Constance Teo Ee Hoon
INTRODUCTION: Recurrent respiratory papillomatosis results in hoarseness, stridor and airway obstruction. Management is surgical, with most surgeons using microdebrider or laser. Transoral robotic surgery (TORS) has been successfully utilised for the excision of oropharyngeal malignancies and paediatric airway surgery. This is the first case report of TORS being used for the excision of laryngeal papillomas. CASE REPORT: A 36 year old Chinese female was diagnosed with juvenile onset recurrent respiratory papillomatosis...
March 3, 2018: American Journal of Otolaryngology
Ashley J Guthrie, Raymond L Chai
IMPORTANCE: Transoral robotic surgery has revolutionized the practice of head and neck surgery over the past decade, with indications now expanding to include laryngeal pathology. Although laryngeal chondrosarcoma is a rare entity, trends in otolaryngology literature suggest that it can frequently be managed with conservative approaches. We hope to inspire other head and neck surgeons to consider transoral robotic surgery for the treatment of such tumors so that outcomes data can be collected and studied...
March 1, 2018: American Journal of Otolaryngology
Ashley P O'Connell Ferster, Tom Shokri, Michele Carr
IMPORTANCE: Paradoxical vocal fold motion (PVFM) is a disorder often misdiagnosed in children presenting with shortness of breath and stridor. In infants, little is known about the clinical course and best approach for treatment of PVFM. This retrospective study assesses the approach to treatment and outcomes for infants with PVFM. OBJECTIVE: To investigate the clinical course of paradoxical vocal fold motion (PVFM) in infants. DESIGN: Retrospective review...
April 2018: International Journal of Pediatric Otorhinolaryngology
Amy L Dimachkieh, Allison Dobbie, Damon R Olson, Mark A Lovell, Jeremy D Prager
OBJECTIVE: To review tracheal paragangliomas and describe the clinical presentation, radiologic findings, operative management, and histologic findings of a pediatric patient who presented with stridor refractory to traditional asthma therapy. METHODS: Chart review of an 8-year-old male who presented to a tertiary care pediatric hospital and literature review of tracheal paragangliomas. RESULTS: We present the case of an 8-year-old male who presented with new-onset of wheezing and dyspnea on exertion...
April 2018: International Journal of Pediatric Otorhinolaryngology
Jacob Melchiors, Mikael Johannes Vuokko Henriksen, Frederik G Dikkers, Javier Gavilán, J Pieter Noordzij, Marvin P Fried, Daniel Novakovic, Johannes Fagan, Birgitte W Charabi, Lars Konge, Christian von Buchwald
PURPOSE: Proper training and assessment of skill in flexible pharyngo-laryngoscopy are central in the education of otorhinolaryngologists. To facilitate an evidence-based approach to curriculum development in this field, a structured analysis of what constitutes flexible pharyngo-laryngoscopy is necessary. Our aim was to develop an assessment tool based on this analysis. METHODS: We conducted an international Delphi study involving experts from twelve countries in five continents...
February 13, 2018: European Archives of Oto-rhino-laryngology
Kyle Zanocco, David J Kaltman, James X Wu, Abbey Fingeret, Keith S Heller, James A Lee, Michael W Yeh, Julie Ann Sosa, Cord Sturgeon
BACKGROUND: Some surgeons perform flexible fiberoptic laryngoscopy (FFL) in all patients prior to thyroid cancer operations. Given the low likelihood of recurrent laryngeal nerve (RLN) or aerodigestive invasion in clinically low-risk thyroid cancers, the value of routine FFL in this group is controversial. We hypothesized that routine preoperative FFL would not be cost effective in low-risk differentiated thyroid cancer (DTC). METHODS: A decision model was constructed comparing preoperative FFL versus surgery without FFL in a clinical stage T2 N0 DTC patient without voice symptoms...
February 7, 2018: Annals of Surgical Oncology
Pejman Pourfakhr, Ailar Ahangari, Farhad Etezadi, Reza Shariat Moharari, Ayat Ahmadi, Negin Saeedi, Atabak Najafi
BACKGROUND: Nasotracheal intubation is commonly performed to provide a secure airway for the maintenance of general anesthesia in maxillofacial surgeries. Routine nasotracheal intubation is performed under general anesthesia by direct laryngoscopy, frequently with the aid of Magill forceps. This method can be time-consuming and may cause bleeding in the field of view. A gum elastic bougie (GEB) is a cheap, slender, and flexible device that could expedite nasotracheal intubation. The aim of this study was to evaluate the use of a GEB during nasotracheal intubation to facilitate the procedure and reduce the rate of complications...
February 2, 2018: Anesthesia and Analgesia
Margaret A Kenna, Alexandria L Irace, Julie E Strychowsky, Kosuke Kawai, Devon Barrett, Juliana Manganella, Michael J Cunningham
Importance: Children with Klippel-Feil syndrome (KFS), characterized principally by abnormal fusion of 2 or more cervical vertebrae, may have many additional congenital anomalies. The overall prevalence of otolaryngologic manifestations among patients with KFS has not been previously characterized. Objective: To define the otolaryngologic diagnoses made and procedures performed in 95 patients with KFS, which, to our knowledge, is the largest series of this challenging patient population published to date...
January 25, 2018: JAMA Otolaryngology—Head & Neck Surgery
Jessica M Pisegna, Joseph Murray
This article aims to review the use of laryngoscopy to assess swallowing function in the stroke population. Since its inception in 1988, fiberoptic endoscopic evaluation of swallowing (FEES) has become an established procedure with distinct objective findings and practical applications, enabling many to choose it as the primary instrumental tool in evaluating poststroke dysphagia. In this article, we outline the decision-making process of when to use FEES. We highlight considerations for the acute stroke patient and visual signs that guide decision making during a FEES, such as secretions, swallowing frequency, and pharyngeal squeeze elicitation...
February 2018: Seminars in Speech and Language
Hassan Mohammed, Matthew Coates, Liam Masterson, Ramez Nassif
Lamm introduced fibre-optic imaging in 1930s 1 . In the following decades it has been utilized in otolaryngology as an alternative to indirect mirror laryngoscopy. In its present form it allows for image capture and video recording when connected to a camera, it also allows for manoeuvring around anatomical structures due to its flexibility and articulation. It now forms an essential part of any head and neck examination especially when assessing for suspected cancer. This article is protected by copyright...
January 5, 2018: Clinical Otolaryngology
Diane S Lazard, Héloïse Bergeret-Cassagne, Muriel Lefort, Laurence Leenhardt, Gilles Russ, Frédérique Frouin, Christophe Trésallet
BACKGROUND: Transcutaneous laryngeal ultrasonography (TLUS) was recently developed to assess recurrent nerve palsy after thyroid/parathyroid surgery, with variable rates of efficiency. The aim of the current study was to evaluate this technique using subjective estimation and post-processing quantitative data. METHODS: Fifty subjects presenting with a recurrent nerve palsy and 50 "controls" presenting with voice, swallowing, or breathing disorders following thyroid/parathyroid surgery were prospectively included...
January 3, 2018: World Journal of Surgery
Takahiro Fukuhara, Eriko Matsuda, Yuiko Hattori, Ryohei Donishi, Hiroaki Ehara, Kazunori Fujiwara, Hiromi Takeuchi
Objectives: To clarify the usefulness of ultrasonography for detecting hypopharyngeal cancer. Study Design: Cross-sectional study. Methods: The study included 95 patients who underwent pre-treatment ultrasonography. We evaluated the usefulness of ultrasonography for detecting primary hypopharyngeal carcinoma of each T stage and subsite, and for assessing extrahypopharyngeal invasion. Additionally, we determined the efficacy of color Doppler for evaluating primary hypopharyngeal carcinoma...
December 2017: Laryngoscope Investigative Otolaryngology
Carlos Torre, Soroush Zaghi, Macario Camacho, Robson Capasso, Stanley Yung-Chuan Liu
OBJECTIVE: To validate the use of Cormack-Lehane and Modified Cormack-Lehane scoring systems to classify patterns of hypopharyngeal airway visualization seen during awake flexible laryngoscopy among patients with obstructive sleep apnea. STUDY DESIGN: Validation study using samples collected from a prospective database. SETTING: University Medical Center. PARTICIPANTS: Data was obtained from a retrospective review of a prospective database of flexible fiberoptic examination recordings in 274 consecutive OSA subjects (Stanford Sleep Medicine/Surgery Clinic)...
December 26, 2017: Clinical Otolaryngology
N Seymour, G Burkill, M Harries
OBJECTIVES: Positron emission tomography-computed tomography with fluorine-18 fluorodeoxy-D-glucose has a major role in the investigation of head and neck cancers. Fluorine-18 fluorodeoxy-D-glucose is not a tumour-specific tracer and can also accumulate in benign pathology. Therefore, positron emission tomography-computed tomography scan interpretation difficulties are common in the head and neck, which can produce false-positive results. This study aimed to investigate patients detected as having abnormal vocal fold uptake on fluorine-18 fluorodeoxy-D-glucose positron emission tomography-computed tomography...
December 18, 2017: Journal of Laryngology and Otology
Salil Sood, Ian Street, Adam Donne
Hoarseness or dysphonia are terms used to describe a change in the quality of the voice. The voice quality can be raspy, breathy, strained, fatigued, rough, tremulous or weak. There may be a change in pitch, restriction of range, voice breaks, decreased projection, or abnormal resonance. It is important to remember that a voice disorder is not a disease in itself but rather a presentation of an underlying pathology. Clinicians' knowledge of paediatric hoarseness is limited as it can be difficult to examine children using fibreoptic laryngoscopy and the child may not comprehend the need for detailed examination...
December 2, 2017: British Journal of Hospital Medicine
Prasanna Kumar Saravanam, Vinoth Manimaran
The incidence of congenital stridor is on rise due to improved neonate and infant survival rate. The gold standard investigation for evaluation of stridor is rigid laryngotracheobronchoscopy, but this is invasive and requires general anesthesia. Flexible fibreoptic laryngoscopy, a relatively simple and less invasive procedure can be done under topical anaesthesia for evaluation of stridor. In this study, we have presented our experience of flexible laryngoscopy in children with congenital stridor, their results and management...
December 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
Henry T Hoffman, Helen Stegall, Troy Wingler, Andrew Blitzer
OBJECTIVE: The aim was to study the feasibility of performing office-based laryngeal procedures employing a flexible hollow steerable sheath placed contralateral to the nostril through which a standard flexible video endoscope is placed. METHODS: The study design included simulation of transnasal endoscopic laryngeal procedures evaluating the use of a flexible steering sheath in laboratory and clinic settings. Transnasal laryngeal procedures were performed in an otolaryngology office setting employing an airway-management-trainer mannequin and then repeated in a human cadaver lab with standard transnasal flexible video laryngoscopy...
February 2018: Annals of Otology, Rhinology, and Laryngology
Frédéric Borel, Niki Christou, Olivier Marret, Muriel Mathonnet, Cécile Caillard, Sahar Bannani, Delphine Drui, Florent Espitalier, Claire Blanchard, Eric Mirallié
BACKGROUND: Postthyroidectomy voice disorders can occur without any recurrent laryngeal nerve injury, and probably are the most frequent complication after thyroidectomy. We report the long-term voice quality outcomes after total thyroidectomy without vocal cord palsy using a simple self-assessment tool: the voice handicap index self-questionnaire. METHODS: This observational prospective multicenter study included 203 patients from the "ThyrQoL" study (ClinicalTrial NCT02167529), who underwent total thyroidectomy between October 2014 and August 2015 in 3 French Hospitals (Nantes, La Roche-sur-Yon, and Limoges)...
November 18, 2017: Surgery
Jonathan C Garneau, Isaac Wasserman, Neeraja Konuthula, Benjamin D Malkin
OBJECTIVES/HYPOTHESIS: Patients who present to the emergency department (ED) with various otolaryngologic disorders are frequently referred to an otolaryngologist for follow-up care. Our aim was to further characterize this group as it has not been well described in the literature. STUDY DESIGN: Cross-sectional retrospective study. METHODS: We reviewed the charts of patients seen during an 18-month period in an urban public hospital trauma center adult ED and referred to an otolaryngology clinic for follow-up care...
November 20, 2017: Laryngoscope
Enrique Cadena, Alfredo Romero-Rojas, Ricardo Guerra, Carlos Pérez-Mitchell
Hypopharyngeal cysts are very uncommon pathology. They are presented in adult people over 60 years. Although oncocytic cysts are benign tumors, an incomplete resection causes recurrence. The symptoms are not specific, but the more frequent are dyspnea and foreign body sensation upon swallowing. Diagnosis usually is under general anesthesia during intubation. A flexible fiberoptic laryngoscopy could be insufficient; the trumpet maneuver during this examination can reveled occult cysts. To perform a total resection, the surgeon must have a complete exposition of the operative field...
November 6, 2017: Journal of Robotic Surgery
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