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Flexible laryngoscopy

P D Karkos, M Stavrakas, K Markou
Transoral laser Assisted Microsurgical resection, Radiotherapy or Open partial laryngeal surgery are the management options for early glottic cancer. When endoscopic access is difficult(1-4) , radiotherapy or open surgery seems to be the other available options. The oncological safety of a Flexible Endoscopic Diode Laryngeal Laser Assisted Surgical (FEDLAS) Technique for patients with early glottic cancer and difficult laryngoscopy was tested in a preliminary pilot study. Patients with Grade three or more laryngoscopy(Cormack-Lehane classification)(5) and biopsy proven glottic cancer were included in the study...
October 11, 2016: Clinical Otolaryngology
Frederik Buchvald, Lue Drasbaek Phillipsen, Thomas Hjuler, Kim G Nielsen
BACKGROUND AND AIMS: Exercise-induced inspiratory symptoms (EIIS) have multiple causes, one of which is exercise-induced laryngeal obstruction (EILO). There is limited knowledge regarding EIIS in children, both in primary care practices and in pediatric asthma clinics. The aim of this study was to describe the feasibility of a diagnostic methodology and its results in a cohort of children with EIIS referred to our tertiary pediatric pulmonary center. METHODS: This study analyzed consecutively collected data in children from East Denmark and Greater Copenhagen referred during a 3½ years period...
November 2016: Pediatric Pulmonology
Rashmi Mishra, Pavithra Reddy, Misbahuddin Khaja
Cerebral air embolism (CAE) is an infrequently reported complication of routine medical procedures. We present two cases of CAE. The first patient was a 55-year-old male presenting with vomiting and loss of consciousness one day after his hemodialysis session. Physical exam was significant for hypotension and hypoxia with no focal neurologic deficits. Computed tomography (CT) scan of head showed gas in cerebral venous circulation. The patient did not undergo any procedures prior to presentation, and his last hemodialysis session was uneventful...
2016: Case Reports in Critical Care
Tunn Ren Tay, Ryan Hoy, Amanda L Richards, Paul Paddle, Mark Hew
OBJECTIVES: Timely diagnosis of vocal cord dysfunction (VCD), more recently termed "inducible laryngeal obstruction," is important because VCD is often misdiagnosed as asthma, resulting in delayed diagnosis and inappropriate treatment. Visualization of paradoxical vocal cord movement on laryngoscopy is the gold standard for diagnosis, but is limited by poor test sensitivity. Provocation tests may improve the diagnosis of VCD, but the diagnostic performance of current tests is less than ideal...
August 23, 2016: Journal of Voice: Official Journal of the Voice Foundation
Jordan J Allensworth, Karla D O'Dell, Joshua S Schindler
BACKGROUND: Diffuse idiopathic skeletal hyperostosis (DISH) is an idiopathic spinal disease common in the elderly and characterized by flowing ossification and osteophyte formation along the spinal column. Cervical hyperostosis is capable of producing dysphagia, stridor, and airway obstruction; however, there are no extant reports of true paralysis of bilateral vocal folds in patients fulfilling the criteria for DISH. METHODS AND RESULTS: We report a case of a 61-year-old man presenting with dysphagia and dyspnea...
August 24, 2016: Head & Neck
Ning Fang, Le Sun, Yan Zhang, Wei Zhu, Xin Wang
Foreign body aspiration is a life-threatening emergency in children. An 11-year-old girl presented at the emergency department with a case of accidental foreign body aspiration. The patient had symptoms of acute respiratory distress followed by cyanosis of the lips. Radiological examination demonstrated a radiopaque foreign body. Under analgesic and amnestic anesthesia, we extracted the metal bead using alligator forceps, with a direct laryngoscope and a flexible bronchoscope. This method afforded an improved visual access to the operative field and allowed for intra-operative manipulation, thus obviating the need for thoracotomy...
July 11, 2016: Minimally Invasive Therapy & Allied Technologies: MITAT
Kourosh Parham, Nikita Chapurin, Kris Schulz, Jennifer J Shin, Melissa A Pynnonen, David L Witsell, Alan Langman, Anh Nguyen-Huynh, Sheila E Ryan, Andrea Vambutas, Anne Wolfley, Rhonda Roberts, Walter T Lee
OBJECTIVES: (1) Describe thyroid-related diagnoses and procedures in Creating Healthcare Excellence through Education and Research (CHEER) across academic and community sites. (2) Compare management of malignant thyroid disease across these sites. (3) Provide practice-based data related to flexible laryngoscopy vocal fold assessment before and after thyroid surgery based on the American Academy of Otolaryngology-Head and Neck Surgery Foundation's clinical practice guidelines. STUDY DESIGN: Review of retrospective data collection (RDC) database of the CHEER network using ICD-9 and CPT codes related to thyroid conditions...
July 2016: Otolaryngology—Head and Neck Surgery
Christina H Kang, Joseph G Hentz, David G Lott
OBJECTIVE: To identify symptoms, common diagnostic findings, pattern of treatments and referrals offered, and their efficacy in a group of patients with idiopathic functional dysphagia in an otolaryngology setting with multiple providers. STUDY DESIGN: Case series with chart review. SETTING: Tertiary academic center. SUBJECTS AND METHODS: Following Mayo Clinic Institutional Review Board approval, a retrospective chart review was conducted of patients with dysphagia who had a videofluoroscopic swallow study between January 1, 2013, and April 30, 2015...
June 28, 2016: Otolaryngology—Head and Neck Surgery
Mark A Fritz, Michael J Persky, Yixin Fang, C Blake Simpson, Milan R Amin, Lee M Akst, Gregory N Postma
OBJECTIVE: To determine the prevalence and also accuracy of the laryngopharyngeal reflux (LPR) referring diagnosis and to determine the most useful clinical tool in arriving at the final diagnosis in a tertiary laryngology practice. STUDY DESIGN: Case series with planned data collection. SETTING: Six tertiary academic laryngology practices. SUBJECTS AND METHODS: We collected referring diagnosis and demographic information, including age, sex, ethnicity, referring physician, and whether or not patients had prior flexible laryngoscopy for 1077 patients presenting with laryngologic complaints from January 2010 and June 2013...
October 2016: Otolaryngology—Head and Neck Surgery
Ayman Ads, Frederic Auerbach, Kelly Ryan, Abdel R El-Ganzouri
We report the successful use of the Air-Q laryngeal airway (Air-Q LA) as a ventilatory device and a conduit for tracheal intubation to rescue the airway in a patient with difficult airway and tracheal stenosis. This is the first case report of the device to secure the airway after two episodes of hypoxemia in the operating room and intensive care unit. Consent for submission of this case report was obtained from our institution's human studies institutional review board given that the patient died a few months after his discharge from the hospital before his personal consent could be obtained and before preparation of this report...
August 2016: Journal of Clinical Anesthesia
Cláudia Schweiger, Denise Manica, Gabriel Kuhl, Leo Sekine, Paulo José Cauduro Marostica
OBJECTIVE: To compare the Classification of Acute Laryngeal Injuries (CALI) with other classifications to determine which of these offers the greatest sensitivity and specificity in predicting the development of subglottic stenosis. METHODS: All children intubated for the first time in the pediatric intensive care unit were included and subjected to flexible fiber-optic laryngoscopy (FFL) within 8 h of extubation. Their injuries were categorized using the CALI, as well as adapted classifications from Lindholm, Colice and Benjamin...
July 2016: International Journal of Pediatric Otorhinolaryngology
Maartje M J Singendonk, Bas Pullens, Jan A A van Heteren, Henriëtte H W de Gier, Hans L J Hoeve, Astrid M König, Marc P van der Schroeff, Carlijn E L Hoekstra, Laura L Veder, Rachel J van der Pol, Marc A Benninga, Michiel P van Wijk
OBJECTIVES: The Reflux Finding Score for Infants (RFS-I) was developed to assess signs of laryngopharyngeal reflux (LPR) in infants. With flexible laryngoscopy, moderate inter- and highly variable intraobserver reliability was found. We hypothesized that the use of rigid laryngoscopy would increase reliability and therefore evaluated the reliability of the RFS-I for flexible versus rigid laryngoscopy in infants. METHODS: We established a set of videos of consecutively performed flexible and rigid laryngoscopies in infants...
July 2016: International Journal of Pediatric Otorhinolaryngology
Libby J Smith, Clark A Rosen, Michael C Munin
OBJECTIVES/HYPOTHESIS: As laryngeal electromyography (LEMG) becomes more refined, accurate predictions of vocal fold motion recovery are possible. Focus has been on outcomes for patients with poor prognosis for vocal fold motion recovery. Limited information is available regarding the expected rate of purposeful vocal fold motion recovery when there is good to normal motor recruitment, no signs of denervation, and no signs of synkinetic activity with LEMG, termed excellent prognosis. The objective of this study is to determine the rate of vocal fold motion recovery with excellent prognosis findings on LEMG after acute recurrent laryngeal nerve injury...
October 2016: Laryngoscope
Bhartendu Bharti, Kamran Asif Syed, Kala Ebenezer, Ajoy Mathew Varghese, Mary Kurien
STUDY OBJECTIVES: To identify acute laryngeal injuries among pediatric patients intubated for more than 48hours, and to correlate these injuries with clinical variables. SETTING: Pediatric Intensive Care Unit (PICU) of a tertiary level hospital in India. PATIENTS AND METHODS: Prospective, observational study. Thirty-four children meeting the inclusion and exclusion criteria were recruited into the study after obtaining informed consent from the parents...
June 2016: International Journal of Pediatric Otorhinolaryngology
Tiina Andersen, Astrid Sandnes, Anne Kristine Brekka, Magnus Hilland, Hege Clemm, Ove Fondenes, Ole-Bjørn Tysnes, John-Helge Heimdal, Thomas Halvorsen, Maria Vollsæter, Ola Drange Røksund
BACKGROUND: Most patients with amyotrophic lateral sclerosis (ALS) are treated with mechanical insufflation-exsufflation (MI-E) in order to improve cough. This method often fails in ALS with bulbar involvement, allegedly due to upper-airway malfunction. We have studied this phenomenon in detail with laryngoscopy to unravel information that could lead to better treatment. METHODS: We conducted a cross-sectional study of 20 patients with ALS and 20 healthy age-matched and sex-matched volunteers...
May 12, 2016: Thorax
Pui Y Lee, Eelam A Adil, Alexandria L Irace, Laura Neff, Mary Beth F Son, Edward Y Lee, Antonio Perez-Atayde, Reza Rahbar
OBJECTIVE: Granulomatosis with polyangiitis (GPA) is a necrotizing inflammatory disease that can affect the airway. The purpose of this study was to present a case of pediatric laryngotracheal GPA and provide management recommendations based on a thorough review of the literature. DATA SOURCES: Retrospective chart and literature review REVIEW METHODS: A pediatric patient with laryngotracheal and pulmonary manifestations of GPA who underwent chemotherapy and intralesional corticosteroid injection is described...
April 26, 2016: Laryngoscope
Catherine Chang, Wan-Ni Lin, Li-Jen Hsin, Li-Ang Lee, Chien-Yu Lin, Hsueh-Yu Li, Chun-Ta Liao, Tuan-Jen Fang
OBJECTIVES/HYPOTHESIS: Direct suspension laryngoscopic biopsy performed under general anesthesia is the conventional management for obtaining pathological diagnosis for neoplasms of the larynx, oropharynx, and hypopharynx. Since the development of distal chip laryngoscopy and digital imaging systems, transnasal flexible laryngoscopy tissue sampling has gained popularity as an office-based procedure. Additional assessment with narrow-band imaging (NBI) can help to increase the diagnostic yield...
April 23, 2016: Laryngoscope
A K Nørskov, J Wetterslev, C V Rosenstock, A Afshari, G Astrup, J C Jakobsen, J L Thomsen, M Bøttger, M Ellekvist, B M B Schousboe, A Horn, B G Jørgensen, K Lorentzen, M H Madsen, J S Knudsen, B K Thisted, S Estrup, H B Mieritz, T Klesse, H J Martinussen, A G Vedel, R Maaløe, K B Bøsling, P R C Kirkegaard, C R Ibáñez, G Aleksandraviciute, L S Hansen, T Mantoni, L H Lundstrøm
BACKGROUND: Unanticipated difficult intubation remains a challenge in anaesthesia. The Simplified Airway Risk Index (SARI) is a multivariable risk model consisting of seven independent risk factors for difficult intubation. Our aim was to compare preoperative airway assessment based on the SARI with usual airway assessment. METHODS: From 01.10.2012 to 31.12.2013, 28 departments were cluster-randomized to apply the SARI model or usual airway assessment. The SARI group implemented the SARI model...
May 2016: British Journal of Anaesthesia
Wonjae Cha, Ilyoung Cho, Jeon Yeob Jang, Jae-Keun Cho, Soo-Geun Wang, Ji-Hwan Park
OBJECTIVES/HYPOTHESIS: Recurrent laryngeal nerve (RLN) injury during thyroidectomy or parathyroidectomy is a challenging issue and causes significant morbidity. We adopted the supramaximal stimulation protocol for neurostimulation with laryngeal palpation (NSLP) and tried to evaluate the predictive values of supramaximal NSLP for immediate postoperative vocal fold (VF) mobility. STUDY DESIGN: Prospective cohort study. METHODS: Prospectively, 293 patients who underwent thyroid and parathyroid surgery and 542 RLNs at risk were enrolled in this study...
April 14, 2016: Laryngoscope
Adriana Pardo-Maza, Isabel García-Lopez, Susana Santiago-Pérez, Javier Gavilán
OBJECTIVE: This study aimed to determine the value of laryngeal electromyography in the prognosis of vocal fold paralysis. STUDY DESIGN: This is a retrospective descriptive study. MATERIALS AND METHODS: This study included 80 patients diagnosed with unilateral or bilateral vocal fold paralysis on flexible laryngoscopy between 2002 and 2014 in a tertiary medical center. Laryngeal electromyography using a standardized protocol was performed; the outcome measures were classified and analyzed into two groups according to the degree of injury...
April 5, 2016: Journal of Voice: Official Journal of the Voice Foundation
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