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https://www.readbyqxmd.com/read/28345075/ultrasonographic-detection-of-airway-obstruction-in-a-model-of-obstructive-sleep-apnea
#1
Amal Isaiah, Reuben Mezrich, Jeffrey Wolf
Purpose Obstructive sleep apnea (OSA) is a common clinical disorder characterized by repetitive airway obstruction during sleep. The gold standard for diagnosis of OSA, polysomnogram (PSG), cannot anatomically localize obstruction. Precise identification of obstruction has potential to improve outcomes following surgery. Current diagnostic modalities that provide this information require anesthesia, involve ionizing radiation or disrupt sleep. To mitigate these problems, we conceived that ultrasound (US) technology may be adapted (i) to detect, quantify and localize airway obstruction and (ii) for translational application to home-based testing for OSA...
February 2017: Ultrasound International Open
https://www.readbyqxmd.com/read/28338364/indications-risk-of-lower-airway-infection-and-complications-to-pediatric-tracheotomy-report-from-a-tertiary-referral-center
#2
Christian Grønhøj, Birgitte Charabi, Christian von Buchwald, Thomas Hjuler
BACKGROUND: Although pediatric tracheotomy is potentially life-saving, the procedure is associated with high risk of complications, and indications have changed the last decade. We report indications, complications, and lower airway infections (LAIs) to pediatric tracheotomy performed at a tertiary referral center. METHODS: We identified all children (<18 years) who underwent tracheotomy at our institution during 2008-2015. A review of hospital records was performed to extract data on indication of the procedure, complications, and information on pre- and postoperative LAI...
March 24, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28337533/incidence-of-second-surgery-following-pediatric-adenotonsillar-surgery-a-population-based-cohort-study
#3
Ola Sunnergren, Erik Odhagen, Joacim Stalfors
The aim of the study is to evaluate the incidence and risk factors of a second surgery of the adenoids or tonsils for hypertrophy in children who have already undergone surgery for the same condition. This is a retrospective study (2004-2013) based on data from the National patient registry in Sweden. A total of 41,401 children underwent a first surgery of the adenoids or tonsils during the studied period. The most commonly performed (first) surgical procedure was adenoidectomy followed by adenotonsillotomy, adenotonsillectomy, tonsillotomy, and tonsillectomy...
March 23, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28337439/a-brief-review-of-non-invasive-monitoring-of-respiratory-condition-for-extubated-patients-with-or-at-risk-for-obstructive-sleep-apnea-after-surgery
#4
REVIEW
Xuezheng Zhang, Mahmoud Attia Mohamed Kassem, Ying Zhou, Muhammad Shabsigh, Quanguang Wang, Xuzhong Xu
Obstructive sleep apnea (OSA) is one of the important risk factors contributing to postoperative airway complications. OSA alters the respiratory physiology and increases the sensitivity of muscle tone of the upper airway after surgery to residual anesthetic medication. In addition, the prevalence of OSA was reported to be much higher among surgical patients than the general population. Therefore, appropriate monitoring to detect early respiratory impairment in postoperative extubated patients with possible OSA is challenging...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28329273/is-surgical-resection-superior-to-bronchoscopic-resection-in-patients-with-symptomatic-endobronchial-hamartoma
#5
Sarah M Abdel Hady, Salma E Elbastawisy, Aly S Hassaballa, Hany H Elsayed
A best evidence topic was written according to a structured protocol. The question addressed was: in surgically fit patients with biopsy proven symptomatic endobronchial hamartoma (EH), is surgical resection superior to bronchoscopic resection in terms of outcome. A total of 756 articles were identified using the reported search, of which 8 represented the best evidence to answer the clinical question. The authors, date, journal, country, study type, population, outcomes and key results are tabulated. Three studies included patients who had either bronchoscopic or surgical treatment of EH in the same study...
February 17, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28325565/impact-of-the-method-and-success-of-pharyngeal-reconstruction-on-the-outcome-of-treating-laryngeal-and-hypopharyngeal-cancers-with-pharyngolaryngectomy-a-national-analysis
#6
S A R Nouraei, A Dias, H Kanona, D Vokes, P O'Flynn, P M Clarke, S E Middleton, A Darzi, P Aylin, N Jallali
BACKGROUND: Surgical treatment of cancers that arise from or invade the hypopharynx presents major reconstructive challenges. Reconstructive failure exposes the airway and neck vessels to digestive contents. METHODS: We performed a national N = near-all analysis of the administrative dataset to identify pharyngolaryngectomies in England between 2002 and 2012. Information about morbidity, pharyngeal closure method and post-operative complications was derived. RESULTS: There were 1589 predominantly male (78%) patients whose mean age at surgery was 62 years...
January 9, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28325564/the-effect-of-age-at-surgery-and-compensatory-articulation-on-speech-outcome-in-submucous-cleft-palate-patients-treated-with-double-opposing-z-plasty-a-10-year-experience
#7
Rong-Min Baek, Baek-Kyu Kim, Jae Hoon Jeong, Taeseon Ahn, Mikyong Park, Jihyeon Han
BACKGROUND: Submucous cleft palate is a congenital deformity that may present as velopharyngeal insufficiency. The degree of anatomical abnormality varies widely among patients and does not predict severity of symptom. We present our 10-year experience treating submucous cleft palate patients with double opposing z-plasty and explore the effect of age at surgery and compensatory articulation on speech. METHODS: Preoperative assessment included intraoral examination, nasoendoscopy, and perceptual speech evaluation...
March 7, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28323670/prevention-of-respiratory-complications-of-the-surgical-patient-actionable-plan-for-continued-process-improvement
#8
Katarina J Ruscic, Stephanie D Grabitz, Maíra I Rudolph, Matthias Eikermann
PURPOSE OF REVIEW: Postoperative respiratory complications (PRCs) increase hospitalization time, 30-day mortality and costs by up to $35 000. These outcomes measures have gained prominence as bundled payments have become more common. RECENT FINDINGS: Results of recent quantitative effectiveness studies and clinical trials provide a framework that helps develop center-specific treatment guidelines, tailored to minimize the risk of PRCs. The implementation of those protocols should be guided by a local, respected, and visible facilitator who leads proper implementation while inviting center-specific input from surgeons, anesthesiologists, and other perioperative stakeholders...
March 20, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28322112/national-database-analysis-of-single-level-versus-multilevel-sleep-surgery
#9
Scott E Brietzke, Stacey L Ishman, Seth Cohen, Derek D Cyr, Jennifer J Shin, Eric J Kezirian
Objective Recent evidence suggests that multilevel sleep surgery improves outcomes when compared with palate surgery alone for most patients. The study objective was to compare demographic and outcomes data for palate surgery (uvulopalatopharyngoplasty [UPPP]) alone versus multilevel surgery through a national insurance claims database. Study Design Retrospective cohort study. Setting National insurance claims database. Subjects and Methods An adult cohort undergoing single-level UPPP versus UPPP with nasal and/or tongue/hypopharyngeal surgery was identified in the Truven Health Analytics MarketScan Research Databases for the years 2010 through 2012...
March 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28322040/design-and-fabrication-of-a-thin-walled-freeform-scaffold-on-the-basis-of-medical-image-data-and-a-3d-printed-template-potential-use-in-bile-duct-regeneration
#10
Suk Hee Park, Bo-Kyeong Kang, Ji Eun Lee, Seung Woo Chun, Kiseok Jang, Youn Hwan Kim, Mi Ae Jeong, Yohan Kim, Kyo Jin Kang, Nak Kyu Lee, Dongho Choi, Han Joon Kim
Three-dimensional (3D) printing, combined with medical imaging technologies, such as computed tomography (CT) and magnetic resonance imaging (MRI), has shown great potential in patient-specific tissue regeneration. Here, we successfully fabricated an ultrathin tubular freeform structure that has a wall thickness of several tens of micrometers and is capable of providing sufficient mechanical flexibility. Such a thin geometry cannot easily be achieved by 3D printing alone; therefore, it was realized through a serial combination of processes that included the 3D printing of a sacrificial template, the dip-coating of the biomaterial, and the removal of the inner template...
March 21, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28321836/intra-oral-ignition-of-monopolar-diathermy-during-transnasal-humidified-rapid-insufflation-ventilatory-exchange-thrive
#11
D Onwochei, K El-Boghdadly, R Oakley, I Ahmad
We present the case of unanticipated airway ignition during hard palate biopsy. Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) and monopolar diathermy were utilised for the procedure, during which an arc arose from the diathermy tip to a titanium implant, causing a brief ignition on the monopolar diathermy grip. This case highlights the need for maintained awareness of fire risk when using diathermy in the presence of THRIVE during airway surgery.
March 20, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28320312/the-effect-of-an-electronic-cognitive-aid-on-the-management-of-st-elevation-myocardial-infarction-during-caesarean-section-a-prospective-randomised-simulation-study
#12
Michael St Pierre, Bjoern Luetcke, Dieter Strembski, Christopher Schmitt, Georg Breuer
BACKGROUND: Cognitive aids have come to be viewed as promising tools in the management of perioperative critical events. The majority of published simulation studies have focussed on perioperative crises that are characterised by time pressure, rare occurrence, or complex management steps (e.g., cardiac arrest emergencies, management of the difficult airway). At present, there is limited information on the usefulness of cognitive aids in critical situations with moderate time pressure and complexity...
March 20, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28318970/transcricothyroid-endoscopic-subglottic-surgery-for-posterior-glottic-stenosis-a-case-report
#13
Koji Matsushima, Kentaro Matsuura, Teppei Takeda, Yuko Sasaki, Akira Fukuo, Kota Wada, Yusuke Watanabe
Posterior glottic stenosis (PGS) is a rare but life-threatening condition mostly caused by damage to the interarytenoid mucosa by an endotracheal tube. In surgical treatment of PGS, airway patency is prioritized, and the laryngeal functions involved in swallowing and phonation are considerably sacrificed. In the majority of cases, lateralization of a vocal fold or partial excision of a vocal fold and arytenoid cartilage results in glottal closure insufficiency and deterioration of phonatory function. We present the first report of transcricothyroid endoscopic subglottic surgery to treat a 46-year-old man with PGS who was intubated for 10 days...
March 16, 2017: Journal of Voice: Official Journal of the Voice Foundation
https://www.readbyqxmd.com/read/28315747/multivariate-analysis-of-airway-obstruction-and-reintubation-after-anterior-cervical-surgery-a-retrospective-cohort-study-of-774-patients
#14
REVIEW
Haoxi Li, Yufeng Huang, Bin Shen, Zhaoyu Ba, Desheng Wu
STUDY DESIGN: A retrospective study. PURPOSE: To explore the risk factors for reintubation after airway obstruction following anterior cervical surgery. STUDY BACKGROUND: Anterior cervical surgery is an effective surgical therapy for cervical spine disorders. As the anterior approach is adopted more frequently, some rare postoperative complications come under the spotlight, among which, airway obstruction is extremely detrimental. However, the risk factors and the pathogenesis of the airway obstruction still remain unknown...
March 16, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28298794/anesthetic-implications-in-a-child-with-crouzon-syndrome
#15
Ajeet Kumar, Nitika Goel, Chandni Sinha, Abhishek Singh
Crouzon syndrome (CS) is an autosomal dominant genetic disorder characterized by craniofacial dysostosis. Premature fusion of skull base leads to midfacial hypoplasia, shallow orbit, mandibular prognathism, overcrowding of upper teeth, high-arched palate, and upper airway obstruction. It is important for anesthesiologists managing such patients to recognize and avoid potential airway complications. Here, we present a case of a 10-year-old child with CS posted for ptosis correction surgery. Use of peripheral nerve blocks to cut down opioid requirement, inhalational induction, and maintenance are key aspects in successful management of such cases...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298784/ventilation-of-nonparalyzed-patients-under-anesthesia-with-laryngeal-mask-airway-comparison-of-three-modes-of-ventilation-volume-controlled-ventilation-pressure-controlled-ventilation-and-pressure-controlled-ventilation-volume-guarantee
#16
Maroun Badwi Ghabach, Elie M El Hajj, Rouba D El Dib, Jeanette M Rkaiby, May S Matta, May R Helou
BACKGROUND: Pressure controlled ventilation (PCV) is the preferable mode of ventilation of nonparalyzed patients undergoing anesthesia with laryngeal mask airway (LMA) as compared to volume controlled ventilation (VCV) and spontaneously breathing patient. In this study, we compared the PC-volume guarantee (PC-VG) mode of ventilation with VCV and PCV modes. MATERIALS AND METHODS: A total of 30 patients, American Society of Anesthesiologists (ASA) physical status Classes I and II, scheduled for elective surgery under general anesthesia with a classic LMA were ventilated, subsequently, with the three modes of ventilation: VCV, PCV, and PC-VG for 10 min each mode...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298751/comparative-study-of-two-laryngeal-mask-airways-proseal-laryngeal-mask-airway-and-supreme-laryngeal-mask-airway-in-anesthetized-paralyzed-adults-undergoing-elective-surgery
#17
Ravneet Kaur Gill, Abhijit Tarat, Debagopal Pathak, Suneeta Dutta
CONTEXT: Supraglottic airway devices can act as an alternative to endotracheal intubation in both normal and difficult airway. LMA Proseal (P-LMA) and LMA Supreme (S-LMA) alongwith acting as effective ventilating device, provide port for gastric drainage. AIM: The objective of this study was to compare the two devices for effective ventilation and complications. SETTING AND DESIGN: A prospective, randomized, single-blinded study was conducted in a tertiary care teaching hospital...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28294946/continuing-the-original-stanford-sleep-surgery-protocol-from-upper-airway-reconstruction-to-upper-airway-stimulation-our-first-successful-case
#18
Stanley Yung Liu, Robert Wayne Riley
In 1993, a surgical protocol for dynamic upper airway reconstruction in patients with obstructive sleep apnea (OSA) was published, and it became commonly known as the Stanford phase 1 and 2 sleep surgery protocol. It served as a platform on which research and clinical studies have continued to perfect the surgical care of patients with OSA. However, relapse is inevitable in a chronic condition such as OSA, and a subset of previously cured surgical patients return with complaints of excessive daytime sleepiness...
February 20, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28293700/optimal-age-for-elective-surgery-of-asymptomatic-congenital-pulmonary-airway-malformation-a-meta-analysis
#19
REVIEW
Katrina J Sullivan, Michelle Li, Sarah Haworth, Elizabeth Chernetsova, Carolyn Wayne, Jessica Kapralik, Emily Chan, Ahmed Nasr
Controversy exists on the optimal age for elective resection of asymptomatic congenital pulmonary airway malformation. Current recommendations vary widely, highlighting the overall lack of consensus. A systematic search of Embase, MEDLINE, CINAL, and CENTRAL was conducted in January 2016. Identified citations were screening independently in duplicate and consensus was required for inclusion. Results were pooled using inverse variance fixed effects meta-analysis. Meta-analysis results indicate no statistically significant differences for complications within the 3-month and 6-month age comparison groups [odds ratio (OR) 4...
March 14, 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28293493/technique-to-improve-tracheostomy-speaking-valve-tolerance-after-head-and-neck-free-flap-reconstruction
#20
John T Stranix, Keri M Danziger, Veturia L Dumbrava, Ginger Mars, David L Hirsch, Jamie P Levine
Increased upper airway resistance from postoperative changes after major head and neck surgery may cause elevated transtracheal pressures and result in tracheostomy speaking valve intolerance. This may be particularly true among patients with baseline pulmonary disease. We describe a patient recovering from oral cancer resection and flap reconstruction who demonstrated prolonged ventilator dependence and tracheostomy speaking valve intolerance with abnormal tracheal manometry. We attempted to improve speaking valve tolerance through the adaptation of a valve modification intended to reduce transtracheal pressures...
December 2016: Plastic and Reconstructive Surgery. Global Open
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