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fibreoptic laryngoscopy

Elangovan Muthukumar, Lenin Babu Elakkumanan, Prasanna Udupi Bidkar, Mvs Satyaprakash, Sandeep Kumar Mishra
BACKGROUND AND AIMS: The difficulty during flexible fiber-optic bronchoscopy (FOB) guided tracheal intubation could be because of inability in visualising glottis, advancing and railroading of endotracheal tube. Several methods are available for visualising glottis, but none is ideal. Hence, this randomised controlled study was designed to evaluate the simple pre-determined length insertion technique (SPLIT) during oral FOB. METHODS: Fifty-eight patients were randomised into Group C and Group P...
January 2017: Indian Journal of Anaesthesia
Pavel Michálek, Will Donaldson, Francis McAleavey, Alexander Abraham, Rachel J Mathers, Claire Telford
Fibreoptic intubation through a supraglottic airway is an alternative plan for airway management in difficult or failed laryngoscopy. The aim of this study was to compare three supraglottic airways as conduits in patients with at least one predictor for difficult laryngoscopy. The i-gel was compared with the single-use intubating laryngeal mask airway (sILMA) and CTrach laryngeal mask in 120 adult patients scheduled for elective surgeries under general anaesthesia using a prospective, randomized and single-blinded design...
2016: Prague Medical Report
Sharon R Lewis, Andrew R Butler, Joshua Parker, Tim M Cook, Andrew F Smith
BACKGROUND: Successful tracheal intubation during general anaesthesia traditionally requires a line of sight to the larynx attained by positioning the head and neck and using a laryngoscope to retract the tongue and soft tissues of the floor of the mouth. Difficulties with intubation commonly arise, and alternative laryngoscopes that use digital and/or fibreoptic technology have been designed to improve visibility when airway difficulty is predicted or encountered. Among these devices, a rigid videolaryngoscope (VLS) uses a blade to retract the soft tissues and transmits a lighted video image to a screen...
November 15, 2016: Cochrane Database of Systematic Reviews
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
M C Rajesh, K Suvarna, S Indu, Taznim Mohammed, A Krishnadas, Priyanka Pavithran
BACKGROUND AND AIMS: Difficult airway (DA) management depends on both training and actual usage of the various approaches in the event of difficulty. The aim of the study was to assess how well the anaesthesiologists are equipped to deal with DA situations. The current practice preference of DA management was also assessed. METHODS: A questionnaire was distributed in a continuing medical education (CME) programme dedicated to DA and responses were noted and analysed, using Statistical Package for Social Sciences (SPSS) version 18...
December 2015: Indian Journal of Anaesthesia
Ali Sanei-Moghaddam, Amin Sanei-Moghaddam, Sara Kahrobaei
INTRODUCTION: Fishbone is the most common foreign body found in the oropharynx. Conventionally patients with suspected fishbone in the throat would have mirror laryngoscopy followed by lateral soft tissue X-ray to look for the fishbone or observe impacts caused by the fishbone i.e. soft tissue swelling or air in upper esophagus. However, the most common site of fishbone impact is the suprahyoid area, which contains high soft tissue and bony density. This makes X-rays less reliable, especially because not all fish have radio-opaque bones...
November 2015: Iranian Journal of Otorhinolaryngology
M C Lee, K Y Tseng, Y C Shen, C H Lin, C W Hsu, H J Hsu, I C Lu, K I Cheng
In patients with limited mouth opening, traditional laryngoscopy and videolaryngoscopes are not useful when performing nasotracheal intubation. Eighty patients with limited mouth opening who required nasotracheal intubation were randomly assigned to either fibreoptic intubation (n = 40) or the Trachway(®) (n = 40). Using the modified nasal intubation difficulty scale, 22 (55%) patients who received fibreoptic intubation were categorised as no difficulty compared with 40 (100%) patients in the Trachway group (p < 0...
January 2016: Anaesthesia
Sarah Siaki Loterh, Vinod Prabhu, Ciaran O'Brien
A 58-year-old man was referred to ear, nose and throat (ENT) with an 8-week history of painless right submandibular swelling with no history of weight loss, dysphagia or difficulty with mastication. On examination, there was enlargement of the right submandibular gland, which was diffuse, nodular and firm; but no calcification of the duct or cervical lymphadenopathy. ENT examination including fibreoptic laryngoscopy was normal. Fine-needle aspiration of the lump was inconclusive. Neck ultrasound scan showed a well-defined 3 cm × 3...
August 13, 2015: BMJ Case Reports
Cengiz Karsli
PURPOSE: This module will give the anesthesia provider the information needed to identify, prepare for, and clinically manage a difficult airway in children. PRINCIPAL FINDINGS: Although the incidence of difficult intubation is lower in children than in adults, the anesthesiologist who even occasionally cares for children must be prepared to manage the pediatric patient with a known or suspected difficult airway. Many of the predictors of a difficult intubation that are useful in adults do not apply to children...
September 2015: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
P Lennon, E Lang, T O'Dwyer
We report the first case of an anterior laryngeal web post gunshot wound in the modern literature. A 27 year-old man suffered a close range shotgun injury to his neck. He presented with stridor and a large open neck wound. Emergency tracheostomy was required. A postoperative fibreoptic laryngoscopy revealed anterior glottic web formation. This case report highlights the difficulties in managing acquired anterior laryngeal webs and reviews the only other case in the in the literature from 1915.
June 2015: Irish Medical Journal
S J Chen, N Ji, Y-x Chen, S-j Zhao, J-r Xiao, X-m Lin, X-x Han
Cervical necrotising fasciitis is a progressive deep infection of the neck associated with high mortality, and skillful management of the airway is critical for operations under general anaesthesia. Tracheostomy under local anaesthesia has been considered the gold standard of airway management in patients with deep neck infections, but it may be difficult or impossible in advanced cases. We report here our experience over 6 years (January 2008 and December 2013) during which a total of 15 patients was diagnosed with cervical necrotising fasciitis...
September 2015: British Journal of Oral & Maxillofacial Surgery
Margaret Coffey, Neil Tolley
PURPOSE OF REVIEW: This article examines the emergence of dysphagia as an area for rehabilitation postlaryngectomy. The use of dysphagia evaluation tools postlaryngectomy is described and the causes of dysphagia discussed. RECENT FINDINGS: Although the risk of aspiration postlaryngectomy is low, significant symptoms of dysphagia can exist in this patient population. A comprehensive evaluation is the cornerstone for both the identification and management of postlaryngectomy dysphagia...
June 2015: Current Opinion in Otolaryngology & Head and Neck Surgery
(no author information available yet)
A clinical case reported to SENSAR is presented ( A patient came to the operating room for surgery for parathyroidectomy. She had several predictors of difficult airway management, including a story of difficulties in previous intubations in other hospitals, as the patient reported. Therefore, after evaluation in preoperative consultation, fibreoptic bronchoscopy intubation was recommended. The day of surgery after induction of general anesthesia direct laryngoscopy was performed, without recognizing any glottic structure (Cormack-Lehane grade iv)...
June 2015: Revista Española de Anestesiología y Reanimación
A Kramer, D Müller, R Pförtner, C Mohr, H Groeben
Numerous indirect laryngoscopes have been introduced into clinical practice and their use for tracheal intubation under local anaesthesia has been described. However, a study comparing indirect laryngoscopic vs fibreoptic intubation under local anaesthesia and sedation appears lacking. Therefore, we evaluated both techniques in 100 patients with an anticipated difficult nasal intubation time for intubation the primary outcome. We also assessed success rate, glottic view, Ramsey score, and patients' and anaesthetists' satisfaction...
April 2015: Anaesthesia
Rachel L Gill, Audrey S Y Jeffrey, Alistair F McNarry, Geoffrey H C Liew
Fibreoptic intubation, high frequency jet ventilation, and videolaryngoscopy form part of the Royal College of Anaesthetists compulsory higher airway training module. Curriculum delivery requires equipment availability and competent trainers. We sought to establish (1) availability of advanced airway equipment in UK hospitals (Survey I) and (2) if those interested in airway management (Difficult Airway Society (DAS) members) had access to videolaryngoscopes, their basic skill levels and teaching competence with these devices and if they believed that videolaryngoscopy was replacing conventional or fibreoptic laryngoscopy (Survey II)...
2015: Anesthesiology Research and Practice
Karim Kassam, Tasmin Rope
The routine way to access the uncomplicated airway is via direct laryngoscopy. When this is not possible, there are a number of other techniques to help visualization such as the video laryngoscopy. These require a degree of mouth opening. With almost complete trismus, the clinician should resort to awake fibreoptic nasal intubation to secure the airway.
February 2014: Clinical Case Reports
N Gilfillan, C M Ball, P S Myles, J Serpell, W R Johnson, E Paul
Patients undergoing thyroid surgery with retrosternal goitre may raise concerns for the anaesthetist, especially airway management. We reviewed a multicentre prospective thyroid surgery database and extracted data for those patients with retrosternal goitre. Additionally, we reviewed the anaesthetic charts of patients with retrosternal goitre at our institution to identify the anaesthetic induction technique and airway management. Of 4572 patients in the database, 919 (20%) had a retrosternal goitre. Two cases of early postoperative tracheomalacia were reported, one in the retrosternal group...
November 2014: Anaesthesia and Intensive Care
Jitin N Trivedi
Video laryngoscope (VL) provides excellent laryngeal exposure in patients when anaesthesiologists encounter difficulty with direct laryngoscopy. Videolaryngoscopy, like flexible fibreoptic laryngoscopy demands a certain level of training by practitioners to become dexterous at successful intubation with a given instrument. Due to their cost factors, VLs are not easily available for training purposes to all the students, paramedics and emergency medical services providers in developing countries. We tried to develop a cost-effective instrument, which can work analogous to various available VLs...
July 2014: Indian Journal of Anaesthesia
A Iu Zaĭtsev, V A Svetlov, K V Dubrovin, B A Kozhevnikov, N Iu Beginina, O A Velichko
Anatomic deformations can cause complications during the tracheal intubation in the maxillofacial surgery and otorhinolaryngology. The article deals with a clinical case of tracheal intubation in a patient with the anatomic deformations. Successful tracheal intubation was performed in the patient in conditions of conscious and spontaneous breathing under the local anaesthesia, when a fibreoptic bronchoscopy was not available. Furthermore the article briefly discusses techniques of the tracheal intubation in conditions of anatomic deformations of the upper airways and methods of local anaesthesia for the guttur and hypopharynx...
January 2014: Anesteziologiia i Reanimatologiia
Huw A S Jones, Joseph G Manjaly, Ann Sandison, John S Almeyda, Gurpreet S Sandhu
A 29-year old man of Eritrean origin presented with acute stridor and respiratory distress on a background 1 year history of progressive breathing difficulty and worsening inspiratory stridor. Fibreoptic laryngoscopy revealed an indeterminate swelling of the left vocal fold leaving no clear airway visible. The patient refused surgical tracheostomy. Microlaryngoscopy revealed a hard, calcified mass arising from the left cord preventing intubation. Histological analysis after excision revealed features consistent with heterotopic ossification...
March 2015: Head and Neck Pathology
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