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https://www.readbyqxmd.com/read/27871527/two-lost-airways-and-one-unexpected-problem-undiagnosed-tracheal-stenosis-in-a-morbidly-obese-patient
#1
Miguel A Cobas, Nicole D Martin, Heather B Barkin
Anesthetic care of the morbidly obese is complex due to anatomic and physiologic alterations. Airway management in particular can be challenging. High body mass index is predictive of difficult ventilation and possibly difficult intubation. Other airway anomalies, such as tracheal stenosis, add to the complexity of airway management. Tracheal stenosis, a form of central airway obstruction, may be challenging to diagnose, especially in the obese. Comorbidities can mask the diagnosis and routine imaging may fail to identify the pathology...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27642166/critical-airway-obstruction-in-apparently-asymptomatic-neonates
#2
Benedict Griffiths, Geraint Lee, Andrew Durward
Central airway obstruction (trachea and major bronchi) in neonates can be caused by malacia, stenosis, or compression by masses or vascular structures. These abnormalities may be present in the neonatal period but are typically not detected until at least 6 months of age. We present four patients (1.6-4.1 kg, 32-41 weeks gestation) with nonspecific symptoms (e.g., poor weight gain, difficulty weaning from CPAP) who underwent bronchoscopy in the neonatal period. Critical airway obstruction (>90%) was identified in these relatively asymptomatic neonates...
September 18, 2016: Pediatric Pulmonology
https://www.readbyqxmd.com/read/27523896/-the-effect-of-locally-injected-betamethasone-on-collagen-deposition-in-benign-central-airway-stenosis
#3
Y F Chen, D F Xu, Y M Zeng, H P Zhang, D Y Yang, X Y Chen, J Zhang
OBJECTIVE: To assess the effects of locally injected betamethasone on cicatricial tissue hyperplasia in patients with benign central airway stenosis. METHODS: A prospective study was conducted with 2 treatment modalities: conventional interventional(CI)therapy, and CI combined with local betamethasone injection(LBI). The average optical density value of TGF-β1 and collagen density in the local airway tissues were compared before therapy and 7 d after the CI treatment and the LBI treatment, respectively...
August 2016: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/27434479/occult-central-venous-stenosis-leading-to-airway-obstruction-after-subtotal-parathyroidectomy
#4
Duncan A Meiklejohn, Dylan K Chan, M Lauren Lalakea
Subtotal parathyroidectomy may be indicated in patients with chronic renal failure and tertiary hyperparathyroidism, a population at increased risk for central venous stenosis (CVS) due to repeated vascular access. Here we report a case of complete upper airway obstruction precipitated by subtotal parathyroidectomy with ligation of anterior jugular vein collaterals in a patient with occult CVS. This case demonstrates a previously unreported risk of anterior neck surgery in patients with chronic renal failure...
July 2016: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/27410718/safety-of-hyperbaric-oxygen-therapy-for-management-of-central-airway-stenosis-after-lung-transplant
#5
Kamran Mahmood, Bryan D Kraft, Kristen Glisinski, Matthew G Hartwig, Nicole P Harlan, Claude A Piantadosi, Scott L Shofer
BACKGROUND: Central airway stenosis (CAS) is common after lung transplantation and causes significant post-transplant morbidity. It is often preceded by extensive airway necrosis, related to airway ischemia. Hyperbaric oxygen therapy (HBOT) is useful for ischemic grafts and may reduce the development of CAS. METHODS: The purpose of this study was to determine whether HBOT could be safely administered to lung transplant patients with extensive necrotic airway plaques...
September 2016: Clinical Transplantation
https://www.readbyqxmd.com/read/27114241/anterograde-catheterization-of-severe-tracheal-stenosis-as-a-difficult-airway-management-option-followed-by-emergent-tracheostomy-a-case-report
#6
Behrad Ziapour
BACKGROUND: To describe the successful management of a patient with severe dyspnea and hypoxia due to tracheal stenosis by the application of a novel bridging technique-anterograde tracheal catheterization-prior to tracheostomy. CASE PRESENTATION: A 55-year-old woman entered the Emergency Department with severe dyspnea, tachypnea, and stridor and a pulse oximetry reading of 60 %. An attempt at intubation failed because of tracheal stenosis discovered 3-4 cm distal to the vocal cords, which had been formed as a complication of intubation the previous month...
2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/26968044/congenital-nasal-pyriform-aperture-stenosis-elaboration-of-a-management-algorithm-from-25-years-of-experience
#7
E Moreddu, C Le Treut-Gay, J M Triglia, R Nicollas
INTRODUCTION: Congenital nasal pyriform aperture stenosis (CNPAS) is a rare disease presenting with neonatal respiratory distress, often associated with other anomalies. MATERIALS AND METHODS: This study reports the clinical and radiological characteristics of the patients managed in The Department of Pediatric Otolaryngology Head and Neck Surgery of La Timone Children's Hospital in Marseille between 1988 and 2014. Pyriform aperture (PA) widths were measured on CT-scans, obtained by using hand calipers at the largest portion of the PA in a plan parallel to the Francfort plan...
April 2016: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/26918052/drug-eluting-stents-for-malignant-airway-obstruction-a-critical-review-of-the-literature
#8
REVIEW
Wolfgang Hohenforst-Schmidt, Paul Zarogoulidis, Georgia Pitsiou, Bernd Linsmeier, Drosos Tsavlis, Ioannis Kioumis, Eleni Papadaki, Lutz Freitag, Theodora Tsiouda, J Francis Turner, Robert Browning, Michael Simoff, Nikolaos Sachpekidis, Kosmas Tsakiridis, Bojan Zaric, Lonny Yarmus, Sofia Baka, Grigoris Stratakos, Harald Rittger
Lung cancer being the most prevalent malignancy in men and the 3(rd) most frequent in women is still associated with dismal prognosis due to advanced disease at the time of diagnosis. Novel targeted therapies are already on the market and several others are under investigation. However non-specific cytotoxic agents still remain the cornerstone of treatment for many patients. Central airways stenosis or obstruction may often complicate and decrease quality of life and survival of these patients. Interventional pulmonology modalities (mainly debulking and stent placement) can alleviate symptoms related to airways stenosis and improve the quality of life of patients...
2016: Journal of Cancer
https://www.readbyqxmd.com/read/26674912/management-of-the-airway-in-apert-syndrome
#9
Carol Xie, Sujata De, Andrew Selby
The management of the airway in Apert syndrome is complex and multidisciplinary. This rare syndrome, occurring in up to approximately 1 in 65,000 live births, results in airway compromise at various anatomic levels, in addition to abnormal central respiratory drive. Obstructive apneas arise because of decreased airway caliber, which may occur in the form of congenital bony nasal stenosis, choanal atresia, a deviated nasal septum, a narrowed nasopharynx, a thick long soft palate, lateral palatal swellings, and a tracheal cartilage sleeve...
January 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/26606433/a-review-and-update-on-the-current-and-emerging-clinical-trials-for-the-acute-management-of-cervical-spine-and-spinal-cord-injuries-part-iii
#10
John K Yue, Pavan S Upadhyayula, Andrew K Chan, Ethan A Winkler, John F Burke, William J Readdy, Sourabh Sharma, Hansen Deng, Sanjay S Dhall
INTRODUCTION: Spinal cord injury (SCI) is a debilitating disease with an average annual incidence of 29.5 persons per million worldwide. Hence, it is critical to refine and bolster evidence to inform standards of care and improve outcomes. EVIDENCE ACQUISITION: In 2013 the American Association of Neurological Surgeons and the Congress of Neurological Surgeons released updated management guidelines for acute cervical spine injuries and SCI; here, we explore cervical SCI treatment trials since the 2013 publication...
December 2016: Journal of Neurosurgical Sciences
https://www.readbyqxmd.com/read/26520064/the-use-of-a-prefabricated-radial-forearm-free-flap-for-closure-of-a-large-tracheocutaneous-fistula-a-case-report-and-review-of-the-literature
#11
REVIEW
Allison K Royer, Mark C Royer, Jonathan Y Ting, Edward C Weisberger, Michael G Moore
INTRODUCTION: The closure of complex tracheocutaneous fistulae is a surgical challenge. We describe a staged approach for management of a patient with a large tracheocutaneous fistula in the setting of prior surgery and local radiation therapy. CASE PRESENTATION: A 66-year-old Caucasian man who had undergone prior surgery and radiation therapy to the lower neck presented to our hospital for treatment of a large tracheocutaneous fistula that had developed with an adjacent area of tracheal stenosis...
2015: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/26512656/photodynamic-therapy-pdt-with-chemotherapy-for-advanced-lung-cancer-with-airway-stenosis
#12
Masakazu Kimura, Kuniharu Miyajima, Masakazu Kojika, Takafumi Kono, Harubumi Kato
Intractable advanced lung cancer can be treated palliatively with photodynamic therapy (PDT) combined with chemotherapy to remove central and peripheral (lobar or segmental bronchi) bronchial stenosis and obstruction. We present data for 12 (eight men, four women) consecutive patients with 13 advanced non-small cell lung carcinomas in whom curative operations were contraindicated, who underwent PDT combined with chemotherapy for local control of the intraluminal lesions. The mean age was 73.3 years (range, 58-80 years), and the stages of cancer were IIA-IV...
2015: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/26488115/hypoxic-gene-expression-of-donor-bronchi-linked-to-airway-complications-after-lung-transplantation
#13
Bryan D Kraft, Hagir B Suliman, Eli C Colman, Kamran Mahmood, Matthew G Hartwig, Claude A Piantadosi, Scott L Shofer
RATIONALE: Central airway stenosis (CAS) after lung transplantation has been attributed in part to chronic airway ischemia; however, little is known about the time course or significance of large airway hypoxia early after transplantation. OBJECTIVES: To evaluate large airway oxygenation and hypoxic gene expression during the first month after lung transplantation and their relation to airway complications. METHODS: Subjects who underwent lung transplantation underwent endobronchial tissue oximetry of native and donor bronchi at 0, 3, and 30 days after transplantation (n = 11) and/or endobronchial biopsies (n = 14) at 30 days for real-time polymerase chain reaction of hypoxia-inducible genes...
March 1, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/26290035/-history-and-progress-of-trachea-transplantation-in-mexico
#14
Rubén E Garrido-Cardona, Edna Rico-Escobar, Elisa Barrera-Ramírez
Central airway obstruction and particularly tracheal stenosis is a clinical problem where definite resolution is a tracheal resection, evaluating the magnitude, length, and ventilatory compromise of patient. The resectable fragment is limited to 30% of the total length in children, or 6 cm in adults with terminal end anastomosis. The replacement of longer sections through allogeneic transplantation has been disappointing due to the unfeasibility of the organ, rejection of the graft, and the highly complicated surgical procedure...
July 2015: Gaceta Médica de México
https://www.readbyqxmd.com/read/26072007/-treatment-of-malignant-central-airways-obstruction-by-rigid-bronchoscopy
#15
B Huret, T Perez, X Dhalluin, F Dewavrin, P-P Ramon, C Fournier
INTRODUCTION: Endobronchial resection is now the standard treatment for tracheobronchial narrowing due to malignancy. The clinical and functional respiratory improvement has been evaluated previously but only in heterogeneous population. METHODS: Between February 2009 and February 2011, we conducted a prospective single centre study at the University Hospital of Lille. Twenty-five patients with malignant tracheobronchial stenosis received a clinical and functional respiratory evaluation before and after a rigid bronchoscopy procedure to reduce the obstruction followed where appropriate by placement of an endobronchial stent...
May 2015: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/25504056/computed-tomography-findings-of-tracheobronchial-system-diseases-a-pictorial-essay
#16
REVIEW
Turker Acar, Selen Bayraktaroglu, Naim Ceylan, Recep Savas
The diseases affecting the trachea and main bronchi can be categorized into congenital or acquired abnormalities and also into focal or diffuse diseases. Major congenital bronchial abnormalities cover accessory cardiac bronchus and tracheal bronchus. Tracheobronchial strictures, such as post-intubation and post-infectious stenosis and tracheobronchial neoplasms are regarded as focal diseases, whereas tracheobronchomegaly, relapsing polychondritis, tracheobronchopathia osteochondroplastica, amyloidosis, granulomatosis with polyangiitis, tracheobronchomalacia, saber-sheath trachea and tracheobronchitis associated with ulcerative colitis are examples of diffuse diseases...
February 2015: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/25429400/sleep-apnea-and-asymptomatic-carotid-stenosis-a-complex-interaction
#17
Jens Ehrhardt, Matthias Schwab, Sigrid Finn, Albrecht Guenther, Torsten Schultze, Otto W Witte, Sven Rupprecht
BACKGROUND: Carotid arteriosclerosis and sleep apnea are considered as independent risk factors for stroke. Whether sleep apnea mediates severity of carotid stenosis remains unclear. Sleep apnea comprises two pathophysiologic conditions: OSA and central sleep apnea (CSA). Although OSA results from upper airway occlusion, CSA reflects enhanced ventilatory drive mainly due to carotid chemoreceptor dysfunction. METHODS: Ninety-six patients with asymptomatic extracranial carotid stenosis of ≥ 50% underwent polysomnography to (1) determine prevalence and severity of sleep apnea for different degrees of carotid stenosis and (2) analyze associations between OSA and CSA, carotid stenosis severity, and other arteriosclerotic risk factors...
April 2015: Chest
https://www.readbyqxmd.com/read/25279189/placement-of-self-expandable-metallic-stents-for-tracheal-stenosis-secondary-to-thyroid-cancer
#18
Rena Yuasa, Yoshinobu Hata, Hajime Otsuka, Takashi Makino, Satoshi Koezuka, Fumitomo Sato, Kazuyoshi Tamaki, Shuichi Sasamoto, Keigo Takagi, Akira Iyoda
The indications and suitable approaches for treating upper airway obstruction secondary to thyroid cancer are controversial. Patients with thyroid cancer generally have a good prognosis, but airway stenosis and vocal cord paralysis are not uncommon. Subglottic airway stenting may be challenging, due to stent migration, granulation tissue formation and supraglottic stenosis. In this study, we evaluated the application of covered self-expandable metallic stents to relieve upper airway obstruction. This was a retrospective study of 5 patients with airway stenosis due to thyroid cancer treated in 2009 and 2010...
November 2014: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/25191414/balloon-bronchoplasty-case-series
#19
Hamid Reza Jabbardarjani, Arda Kiani, Negar Sheikhi, Azadeh Arab, Mohammad Reza Masjedi
Central airway stenosis may be a manifestation of benign or malignant lesions and can be a life threatening condition. There are different surgical and endoscopic modalities for treatment of these lesions. Balloon bronchoscopy is an interventional pulmonologic modality and can be performed under direct vision or fluoroscopic guidance. This technique can be used along with other interventional modalities for treatment of patients with tracheal stenosis. In this study we report balloon bronchoscopy as an interventional modality in a series of patients with tracheal stenosis and assess the outcome...
2012: Tanaffos
https://www.readbyqxmd.com/read/25190454/postmortem-magnetic-resonance-appearances-of-congenital-high-airway-obstruction-syndrome
#20
Owen J Arthurs, Lyn S Chitty, Lydia Judge-Kronis, Neil J Sebire
BACKGROUND: Congenital high airway obstruction syndrome (CHAOS) is a rare life-threatening condition characterised by complete or near-complete developmental obstruction of the foetal airway. Although antenatal imaging findings have been described, the postmortem MRI findings have not been reported. OBJECTIVE: To present postmortem MRI features of CHAOS. MATERIALS AND METHODS: We retrospectively reviewed our hospital pathology and imaging databases for cases of CHAOS over a 2-year period...
April 2015: Pediatric Radiology
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