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airway reconstruction

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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
#1
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/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
#2
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/28315041/positive-pressure-ventilation-in-a-patient-with-a-right-upper-lobar-bronchocutaneous-fistula-right-upper-bronchus-occlusion-using-the-cuff-of-a-left-sided-double-lumen-endobronchial-tube
#3
Chieko Omori, Hiroaki Toyama, Yusuke Takei, Yutaka Ejima, Masanori Yamauchi
In patients with a bronchocutaneous fistula, positive pressure ventilation leads to air leakage and potential hypoxemia. A male patient with a right upper bronchocutaneous fistula was scheduled for esophageal reconstruction. His preoperative chest computed tomography image revealed aeration in the right middle and lower lobe, a large bulla in the left upper lobe, and pleural effusion and pneumonia in the left lower lobe. Therefore, left one-lung ventilation was considered to result in hypoxemia. Before anesthesia induction, the bronchocutaneous fistula was covered with gauze and film to prevent air leakage...
March 17, 2017: Journal of Anesthesia
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
#4
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/28293493/technique-to-improve-tracheostomy-speaking-valve-tolerance-after-head-and-neck-free-flap-reconstruction
#5
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
https://www.readbyqxmd.com/read/28292706/effect-of-airflow-and-material-models-on-tissue-displacement-for-surgical-planning-of-pharyngeal-airways-in-pediatric-down-syndrome-patients
#6
Dhananjay Radhakrishnan Subramaniam, Goutham Mylavarapu, Robert J Fleck, Raouf S Amin, Sally R Shott, Ephraim J Gutmark
Pharyngeal narrowing in obstructive sleep apnea (OSA) results from flow-induced displacement of soft tissue. The objective of this study is to evaluate the effect of airflow parameters and material model on soft tissue displacement for planning surgical treatment in pediatric patients with OSA and Down syndrome (DS). Anatomically accurate, three-dimensional geometries of the pharynx and supporting tissue were reconstructed for one pediatric OSA patient with DS using magnetic resonance images. Six millimeters of adenoid tissue was virtually removed based on recommendations from the surgeon, to replicate the actual adenoidectomy...
March 8, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28289906/pediatric-chest-ct-at-chest-radiograph-doses-when-is-the-ultralow-dose-chest-ct-clinically-appropriate
#7
Javier E Villanueva-Meyer, David M Naeger, Jesse L Courtier, Michael D Hope, Jack W Lambert, John D MacKenzie, Andrew S Phelps
PURPOSE: Computed tomography (CT) use in emergency departments represents a significant contribution to pediatric patients' exposure to ionizing radiation. Here, we evaluate whether ultralow-dose chest CT can be diagnostically adequate for other diagnoses and whether model-based iterative reconstruction (MBIR) can improve diagnostic adequacy compared to adaptive statistical iterative reconstruction (ASIR) at ultralow doses. METHODS: Twenty children underwent chest CTs: 10 standard-dose reconstructed with ASIR and 10 ultralow-dose reconstructed with ASIR and MBIR...
March 14, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28277335/voice-and-swallowing-outcomes-for-adults-undergoing-reconstructive-surgery-for-laryngotracheal-stenosis
#8
Gemma M Clunie, Andrew J Kinshuck, Gurpreet S Sandhu, Justin W G Roe
PURPOSE OF REVIEW: Adult laryngotracheal stenosis is a rare, multifactorial condition which carries a significant physical and psychosocial burden. Surgical approaches have developed in recent years, however, voice and swallowing function can be affected prior to treatment, in the immediate postoperative phase, and as an ongoing consequence of the condition and surgical intervention. In this study we discuss: the nature of the problem; surgical interventions to address airway disorders; optimal patterns of care to maximize voice and swallowing outcomes...
March 8, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28275475/surgery-and-perioperative-management-for-post-intubation-tracheoesophageal-fistula-case-series-analysis
#9
Francesco Puma, Jacopo Vannucci, Stefano Santoprete, Moira Urbani, Lucio Cagini, Marco Andolfi, Rossella Potenza, Niccolò Daddi
BACKGROUND: Post-intubation tracheoesophageal fistula (PITEF) is an often mistreated, severe condition. This case series reviewed for both the choice and timing of surgical technique and outcome PITEF patients. METHODS: This case series reviewed ten consecutive patients who had undergone esophageal defect repair and airway resection/reconstruction between 2000 and 2014. All cases were examined for patients: general condition, medical history, preparation to surgery, diagnostic work-up, timing of surgery and procedure, fistula size and site, ventilation type, nutrition, post-operative course and complications...
February 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28267299/predicting-the-effect-of-treatment-in-paediatric-osa-by-clinical-examination-and-functional-respiratory-imaging
#10
Monique Slaats, Wim Vos, Cedric Van Holsbeke, Jan De Backer, Dieter Loterman, Wilfried De Backer, An Boudewyns, Stijn Verhulst
OBJECTIVE: The aim of this study was to investigate whether functional respiratory imaging (FRI) or clinical examination could predict treatment outcome for obstructive sleep apnea (OSA) in normal-weight, non-syndromic children. METHODS: Normal weight children diagnosed with OSA by polysomnography were prospectively included. All children got a thorough evaluation and an ultra-low dose computed tomography scan of the upper airway (UA). A 3-D reconstruction was built combined with computational fluid dynamics for FRI...
March 7, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28257487/cone-beam-computed-tomography-evaluation-of-the-maxillofacial-features-of-patients-with-unilateral-temporomandibular-joint-ankylosis-undergoing-condylar-reconstruction-with-an-autogenous-coronoid-process-graft
#11
Li Liu, Jiayang Li, Huanzhong Ji, Nian Zhang, Yiyao Wang, Guangning Zheng, Hu Wang, En Luo
OBJECTIVE: To evaluate the changes in the jaws and the upper airways of unilateral temporomandibular joint ankylosis patients who underwent condylar reconstruction via autogenous coronoid process grafts using cone-beam computed tomography (CBCT). STUDY DESIGN: The 27 included patients underwent CBCT examinations at three stages: T0 (within two weeks before surgery), T1 (two weeks after surgery), and T2 (an average of 13 months after surgery). Forty items related to the maxillofacial hard tissues and the upper airway collected at the three times and the coronoid process graft volumes after surgery were compared...
2017: PloS One
https://www.readbyqxmd.com/read/28228614/current-solutions-for-long-segment-tracheal-reconstruction
#12
Ahmed A Abouarab, Hany H Elsayed, Hussein Elkhayat, Ahmed Mostafa, David C Cleveland, Ahmed El Nori
This article is a continuation of previous reviews about the appropriate method for long-segment tracheal reconstruction. We attempted to cover the most recent, successful and promising results of the different solutions for reconstruction that are rather innovative and suitable for imminent clinical application. Latest efforts to minimize the limitations associated with each method have been covered as well. In summary, autologous and allogenic tissue reconstruction of the trachea have been successful methods for reconstruction experimentally and clinically...
February 23, 2017: Annals of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28226372/reconstruction-of-the-intranasal-lining
#13
Joseph Zenga, John J Chi
Reconstruction of full-thickness nasal defects has been the subject of surgical inquiry and innovation for over 2,000 years. The replacement of the internal nasal lining is a critical feature of complex nasal reconstruction. Successful reconstruction can prevent cicatricial contraction, external distortion, and internal stenosis. An array of reconstructive possibilities has been described, including cutaneous, mucosal, and fascial options. The challenge to the reconstructive surgeon is to select the repair that maximizes internal stability, while maintaining a patent nasal airway, minimizing morbidity, and meeting patient expectations...
February 2017: Facial Plastic Surgery: FPS
https://www.readbyqxmd.com/read/28213879/arthrogryposis-multiplex-congenita-classification-diagnosis-perioperative-care-and-anesthesia
#14
REVIEW
Lulu Ma, Xuerong Yu
Arthrogryposis multiplex congenita (AMC) is a rare disorder characterized by non-progressive, multiple contractures. In addition to affected extremities, patients may also present microstomia, decreased temporomandibular joint mobility. Although the etiology of AMC is unclear, any factor that decreases fetal movement is responsible for AMC. Thus, accurate diagnosis and classification are crucial to the appropriate treatment of AMC. The development of ultrasound technology has enabled prenatal diagnosis. Very early treatment is favorable, and multidisciplinary treatment is necessary to improve the function of AMC patients...
February 17, 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28203403/clinic-application-of-tissue-engineered-bronchus-for-lung-cancer-treatment
#15
Qiang Tan, Ruijun Liu, Xiaoke Chen, Jingxiang Wu, Yinggen Pan, Shun Lu, Walter Weder, Qingquan Luo
BACKGROUND: Delayed revascularization process and substitute infection remain to be key challenges in tissue engineered (TE) airway reconstruction. We propose an "in-vivo bioreactor" design, defined as an implanted TE substitutes perfused with an intra-scaffold medium flow created by an extracorporeal portable pump system for in situ organ regeneration. The perfusate keeps pre-seeded cells alive before revascularization. Meanwhile the antibiotic inside the perfusate controls topical infection...
January 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28197883/central-airway-pathology-clinic-features-ct-findings-with-pathologic-and-virtual-endoscopy-correlation
#16
REVIEW
Daniel Barnes, José Gutiérrez Chacoff, Mariana Benegas, Rosario J Perea, Teresa M de Caralt, José Ramirez, Ivan Vollmer, Marcelo Sanchez
OBJECTIVES: To describe the imaging features of the central airway pathology, correlating the findings with those in pathology and virtual endoscopy. To propose a schematic and practical approach to reach diagnoses, placing strong emphasis on multidetector computed tomography (MDCT) findings. METHODS: We reviewed our thoracic pathology database and the central airway pathology-related literature. Best cases were selected to illustrate the main features of each disease...
February 15, 2017: Insights Into Imaging
https://www.readbyqxmd.com/read/28187782/sputum-dna-sequencing-in-cystic-fibrosis-non-invasive-access-to-the-lung-microbiome-and-to-pathogen-details
#17
Rounak Feigelman, Christian R Kahlert, Florent Baty, Frank Rassouli, Rebekka L Kleiner, Philipp Kohler, Martin H Brutsche, Christian von Mering
BACKGROUND: Cystic fibrosis (CF) is a life-threatening genetic disorder, characterized by chronic microbial lung infections due to abnormally viscous mucus secretions within airways. The clinical management of CF typically involves regular respiratory-tract cultures in order to identify pathogens and to guide treatment. However, culture-based methods can miss atypical or slow-growing microbes. Furthermore, the isolated microbes are often not classified at the strain level due to limited taxonomic resolution...
February 10, 2017: Microbiome
https://www.readbyqxmd.com/read/28185301/feasibility-of-through-time-spiral-generalized-autocalibrating-partial-parallel-acquisition-for-low-latency-accelerated-real-time-mri-of-speech
#18
Sajan Goud Lingala, Yinghua Zhu, Yongwan Lim, Asterios Toutios, Yunhua Ji, Wei-Ching Lo, Nicole Seiberlich, Shrikanth Narayanan, Krishna S Nayak
PURPOSE: To evaluate the feasibility of through-time spiral generalized autocalibrating partial parallel acquisition (GRAPPA) for low-latency accelerated real-time MRI of speech. METHODS: Through-time spiral GRAPPA (spiral GRAPPA), a fast linear reconstruction method, is applied to spiral (k-t) data acquired from an eight-channel custom upper-airway coil. Fully sampled data were retrospectively down-sampled to evaluate spiral GRAPPA at undersampling factors R = 2 to 6...
February 10, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/28167015/external-airway-splint-to-treat-tracheomalacia-following-laryngotracheal-reconstruction
#19
Wayne D Hsueh, Lee P Smith
This observation reports the use of an external airway splint to treat tracheomalacia in a pediatric patient. The patient underwent a double stage laryngotracheal reconstruction however was unable to be decannulated due to severe tracheomalacia. Our purpose is to further support the use of external splinting in the treatment of tracheomalacia in a unique case involving isolated nighttime airway obstruction following laryngotracheal reconstruction.
March 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28144465/incidence-rate-of-post-intubation-tracheal-stenosis-in-patients-admitted-to-five-intensive-care-units-in-iran
#20
Roya Farzanegan, Behrooz Farzanegan, Mahdi Zangi, Majid Golestani Eraghi, Shahram Noorbakhsh, Neda Doozandeh Tabarestani, Mohammad Behgam Shadmehr
BACKGROUND: Tracheal stenosis is one of the worst complications associated with endotracheal intubation and it is the most common reason for reconstructive airway surgeries. Due to various local risk factors, the incidence rate of tracheal stenosis may vary in different countries. In order to estimate the incidence rate of post-intubation tracheal stenosis (PITS) in patients admitted to an intensive care unit (ICU), a follow-up study was planned. As there was no similar methodological model in the literature, a feasibility step was also designed to examine the whole project and to enhance the follow-up rate...
September 2016: Iranian Red Crescent Medical Journal
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