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airway reconstruction

Takeshi Konuma, Syunsuke Sakamoto, Syuhei Toba, Ayano Futsuki, Naoki Yamamoto, Shinji Kanemitsu, Hideto Shimpo
OBJECTIVES: Postoperative left pulmonary artery (PA) or bronchus compression occasionally follows narrowing of the retroaortic space after the Norwood procedure. We examined hypoplastic left heart syndrome (HLHS)-specific anatomical malformations and hypothesized that a long main pulmonary arterial trunk might contribute to a larger retroaortic space. In this study, we introduced a modified Norwood procedure [pulmonary artery trunk-saving method (PATS)] and evaluated the results. METHODS: HLHS-specific anatomical malformations were examined using computed tomographic data from 23 consecutive patients who underwent bilateral pulmonary banding...
March 12, 2018: Interactive Cardiovascular and Thoracic Surgery
Janki Shah, Jonathon O Russell, Tina Waters, Alan H Kominsky, Douglas Trask
OBJECTIVES: Hypoglossal nerve stimulation (HNS) therapy is an emerging surgical treatment for select patients with obstructive sleep apnea (OSA). This study aims to compare outcomes in patients with moderate to severe OSA who underwent HNS surgery (Inspire Medical Systems) and those who underwent traditional airway reconstructive surgery, specifically uvulopalatopharyngoplasty (UPPP). METHODS: Patients who underwent HNS implantation (n = 20), all with moderate to severe OSA, inability to adhere to positive pressure therapy, and compliant with previously published inclusion criteria, were compared to a historical cohort that were intolerant of CPAP with similar inclusion criteria who all underwent UPPP (n = 20) with some also undergoing additional procedures such as septoplasty/turbinate reduction...
March 2, 2018: American Journal of Otolaryngology
Fernando González-Magaña, Héctor Omar Malagón-Hidalgo, Eugenio García-Cano, Roberto Vilchis-López, Adriana Fentanes-Vera, Fernan-Alejandra Ayala-Ugalde
Objectives: Airway management in patients with panfacial trauma is complicated. In addition to involving facial lesions, such trauma compromises the airway, and the use of intermaxillary fixation makes it difficult to secure ventilation by usual approaches (nasotracheal or endotracheal intubation). Submental airway derivation is an alternative to tracheostomy and nasotracheal intubation, allowing a permeable airway with minimal complications in complex patients. Materials and Methods: This is a descriptive, retrospective study based on a review of medical records of all patients with facial trauma from January 2003 to May 2015...
February 2018: Journal of the Korean Association of Oral and Maxillofacial Surgeons
M H Zou, L Ma, Y S Xia, S C Yang, W D Chen, F Cao, X X Chen
Objective: To review the early and mid-term results of end-to-side anastomosis technique for interrupted aortic arch in neonates and infants. Methods: Clinic data of 46 patients were diagnosed as interrupted aortic arch in Department of Cardiac Surgery, Guangzhou Women and Children's Medical Center between January 2010 and December 2016 were analyzed retrospectively. Twenty-six cases were neonates. The median age underwent surgery was 23 days (range: 2 days to 8 years). Anatomical subtypes included 36 cases of type A and 10 cases of type B...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Bingqing Xie, Bharathi Laxman, Somaye Hashemifar, Randi Stern, T Conrad Gilliam, Natalia Maltsev, Steven R White
Basal airway epithelial cells (AEC) constitute stem/progenitor cells within the central airways and respond to mucosal injury in an ordered sequence of spreading, migration, proliferation, and differentiation to needed cell types. However, dynamic gene transcription in the early events after mucosal injury has not been studied in AEC. We examined gene expression using microarrays following mechanical injury (MI) in primary human AEC grown in submersion culture to generate basal cells and in the air-liquid interface to generate differentiated AEC (dAEC) that include goblet and ciliated cells...
2018: PloS One
Constantin Ciuce, Răzvan Scurtu, Cătălin Ciuce, Raluca Apostu, Horea Bocşe, George Dindelegan
Introduction: Neoplastic invasion of the structures of the cervical region originating from a malignant tumour developed in one of the viscera of the throat may benefit from cervical exenteration. Defined as resection of the hypopharynx, cervical oesophagus, larynx and cervical trachea, exenteration has limited indications and is mandatorily accompanied by digestive tube reconstruction. The aim of this article is to highlight the indication, surgical strategy and important surgical stages illustrated by images from personal professional experience...
January 2018: Chirurgia
Roman Dudaryk, Danielle B Horn, J Marshall Green
A patient with recent jaw reconstruction presented for treatment of postoperative oropharyngeal hemorrhage. Asleep nasal fiberoptic intubation was attempted, but a rare and unanticipated complication ensued: rupture of right facial artery pseudoaneurysm. The difficult airway algorithm was followed up to the point of surgical airway. While nasal or oral fiberoptic intubation is often perceived as the safest approach for management of a difficult airway, we discuss alternative treatment strategies for patients with a facial pseudoaneurysm...
2018: Anesthesia Progress
Céline Thomet, Ali Modarressi, Eva Meia Rüegg, Pavel Dulguerov, Brigitte Pittet-Cuénod
Long-segment tracheal reconstruction remains a challenge. The ideal tracheal substitute should be an epithelialized tube to prevent stenosis and sufficiently rigid to maintain airflow patency. An autologous technique using a radial forearm free flap reinforced by rib cartilage has been recently described for tracheal reconstruction. We report here two cases of complex tracheal reconstruction with a modification of this technique, which consists of the creation of two independent skin paddles to allow the reconstruction of the trachea and a second adjacent defect (eg, cervical skin, esophagus)...
February 27, 2018: Annals of Plastic Surgery
Yeong Shiong Chiew, Chee Pin Tan, J Geoffrey Chase, Yeong Woei Chiew, Thomas Desaive, Azrina Md Ralib, Mohd Basri Mat Nor
BACKGROUND AND OBJECTIVE: Respiratory mechanics estimation can be used to guide mechanical ventilation (MV) but is severely compromised when asynchronous breathing occurs. In addition, asynchrony during MV is often not monitored and little is known about the impact or magnitude of asynchronous breathing towards recovery. Thus, it is important to monitor and quantify asynchronous breathing over every breath in an automated fashion, enabling the ability to overcome the limitations of model-based respiratory mechanics estimation during asynchronous breathing ventilation...
April 2018: Computer Methods and Programs in Biomedicine
Alexandria L Irace, Catherine Shank, Eelam A Adil, Michael J Cunningham, Kosuke Kawai, Georgios Sideridis, Reza Rahbar
Importance: Monitoring current trends in pediatric otolaryngology will help adjust our training and practice paradigms in a way that ensures the long-term viability of the specialty. Objectives: To gauge the current scope of pediatric otolaryngology (ORL) practice within and outside of the United States and to identify changes in caseload over the past decade. Design, Setting, and Participants: An online survey was sent to pediatric ORL chairs and/or fellowship directors at 42 institutions in the United States and abroad...
February 22, 2018: JAMA Otolaryngology—Head & Neck Surgery
A Yu Zaytcev, K V Dubrovin, V A Svetlov
BACKGROUND: The development of modern video - and endoscopic equipment allows for revision and adjust to modern protocols for maintaining patency of the difficult airway, especially in maxillofacial or ENT -surgery. THE PURPOSE OF THE STUDY: Comparison the efficacy ofvarious methods of maintaining the airway patency in the practice of reconstructive maxillofacial surgery. MATERIALS AND METHODS: 89 patients, who were divided into 4 groups, were examined...
September 2017: Anesteziologiia i Reanimatologiia
Sara Tanini, Giulia Lo Russo
Columella is an important structure in the center of the face, and its structural integrity has an important functional, social, and psychological role. Columella reconstruction can be very challenging for surgeons and the ideal technique remains elusive. This article describes a reconstruction technique in a young woman with columella necrosis due to nasal continuous positive airway pressure treatment. The method of reconstruction described here, with a V-shaped internal nasal vestibular flap and a cartilage grafts from lateral crura, is simple and easily reproducible, providing an optimal aesthetic result and in addition the donor site does not create a secondary deformity by disrupting normal anatomy...
January 2018: Plastic and Reconstructive Surgery. Global Open
Antonella Concerto, Marco Cavallaro, Carmela Visalli, Anna Maria Bagnato, Ugo Barbaro, Ignazio Salamone
A laryngeal foreign body (FB) is a significant, life-threatening event in the paediatric population. Incomplete airways obstruction by a thin, laminar, radiolucent FB lodged in the glottis or supraglottis is a rare occurrence that may present with non-specific symptoms, absence of chest findings, and normal radiographic investigations, resulting in misdiagnosis, delay in diagnosis, or prolonged recovery. We report two cases of 10-month-old male infants, each with a thin radiolucent FB lodged between the vocal folds that was detected with low-dose multidetector computed tomography (MDCT) and thin-slice reconstruction...
April 2018: Respirology Case Reports
Andrés Di Pietrantonio, Humberto Asmus, Christian Ingratta, Walter Brennan, Javier Schulz, Leandro Carballo
Introduction: Inverted papilloma is a locally-aggressive benign neoplasm of the paranasal sinuses with a high potential for recurrence and malignancy. Intracranial extension is infrequent, and dural penetration even more so, typically associated with recurrence of the disease or its degeneration into squamous cell carcinoma. Clinical Case: A 32-year-old female patient consulted us for an exophytic lesion in her right nostril and exophthalmos, associated with headache, anosmia and dysgeusia...
2018: Surgical Neurology International
Jeanine Blatter, Thorsten Krueger, Hans-Beat Ris, Moira Baeriswyl, Alban Lovis, Mathieu Zellweger, Michel Gonzalez, Jean Yannis Perentes
BACKGROUND: Extrathoracic muscle flaps can be used as airway substitutes for the closure of complex broncho-pleural or tracheo-esophageal fistulas or in the context of tracheo-carinal reconstructions after resection for centrally localized tumors in order to alleviate excess anastomotic tension. METHODS: Evaluation of all patients undergoing tracheo-carinal reconstructions with extrathoracic muscle flap patches as airway substitutes in our institution from 1996 to 2016...
February 7, 2018: Annals of Thoracic Surgery
Masaru Takenaka, Yoshinobu Ichiki, Akihiro Taira, Fumihiro Tanaka
Mediastinal liposarcoma is an extremely rare malignancy with a poor prognosis. We report the case of a 73-year-old man who presented with severe respiratory distress. He had previously been diagnosed with mediastinal liposarcoma, which had been treated with extirpation 6 years ago. The histological type was a well-differentiated liposarcoma. Three years ago, he experienced respiratory distress due to postoperative recurrence of mediastinal liposarcoma. To establish an airway, tracheotomy was urgently performed...
February 3, 2018: European Journal of Cardio-thoracic Surgery
J A Murphy, S R McWilliams, M Lee, G Warburton
There are limited published data about the surgical management of self-inflicted facial gunshot wounds. The aim of this retrospective study was to review our management of subjects who initially survive such a wound and were admitted to a tertiary care trauma centre between 2002 and 2012. Only subjects with definitive evidence of a self-inflicted facial gunshot wound and who were admitted alive were included. Data collected included personal and clinical details, characteristics of the gunshot wound, and medical and surgical management...
January 27, 2018: British Journal of Oral & Maxillofacial Surgery
Takuya Tsuji, Ryosuke Nakamura, Tatsuya Katsuno, Yo Kishimoto, Atsushi Suehiro, Masaru Yamashita, Ryuji Uozumi, Tatsuo Nakamura, Ichiro Tateya, Koichi Omori
BACKGROUND: Planar cell polarity (PCP) coordinates the patterning and orientation of cells and their structures along tissue planes, and although its acquisition during the formation of airway epithelium has been described, the mechanisms for its maintenance and reconstruction are poorly understood. We aimed to clarify whether ambient environment change by orthotropic autologous transplantation affected PCP at the cellular level. METHODS: We performed orthotropic autologous transplantation by inverting tracheal segments in rats, and then performed morphological evaluation by microscopy...
February 2, 2018: Respiratory Research
Yabing Zhang, Juan Xin, Ye Ma, Qian Li, Bin Liu
RATIONALE: Primary tracheal adenoid cystic carcinoma of the trachea primary is a rare neoplasm and commonly misdiagnosed. Lung isolation during surgery and ventilation pose a tremendous challenge to anesthesiologists. PATIENT CONCERNS: The authors describe a novel technique of lung isolation and ventilation with a Univent tube during thoracoscopic mediastinal tracheal resection and reconstruction in a female patient. DIAGNOSES: Primary tracheal adenoid cystic carcinoma, nonsmall cell carcinoma...
December 2017: Medicine (Baltimore)
Nataliya I Biskup, Brian S Pan, Haithem Elhadi-Babiker, Ronald R Hathaway, John van Aalst, Christopher B Gordon
BACKGROUND: Treacher Collins syndrome is a rare disorder (1/50,000 live births) with features that include hypoplastic orbitozygomatic complex with downward slanting eyes, and maxillary/mandibular retrusion. Obstructive sleep apnea and tracheostomy-dependence are common. This study presents the outcomes of skeletal distraction on avoidance of tracheostomy and decannulation in this patient population. METHODS: The authors reviewed charts of all patients with Treacher Collins syndrome who underwent craniofacial reconstruction from 2003 to 2016...
January 29, 2018: Journal of Craniofacial Surgery
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