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subglottic stenosis

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https://www.readbyqxmd.com/read/28990664/hormone-receptors-analysis-in-idiopathic-progressive-subglottic-stenosis
#1
Ivana Fiz, Zeid Bittar, Cesare Piazza, Jan Constantin Koelmel, Federico Gatto, Diego Ferone, Francesco Fiz, Diana Di Dio, Alexander Bosse, Giorgio Peretti, Christian Sittel
OBJECTIVE: Idiopathic subglottic stenosis predominantly affects fertile and perimenopausal women. Estrogens and/or progesterone have been proposed as mediators of its pathogenesis by stimulating collagen deposition within the upper airway. We evaluated the presence and expression of estrogen-alpha (ER-α), estrogen-beta (ER-β), and progesterone receptors (PR) in idiopathic stenotic patients. STUDY DESIGN: A retrospective analysis on 42 surgical specimens from idiopathic stenosis female patients (mean age, 52...
October 9, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28988454/awake-serial-intralesional-steroid-injections-without-surgery-as-a-novel-targeted-treatment-for-idiopathic-subglottic-stenosis
#2
Ramon A Franco, Inna Husain, Lindsay Reder, Paul Paddle
OBJECTIVES/HYPOTHESIS: The fibrotic/erythematous appearance of the subglottis in idiopathic subglottic stenosis (iSGS) hints that it might respond to repeated intralesional steroid treatment similar to keloids. STUDY DESIGN: Retrospective cohort study. METHODS: Thirteen iSGS subjects (six treated in-office with serial intralesional steroid injections [SILSI] versus seven treated endoscopically in the operating room [OR] followed by awake SILSI) between October 2011 and April 2017...
October 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28940431/targeting-metabolic-abnormalities-to-reverse-fibrosis-in-iatrogenic-laryngotracheal-stenosis
#3
Michael K Murphy, Kevin M Motz, Dacheng Ding, Linda Yin, Madhavi Duvvuri, Michael Feeley, Alexander T Hillel
OBJECTIVE: Management of laryngotracheal stenosis (LTS) remains primarily surgical, with a critical need to identify targets for adjuvant therapy. Laryngotracheal stenosis scar fibroblasts exhibit a profibrotic phenotype with distinct metabolic shifts, including an increased glycolysis/oxidative phosphorylation ratio. This study examines the effects of the glutamine antagonist 6-diazo-5-oxo-l-norleucine (DON) on collagen production, gene expression, proliferation, and metabolism of human LTS-derived fibroblasts in vitro...
September 20, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28929076/role-of-topical-medication-in-prevention-of-post-extubation-subglottic-stenosis
#4
Saravanam Prasanna Kumar, Arunachalam Ravikumar, Johnson Thanka
Iatrogenic laryngotracheal injury is the most serious complication of endotracheal intubation since this method of establishing airway was first described by Eugene Bouchut in 1858. Even today, subglottic stenosis is the most dreaded complication of intubation. This animal study is focused on the host tissue response to intubation induced injury resulting in subglottic stenosis and methods to prevent this complication. To assess the role of topically applied Mitomycin-C and Triamcinolone Acetonide in wound healing process following post-extubation subglottic injury...
September 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28882637/successful-retrograde-intubation-after-failed-fiberoptic-intubation-and-percutaneous-cricothyrotomy
#5
Stephanie Brenman, Sachin Gupta, Stephanie Tseeng
BACKGROUND: An obstructive neck lesion presents an airway challenge for any emergency physician. Retrograde intubation is an infrequently used airway alternative that can be employed in the difficult airway algorithm that requires little training and is less invasive than surgical cricothyrotomy. CASE REPORT: We report a case of a 31-year-old male patient who presented with respiratory distress progressing to respiratory failure from upper airway obstruction. The patient had significant tracheal thickening at the level of the thyroid gland based on a computed tomography report from 3 weeks prior to his presentation...
September 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28866624/severe-acquired-subglottic-stenosis-in-neonatal-intensive-care-graduates-a-case-control-study
#6
Rebecca E Thomas, Shripada C Rao, Corrado Minutillo, Shyan Vijayasekaran, Elizabeth A Nathan
OBJECTIVE: To analyse current incidence and risk factors associated with severe acquired subglottic stenosis (SASGS) requiring surgical intervention in neonates. DESIGN: Retrospective case-control study. SETTING: Sole tertiary children's hospital. PARTICIPANTS: Patients who underwent surgical intervention for SASGS from January 2006 to December 2014. For each neonatal intensive care unit (NICU) graduate with acquired SASGS, two controls were selected (matched for gestation and year of birth)...
September 2, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
https://www.readbyqxmd.com/read/28772006/accuracy-of-magnetic-resonance-imaging-for-grading-of-subglottic-stenosis-in-patients-with-granulomatosis-with-polyangiitis-correlation-with-pulmonary-function-tests-and-laryngoscopy
#7
Frank O Henes, Martin Laudien, Laura Linsenhoff, Jan P Bremer, Tim Oqueka, Gerhard Adam, Gerhard Schön, Peter Bannas
OBJECTIVES: To compare magnetic resonance imaging (MRI)-based and laryngoscopy-based subglottic stenosis (SGS) grading with pulmonary function tests (PFT) in patients with granulomatosis with polyangiitis (GPA). METHODS: In this retrospective study we included 118 examinations of 44 patients with GPA and suspected SGS. All patients underwent MRI, laryngoscopy, and PFT. Stenosis was graded on a 4-point scale by endoscopy and MRI using the Meyer-Cotton (MC)-Score (score1: ≤50%; 2: 51-70%; 3: 71-99%; 4: 100%) and as percentage by MRI...
August 3, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28745802/progressive-subglottic-stenosis-in-a-child-with-pallister-killian-syndrome
#8
Tadashi Shiohama, Katsunori Fujii, Kenji Shimizu, Hirofumi Ohashi, Tomozumi Takatani, Nobuhiko Okamoto, Gen Nishimura, Mitsuhiro Kato, Naoki Shimojo
Pallister-Killian syndrome (PKS) is rare genetic disorder caused by tetrasomy 12p mosaicism with supernumerary isochromosome 12p that manifests with intellectual disability, craniofacial dysmorphism, and epilepsy. Although PKS presents as a multisystem morphological defect, respiratory system involvement is rare, except for diaphragmatic hernia. We are the first to report a case of PKS with progressive subglottic stenosis. Subglottic stenosis is a potentially lethal condition due to severe respiratory obstruction and difficult intubation; therefore, further accumulation of cases is required to assess the causal link between PKS and subglottic stenosis...
July 26, 2017: Congenital Anomalies
https://www.readbyqxmd.com/read/28715559/interferon-%C3%AE-treatment-of-human-laryngotracheal-stenosis-derived-fibroblasts
#9
Kevin Motz, Idris Samad, Linda X Yin, Michael K Murphy, Madhavi Duvvuri, Dacheng Ding, Alexander T Hillel
Importance: Laryngotracheal stenosis (LTS) is a fibroproliferative disorder of the glottis, subglottis, and trachea. In models of fibrosis from other organ systems, the CD4+ T-cell response has been shown to regulate extracellular matrix deposition. Specifically, helper T cell 2 (TH2) promotes fibrosis, whereas TH1 and associated cytokines have been shown to be antifibrotic. However, this antifibrotic effect of the TH1 response has not been demonstrated in LTS. Objective: To determine whether the TH1 cytokine interferon-γ inhibits the function of LTS-derived fibroblasts in vitro...
July 13, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28688566/dysphagia-in-healthy-children-characteristics-and-management-of-a-consecutive-cohort-at-a-tertiary-centre
#10
Orysya Svystun, Wendy Johannsen, Rabin Persad, Justine M Turner, Carina Majaesic, Hamdy El-Hakim
OBJECTIVE: Whereas the literature is replete with reports on complex children with dysphagia (DP), the parameters characterizing non-neurologically impaired (NNI) children have been underreported, leaving a substantial knowledge gap. We set to characterize a consecutive cohort of NNI children, their management, and outcomes. METHODS: We undertook a retrospective case series. Children (<18 years old) attending a tertiary multidisciplinary swallowing clinic were eligible...
August 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28688557/the-outcomes-of-endoscopic-management-in-young-children-with-subglottic-stenosis
#11
Chao Chen, Wei-Hua Ni, Tan-le Tian, Zheng-Min Xu
Subglottic stenosis (SGS) is a common cause of obstructed airway in children, and the treatment of pediatric SGS, especially congenital SGS, remains a challenge for the otolaryngologist. OBJECTIVE: To analyze the outcomes of endoscopic management in young children with SGS. METHODS: We performed a retrospective review of treatment with endoscopic balloon dilation (EBD) or EBD combined with endoscopic anterior cricoid split (EACS) for young SGS children, from December 2008 to December 2015...
August 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28636155/the-use-of-transnasal-humidified-rapid-insufflation-ventilatory-exchange-thrive-in-17-cases-of-subglottic-stenosis
#12
Kim To, Fleur Harding, McNeill Scott, Pamela Milligan, Iain J Nixon, Richard Adamson, Alistair F McNarry
Shared airway management in patients with subglottic stenosis (SGS) is challenging for both the anaesthetist and surgeon. Various methods of airway management have been described but currently no gold standard exists. Jet ventilation has been described as the preferred technique despite a UK National Survey highlighting potential complications including pneumothorax, pneumomediastinum, surgical emphysema, hypoxia and death. This article is protected by copyright. All rights reserved.
June 21, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28620493/a-bronchoscopic-approach-to-benign-subglottic-stenosis
#13
Tuhina Raman, Kshitij Chatterjee, Bashar N Alzghoul, Ayoub A Innabi, Ozlem Tulunay, Thaddeus Bartter, Nikhil K Meena
OBJECTIVES: Subglottic stenosis is an abnormal narrowing of the tracheal lumen at the level of subglottis (the area in between the vocal cords and the cricoid cartilage). It can cause significant symptoms due to severe attenuation of airflow. We describe our experience in alleviating symptoms by addressing the stenosis using fibreoptic bronchoscopic methods. METHODS: We report all concurrent cases performed between September 2015 and July 2016. We use a combination of balloon dilation, electro-surgery knife to dilate and incise stenotic segments followed by steroid injection to modulate healing...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28619544/changes-in-tracheostomy-and-intubation-related-tracheal-stenosis-implications-for-surgery
#14
Samuel S Kim, Zain Khalpey, Charles Hsu, Alex G Little
BACKGROUND: This study sought to identify the changing characteristic patterns and locations of stenosis after tracheostomy or intubation and to assess the risk factors associated with perioperative complication and restenosis after primary resection and reconstruction. METHODS: A retrospective review was performed (January /2012 to March 2015) on patients treated at the University of Arizona Medical Center (Tucson, Arizona) who had symptomatic tracheal stenosis secondary to prolonged intubation or tracheostomy...
September 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28581185/serial-office-based-steroid-injections-for-treatment-of-idiopathic-subglottic-stenosis
#15
Matthew R Hoffman, Adam R Coughlin, Seth H Dailey
OBJECTIVES/HYPOTHESIS: Current treatment options for idiopathic subglottic stenosis include endoscopic interventions, resection, and tracheotomy. Recently, serial office-based steroid injections were proposed as an alternative that may stabilize or induce regression of airway stenosis without the need for repeated operations. Procedure completion rate, pain, complications, effect on stenosis, time since the last operation, and limitations have not been described. STUDY DESIGN: Retrospective case series...
June 5, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28504622/-severe-cervical-kyphosis-causing-sudden-inspiratory-stridor
#16
Karen Lise Dahl Andersen, Allan Bach, Rikke Haahr Iversen, Søren Helbo Skaarup
An 85-year-old woman was brought to an accident and emergency department with breathing difficulties accompanied by inspiratory stridor. She was being treated for hypertension and severe osteoporosis which had caused thoracal and cervical fractures of the columna. Intubation was initiated as she desaturated and deteriorated despite maximum oxygen therapy. The intubation revealed a subglottic stenosis as a consequence of a recent osteoporotic fracture in the cervical columna. This represents a rare cause of respiratory failure as all other cardial, pulmonary and allergic aetiologies had been eliminated...
May 8, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28502210/-esophageal-complications-of-gastroesophageal-reflux-disease-consequences-or-defensive-reactions
#17
REVIEW
Örs Péter Horváth, Laura Bognár, András Papp, András Vereczkei
Gastroesophageal reflux disease affects more than 10% of the adult population. Most patients can be effectively treated with lifestyle changes and adequate acid-reducing therapy. However, about 10% of the patients remain symptomatic despite treatment and severe complications may develop. Interestingly, some of these complications seem to be a sort of defensive mechanism that may either alleviate the patient's symptoms or prevent developing further complications. In Barrett's esophagus, which can be unambigously considered as a complication of gastroesophageal reflux disease, reflux symptoms ruining the quality of life may significantly improve, since the metaplastic Barrett epithelium is much more resistent to gastric acid, than the normal epithelial lining of the esophagus...
May 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28499712/quattro-flap-tracheotomy-the-impact-of-a-novel-surgical-technique-for-young-infants
#18
Jun-Ya Kita, Seiji Hosokawa, Kastuyoshi Suzuki, Katsura Hakamada, Hiroyuki Mineta
BACKGROUND: Tracheotomy for pediatric patients is a surgical procedure with greater technical difficulty and higher rates of morbidity and mortality than that in adults. We report a new technique for pediatric tracheotomy that reduces the issue of granulation and recannulation after accidental decannulation. METHODS: Clinical data were retrospectively reviewed for 32 pediatric patients aged 3weeks-32months who underwent Quattro Flap Tracheotomy (QFT) at our hospital...
May 3, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28485188/quantification-of-inflammatory-markers-in-laryngotracheal-stenosis
#19
COMPARATIVE STUDY
Kevin M Motz, Linda X Yin, Idris Samad, Dacheng Ding, Michael K Murphy, Madhavi Duvvuri, Alexander T Hillel
Objectives (1) Develop a novel method for serial assessment of gene and protein expression in laryngotracheal stenosis (LTS). (2) Assess cytokine expression and determine an immunophenotype in LTS. Study Design A matched comparison of endolaryngeal brush biopsy samples from laryngotracheal scar and normal airway. Setting Tertiary care hospital, 2015-2016. Methods Brush biopsy specimens of laryngotracheal scar and normal trachea were obtained from 17 patients with LTS at the time of operating room dilation and were used for protein and RNA extraction...
September 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28483239/the-efficacy-and-safety-of-the-flexible-fiber-co2-laser-delivery-system-in-the-endoscopic-management-of-pediatric-airway-problems-our-long-term-experience
#20
Gi Soo Lee, Alexandra Irace, Reza Rahbar
OBJECTIVE: To report the use of flexible fiber CO2 laser in the endoscopic management of pediatric airway cases. METHODS: A retrospective review was conducted of patients who underwent CO2 laser-assisted airway procedures between September 2007 and January 2014 at a tertiary pediatric hospital. RESULTS: Sixty-eight patients underwent 80 procedures utilizing flexible fiber CO2 laser. Procedures included supraglottoplasty (n = 32), laryngeal cleft repair (type I [n = 10], type II [n = 7], type III [n = 6]), suprastomal granuloma excision (n = 6), cordotomy (n = 4), laryngeal neurofibroma excision (n = 4), laryngeal granulomatous mass excision (n = 1), subglottic stenosis excision (n = 6), division of glottic web (n = 2), subglottic cyst excision (n = 1), and supraglottic biopsy (n = 1)...
June 2017: International Journal of Pediatric Otorhinolaryngology
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