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Airway endoscopy

P E Vonk, A M E H Beelen, N de Vries
PURPOSE: To evaluate the effect of different passive maneuvers on upper airway patency during drug-induced sleep endoscopy (DISE) compared to recent literature on treatment outcomes of positional therapy (PT), oral appliance therapy (OAT), and combined treatment in obstructive sleep apnea (OSA) patients. METHODS: A retrospective, single-center cohort study including a consecutive series of 200 OSA patients. All patients underwent DISE with and without manually performed jaw thrust and lateral head rotation by using the VOTE classification...
March 9, 2018: Sleep & Breathing, Schlaf & Atmung
Hsueh-Yu Li, Li-Ang Lee, Eric J Kezirian, Meiho Nakayama
Suspension palatoplasty, a new surgical technique to treat obstructive sleep apnea (OSA), has been developed to correct the retropalatal obstruction in patients with small tonsils (grade I/II) and anterior-posterior palatal (A-P) obstruction. The objecteive of this preliminary study was to investigate the effectiveness and change in retropalatal airway dimensions after suspension palatoplasty. This retrospective case series study included 25 consecutive male adults with OSA. Unique technical features of suspension palatoplasty are exposure of pterygomandibular raphe and suspension of palatopharyngeus muscle to the raphe...
March 9, 2018: Scientific Reports
Seo Yun Jo, Sung Min Lee, Kang Hyun Lee, Dong-Kyu Kim
PURPOSE: Oral appliance therapy is an alternative treatment modality for obstructive sleep apnea (OSA). However, there have been no studies to determine whether changes in the obstructive pattern occur following long-term use of oral devices. Therefore, we examined whether the obstructive pattern changes in patients with OSA who undergo long-term oral appliance therapy using drug-induced sleep endoscopy (DISE). METHODS: We investigated 156 consecutive patients diagnosed with OSA...
February 26, 2018: European Archives of Oto-rhino-laryngology
Erkman Sanri, Ebru Unal Akoglu, Sinan Karacabey, Ural Verimli, Haldun Akoglu, Umit Sehirli, Arzu Denizbasi
OBJECTIVES: Confirmation of the endotracheal tube placement (CoETP) has the utmost importance in the management of an airway. Visualization of tracheal rings or carina with a fiber-optical bronchoscope (FOB) has considered to be a reliable method for the CoETP. However, FOB is expensive, time-consuming, and not always practical. Inexpensive endoscopic USB-cameras were shown to aid intubation successfully and reliably. On the other hand, there have been no studies investigating their use for the CoETP...
February 17, 2018: American Journal of Emergency Medicine
G M Oakley, J M Christensen, R Sacks, P Earls, R J Harvey
INTRODUCTION: The anti-inflammatory effects of long term low dose macrolide therapy have shown benefit in the management of diffuse panbronchiolitis. Dramatic responses to macrolide in the upper airway are seen but our understanding of the patient phenotype predisposing to macrolide response in chronic rhinosinusitis (CRS) is poor. METHODS: A case control study was performed in a tertiary level rhinology practice of consecutive chronic rhinosinusitis patients placed on a 3-month low dose macrolide therapy after failing at least 3 months of corticosteroid irrigation therapy post-endoscopic sinus surgery...
February 24, 2018: Rhinology
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
Jake J Lee, Matthew D Ford, Allison B Tobey, Noel Jabbour
OBJECTIVE: To investigate whether awake endoscopy can diagnose base-of-tongue obstruction as reliably as sleep endoscopy in infants with Pierre Robin sequence (PRS). DESIGN: The study was retrospective with the clinicians blinded to patient identity. Endoscopy findings were assessed and measured by the performing pediatric otolaryngologist. SETTING: Tertiary care children's hospital. PATIENTS: All infants with PRS managed between January 2005 and July 2015 were included...
January 1, 2018: Cleft Palate-craniofacial Journal
Bhik Kotecha, Andrea De Vito
Sleep related breathing disorders cause obstruction of the upper airway which can be alleviated by continuous positive airway pressure (CPAP) therapy, oral devices or surgical intervention. Non-surgical treatment modalities are not always accepted by patients and in order to attain successful surgical outcomes, evaluation of the upper airway is necessary to carefully select the patients who would benefit from surgery. There are numerous techniques available to assess the upper airway obstruction and these include imaging, acoustic analysis, pressure transducer recording and endoscopic evaluation...
January 2018: Journal of Thoracic Disease
Roberto Herrera, Héctor Rojas, Ariel Estramian, Julieta Gómez, José Luis Ledesma, José Pablo, Julián Pastore
Background: Craniocervical junction pathology is infrequent in daily neurosurgical practice. In general, most of these lesions are of traumatic or rheumatic origin. Atlantoaxial instability of inflammatory origin (Grisel syndrome) is a rare entity of which only 16 adult cases have been reported in the literature. This pathology is characterized by the development of an osteolytic lesion at the level of the atlantoaxial joint after an infectious event, usually of the upper airways. Case Description: We present the case of a 76-year-old patient who attended our office for clinical symptoms of spinal instability secondary to an osteolytic lesion, with involvement of C1 and C2...
2018: Surgical Neurology International
Wen-Jue Soong, Pei-Chen Tsao, Yu-Sheng Lee, Chia-Feng Yang
OBJECTIVES: To assess the placement, surveillance management and long-term outcomes of the tracheobronchial (TB) balloon expandable metallic stent (BEMS) managed by therapeutic flexible endoscopy (TFE). METHODS: This is a retrospective review and analysis of all computerized medical records and related flexible endoscopy videos of pediatric patients who received TB BEMS during 20 years period, from January 1997 to December 2016. TFE techniques with forceps debridement, balloon dilatation and laser ablation were used to implant stents, perform regular surveillance, maintain their functions, and expand the diameters of BEMS...
2018: PloS One
Christoph Janott, Maximilian Schmitt, Yue Zhang, Kun Qian, Vedhas Pandit, Zixing Zhang, Clemens Heiser, Winfried Hohenhorst, Michael Herzog, Werner Hemmert, Björn Schuller
OBJECTIVE: Snoring can be excited in different locations within the upper airways during sleep. It was hypothesised that the excitation locations are correlated with distinct acoustic characteristics of the snoring noise. To verify this hypothesis, a database of snore sounds is developed, labelled with the location of sound excitation. METHODS: Video and audio recordings taken during drug induced sleep endoscopy (DISE) examinations from three medical centres have been semi-automatically screened for snore events, which subsequently have been classified by ENT experts into four classes based on the VOTE classification...
January 31, 2018: Computers in Biology and Medicine
N C S Terblanche, C Middleton, D L Choi-Lundberg, M Skinner
BACKGROUND: Significant cardiorespiratory events are frequent in patients undergoing gastrointestinal endoscopy. Central to the occurrence of respiratory events is an unsecured airway. This study sought to determine the efficacy of a new laryngeal mask airway, the LMA® GastroTM Airway (Teleflex Medical, Athlone, Ireland), in patients undergoing upper gastrointestinal endoscopy. New design features include a dedicated channel for oesophageal intubation and separate channel with terminal cuff for lung ventilation...
February 2018: British Journal of Anaesthesia
Meritxell Valls-Mateus, Anna Nogués-Sabaté, Jose Luis Blanch, Manuel Bernal-Sprekelsen, Francesc Xavier Avilés-Jurado, Isabel Vilaseca
BACKGROUND: The accuracy of white light endoscopy in combination with narrow band imaging (WLE + NBI) for diagnosis of squamous cell carcinoma (SCC) does not reach 100%. We evaluated the characteristics of the false-negative and false-positive cases. METHODS: Five hundred thirty lesions of the upper airways were evaluated. The WLE was followed by NBI examination before performing a biopsy. RESULTS: The false-negative lesions (7.36%) were represented by submucosal and non-SCC tumors...
January 31, 2018: Head & Neck
Margaret A Kenna, Alexandria L Irace, Julie E Strychowsky, Kosuke Kawai, Devon Barrett, Juliana Manganella, Michael J Cunningham
Importance: Children with Klippel-Feil syndrome (KFS), characterized principally by abnormal fusion of 2 or more cervical vertebrae, may have many additional congenital anomalies. The overall prevalence of otolaryngologic manifestations among patients with KFS has not been previously characterized. Objective: To define the otolaryngologic diagnoses made and procedures performed in 95 patients with KFS, which, to our knowledge, is the largest series of this challenging patient population published to date...
January 25, 2018: JAMA Otolaryngology—Head & Neck Surgery
C Chen, L T Tan, Z M Xu
Objectives: To provide the experience about the diagnostic process and following management, and to discuss the outcome and predictors in children with laryngeal cleft (LC). Methods: A retrospective case study was conducted at an academic children's hospital. Thirty children were diagnosed as laryngeal cleft between January 2016 and April 2017.Airway evaluations were performed using both flexible and rigid endoscopy, and swallowing evaluations were performed using fiberoptic endoscopic examination of swallowing or modified barium swallow...
January 7, 2018: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Luca Di Vece, Tiziana Doldo, Giacomo Faleri, Maria Picciotti, Lorenzo Salerni, Alessandro Ugolini, Cecilia Goracci
OBJECTIVE: The aim of this study was to evaluate through nasal fiber optic endoscopy and rhinomanometry the patency of upper nasal airways in patients treated with rapid palatal expansion Study design: 30 patients (12 males and 18 females) aged 7-11 years with transverse maxillary constriction underwent rhinomanometric and fiberoptic examination before (T0) and after rapid palatal expansion (T1).The amount of nasopharynx obstruction was quantified with reference to the full choanal surface...
2018: Journal of Clinical Pediatric Dentistry
Danai Khemasuwan, Krittika Teerapuncharoen, David C Griffin
BACKGROUND: The propofol use for moderate sedation (MS) during endobronchial ultrasound (EBUS) bronchoscopy is primarily restricted for use by an anesthesiologist because of safety concerns. The goals of this study were to demonstrate the safety and the diagnostic yield of the use of propofol by bronchoscopists and trained endoscopy nurses during EBUS bronchoscopy without intubation. METHODS: We tested a bolus propofol administration protocol targeting MS for EBUS bronchoscopy...
January 16, 2018: Journal of Bronchology & Interventional Pulmonology
Marina Pieri, Giovanni Landoni, Luca Cabrini
Endoscopic procedures, such as transesophageal echocardiography, gastroscopy, and airway fibroscopy, routinely are performed in a heterogenous population of patients for diagnostic/interventional purposes (eg, transfemoral aortic valve replacement, airway fibroscopies, and intubation). Sedation frequently is administered to achieve an appropriate degree of patient compliance and procedure success. Patients with reduced respiratory reserve or those who are overly sedated, however, may develop hypoxia and respiratory failure during endoscopies, necessitating premature termination of the examination itself...
September 27, 2017: Journal of Cardiothoracic and Vascular Anesthesia
Pierre Fayoux, Martin Morisse, Rony Sfeir, Laurent Michaud, Sam Daniel
OBJECTIVE: Esophageal atresia (EA) is the most common congenital esophageal malformation. Airway pathology, in particular, tracheomalacia and laryngotracheal anomalies is a major cause of morbidity and mortalilty in patients with EA. The aim of this study was to report the incidence and type of laryngotracheal anomalies seen in a large series of patients with EA, and to evaluate their impact on the management of children with EA. STUDY DESIGN: Retrospective study...
February 2018: European Archives of Oto-rhino-laryngology
Lyndy J Wilcox, Mathieu Bergeron, Saranya Reghunathan, Stacey L Ishman
Objectives: Drug-induced sleep endoscopy (DISE) involves assessment of the upper airway using a flexible endoscope while patients are in a pharmacologically-induced sleep-like state. The aim of this article is to review the current literature regarding the role of DISE in children with obstructive sleep apnea (OSA). The indications, typical anesthetic protocol, comparison to other diagnostic modalities, scoring systems, and outcomes are discussed. Methods: A comprehensive review of literature regarding pediatric DISE up through May 2017 was performed...
December 2017: Laryngoscope Investigative Otolaryngology
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