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Airway endoscopy

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https://www.readbyqxmd.com/read/29346245/diagnostic-yield-and-safety-of-bronchoscopist-directed-moderate-sedation-with-a-bolus-dose-administration-of-propofol-during-endobronchial-ultrasound-bronchoscopy
#1
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
https://www.readbyqxmd.com/read/29317119/noninvasive-ventilation-during-endoscopic-procedures-rationale-clinical-use-and-devices
#2
REVIEW
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
https://www.readbyqxmd.com/read/29299746/laryngotracheal-anomalies-associated-with-esophageal-atresia-importance-of-early-diagnosis
#3
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...
January 4, 2018: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29299518/an-updated-review-of-pediatric-drug-induced-sleep-endoscopy
#4
REVIEW
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
https://www.readbyqxmd.com/read/29291277/ectopic-thymic-cyst-of-the-subglottis-considerations-for-diagnosis-and-management
#5
Iram Ahmad, Patricia Kirby, Bryan Liming
OBJECTIVES: To share the diagnostic and management challenges created by an extremely rare airway lesion-the subglottic ectopic thymic cyst. STUDY DESIGN: Case report and literature review. METHODS: We review the presentation, management, and clinical course of an infant who presented with a subglottic mass that was histologically confirmed as a thymic cyst. A brief literature review supplements the case presentation Results: We present the third described case of an ectopic thymic cyst presenting as a subglottic mass...
December 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/29280292/hypopharyngeal-evaluation-in-obstructive-sleep-apnea-with-awake-flexible-laryngoscopy-validation-and-updates-to-cormack-lehane-and-modified-cormack-lehane-scoring-systems
#6
Carlos Torre, Soroush Zaghi, Macario Camacho, Robson Capasso, Stanley Yung-Chuan Liu
OBJECTIVE: To validate the use of Cormack-Lehane and Modified Cormack-Lehane scoring systems to classify patterns of hypopharyngeal airway visualization seen during awake flexible laryngoscopy among patients with obstructive sleep apnea. STUDY DESIGN: Validation study using samples collected from a prospective database. SETTING: University Medical Center. PARTICIPANTS: Data was obtained from a retrospective review of a prospective database of flexible fiberoptic examination recordings in 274 consecutive OSA subjects (Stanford Sleep Medicine/Surgery Clinic)...
December 26, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/29247295/the-predictive-value-of-drug-induced-sleep-endoscopy-for-cpap-titration-in-osa-patients
#7
Ming-Chin Lan, Yen-Bin Hsu, Ming-Ying Lan, Yun-Chen Huang, Ming-Chang Kao, Tung-Tsun Huang, Tsan-Jen Chiu, Mei-Chen Yang
PURPOSE: The aim of this study was to identify possible upper airway obstructions causing a higher continuous positive airway pressure (CPAP) titration level, utilizing drug-induced sleep endoscopy (DISE). METHODS: A total of 76 patients with obstructive sleep apnea (OSA) underwent CPAP titration and DISE. DISE findings were recorded using the VOTE classification system. Polysomnographic (PSG) data, anthropometric variables, and patterns of airway collapse during DISE were analyzed with CPAP titration levels...
December 15, 2017: Sleep & Breathing, Schlaf & Atmung
https://www.readbyqxmd.com/read/29242653/awake-orotracheal-fibre-optic-intubation-comparison-of-two-different-doses-of-dexmedetomidine-on-intubation-conditions-in-patients-undergoing-cervical-spine-surgery
#8
Jaya Sharma, Shobha Purohit, Sonali Bhatia, Poonam Kalra, Mamta Sharma, Reema Meena
Background and Aims: Awake fibre-optic intubation (AFOI) is an integral part of anaesthetic management of difficult airways. Conscious sedation is essential to assist AFOI. This study compared two different doses of dexmedetomidine in combination with topical spray and airway blocks for awake orotracheal fibre-optic intubation in patients undergoing elective cervical spine surgery with rigid cervical collar in situ. Methods: A randomized, prospective, comparative study design was conducted in sixty patients divided into two groups: Group (L) (n = 30) patients received low dose of dexmedetomidine (0...
October 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29242648/enhancing-airway-assessment-of-patients-with-head-and-neck-pathology-using-virtual-endoscopy
#9
Imran Ahmad, Oliver Keane, Sarah Muldoon
Studies have demonstrated that poor assessment and planning contribute to airway complications and that current airway assessment strategies have a poor diagnostic accuracy in predicting difficult intubation in the general population. Patients with head and neck pathology are at higher risk for difficulties during airway management and are more likely to need emergency surgical access. Therefore, thorough assessment of this group of patients is mandatory. The addition of virtual endoscopy (VE) to clinical history and computerised tomography imaging has been shown to improve diagnostic accuracy for supraglottic, glottic and infraglottic lesions and has a positive influence in formulating a more cautious and thorough airway management strategy in this high-risk group of patients...
October 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29242258/ers-statement-interventional-bronchoscopy-in-children
#10
Ernst Eber, Juan L Antón-Pacheco, Jacques de Blic, Iolo Doull, Al Faro, Raffaella Nenna, Thomas Nicolai, Petr Pohunek, Kostas N Priftis, Paola Serio, Courtney Coleman, Sarah Masefield, Thomy Tonia, Fabio Midulla
Paediatric airway endoscopy is accepted as a diagnostic and therapeutic procedure, with an expanding number of indications and applications in children. The aim of this European Respiratory Society task force was to produce a statement on interventional bronchoscopy in children, describing the evidence available at present and current clinical practice, and identifying areas deserving further investigation. The multidisciplinary task force panel performed a systematic review of the literature, focusing on whole lung lavage, transbronchial and endobronchial biopsy, transbronchial needle aspiration with endobronchial ultrasound, foreign body extraction, balloon dilation and occlusion, laser-assisted procedures, usage of airway stents, microdebriders, cryotherapy, endoscopic intubation, application of drugs and other liquids, and caregiver perspectives...
December 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/29214634/a-case-of-hypoglossal-nerve-stimulator-resistant-obstructive-sleep-apnea-cured-with-the-addition-of-a-chin-strap
#11
Apoorva T Ramaswamy, Carol Li, Maria V Suurna
A population of appropriately selected patients does not respond, or does not achieve cure, with hypoglossal nerve stimulation (HGNS). We describe the case of nonresponder whose obstructive sleep apnea (OSA) resolved with the addition of chin strap. After initial placement and titration of HGNS implant, follow-up sleep study demonstrated persistent moderate OSA. Drug-induced sleep endoscopy demonstrated supraglottic collapse with activate neurostimulation. With mouth closure and change of stimulation settings to unipolar from bipolar, the airway collapse and desaturations improved...
December 7, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29204585/application-of-drug-induced-sleep-endoscopy-in-patients-treated-with-upper-airway-stimulation-therapy
#12
Adrian A Ong, Christopher M Ayers, Eric J Kezirian, B Tucker Woodson, Nico de Vries, Shaun A Nguyen, M Boyd Gillespie
Objective: To determine the level of agreement among experienced operators of candidacy for upper airway stimulation (UAS) based on evaluation of drug-induced sleep endoscopy (DISE). Methods: The trial was designed as a single-blinded cross-sectional study. Four otolaryngologists with extensive DISE experience were given 63 video clips from the STAR trial video library. These videos were graded using the VOTE classification. Percentage agreement and Cohen's κ (for inter-rater reliability) were calculated between pairs of reviewers, assessing palatal complete concentric collapse (CCC) and determining UAS eligibility...
June 2017: World journal of otorhinolaryngology—head and neck surgery
https://www.readbyqxmd.com/read/29204289/successful-treatment-of-tracheal-lymphoma-in-a-siamese-cat
#13
Laura Bataller, Alice Tamborini, Henry L'Eplattenier, Slavka Necova, Elise Robertson
Case summary: An 8-year-old female spayed Siamese indoor cat presented with a 3 week history of inspiratory dyspnoea, stridor and open-mouth breathing after exercise. Laryngoscopy, tracheoscopy, bronchoscopy and retroflexed nasopharyngoscopy were performed, and identified a multilobulated intraluminal mass within the trachea. Brush cytology was performed on the mass but was inconclusive in providing a definitive diagnosis. A CT scan of the neck failed to identify an obvious intraluminal mass and was negative to contrast uptake...
July 2017: JFMS Open Reports
https://www.readbyqxmd.com/read/29195837/evaluation-of-the-efficacy-of-tongue-lip-adhesion-in-pierre-robin-sequence
#14
H Broucqsault, M-D Lamblin, G Hosana, P Fayoux
OBJECTIVE: Tongue-lip adhesion may be used to relieve obstructive sleep apnoea in infants with Pierre Robin sequence (PRS), but only a few studies have objectively evaluated its efficacy. The purpose of this study was to evaluate the results of tongue-lip adhesion by polysomnography. MATERIEL AND METHODS: A single-centre retrospective study was conducted in infants with PRS treated by tongue-lip adhesion from 2004 to 2015, in whom at least laryngotracheal endoscopy and polysomnography were performed...
November 28, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/29174644/does-the-reduction-of-inferior-turbinate-affect-lower-airway-functions
#15
Ozlem Unsal, Mehtap Ozkahraman, Mufide Arzu Ozkarafakili, Meltem Akpinar, Arzu Yasemin Korkut, Senem Kurt Dizdar, Berna Uslu Coskun
INTRODUCTION: Although the nose and lungs are separate organs, numerous studies have reported that the entire respiratory system can be considered as a single anatomical and functional unit. The upper and lower airways affect each other either directly or through reflex mechanisms. OBJECTIVE: In this study, we aimed to evaluate the effects of the radiofrequency ablation of persistent inferior turbinate hypertrophy on nasal and pulmonary function. METHODS: Twenty-seven patients with bilateral persistent inferior turbinate hypertrophy without septal deviation were included in this study...
November 6, 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/29166423/exhaled-and-nasal-nitric-oxide-in-chronic-rhinosinusitis-patients-with-nasal-polyps-in-primary-care
#16
M Frendø, K Håkansson, S Schwer, A T Ravn, H Meteran, C Porsbjerg, V Backer, C von Buchwald
BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common inflammatory disorder associated with lower airway disease. However, only few studies of CRSwNP from outside secondary/tertiary care centres have been published. We recently reported an asthma frequency of 44% and 65% in primary and secondary care patients respectively. Therefore, we hypothesise that inflammation of the lower airways could be present in all CRSwNP patients, even without asthma. Here, we assessed the degree of lower and upper airway inflammation using exhaled and nasal nitric oxide (NO) in primary care CRSwNP patients with and without asthma...
November 23, 2017: Rhinology
https://www.readbyqxmd.com/read/29159491/-algorithm-for-securing-an-unexpected-difficult-airway-user-analysis-on-a-simulator
#17
T Ott, K Truschinski, M Kriege, M Naß, S Herrmann, V Ott, S Sellin
BACKGROUND: Critical incidents in difficult airway management are still a main contributory factor for perioperative morbidity and mortality. Many national associations have developed algorithms for management of these time critical events. For implementation of these algorithms the provision of technical requirements and procedure-related training are essential. Severe airway incidents are rare events and clinical experience of the individual operators is limited; therefore, simulation is an adequate instrument for training and evaluating difficult airway algorithms...
November 20, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/29103442/clinical-recognition-of-mouth-breathers-by-orthodontists-a-preliminary-study
#18
Julia Garcia Costa, Genilza Silva Costa, Carolina Costa, Oswaldo de Vasconcellos Vilella, Claudia Trindade Mattos, Adriana de Alcantara Cury-Saramago
INTRODUCTION: A routine diagnosis of a patient's breathing status performed by an orthodontist normally includes visual assessment, medical history, clinical examination of habitual lip posture, size and shape of the nostrils, reflex control of the alar muscle and respiratory tests, and the dental mirror test. The objective of this study was to test the recognition of mouth breathers in young persons by an orthodontist and agreement with an otolaryngologist's reference diagnosis when routine assessments were carried out...
November 2017: American Journal of Orthodontics and Dentofacial Orthopedics
https://www.readbyqxmd.com/read/29101957/anesthesia-for-colonoscopy-and-lower-endoscopic-procedures
#19
REVIEW
John Michael Trummel, Vinay Chandrasekhara, Michael L Kochman
Demand for anesthesiologist-assisted sedation is expanding for gastrointestinal lower endoscopic procedures and may add to the cost of these procedures. Most lower endoscopy can be accomplished with either no, moderate, or deep sedation; general anesthesia and active airway management are rarely needed. Propofol-based sedation has advantages in terms of satisfaction and recovery over other modalities, but moderate sedation using benzodiazepines and opiates work well for low-risk patients and procedures. No sedation for routine colonoscopy works well for selected patients and eliminates sedation-related risks...
December 2017: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29094360/effects-of-manipulations-to-detect-sliding-hiatal-hernia-in-dogs-with-brachycephalic-airway-obstructive-syndrome
#20
Olivier Broux, Cécile Clercx, Anne-Laure Etienne, Valeria Busoni, Stéphanie Claeys, Annick Hamaide, Frédéric Billen
OBJECTIVE: To determine the influence of manipulations aimed at increasing the transdiaphragmatic pressure gradient on the gastro-esophageal junction (GEJ) of dogs with brachycephalic airway obstructive syndrome (BAOS), and to identify the manipulation that most improves the detection of GEJ abnormalities and sliding hiatal hernia (SHH) in dogs with BAOS. STUDY DESIGN: In vivo experimental pilot study and prospective clinical study. ANIMALS: Five purpose-bred Beagles and 20 dogs diagnosed with BAOS...
November 2, 2017: Veterinary Surgery: VS
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