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https://www.readbyqxmd.com/read/27891426/palatonasal-fistula-repair-a-case-of-unanticipated-difficult-intubation
#1
Hemraj Tungaria, Lalit K Raiger, Rajkumar Paliwal, Shekhar Suman Saxena, Bishan Kumar Bairwa
Patients with present or previous history of facio-maxillary trauma will mostly be associated with a difficult airway. Surgical correction of these injuries might not always correct the altered airway. We report a case of palatonasal fistula following an old facio-maxillary fracture, which has led to interpretation of a difficult airway into a normal one. The patient was found to be having difficult airway during direct laryngoscopy which caused failure to intubate initially. Though, the patient was successfully intubated in the third attempt by senior anaesthesiologist making use of manoeuvres and equipment available, it made an impact for us to do a proper pre-op evaluation of patients with history of surgical correction of facial injuries and also for being prepared for can't ventilate and can't intubate situation in such type of cases...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27886977/can-submandibular-tracheal-intubation-be-an-alternative-to-tracheotomy-during-surgery-for-major-maxillofacial-fractures
#2
Ahmed Gaber Hassanein, Ahmed M A Abdel Mabood
PURPOSE: During surgery for major maxillofacial fractures, orotracheal intubation can interfere with some surgical procedures and nasal intubation can be contraindicated or impossible. That is why tracheotomy is presented as a solution, although it carries a relatively high incidence of complications. In this study, the use of submandibular tracheal intubation is basically evaluated as an alternative to tracheotomy in such circumstances. MATERIALS AND METHODS: This prospective study was performed in patients undergoing surgery for major maxillofacial fractures in which oral intubation and/or nasal intubation have been unsuitable, impossible, or contraindicated...
November 2, 2016: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27792823/novel-management-of-an-isolated-comminuted-cricoid-cartilage-fracture
#3
Aurora G Standlee, Derek J Rogers
Laryngeal trauma is a rare occurrence that can result in significant morbidity and mortality. Isolated cricoid cartilage fractures are exceedingly rare, and their treatment is highly variable. We describe a case of an isolated comminuted, uncalcified cricoid cartilage fracture in a 34-year-old man that responded well to novel management with suture and 2-octylcyanoacrylate tissue adhesive fixation intraoperatively and topical ciprofloxacin/dexamethasone applied to the airway postoperatively. We discuss the novel application of cyanoacrylate glue in laryngeal trauma and the potential benefits of topical ciprofloxacin/dexamethasone application to the airway...
October 2016: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/27760561/acute-transfusion-related-abdominal-injury-in-trauma-patients-a-case-report
#4
P Michel, D Wähnert, M Freistühler, M G Laukoetter, S Rehberg, M J Raschke, P Garcia
BACKGROUND: Secondary abdominal compartment syndrome is well known as a life-threatening complication in critically ill patients in an intensive care unit. Massive crystalloid fluid resuscitation has been identified as the most important risk factor. The time interval from hospital admittance to the development of manifest abdominal compartment syndrome is usually greater than 24 hours. In the absence of any direct abdominal trauma, we observed a rapidly evolving secondary abdominal compartment syndrome shortly after hospital admittance associated with massive transfusion of blood products and only moderate crystalloid resuscitation...
October 19, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27666686/-obstructive-sleep-apnea-syndrome-osas-and-bone
#5
Daisuke Inoue
Obstructive sleep apnea syndrome(OSAS)is a sleep disorder characterized by repetitive upper airway collapse during sleep, causing frequent hypoxia and sleep disturbance. Known risk factors of OSAS include obesity, male sex and smoking. OSAS has been linked to various comorbidities such as hypertension, cardiovascular diseases and diabetes. Recent evidence also indicates that OSAS is associated with vitamin D insufficiency, increased bone resorption and bone loss. Thus, although increased fracture rate has not been demonstrated, OSAS is now recognized as a risk factor of osteoporosis...
2016: Clinical Calcium
https://www.readbyqxmd.com/read/27652080/anesthetic-management-of-a-patient-with-localised-scleroderma
#6
Fangfan Ye, Gaoyin Kong, Jia Huang
INTRODUCTION: Scleroderma is a progressive fibrotic disorder of connective tissue which can present multiple anesthetic challenges to anesthetists, especially airway management. Awake intubation with fiberoptic bronchoscope is widely accepted and implemented for progressive systematic scleroderma patients. With the development and improvement of intubation devices these years, there is no report addressing other intubation methods for sclerotic patients. CASE DESCRIPTION: A 47 year-old, 42-kg man with 1-year history of localized scleroderma was scheduled for the operation of inner fixation after 6 days of his acetabular fracture...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27624630/cough-augmentation-techniques-in-the-critically-ill-a-canadian-national-survey
#7
Louise Rose, Neill K Adhikari, Joseph Poon, David Leasa, Douglas A McKim
BACKGROUND: Critically ill mechanically ventilated patients experience impaired airway clearance due to ineffective cough and impaired secretion mobilization. Cough augmentation techniques, including mechanical insufflation-exsufflation (MI-E), manually assisted cough, and lung volume recruitment, improve cough efficiency. Our objective was to describe use, indications, contraindications, interfaces, settings, complications, and barriers to use across Canada. METHODS: An e-mail survey was sent to nominated local survey champions in eligible Canadian units (ICUs, weaning centers, and intermediate care units) with 4 telephone/e-mail reminders...
October 2016: Respiratory Care
https://www.readbyqxmd.com/read/27622174/osteoporosis-associated-with-chronic-obstructive-pulmonary-disease
#8
REVIEW
Ryo Okazaki, Reiko Watanabe, Daisuke Inoue
Recent epidemiological studies have revealed that osteoporosis is closely associated with common chronic diseases including diabetes, hypertension, chronic kidney disorders, and chronic obstructive pulmonary disease (COPD). COPD is a chronic inflammatory airway disease but now well known to be associated with various systemic comorbidities including osteoporosis. Osteoporosis and osteoporotic fractures are extremely common in COPD patients, which have significant impacts on their quality of life (QOL), activities of daily life (ADL), respiratory function, and possibly their prognosis...
August 2016: Journal of Bone Metabolism
https://www.readbyqxmd.com/read/27601740/submandibular-intubation-as-an-alternative-for-intra-operative-airway-management-in-maxillofacial-fractures-our-institutional-experience
#9
Praveer K Banerjee, Abhineet Jain, Bikram Behera
BACKGROUND AND AIMS: Airway management in anaesthesia for maxillofacial surgical procedures is tricky at times when the nasal/oral routes are contraindicated or are impossible. Tracheostomy as an alternative inherits its own complications. We present a case series of the submandibular route for tracheal intubation as an alternative. METHODS: The procedure was performed in ten selected adult patients with maxillofacial/mandibular fractures associated with a fracture of skull base or nasal bone...
August 2016: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/27573210/a-case-of-cricothyroidotomy-for-facial-trauma-in-a-patient-taking-antiplatelet-agents-after-a-simple-ground-level-fall
#10
Tetsuya Yumoto, Tatsushi Matsumura, Kohei Tsukahara, Keiji Sato, Toyomu Ugawa, Yoshihito Ujike
INTRODUCTION: Cricothyroidotomy is an emergency procedure that can be used to secure the airway in situations in which intubation and ventilation are not possible. PRESENTATION OF CASE: We describe a case of 79-year-old male presenting with facial trauma combined with massive upper airway bleeding and swelling in which cricothyroidotomy was required to open the airway in an elderly male patient taking antiplatelet agents who suffered a simple ground-level fall. DISCUSSION: Although emergency airway management is often required in patients with Le Fort fractures, mandibular condyle fractures exhibit a significant relationship with ground-level falls, which are not usually associated with emergency airway management...
2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27568459/supine-position-and-nonmodifiable-risk-factors-for-ventilator-associated-pneumonia-in-trauma-patients
#11
Christopher P Michetti, Heather A Prentice, Jennifer Rodriguez, Anna Newcomb
BACKGROUND: We studied trauma-specific conditions precluding semiupright positioning and other nonmodifiable risk factors for their influence on ventilator-associated pneumonia (VAP). METHODS: We performed a retrospective study at a Level I trauma center from 2008 to 2012 on ICU patients aged ≥15, who were intubated for more than 2 days. Using backward logistic regression, a composite of 4 factors (open abdomen, acute spinal cord injury, spine fracture, spine surgery) that preclude semiupright positioning (supine composite) and other variables were analyzed...
July 28, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27563598/the-use-of-superficial-cervical-plexus-block-in-oral-and-maxillofacial-surgical-practice-as-an-alternative-to-general-anesthesia-in-selective-cases
#12
R Kamal Kanthan
AIM: (1) To assess the feasibility, safety, and effectiveness of superficial cervical plexus (SCP) block in oral and maxillofacial surgical (OMFS) practice as an alternative to general anesthesia in selective cases. (2) To assess any associated complication specifically related to the procedure. SUBJECTS AND METHODS: The total number of patients was 10, out of which 6 were male and 4 were female patients. Six patients had incision and drainage of perimandibular space infections, two patients had Level Ib cervical lymph node biopsies, one patient had enucleation of cyst in the body of mandible, one patient had open reduction and internal fixation isolated angle fracture...
January 2016: Annals of Maxillofacial Surgery
https://www.readbyqxmd.com/read/27560007/five-common-clinical-presentations-in-the-elderly-an-anatomical-review
#13
Peter G Collin, Rod J Oskouian, Marios Loukas, Anthony V D'Antoni, R Shane Tubbs
Elderly patients face distinct health challenges and have an increased demand for specific medical procedures. As the aging population continues to increase, age-associated conditions such as congestive heart failure, hip fractures, spine degeneration, dementia and airway compromise will increase in prevalence and procedures to correct these conditions will be increasingly performed. A clear understanding of the clinical anatomy of these diseases and procedures is imperative for anatomists and clinicians alike in order to best treat patients and continue to advance aging research and better teach future medical practitioners about the specific anatomy often involved in this group...
August 25, 2016: Clinical Anatomy
https://www.readbyqxmd.com/read/27489759/fractured-metallic-tracheostomy-tube-a-rare-complication-of-tracheostomy
#14
Apichart So-Ngern, Viboon Boonsarngsuk
Although tracheostomy is a well-accepted procedure for airway management, some early and late complications may occur. Fracture of the tracheostomy tube (TT) is a rare complication, particularly in a patient with long-term use. Herein we report a case of fractured metallic TT migrating into the tracheobronchial tree. Rigid bronchoscopy was performed through the tracheostomy stoma and the fractured tube was successfully removed by a balloon catheter. Appropriate cleaning, routine careful examination, and scheduled replacement of the TT may help prevent this complication...
2016: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27461504/-copd-and-bone
#15
Ryo Okazaki
Chronic obstructive pulmonary disease(COPD)is a chronic inflammatory airway disease associated with various systemic comorbidities including osteoporosis. Osteoporosis is extremely common in COPD patients;up to 80%prevalence of vertebral fracture has been reported. However, its low awareness has left many patients untreated. Although pathophysiology of COPD-associated osteoporosis is largely unknown, multiple risk factors for osteoporosis are present, such as smoking, low body weight, systemic inflammation, vitamin D insufficiency, hypoxia...
August 2016: Clinical Calcium
https://www.readbyqxmd.com/read/27429940/submental-intubation-in-maxillofacial-fracture-a-case-report
#16
Hooshang Akbari, Mohammad Ali Heidari-Gorji, Rostam Poormousa, Mitra Ayyasi
It can be challenging to create a safe airway in maxilla facial fracture and some skull surgeries. In this case study, the patient experienced jaw fractures that disturbed the dental occlusion and associated fracture of the base of the skull. Neither nasal nor oral intubation was possible based on the side effects of tracheotomy; therefore, submental intubation was applied successfully. The procedure and results are presented in the text.
June 2016: Journal of the Korean Association of Oral and Maxillofacial Surgeons
https://www.readbyqxmd.com/read/27391510/treatment-options-in-maxillofacial-fractures
#17
Jorge Orlando Guerrissi
From 2000 to 2010, 720 patients with facial trauma were admitted in Plastic Surgery Service of Argerich Hospital, Buenos Aires, Argentina; 58 of them with panfacial fractures were included in this study. Height velocity impact is the principal etiology, and most concomitant extrafacial injuries are neurocranium and cervical spine. Common affected areas were orbits, nose, and malar-zygoma. The timing of the treatment was airway evaluation, control of bleeding and consciousness, treatment of associated injuries, and finally facial reconstruction...
July 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27382821/anesthetic-management-of-femoral-fracture-repair-in-a-patient-with-cervical-myelopathy-autonomic-dysfunction-and-difficult-airway
#18
Ajay R Vellore, Christopher B Robards, Steven R Clendenen
Spinal stenosis is a potentially serious condition that can lead to myelopathies and autonomic instability, both of which, as a result, may complicate anesthetic management. Additionally, neuraxial anesthesia appears to increase the risk of worsened neurological outcomes in this population. A 56-year-old female with spinal stenosis, autonomic dysfunction, and known difficult airway who required anesthesia for repair of a femur fracture is presented. After pre-operative arterial line and femoral block placement, an ultrasound guided subarachnoid block was safely placed...
February 2016: Middle East Journal of Anesthesiology
https://www.readbyqxmd.com/read/27354779/smokers-with-emphysema-and-small-airway-disease-on-computed-tomography-have-lower-bone-density
#19
Esther Pompe, Pim A de Jong, Eva M van Rikxoort, Leticia Gallardo Estrella, Werner U de Jong, Rozemarijn Vliegenthart, Matthijs Oudkerk, Carlijn M van der Aalst, Bram van Ginneken, Jan-Willem J Lammers, Firdaus Aa Mohamed Hoesein
Osteoporosis is more common in patients with COPD and in smokers. The aim of this study was to assess whether measures of emphysema and airway disease on computed tomography (CT) were associated with lower bone density or vertebral fractures in smokers with and without COPD. For this purpose, we included participants from the NELSON lung cancer screening trial. Bone density was measured as Hounsfield Units in the first lumbar vertebra, and vertebral fractures were assessed semiquantitatively. The 15th percentile method (Perc15) was used to assess emphysema, and the airway lumen perimeter (Pi10) was used for airway wall thickness...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27290947/awake-intubating-laryngeal-mask-airway-placement-in-a-morbidly-obese-patient-with-ankylosing-spondylitis-and-unstable-thoracic-spine
#20
Abbey G Herman, Michael E Mahla
Intubating laryngeal mask airways can be used to provide continuous ventilation throughout intubation. This is a case of a morbidly obese (body mass index = 58) 65-year-old woman with T10 and T11 compression fractures. Optimal positioning for airway management was hindered by her unstable spine, minimal neck range of motion, and extreme pain with any movement. An intubating laryngeal mask airway was placed in the awake, topically anesthetized patient, and the laryngeal mask airway and endotracheal tube combination was left in place throughout surgery...
August 2016: Journal of Clinical Anesthesia
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