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Direct Laryngoscopy

Jacob T Cohen, Taiser Bishara, Vladimir Trushin, Limor Benyamini
Objective To examine the adverse events and time to diagnosis of in-office laryngeal biopsy (IOB) procedures. Study Design Retrospective cohort study. Setting Outpatient clinic-tertiary referral medical center. Subjects and Methods A total of 390 IOBs were included in this study. Data on demographic characteristics, outcomes, and complications were collected. Complications were classified as severe-necessitating further intervention or admission-or mild and self-limited. Delay in diagnosis, assessed as a complication of IOB, was calculated as the time from initial examination to final diagnosis...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Chia-Chih Liao, Fu-Chao Liu, Allen H Li, Huang-Ping Yu
Video laryngoscopy-assisted tracheal intubation devices have become alternatives to traditional laryngoscopes in recent years. This review will provide information on commonly used video laryngoscopes, and their clinical applications in airway management. Areas covered: In this review, the differences between video laryngoscopy and direct laryngoscopy, and the utilization of video laryngoscopes in specific clinical settings are discussed. Expert Commentary: Video laryngoscopy should be embraced as an initial approach to intubation in patients with suspected difficult airway...
March 5, 2018: Expert Review of Medical Devices
Hanyue Li, Yingjie Hu, Jia Huang, Yunhai Yang, Kaichen Xing, Qingquan Luo
BACKGROUND: Vagus nerve and recurrent laryngeal nerve (RLN) injury are not rare complications of lung cancer surgery and can cause lethal consequences. Until now, no optimal method other than paying greater attention during surgery has been available. METHODS: Four patients underwent lung surgery that involved RLN or vagus nerve injury. The left RLN or vagus nerve was cut off and then reconstructed immediately during surgery. Two patients underwent direct anastomosis, while the remaining two underwent phrenic nerve replacing tension-relieving anastomosis...
March 2, 2018: Thoracic Cancer
Sevtap Hekimoglu Sahin, Beyhan Karamanlioglu, Mehmet Turan Ina, Huseyin Ugur, Tolgay Akıncı, Hakan Tagrikulu, Banu Tutunculer
Tracheal intubation is performed as part of daily routine in the operating room, rarely with complications. However, management of airway for cases such as a penetrating neck trauma case might constitute exceptions, in which cases the stabilization of the neck to prevent any further neural damage is a significant source of concern for the anesthesiologist. Generally, intubation techniques for penetrating neck trauma were planned according to the initial position of patients. To our knowledge, this is the first case report of alterated the position of the patient during the anesthesia induction for direct laryngoscopy...
January 2018: Asian Journal of Neurosurgery
Kamath Sriganesh, Jason W Busse, Harsha Shanthanna, Venkatapura J Ramesh
Background and Aims: There is a paucity of clinical practice guidelines for the ideal approach to airway management in patients with cervical spine instability (CSI). The aim of this survey was to evaluate preferences, perceptions and practices regarding airway management in patients with CSI among neuroanaesthesiologists practicing in India. Methods: A 25-item questionnaire was circulated for cross-sectional survey to 378 members of the Indian Society of Neuroanaesthesiology and Critical Care (ISNACC) by E-mail...
February 2018: Indian Journal of Anaesthesia
Emad Kandil, Khuzema Mohsin, Mohammad A Murcy, Gregory W Randolph
OBJECTIVES/HYPOTHESIS: Continuous intraoperative neuromonitoring (CIONM) of the vagus nerve was proposed to obtained frequent repetitive electromyography (EMG) data to recognize early change in intraoperative function of the recurrent laryngeal nerve. We examine our initial experience using this technology. STUDY DESIGN: Retrospective review. METHODS: Data for all patients who underwent neck surgery by a single surgeon at a North American institution over a 5-year period were reviewed...
February 26, 2018: Laryngoscope
A B Ozer, E Bolat, O L Erhan, M Kilinc, I Demirel, G Caglar Toprak
Context: Sugammadex has steroid-encapsulating effect. Aim: This study was undertaken to assess whether the clinical efficacy of sugammadex was altered by the administration of steroids. Setting and Design: Sixty patients between 18 and 60 years of age with the American Society of Anesthesiologists I-IV and undergoing elective direct laryngoscopy/biopsy were included in this study. Materials and Methods: Patients were assigned to two groups based on the intraoperative steroid use: those who received steroid (Group S) and who did not (Group C)...
February 2018: Nigerian Journal of Clinical Practice
Scott M Alter, Eithan D Haim, Alex H Sullivan, Lisa M Clayton
OBJECTIVE: Direct laryngoscopy can be performed using curved or straight blades, and providers usually choose the blade they are most comfortable with. However, curved blades are anecdotally thought of as easier to use than straight blades. We seek to compare intubation success rates of paramedics using curved versus straight blades. METHODS: Design: retrospective chart review. SETTING: hospital-based suburban ALS service with 20,000 annual calls...
February 17, 2018: American Journal of Emergency Medicine
Marissa A Schwartz, James G Naples, Chia-Ling Kuo, Todd E Falcone
Objectives To evaluate national trends in opioid prescribing patterns by otolaryngologists for postoperative pain control after common otolaryngologic procedures. Study Design Cross-sectional; survey. Subjects and Methods A survey to determine opioid prescribing patterns for the treatment of postoperative pain following common otolaryngologic procedures was distributed to all members of the American Academy of Otolaryngology-Head and Neck Surgery. Results The most common pain medication prescribed for adults postoperatively was hydrocodone-acetaminophen (73%), followed by oxycodone-acetaminophen (39%)...
February 1, 2018: Otolaryngology—Head and Neck Surgery
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
Resit Murat Acikalin, Ayşe Vildan Özsan, Yalcin Alimoglu, Zafer Gezginadam, Huseyin Tarik Yanik, Samet Cagri Coskun, Hasan Kaya
Giant cell tumor of the larynx is a rare tumor. It was first reported by Wessely et al in 1940. Thirty-nine cases have been reported until now and together with the current case 2 recurrences were encountered. In this case report, our aim was to discuss conservative management because of the suspicion of recurrence. A 70-year-old male patient was admitted to our clinic with the complaint of hoarseness. A tumor measuring 1 × 1 cm located in the anterior half right vocal fold and extending to the anterior comissure was found on laryngeal endoscopy...
February 6, 2018: Journal of Craniofacial Surgery
Romualdo Del Buono, Lorenzo Sabatino, Federico Greco
Background: Direct laryngoscopy is the gold standard of the airway management in patients without predicted difficulties. If unpredicted difficulties are encountered instead, different algorithms to follow have been developed. To date, no single predictor is sufficiently valid. In clinical practice, it is used a combination of them to enhance the estimate, and despite the variety of parameters used, not all the difficult intubations are predicted. The aim of this work is to retrospectively analyze neck computed tomography scans of 37 patients who have had tracheal intubation and search for anatomic neck fat compartments that correlate with the intubation difficulty, and eventually find a suitable, clinical parameter that can potentially enhance the prediction of a difficult airway when used in combination of the preexisting scores...
January 2018: Saudi Journal of Anaesthesia
Karri Pavani, Handattu Mahabaleswara Krishna, Joseph Nandhini
Background and Aims: Higher success rate of intubation is observed with the reverse orientation of polyvinyl chloride (PVC) tracheal tube while intubating through laryngeal mask airway (LMA) Fastrach™. It is not clear whether the same is true during intubation through LMA CTrach™ visualizing the process of intubation. The primary aim of this study was to compare the influence of the PVC tracheal tube orientation on the success rate of intubation while intubating through LMA CTrach™...
October 2017: Journal of Anaesthesiology, Clinical Pharmacology
Pejman Pourfakhr, Ailar Ahangari, Farhad Etezadi, Reza Shariat Moharari, Ayat Ahmadi, Negin Saeedi, Atabak Najafi
BACKGROUND: Nasotracheal intubation is commonly performed to provide a secure airway for the maintenance of general anesthesia in maxillofacial surgeries. Routine nasotracheal intubation is performed under general anesthesia by direct laryngoscopy, frequently with the aid of Magill forceps. This method can be time-consuming and may cause bleeding in the field of view. A gum elastic bougie (GEB) is a cheap, slender, and flexible device that could expedite nasotracheal intubation. The aim of this study was to evaluate the use of a GEB during nasotracheal intubation to facilitate the procedure and reduce the rate of complications...
February 2, 2018: Anesthesia and Analgesia
Constantine Tarabanis, Nicholas B Abt, Heather A Osborn
BACKGROUND: The etiologies of intraoperative cardiac arrest within otolaryngology are not well understood as they are rare events. METHODS: A comprehensive review of the etiologies and corresponding pathophysiologic neural mechanisms of intraoperative cardiac arrest in otolaryngologic surgery are examined. RESULTS: The occurrence of this rare complication has been described in a range of head and neck procedures, including but not limited to suspension laryngoscopy and oncologic resections in the neck, maxilla and thyroid...
January 31, 2018: Head & Neck
Sampan-Singh Bist, Mahima Luthera, Poonam Arora, Lovneesh Kumar
Introduction: Aspirated foreign bodies continue to present challenges to otorhinolaryngologists. Removal of impacted airway foreign bodies via conventional methods can at times pose difficulty. This may be related to the location and type of foreign body, experience of the surgeon and anesthetist, and the availability of appropriate instruments. In adults, especially in edentulous patients, a swallowed denture usually gets lodged in the esophagus and entrance into the airway is uncommon...
November 2017: Iranian Journal of Otorhinolaryngology
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
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
José Luis Che-Morales, Esperanza Figueroa-Hurtado, Arturo Cortes-Télles
BACKGROUND: Based on international epidemiology, some laryngeal diseases could be more frequent at certain ages. The objective was to describe endoscopic findings in patients through distinct decades of age in a laryngoscopy facility. METHODS: retrospective and descriptive study; clinical and endoscopic records were collected from 1493 procedures performed between 2009 and 2015, and organized in five groups of age for analysis. Differences among them were analyzed by chi squared and ANOVA...
January 2018: Revista Médica del Instituto Mexicano del Seguro Social
M Megan Chacon, Sreekanth R Cheruku, Peter J Neuburger, Laeben Lester, Sasha K Shillcutt
Morbid obesity is associated with impairment of cardiovascular, pulmonary, gastrointestinal, and renal physiology with significant perioperative consequences and has been linked with higher morbidity and mortality after cardiac surgery. Cardiac surgery patients have a higher incidence of difficult airway and difficult laryngoscopy than general surgery patients do, and obesity is associated with difficult mask ventilation and direct laryngoscopy. Positioning injuries occur more frequently because obese patients are at greater risk of pressure injury, such as rhabdomyolysis and compartment syndrome...
December 13, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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