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Gargi Banerjee, Divya Jain, Indu Bala, Komal Gandhi, Ram Samujh
Background and Aims: Head and neck movements alter the shape of the pharynx, resulting in changes in the oropharyngeal leaking pressures and ventilation with supragottic airway devices. We compared the effect of the different head-and-neck positions on the oropharyngeal leak pressures and ventilation with the I-Gel™ and ProSeal™ laryngeal mask airway (PLMA) in anaesthetised paralysed children. Methods: A total of 70 children were randomly assigned to receive PLMA ( n = 35) or I-Gel™ ( n = 35) for airway management...
February 2018: Indian Journal of Anaesthesia
C Sadullahoğlu, B Yaman, A Veral, D Nart
INTRODUCTION: Fibreoptic bronchoscopy is used for the diagnosis and treatment of several pulmonary diseases. Conventional smear and Liquid-based cytology (LBC) methods are applied to cytology samples of various bronchoscopic techniques. If the cytology sample is sufficient for evaluation, a cell block (CB) can be prepared from the remaining material. The aim of this study is to identify the diagnostic value of conventional smear, LBC and CB methods in bronchial cytological specimens. METHODS: A retrospective review of 329 samples from 240 patients was made and, of these, 144 patients were found to have neoplasia...
February 22, 2018: Cytopathology: Official Journal of the British Society for Clinical Cytology
Margaret M Coffey, Neil Tolley, David Howard, Mary Hickson
Voice prostheses have been examined for their effect on voice production but there is little datum on their effect on swallow function. This study investigated the difference between six commonly available voice prostheses in terms of swallowing. Laryngectomy patients had up to six voice prostheses placed in a random order over two visits. Swallowing was evaluated for each prosthesis using FEES (Fibreoptic Endoscopic Evaluation of Swallowing). After each prosthesis trial, patients self-evaluated their experience of swallowing...
February 19, 2018: Dysphagia
Sook Hui Chaw, Ina I Shariffuddin, Li Lian Foo, Pui Kuan Lee, Ramona Maya Paran, Peak Chee Cheang, Lucy Chan
To date, most of the studies on safety and efficacy of supraglottic airway devices were done in Caucasian patients, and the results may not be extrapolated to Asian patients due to the different airway anatomy. We conducted this study to compare Supreme™ LMA (SLMA) and Proseal™ LMA (PLMA) size 1.5 in anaesthetized children among an Asian population. This prospective randomized clinical trial was conducted in a tertiary teaching hospital from September 2013 until May 2016. Sixty children, weighing 5-10 kg, who were scheduled for elective surgery under general anaesthesia were recruited and completed the study...
February 5, 2018: Journal of Clinical Monitoring and Computing
P Kozler, D Marešová, J Pokorný
Continuous monitoring of the intracranial pressure (ICP) detects impending intracranial hypertension resulting from the impaired intracranial volume homeostasis, when expanding volume generates pressure increase. In this study, cellular brain edema (CE) was induced in rats by water intoxication (WI). Methylprednisolone (MP) was administered intraperitoneally (i.p.) before the start of CE induction, during the induction and after the induction. ICP was monitored for 60 min within 20 h after the completion of the CE induction by fibreoptic pressure transmitter...
December 30, 2017: Physiological Research
Angelo Gianni Casalini, Pier Anselmo Mori, Maria Majori, Miriam Anghinolfi, Enrico Maria Silini, Letizia Gnetti, Federica Motta, Sandra Larini, Sara Montecchini, Roberta Pisi, Adriana Calderaro
Our objective was to evaluate the efficacy of a standardised work-up in the diagnosis of pleural tuberculosis (TB) that included fibreoptic bronchoscopy and medical thoracoscopy. A consecutive series of 52 pleural TB patients observed during the period 2001-2015 was evaluated retrospectively. 20 females, mean (range) age 39.7 (18-74) years, and 32 males, mean (range) age 45.75 (21-83) years, were included (28 non-EU citizens (53.8%)). The diagnosis of TB infections was established by identification (using stains, culture or molecular tests) of Mycobacterium tuberculosis in the pleura, sputum and/or bronchial specimens, or by evidence of caseous granulomas on pleural biopsies...
January 2018: ERJ Open Research
Salil Sood, Ian Street, Adam Donne
Hoarseness or dysphonia are terms used to describe a change in the quality of the voice. The voice quality can be raspy, breathy, strained, fatigued, rough, tremulous or weak. There may be a change in pitch, restriction of range, voice breaks, decreased projection, or abnormal resonance. It is important to remember that a voice disorder is not a disease in itself but rather a presentation of an underlying pathology. Clinicians' knowledge of paediatric hoarseness is limited as it can be difficult to examine children using fibreoptic laryngoscopy and the child may not comprehend the need for detailed examination...
December 2, 2017: British Journal of Hospital Medicine
Prasanna Kumar Saravanam, Vinoth Manimaran
The incidence of congenital stridor is on rise due to improved neonate and infant survival rate. The gold standard investigation for evaluation of stridor is rigid laryngotracheobronchoscopy, but this is invasive and requires general anesthesia. Flexible fibreoptic laryngoscopy, a relatively simple and less invasive procedure can be done under topical anaesthesia for evaluation of stridor. In this study, we have presented our experience of flexible laryngoscopy in children with congenital stridor, their results and management...
December 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
Lavina Vishnu Mirchandani, Sindhu S Kamath, Jayalakshami Thelapurath Kutty, Aparna Iyer
Primary pulmonary tuberculosis can involve regional lymph nodes which may resolve spontaneously or on treatment; or they may enlarge causing extrinsic bronchial compression; or cause endobronchial inflammation and ulceration; or a node may erode through the bronchial wall with extrusion of caseous materials into the bronchial tree, causing focal or lobar pneumonia. This erosion is seen radiologically as hilar lymphadenopathy, with atelectasis and consolidation and described as "epituberculosis". It is more common in infants than older children...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
Hamoud Al Arouj, Abdulmohsen Kamel AlBader, Imtiyaz Nawaz Bhat
INTRODUCTION: (Chondrometaplasia of the larynx is a rare disease. We report a case that presented at the otolaryngology department in our institute in 2015.) PRESENTATION OF CASE: A 62year old man without any history of trauma presented with progressive dysphonia, dyspnoea, without any dysphagia. A fibreoptic laryngoscopic examination revealed nodular mass arising at the junction of anterior 1/3rd and posterior 2/3rd of left vocal cord. DISCUSSION: A computed tomography scan of the neck region showed a rounded and circumscribed mass without infiltration of the surrounding tissues...
2018: International Journal of Surgery Case Reports
C J László, Z Szűcs, Á Nemeskéri, G Baksa, A Szuák, M Varga, E Tassonyi
We assessed the suitability of human cadavers preserved using Thiel's method for teaching flexible fibreoptic tracheal intubation. Thirty-one anaesthetists unacquainted with this technique received didactic teaching followed by handling of the fibrescope on the Oxford teaching box. They then carried out fibreoptic intubations in two cadavers to establish a baseline sample of their intubation skills. Thereafter, we randomly assigned the trainees to two groups to practice fibreoptic intubation either on two distinct cadavers or on two airway manikins...
January 2018: Anaesthesia
Phuong Thao Nguyen, Daveena Meeks, Despoina Liotiri
We present a case that highlights the issues surrounding the delivery of a safe general anaesthetic to a patient with Huntington's disease (HD) and bulbar dysfunction. In the case of a 46-year-old patient undergoing laparoscopic percutaneous endoscopic gastrostomy tube insertion, we discuss the rationale behind our chosen method and anaesthetic agents as well as airway issues specific to HD. In a patient whose condition would not allow for an awake fibreoptic intubation, we opted for a modified rapid sequence induction...
October 19, 2017: BMJ Case Reports
T Piegeler, N G Clausen, M Weiss, Takashi Asai
Background: Proper manipulation of fibreoptic bronchoscopes is essential for successful tracheal intubation or diagnostic bronchoscopy. Failure of proper navigation and rotation of the fibrescope may lead to difficulties in advancing the fibrescope and might also be responsible for (unnecessary) difficulties and delays in fibreoptic tracheal intubation, with subsequent hypoxaemia. The present study, therefore, aimed to assess the effectiveness of tip rotation in flexible bronchoscopes in different experimental conditions...
December 1, 2017: British Journal of Anaesthesia
Silvia DE Rosa, Fiorenza Ferrari, Stefano Carboni Checcacci, Alessandro Rigobello, Paolo Gennaro, Daniele DE Luca, Mirco Primadei, Federico Politi, Adriano Pellizzari, Raffaele Bonato
BACKGROUND: A new promising device, the Spritztube (ST), was developed combining the ability to perform both supraglottic ventilation and orotracheal fibreoptic intubation using the same device, allowing an easy passage from supraglottic ventilation to tracheal ventilation avoiding apnea. The present study aims to compare the speed and the subjective ease of in- sertion of the novel tracheal tube (Spritztube ®) compared to the intubating laryngeal mask airway FastrachTM [FT-LMA] in a simulation environment...
October 4, 2017: Minerva Anestesiologica
D H Kim, J Y Yoo, S Y Ha, Y J Chae
Background: We compared the performances of the paediatric blade of a Pentax Airway Scope and an Ovassapian airway in fibreoptic tracheal intubation in patients whose necks were stabilized by semi-rigid neck collars. Methods: Ninety patients were enrolled in this prospective, open-label, randomized controlled trial. Patients were randomly allocated to one of two groups (Group OVA-FOB and Group AWS-FOB). The time to tracheal intubation, success rate of tracheal intubation, number of optimization manoeuvres (jaw thrust), and difficulty of manipulation of the fibreoptic bronchoscope were compared between the groups...
November 1, 2017: British Journal of Anaesthesia
Bindu K Vasu, Sunil Rajan, Jerry Paul, Lakshmi Kumar
BACKGROUND AND AIMS: Successful awake fibreoptic intubation (AFOI) depends on adequate topical anaesthesia of the airway. We aimed to compare efficacy of atomised local anaesthetic versus transtracheal topical anaesthesia for AFOI. METHODS: It was a prospective, randomised controlled study of 33 patients with the American Society of Anesthesiologists' physical status 1-3 with anticipated difficult airway requiring AFOI. The primary objective was to compare the patient comfort after topical anaesthesia of the airway using atomiser with transtracheal injection of the local anaesthetic agent for AFOI in patients with anticipated difficult airway...
August 2017: Indian Journal of Anaesthesia
Myoung H Kim, Jae H Lee, Yong S Choi, Sujung Park, Seokyung Shin
BACKGROUND: The laryngeal mask airway supreme (LMA-S) and i-gel are both popular second-generation supraglottic airway devices that have been widely studied in surgical patients, but their differences in clinical performance in the elderly are not clear. OBJECTIVE: We compared the efficacy and safety of the LMA-S and i-gel in anaesthetised and paralysed elderly patients. DESIGN: A prospective, randomised and parallel study. SETTING: Single-centre trial, study period January 2014 from to October 2016...
August 28, 2017: European Journal of Anaesthesiology
Silvia Proietti, Bhaskar Somani, Mario Sofer, Amelia Pietropaolo, Marco Rosso, Giuseppe Saitta, Franco Gaboardi, Olivier Traxer, Guido Giusti
OBJECTIVE: To assess the "body mass index" (BMI) (weight and length) of 12 flexible ureteroscopes (digital and fiber optic) along with the light cables and camera heads, to make the best use of our instruments. MATERIALS AND METHODS: Twelve different brand-new flexible ureteroscopes from four different manufacturers, along with eight camera heads and three light cables were evaluated. Each ureteroscope, camera head, and light cable was weighted; the total length of each ureteroscope, shaft, handle, flexible end-tip, and cable were all measured...
October 2017: Journal of Endourology
Nithya Kannan, Alex Quistberg, Jin Wang, Jonathan I Groner, Richard B Mink, Mark S Wainwright, Michael J Bell, Christopher C Giza, Douglas F Zatzick, Richard G Ellenbogen, Linda Ng Boyle, Pamela H Mitchell, Monica S Vavilala
OBJECTIVE: To examine the frequency of and factors associated with emergency department (ED) intracranial pressure (ICP) monitor placement in severe paediatric traumatic brain injury (TBI). METHODS: Retrospective, multicentre cohort study of children <18 years admitted to the ED with severe TBI and intubated for >48 hours from 2007 to 2011. RESULTS: Two hundred and twenty-four children had severe TBI and 75% underwent either ED, operating room (OR) or paediatric intensive care unit (PICU) ICP monitor placement...
2017: Brain Injury: [BI]
Gül Pamukçu Günaydın, Selahattin Gürü, Elif Aslan Taş, Fatih Tanrıverdi, Gülhan Kurtoğlu Çelik
In this article, we present a case of recurrent laryngeal nerve palsy not caused by nerve injury but due to local anesthetic infiltration that was applied prior to central venous catheterization. A 47-year-old female patient was admitted to emergency room with fatigue and nausea and was diagnosed with acute renal failure. Right jugular venous catheterization was performed for emergency hemodialysis with Seldinger technique using middle approach. Within minutes and immediately after the procedure the patient complained of hoarseness and shortness of breath, and she had stridor in her physical exam...
November 2017: American Journal of Emergency Medicine
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