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Tracheotomies

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https://www.readbyqxmd.com/read/28440922/pseudomonas-aeruginosa-and-post-tracheotomy-bacterial-respiratory-tract-infection-readmissions
#1
Christopher J Russell, Tamara D Simon, Mary R Mamey, Christopher J L Newth, Michael N Neely
OBJECTIVE: Identify risk factors for readmission due to a bacterial tracheostomy-associated respiratory tract infection (bTARTI) within 12 months of discharge after tracheotomy. DESIGN/METHODS: We performed a retrospective cohort study of 240 children who underwent tracheotomy and were discharged with tracheotsomy in place between January 1, 2005 and June 30, 2013. Children with prolonged total or post-tracheotomy length of stay (LOS), less than 12 months of follow-up, or who died during the index hospitalization were excluded...
April 25, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28437209/conversations-about-goals-and-values-are-feasible-and-acceptable-in-long-term-acute-care-hospitals-a-pilot-study
#2
Daniela J Lamas, Robert L Owens, R Nicholas Nace, Anthony F Massaro, Nathan J Pertsch, Susan T Moore, Rachelle E Bernacki, Susan D Block
RATIONALE: The chronically critically ill have survived acute critical illness but require prolonged mechanical ventilation. These patients are frequently transferred from acute care to long-term acute care hospitals (LTACHs) for prolonged recovery, yet many suffer setbacks requiring readmission to acute care. The patient's relatively improved condition while at the LTACH might be an opportunity for communication regarding care goals; however, there have been no prior studies of the feasibility of such conversations in the LTACH...
February 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28420845/suffocation-due-to-thoracic-deformity-caused-by-acromegaly
#3
Toshihiko Yoshizawa, Masayuki Iwazaki, Kei Jitsuiki, Kouhei Ishikawa, Hiromichi Ohsaka, Youichi Yanagawa
A 61-year-old man with gigantism and acromegaly choked and fell into a coma. Immediate tracheal intubation resulted in a return of his consciousness. Enhanced computed tomography indicated that the trachea and left main bronchus were compressed by the thoracic spine and sternum. He required tracheotomy and positive end-expiratory pressure to maintain his pulmonary function. This is the first case of suffocation due to a thoracic deformity associated with acromegaly. Physicians should focus on clearing the tracheal airway using computed tomography to elucidate the anatomical relationship between the trachea and surrounding structures in acromegalic patients suffering from dyspnea...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28418347/difficult-cases-of-odontogenic-deep-neck-infections-a-report-of-three-patients
#4
Onur İsmi, Mesut Yeşilova, Cengiz Özcan, Yusuf Vayisoğlu, Kemal Görür
BACKGROUND: Deep neck infections are important otolaryngologic emergencies due to serious complications and the risk of airway compromise, which can lead to mortality. Although the most common causes among pediatric patients are tonsillitis and pharyngeal infections, odontogenic infections are an important cause in adults. CASE REPORT: We present three patients with multiple deep neck space abscess formation due to odontogenic infection. Two of them required tracheotomy due to airway compromise, and one had mediastinitis...
April 5, 2017: Balkan Medical Journal
https://www.readbyqxmd.com/read/28416071/-acute-upper-airway-obstruction-caused-by-a-multinodular-goitre-after-tracheotomy
#5
Chadi Nimeh Abdel-Halim, Bibi Lange
This case report illustrates how a multinodular goitre caused acute airway obstruction in a multitrauma 66-year-old male after tracheotomy. The patient had no symptoms of the goitre before the tracheotomy but developed subglottic airway obstruction at the time of decannulation. He underwent a subacute total thyroidectomy which removed the obstructive symptoms. A weakening of the tracheal tube followed by the tracheotomy possibly caused the tracheal stenosis in combination with the goitre.
April 3, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28410251/association-of-need-for-tracheotomy-with-decreasing-mechanical-in-exsufflation-flows-in-amyotrophic-lateral-sclerosis
#6
John R Bach, Neelam Upadhyaya
Although patients with lower motor neuron and myopathic disorders can prolong their lives by depending on continuous noninvasive ventilatory support, most patients with amyotrophic lateral sclerosis (ALS) cannot and must use tracheostomy mechanical ventilation to prolong survival. This case demonstrates that this occurs because amyotrophic lateral sclerosis patients' upper motor neuron reflex laryngeal closure and stridor cause upper airway collapse that renders mechanical insufflation-exsufflation (MIE) ineffective in expulsing airway secretions as well as for permitting continuous noninvasive ventilatory support...
April 13, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28409444/locally-invasive-thyroid-cancer-options-for-a-treatment
#7
Nicola Avenia, Jacopo Vannucci, Massimo Monacelli, Andrea Polistena, Francesco Puma
Local invasion to neighbor organs by thyroid cancer is an important prognosticator and requires different therapeutic approach. Which one is the possible best treatment option and results are evaluated in this study. A single-institution experience in thyroid cancer invading the airway is evaluated retrospectively (1990-2016). Facts regarding patients' demographics, disease history, comorbidities, condition at first evaluation and reason for referral are analyzed. Hospital records and treatment details are extracted from charts and Institutional folders...
April 13, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28398924/factors-leading-to-transmission-risk-of-acinetobacter-baumannii
#8
Kerri A Thom, Clare Rock, Sarah S Jackson, J Kristie Johnson, Arjun Srinivasan, Laurence S Magder, Mary-Claire Roghmann, Robert A Bonomo, Anthony D Harris
OBJECTIVES: To identify patient and healthcare worker factors associated with transmission risk of Acinetobacter baumannii during patient care. DESIGN: Prospective cohort study. SETTING: ICUs at a tertiary care medical center. PATIENTS: Adult ICU patients known to be infected or colonized with A. baumannii. MEASUREMENTS AND MAIN RESULTS: Cultures of skin, respiratory tract, and the perianal area were obtained from participants and evaluated for the presence of A...
April 10, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28397673/-tracheotomy
#9
Marianne Kromann Nielsen, Erik Gustav Hägerström, Waldemar Trolle
The number of tracheotomies in Denmark has roughly tripled over the past 15 years. During this period, percutaneous dilatational tracheotomy has become still more common because of its easier accessibility, and it accounted for 66% of all tracheotomies in 2015 vs. 9% in 2000. However, due to the risk of fatal complications the method is only applicable when anatomical and medical conditions are favourable. Surgical tracheotomy is a safer method in some patients, and it is preferred if the patient has had a tracheostomy previously or presents with a difficult anatomy, coagulopathy or previous neck irradiation...
February 13, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28391268/a-modified-tracheal-transaction-approach-for-the-repair-of-nonmalignant-tracheoesophageal-fistulas-a-report-of-5-cases
#10
Jie Liu, Wei Wu, Shaoyan Liu, Zhengang Xu, Jian Wang, Baowei Li
BACKGROUND: A postintubation tracheoesophageal fistula is a rare complication of a tracheotomy. Surgical repair is the only viable option for these patients, but the repair techniques presented in the literature vary. METHODS: We used a modified tracheal transaction approach to repair 5 cases of nonmalignant tracheoesophageal fistulas. The procedure was performed with a low cervical collar incision, and the trachea was transected directly. All the procedures were only carried out in the surgical field created by tracheostomy and paratracheal and esophageal dissection was no longer necessary...
April 8, 2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/28390805/from-transmandibular-to-transoral-robotic-approach-for-parapharyngeal-space-tumors
#11
Francesco Chu, Marta Tagliabue, Gioacchino Giugliano, Luca Calabrese, Lorenzo Preda, Mohssen Ansarin
PURPOSE: Parapharyngeal space (PPS) tumors are rare, accounting for 0.5% of all head-and-neck masses. Surgery remains the standard treatment for most cases, including different approaches (cervical approach, parotidectomy, mandibulotomy, transoral/robotic). We report our experience in the management of PPS tumors, aiming to create a surgical algorithm on the base of tumor's radiological and clinical characteristics. MATERIALS AND METHODS: Critical retrospective analysis of patients with PPS neoplasms who underwent surgery at our Institute...
March 31, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28390757/multistage-sclerotherapy-for-extensive-lymphatic-malformations-with-airway-involvement-in-infants-a-protocol-to-prevent-tracheotomy
#12
An-Wei Chen, Tao Wang, Ying-Ying Huang, Shao-Hua Liu
PURPOSE: The management of extensive head and neck lymphatic malformations (LMs) in infants is challenging because of life-threatening upper airway compression. The aim of this study was to present a management protocol and evaluate the clinical outcomes for preventing tracheotomy in these patients. MATERIALS AND METHODS: Fifteen infants with extensive head and neck LMs and airway involvement were enrolled from August 2010 through September 2015 at the Qilu Hospital of Shandong University (Jinan, China)...
March 18, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28377879/membranous-tracheal-stenosis-in-a-patient-with-anorexia-nervosa-and-self-induced-vomiting-challenges-in-securing-the-airway
#13
Motohiro Nakamura, Masaki Hisamura, Masayuki Hashimoto, Makoto Sawano, Midori Joshita, Takahiro Toi, Yoshitaka Asano, Hideyo Matsueda, Fumihito Arima, Hidenori Oi, Takehiro Kitawaki, Yoji Ando, Kenji Koshimizu
We report a rare case of acquired membranous tracheal stenosis in a patient with anorexia nervosa and a history of self-induced vomiting, but without a history of tracheal intubation or tracheostomy. A 50-year-old woman presented with difficulty in breathing and swallowing, self-expectoration, and impaired consciousness due to acute benzodiazepine intoxication. Bronchoscopic examination was performed after tracheotomy and placement of a tracheostomy tube failed to secure her respiratory tract and ventilation continued to deteriorate...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/28358930/association-of-transoral-robotic-surgery-with-short-term-and-long-term-outcomes-and-costs-of-care-in-oropharyngeal-cancer-surgery
#14
Kevin Motz, Hsien-Yen Chang, Harry Quon, Jeremy Richmon, David W Eisele, Christine G Gourin
Importance: The treatment of oropharyngeal cancer has undergone a paradigm shift in the past 2 decades, with an increase in the use of nonoperative treatment owing to poor functional outcomes associated with traditional surgical approaches. Transoral robotic surgery (TORS) allows surgical resection of oropharyngeal cancer (OPC) with less morbidity through a minimally invasive approach. Objective: To investigate the relationship among TORS and short- and long-term outcomes and costs in surgically treated patients with OPC...
March 30, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28338364/indications-risk-of-lower-airway-infection-and-complications-to-pediatric-tracheotomy-report-from-a-tertiary-referral-center
#15
Christian Grønhøj, Birgitte Charabi, Christian von Buchwald, Thomas Hjuler
BACKGROUND: Although pediatric tracheotomy is potentially life-saving, the procedure is associated with high risk of complications, and indications have changed the last decade. We report indications, complications, and lower airway infections (LAIs) to pediatric tracheotomy performed at a tertiary referral center. METHODS: We identified all children (<18 years) who underwent tracheotomy at our institution during 2008-2015. A review of hospital records was performed to extract data on indication of the procedure, complications, and information on pre- and postoperative LAI...
March 24, 2017: Acta Oto-laryngologica
https://www.readbyqxmd.com/read/28334798/risk-factors-for-postoperative-delirium-in-patients-undergoing-major-head-and-neck-cancer-surgery-a-meta-analysis
#16
Yun Zhu, Gangpu Wang, Shengwen Liu, Shanghui Zhou, Ying Lian, Chenping Zhang, Wenjun Yang
Objective: Postoperative delirium is common after extensive surgery. This study aimed to collate and synthesize published literature on risk factors for delirium in patients with head and neck cancer surgery. Methods: Three databases were searched (MEDLINE, Embase, and Cochrane Library) between January 1987 and July 2016. The Newcastle Ottawa Scale (NOS) was adopted to evaluate the study quality. Pooled odds ratios or mean differences for individual risk factors were estimated using the Mantel-Haenszel and inverse-variance methods...
February 24, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28328693/a-giant-pseudoaneurysm-mimicking-retropharyngeal-abscess-in-a-child
#17
Rijuneeta Gupta, Sourabha K Patro, Neha Chauhan, Ajay Kumar
Pseudoaneurysms of the cervical internal carotid artery are rare and usually result from trauma, infection, or rarely spontaneously. They harbor potential risk of life-threatening hemorrhage and warrant immediate management. Endovascular treatment in the form of stent placement and coiling is a well established technique for dealing with both intracranial and extracranial pseudoaneurysms. We present a case of a child who presented with fever, neck swelling, dysphagia, and respiratory distress in emergency for which clinical diagnosis of a neck abscess was made...
March 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28320544/-about-a-case-of-laryngeal-location-of-sapho
#18
L Vatin, E Jean, D Rivière, M Montava, A Giovanni, P Dessi, A Lagier
INTRODUCTION: Synovitis, acne, pustulosis, hyperostosis, osteitis (SAPHO) is a syndrome that combines dermatological, articular and osseous inflammatory manifestations. Bilateral laryngeal immobility relative to cricoarytenoid joint origin is very uncommon. This article presents a case of bilateral cricoarytenoid joint ankylosis in a SAPHO syndrome context. CASE REPORT: A 53-year-old patient presenting with a two year history of intermittent bouts of dyspnea. A SAPHO syndrome was discussed on repeated thoracic CT-scan...
March 17, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28316781/dyspnea-and-dysphagia-associated-to-hypopharyngeal-fibrolipoma-a-case-report
#19
Marco A Mendez Saenz, Vicente J Villagomez Ortiz, Mario Jesús Jr Villegas González, Baltazar Gonzalez Andrade, Miguel Angel Liñan Arce, German A Soto-Galindo, José Luis Treviño González
Fibrolipomas are benign lesions conformed by fat and connective tissue, classified as histologic variants of lipomas. They are rarely located in the head and neck and represent less than 0.6% of the benign tumors of the larynx and hypopharynx. Their clinical presentation depends on its location and size. We present the case of a 51-year-old male patient who reported progressive dyspnea, dysphagia and obstructive sleep symptoms with a duration of 3 months, without apparent cause. A pharyngolaryngeal fiberoptic endoscopy showed a smooth, rounded mass in the posterior wall of the hypopharynx, partially obstructing the laryngeal vestibule, creating a valve effect...
April 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28316160/-effect-of-low-dose-erythromycin-on-the-proliferation-of-granulation-tissue-after-tracheal-injury
#20
L H Li, M P Xu, L M Gan, Y Li, Y L Liang, W T Li, E Y Qin, J H Gan, G N Liu
Objective: To investigate the effect of low dose erythromycin on the proliferation of granulation tissue after tracheal injury. Methods: Forty-two rabbits were randomly divided into 7 groups (n=6 each), group A (saline control group), group B (penicillin group), group C (low dose erythromycin group), group D (low dose erythromycin and penicillin group), group E (budesonide group), group F (low dose erythromycin and budesonide group), group G (low dose erythromycin, penicillin and budesonide group). All rabbits received tracheotomy, and the tracheal mucosa was scraped with a nylon brush 20 times for tracheal stenosis model...
March 14, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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