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https://www.readbyqxmd.com/read/29225749/humble-foley-s-catheter-to-the-rescue-in-a-case-of-t-tube-insertion-a-case-report
#1
Upasana Goswami, Praneet Singh
The Montgomery T-tube poses a challenge to anesthesiologists because of loss of anesthetic gases through the open proximal end of the vertical limb and lack of standard anesthesia circuit connectors. Here, we present a case of a 25-year-old woman with a reported history of accidental strangulation 18 months previously. The patient had a metallic tracheostomy tube in situ due to the development of tracheal stenosis. Computed tomography showed significant narrowing in a 7-8-mm segment, 2 cm proximal to the tracheostomy tube in situ...
December 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29225012/comparison-of-3-techniques-in-percutaneous-tracheostomy-traditional-landmark-technique-ultrasonography-guided-long-axis-approach-and-short-axis-approach-randomised-controlled-study
#2
Kupeli Ilke, Nalbant Aysenur
INTRODUCTION: The aim of this study is to compare the reliabilities of traditional landmark method, ultrasonography-guided long-axis in-plane application, and ultrasonography-guided short-axis out-of-plane application in percutaneous dilatational tracheostomy. PATIENTS AND METHODS: A total of 60 patients were divided in 3 random groups undergoing percutaneous tracheostomy by using landmark method, ultrasonography-guided out-of-plane method, and ultrasonography-guided in-plane method...
December 7, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/29224771/revision-repair-of-type-iv-laryngotracheoesophageal-cleft-using-multiple-long-tapered-engaging-grafts
#3
Evan J Propst
An 8 year-old female with esophageal atresia and a type IV laryngotracheoesophageal cleft underwent tracheostomy, gastric pull-up and fundoplication with G-tube insertion at birth. She remained nil per os due to aspiration. The trachealis was separated from the esophagus that was reapproximated and clavicular periosteum was placed. A long posterior costal cartilage graft that engaged behind the cricoid plate and tapered inferiorly was inserted. A second thin cartilage graft was sutured to it distally to extend the length of the repair...
December 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29222827/responding-to-parental-requests-for-life-sustaining-treatment%C3%A2-relational-potential-revisited
#4
Aaron Wightman, Jennifer Cobelli Kett, Benjamin Wilfond
One of the most challenging situations for pediatric clinicians is responding to parental requests for life-sustaining medical therapies for a child with profound neurodevelopmental disabilities. These therapies (e.g. intravenous medications and fluids, gastrostomy tube feeds, dialysis, tracheostomy, and/or mechanical ventilation) offer the possibility for the child to live, at home or in a facility, for months or years as opposed to experiencing their imminent death. While relatively rare, the tension surrounding these requests can be exceptionally high, as illustrated by the cases of Baby K, Baby Joseph, Jahi McMath, Charlie Gard, and many others from our own experience...
December 8, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29210725/airway-management-in-a-patient-with-tracheal-disruption-due-to-penetrating-neck-trauma-with-hollow-point-ammunition-a-case-report
#5
Angela M Johnson, James L Hill, Dave J Zagorski, Joseph M McClain, Nicole C Maronian
Rapid sequence induction and intubation was performed for a patient in respiratory distress after a gunshot wound to the neck. Resistance was noted distal to vocal cords. With a bronchoscope unavailable, the endotracheal tube was advanced with a corkscrew maneuver. Subcutaneous emphysema had developed. The endotracheal tube was advanced into the right mainstem with adequate ventilation. Imaging illustrated tracheoesophageal injury. The patient was emergently explored. An intraluminal bullet was removed, lateral wall tracheal defect was repaired, and a tracheostomy was placed...
November 27, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29201636/laryngotracheoesophageal-cleft-type-3-and-severe-laryngotracheomalacia-delayed-surgical-repair-a-treatment-challenge-with-an-excellent-outcome
#6
Ahmad Khaleghnejad, Saeed Sadr, Seyyed Ahmad Tabatabaei, Nazanin Farahbakhsh, Payman Dabirmoghaddam, Saeed Saadat Mansori
Laryngotracheoesophageal clefts (LTEC) are rare malformations which involve the upper respiratory and digestive tract. Surgical repair should be undertaken promptly to maintain a secure airway and prevent serious pulmonary aspiration. This paper reports the first case of LTEC type 3 with severe laryngotracheomalacia that was brought to Mofid children's hospital in late infancy with a poor health status. Delayed defect correction was our team strategy for the patient when she had achieved good weight gain. At the age of 22 months in collaboration with the pediatric surgical and otolaryngologist team, the repair of the laryngeal cleft was done with lateral open approach method...
2018: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/29177627/virtual-3d-planning-of-tracheostomy-placement-and-clinical-applicability-of-3d-cannula-design-a-three-step-study
#7
Bertram J de Kleijn, Joep Kraeima, Jasper E Wachters, Bernard F A M van der Laan, Jan Wedman, M J H Witjes, Gyorgy B Halmos
AIM: We aimed to investigate the potential of 3D virtual planning of tracheostomy tube placement and 3D cannula design to prevent tracheostomy complications due to inadequate cannula position. MATERIALS AND METHODS: 3D models of commercially available cannula were positioned in 3D models of the airway. In study (1), a cohort that underwent tracheostomy between 2013 and 2015 was selected (n = 26). The cannula was virtually placed in the airway in the pre-operative CT scan and its position was compared to the cannula position on post-operative CT scans...
November 24, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29160154/staging-neck-dissection-and-transoral-robotic-surgery-treatment-algorithm-in-palatine-tonsil-cancer
#8
Joseph Spellman, Ryan Sload, Paul Kim, Peter Martin, Gabriel Calzada
Objective This study introduces a treatment algorithm based on staging neck dissection to identify patients with palatine tonsil squamous cell carcinoma who can be effectively treated with single-modality transoral robotic surgery while maintaining quality of life. Study Design Retrospective case series. Setting Kaiser Permanente Southern California Medical Group from 2012 to 2017. Subjects and Methods Patients with early-stage (T1/2) palatine tonsil squamous cell carcinoma with clinically and radiographically N0 necks underwent staging neck dissection...
November 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29146179/soft-palate-reconstruction-after-radionecrosis-combined-anterolateral-thigh-adipofascial-and-nasoseptal-flaps
#9
Joseph Zenga, Jeffrey D Sharon, Jennifer Gross, Jay Gantz, Patrik Pipkorn
Although radiation-based treatment for nasopharyngeal cancer may achieve excellent long term oncologic results, late effects of therapy may lead to soft tissue radionecrosis and velopharyngeal insufficiency (VPI). Repair of these oro- and nasopharyngeal defects presents a complex reconstructive challenge. We present a case of a long-term survivor treated with chemoradiotherapy for nasopharyngeal cancer who developed progressive dysphagia, velopharyngeal insufficiency, and radionecrosis of the nasopharynx and soft palate, leading to tracheostomy and gastrostomy tube dependence...
November 13, 2017: Auris, Nasus, Larynx
https://www.readbyqxmd.com/read/29120096/the-association-between-oral-health-status-and-respiratory-pathogen-colonization-with-pneumonia-risk-in-institutionalized-adults
#10
Chl Hong, M M Aung, K Kanagasabai, C A Lim, S Liang, K S Tan
OBJECTIVES: This study aimed to assess the oral health and the prevalence of pre-existing oral colonization with respiratory pathogens in dependent elderly, and whether these factors influence pneumonia development. MATERIALS AND METHODS: Participants residing in a long-term care facility received bedside oral examinations, and information on their oral health (caries status, calculus index and debris index) was obtained. Samples from the tongue and teeth were collected at baseline and at time of pneumonia development...
November 9, 2017: International Journal of Dental Hygiene
https://www.readbyqxmd.com/read/29119320/total-or-subtotal-glossectomy-with-laryngeal-preservation-a-national-study-of-29-patients
#11
Harri Keski-Säntti, Leif Bäck, Patrik Lassus, Petri Koivunen, Ilpo Kinnunen, Henry Blomster, Antti A Mäkitie, Katri Aro
Total glossectomy remains a controversial procedure as it often leads to notorious sequalae in swallowing and speaking functions. Disease entities indicating total glossectomy tend to have poor prognosis. We evaluated whether this type of surgery can be concidered justified based on our national series. We reviewed all total and subtotal glossectomies with laryngeal preservation performed in Finland between 2005 and 2014 in terms of overall survival (OS), disease-specific survival (DSS), locoregional control (LRC), and functional outcome as assessed by gastric tube or tracheostomy dependence and ability to produce intelligible speech...
November 8, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29098448/incidence-of-airway-complications-in-patients-using-endotracheal-tubes-with-continuous-aspiration-of-subglottic-secretions
#12
Jordi Vallés, Susana Millán, Emili Díaz, Eva Castanyer, Xavier Gallardo, Ignacio Martín-Loeches, Marta Andreu, Mario Prenafeta, Paula Saludes, Jorge Lema, Montse Batlle, Néstor Bacelar, Antoni Artigas
BACKGROUND: Continuous aspiration of subglottic secretions is effective in preventing ventilator-associated pneumonia, but it involves a risk of mucosal damage. The main objective of our study was to determine the incidence of airway complications related to continuous aspiration of subglottic secretions. METHODS: In consecutive adult patients with continuous aspiration of subglottic secretions, we prospectively recorded clinical airway complications during the period after extubation...
November 2, 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/29091036/a-prospective-descriptive-study-to-assess-nursing-staff-perceptions-of-and-interventions-to-prevent-medical-device-related-pressure-injury
#13
Ayişe Karadag, Seval C Hanönü, Evrim Eyikara
Nurses play an important role in identifying patients at risk for medical device-related (MDR) pressure injuries and preventing their occurrence. A prospective, descriptive study was conducted across 6 hospitals in Ankara, Turkey between December 2014 and June 2015 to assess nursing perceptions about and interventions used for the pre- vention of MDR pressure ulcers. A questionnaire was used to collect demographic information and data on experience with MDR pressure ulcers; in addition, participants completed a Nursing Interventions Form that included 10 statements regarding basic nursing interventions to prevent MDR pressure ulcers; answer options were I perform, I partly perform, I do not perform...
October 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/29089699/tracheostomy-in-patients-who-need-mechanical-ventilation-early-or-late-surgical-or-percutaneous-a-prospective-study-in-iran
#14
Hamidreza Hemmati, Mohammad Forozeshfard, Babak Hosseinzadeh, Sahar Hemmati, Majid Mirmohammadkhani, Razieh Bandari
Tracheostomy can be performed surgically or by percutaneous (percutaneous dilatory tracheostomy, PDT) methods, and it may be used early or late. In a 3-month follow-up, all patients who underwent tracheostomy in Semnan in 2013 were evaluated for complications of tracheostomy considering the method used and the timing of operation. A total of 55 patients underwent tracheostomy (26 cases surgery, 29 cases PDT, 30 cases early, and 25 cases late based on 14 days reference). The mean durations of operation were 19...
October 2017: Indian Journal of Surgery
https://www.readbyqxmd.com/read/29076556/could-laser-assisted-dissection-of-the-preepiglottic-space-affect-functional-outcome-after-esl
#15
Andy Bertolin, Marco Lionello, Simone Russo, Giuseppe Rizzotto, Marco Lucioni
OBJECTIVES: To evaluate the effect of preepiglottic space (PES) dissection in the endoscopic supraglottic laryngectomy (ESL). STUDY DESIGN: A retrospective cohort study. METHODS: We retrospectively compared 15 patients who underwent ESL with 15 patients matched for clinical stage who underwent open partial horizontal laryngectomy (OPHL). The functional outcomes were assessed in terms of hospital stay; need for nasal feeding tube (NFT) and tracheostomy, as well as duration of their use; postoperative complications; aspiration pneumonia rates; voice quality; and dysphagia...
October 27, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29075740/long-term-functional-and-quality-of-life-outcomes-after-transoral-robotic-surgery-in-patients-with-oropharyngeal-cancer
#16
Virginie Achim, Rachel K Bolognone, Andrew D Palmer, Donna J Graville, Tyler J Light, Ryan Li, Neil Gross, Peter E Andersen, Daniel Clayburgh
Importance: In recent years, transoral robotic surgery (TORS) has emerged as a useful treatment for oropharyngeal squamous cell carcinoma (OPSCC). In appropriately selected patients, the use of TORS may allow avoidance of adjuvant chemotherapy and/or radiotherapy, thereby avoiding the long-term adverse effects of these therapies. Objective: To compare functional speech, swallowing, and quality-of-life outcomes longitudinally between those undergoing TORS only and those undergoing TORS and adjuvant radiotherapy (TORS+RT) or TORS and chemoradiotherapy (TORS+CRT)...
October 26, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29062363/diffuse-idiopathic-skeletal-hyperostosis-persistent-sore-throat-and-dysphagia-in-an-elderly-smoker-male
#17
Ana Goico-Alburquerque, Beenish Zulfiqar, Ranae Antoine, Mohammed Samee
Diffuse idiopathic skeletal hyperostosis (DISH) is rarely symptomatic. However, it can present with dyspnea, hoarseness, dysphagia, and stridor. An 80-year-old chronic smoker male presented with 6-month history of sore throat and progressive dysphagia. Computed tomography of the neck revealed bulky anterior bridging syndesmophytes along the anterior aspect of the cervical spine and facet effusion involving four contiguous vertebrae consistent with DISH. Dysphagia secondary to DISH was diagnosed. Fiberoptic laryngoscopy showed bilateral vocal cord paralysis...
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/29057504/speech-language-pathology-care-and-short-and-long-term-outcomes-of-oropharyngeal-cancer-treatment-in-the-elderly
#18
Kimberly T Webster, Donna Tippett, Marissa Simpson, Rina Abrams, Kristine Pietsch, Robert J Herbert, David W Eisele, Christine G Gourin
OBJECTIVE: To examine associations between speech-language pathology (SLP) care and pretreatment variables, short-term and long-term swallowing and airway impairment, and survival in elderly patients treated for oropharyngeal squamous cell cancer (SCCA). STUDY DESIGN: Retrospective analysis of Surveillance, Epidemiology, and End Results-Medicare data. METHODS: We evaluated longitudinal data from 666 patients diagnosed with oropharyngeal SCCA from 2004 to 2007 using cross-tabulations, multivariate logistic regression, and survival analysis...
October 23, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29050103/-laryngotracheal-stenosis-in-children
#19
G X Wang, J Zhao, J Zhang, X Ni
Laryngotracheal stenosis includes congenital laryngotracheal stenosis and secondary laryngotracheal stenosis. Congenital laryngotracheal anomalies are rare, accounting for 0.3%-1.0% of all laryngotracheal stenosis(LTS). Despite the management of pediatric LTS over the past 30 years had been considerable improved, primary surgery still failed in a significant number of complex LTS cases. In some severe LTS cases combined with glottic stenosis, the primary surgery failed around 30%, even with the latest available techniques...
October 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
https://www.readbyqxmd.com/read/29050090/-laryngotracheal-resection-and-reconstruction-for-the-treatment-of-acquired-laryngotracheal-stenosis
#20
L J Ma, Y Xiao, Q W Yang, J Wang
Objective: To analyze the efficacy of laryngotracheal resection and reconstruction for acquired laryngotracheal stenosis, and to discuss the prevention of complication. Methods: The clinical outcomes of seventy patients with acquired laryngotracheal stenosis, treated with laryngotracheal resection and reconstruction were retrospectively reviewed between January 2007 and December 2016. The degree of stenosis was classified according to Myer-Cotton classification as follows: grade Ⅱ(n=7), grade Ⅲ(n=38) and grade Ⅳ(n=27)...
October 7, 2017: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
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