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Maria M Bausili, Harish Raja, Jacek Kotowski, Jeroni Nadal, Diva R Salomao, Deborah Keenum, Jose S Pulido
BACKGROUND/PURPOSE: To report a new technique for treating patients with uveal effusion syndrome by the fiberoptic-guided CO2 laser. METHODS: Interventional case report. A 74-year-old man presented with exudative detachment of the choroid secondary to uveal effusion syndrome. Partial-thickness sclerotomy and full-thickness sclerotomy were performed to treat the disease using a fiberoptic-guided CO2 laser. RESULTS: After the surgery, the patient's visual acuity improved and choroidal folds disappeared...
October 20, 2016: Retinal Cases & Brief Reports
Joel E Abbott, Roger L Sur
The aim of this paper was to evaluate the current technology and designs of flexible ureterorenoscopes. We will review contemporary fiberoptic and digital ureteroscopes, including a discussion on ureteroscope damage and repair, and lastly present the projected future of flexible ureterorenoscopy. Ureterorenoscopy has evolved dramatically over the past several decades, which has led to landscape reshaping of stone disease treatment and upper tract pathology. Advancements in tip control, miniaturization of scopes, introduction of a digital chip on the tip, disposable devices to augment surgery, surgical experience/familiarity and most recently single use scopes are all independent factors that have increased flexible ureterorenoscopy adoption and success...
October 19, 2016: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
Jung-In Ko, Sang Ook Ha, Min Seok Koo, Miyoung Kwon, Jieun Kim, Jin Jeon, So Hee Park, Sangwoo Shim, Youjin Chang, Taejin Park
OBJECTIVE: Airway management in patients with suspected cervical spine injury is classified as a "difficult airway." The best device for managing difficult airways is not known. Therefore, we conducted an intubation study simulating patients with cervical spine injury using three devices: a conventional Macintosh laryngoscope, a video laryngoscope (GlideScope), and a fiberoptic bronchoscope (MAF-TM). Success rates, intubation time, and complication rates were compared. METHODS: Nine physician experts in airway management participated in this study...
December 2015: Clin Exp Emerg Med
Radhe Sharan, Brij Mohan, Harkomal Kaur, Anju Bala
BACKGROUND: Fiberoptic intubation is a technique commonly used for difficult airways. Conscious sedation is desirable to make this procedure tolerable, and it is essential that patients are cooperative, relaxed, and comfortable especially when difficult airway anatomy or pathology is encountered. OBJECTIVE: To compare the safety and efficacy of propofol versus midazolam in oral fiberoptic endotracheal intubation in terms of hemodynamic changes, level of sedation, ease of intubation, and patient comfort and complications...
September 2016: Anesthesia, Essays and Researches
Cecilia K Andersson, Alexandra Adams, Prasad Nagakumar, Cara Bossley, Atul Gupta, Daphne De Vries, Afiqah Adnan, Andrew Bush, Sejal Saglani, Clare M Lloyd
BACKGROUND: Neutrophils and IL-17A have been linked mechanistically in models of allergic airways disease and have been associated with asthma severity. However, their role in paediatric asthma is unknown. OBJECTIVES: To investigate the role of neutrophils and the IL-17A pathway in mediating paediatric severe therapy resistant asthma (STRA). METHODS: Children with STRA (n=51, age 12.6 (6 -16.3) years) and non-asthmatic controls (n=15, age 4...
October 13, 2016: Journal of Allergy and Clinical Immunology
Alfonso Fiorelli, Fausto Ferraro, Francesca Nagar, Pierluigi Fusco, Salvatore Mazzone, Giuseppe Costa, Davide Di Natale, Nicola Serra, Mario Santini
OBJECTIVE: The authors assessed the diagnostic accuracy of a new modified Evans blue dye test (MEBDT) as a screening test for aspiration in tracheostomized patients. DESIGN: Monocentric retrospective study performed between October 2013 and December 2015. SETTING: Anesthesia and Intensive Care Unit, Second University of Naples. PARTICIPANTS: Among 62 eligible patients, 5 were excluded. The authors' study population included 57 patients...
July 26, 2016: Journal of Cardiothoracic and Vascular Anesthesia
Natamon Charakorn, Eric J Kezirian
Drug-induced sleep endoscopy (DISE) is an upper airway evaluation technique in which fiberoptic examination is performed under conditions of unconscious sedation. Unique information obtained from this 3-dimensional examination of the airway potentially provides additive benefits to other evaluation methods to guide treatment selection. This article presents recommendations regarding DISE technique and the VOTE Classification system for reporting DISE findings and reviews the evidence concerning DISE test characteristics and the association between DISE findings and treatment outcomes...
October 6, 2016: Otolaryngologic Clinics of North America
A Baumann, P O Katz
Swallowing involves complex coordination of the neuromuscular anatomy and physiology of the oropharynx and esophagus, controlled by the enteric and central nervous systems. Dysphagia is classified as either oropharyngeal or esophageal and results from mechanical or structural disturbances. Videofluoroscopy, fiberoptic endoscopic evaluation of swallowing, barium swallow, manometry, and endoscopy are common modalities utilized in diagnosis, but none is as important as a patient's history. Functional dysphagia is a diagnosis of exclusion and is based on Rome criteria...
2017: Handbook of Clinical Neurology
Mostafa Somri, Sonia Vaida, Gustavo Garcia Fornari, Gabriela Renee Mendoza, Pedro Charco-Mora, Naser Hawash, Ibrahim Matter, Forat Swaid, Luis Gaitini
BACKGROUND: The Laryngeal Tube Suction Disposable (LTS-D) and the Supreme Laryngeal Mask Airway (SLMA) are second generation supraglottic airway devices (SADs) with an added channel to allow gastric drainage. We studied the efficacy of these devices when using pressure controlled mechanical ventilation during general anesthesia for short and medium duration surgical procedures and compared the oropharyngeal seal pressure in different head and-neck positions. METHODS: Eighty patients in each group had either LTS-D or SLMA for airway management...
October 6, 2016: BMC Anesthesiology
Jill M Merrow
The instinctual drive to gain nourishment can become complicated by structural differences, physiologic instability and environmental influences. Infants with craniofacial anomalies may experience significant feeding and swallowing difficulties related to the type and severity of the anomalies present as well as social-emotional interactions with caregivers. Typical outcome measures and feeding goals are discussed. Details regarding clinical and instrumental evaluation, including fiberoptic endoscopic evaluation of swallowing and modified barium swallow study, as well as management techniques are reported...
November 2016: Facial Plastic Surgery Clinics of North America
Jung-Min Hong, Hyeon Jeong Lee, Eun Soo Kim, Hae-Kyu Kim, Soeun Jeon, Hyae-Jin Kim
Proteus syndrome (PS) is a rare congenital hamartomatous disorder with multisystem involvement. PS shows highly clinical variability due to overgrowth of the affected areas, and several features can make anesthetic management challenging. Little is known about the airway problem associated with anesthesia in PS patients. An 11-year-old girl with PS was scheduled for ear surgery under general anesthesia. She had features complicating intubation including facial asymmetry and disproportion, abnormal teeth, limitation of neck movement due to torticollis, and thoracolumbar scoliosis...
October 2016: Korean Journal of Anesthesiology
Benjamin Nicholson, Harinder Dhindsa, Louis Seay
BACKGROUND: Blunt injuries to the cervical trachea remain rare but present unique and challenging clinical scenarios for prehospital providers. These injuries depend on prehospital providers either definitively securing the injured airway or bridging the patient to a treatment facility that can mobilize the necessary resources. CASE SUMMARY: The case presented here involves a clothesline injury to a pediatric patient that resulted in complete tracheal transection and partial esophageal transection...
October 4, 2016: Prehospital Emergency Care
Ricardo Fuentes, Juan Carlos De la Cuadra, Hector Lacassie, Alejandro González
: Neonates and small infants with craniofacial malformation may be very difficult or impossible to mask ventilate or intubate. We would like to report the fiberoptic intubation of a small infant with Treacher Collins Syndrome using the technique described by Ellis et al. CASE REPORT: An one month-old infant with Treacher Collins Syndrome was scheduled for mandibular surgery under general endotracheal anesthesia. Direct laryngoscopy for oral intubation failed to reveal the glottis...
September 27, 2016: Revista Brasileira de Anestesiologia
Kaicheng Song, Jie Yi, Wei Liu, Shuang Huang, Yuguang Huang
STUDY OBJECTIVE: We sought to validate ultrasound against other established methods of confirming laryngeal mask airway (LMA) placement. DESIGN: An observational study. SETTING: A university teaching hospital, operating department. PATIENTS: Fifty-eight patients undergoing general anesthesia using an LMA Supreme supraglottic airway device. INTERVENTIONS: The position of the LMA was assessed by ultrasound in 3 planes: the pharynx, the larynx, and along the cranial-caudal axis in the midline...
November 2016: Journal of Clinical Anesthesia
Lakshmi N Kurnutala, Gurneet Sandhu, Sergio D Bergese
A 62-year-old man with a left temporal lobe tumor was scheduled for a semiurgent craniotomy for tumor excision. Previously, the patient had a laryngeal carcinoma that was resected and treated with chemotherapy and radiotherapy and a history of laryngeal biopsy with awake fiberoptic intubation. Because a difficult airway was anticipated, awake fiberoptic nasopharyngoscopy of the airway was performed under topical anesthesia in the operating room. This revealed a narrow glottic opening with no supraglottic pathology or friable tissue...
November 2016: Journal of Clinical Anesthesia
Nathan H Waldron, Bryant W Stolp, Michael P Ogilvie, David B Powers, Michael R Shaughnessy
We present the case report of a 49-year-old gentleman with a history of adenoid cystic carcinoma of the left nare status post curative bifrontal craniotomy, left lateral rhinotomy and medial maxillectomy, adjuvant radiotherapy, and orbital exenteration for optic neuropathy, complicated by medial wall dehiscence. His course was also complicated by severe radiation trismus, for which he was scheduled to undergo bilateral mandibular coronoidectomies. Given his limited mouth opening, the surgeon requested a nasal endotracheal tube...
November 2016: Journal of Clinical Anesthesia
Maarten J J B Vehmeijer, Naomi Verstoep, Jan E H Wolff, Engelbert A J M Schulten, Bas van den Berg
BACKGROUND: Over the last decades, dental implants have become increasingly popular in the prosthetic rehabilitation of patients. This has subsequently led to an increase of perioperative complications. Obstruction of the airway as a result of a floor of mouth hematoma after dental implant surgery is a rare but life-threatening complication. CASE REPORT: A 62-year-old man presented to the emergency department with a compromised airway caused by a hematoma in the floor of the mouth that occurred during dental implant surgery in the edentulous anterior mandible...
September 26, 2016: Journal of Emergency Medicine
Lauren B Bonzelaar, Anna M Salapatas, Michelle S Hwang, Crystal C Andrews, Naftali Y Price, Michael Friedman
OBJECTIVES: It is generally assumed that mouth opening decreases the hypopharyngeal cross-sectional area (HA) and that tongue protrusion (TP) increases the HA. We hypothesize that a substantial number of patients do not exhibit this expected pattern. STUDY DESIGN: Prospective cohort conducted at a tertiary academic center. METHODS: With a flexible fiberoptic scope in position, the hypopharyngeal airway was visualized and assessed in 189 patients with the mouth closed...
September 30, 2016: Laryngoscope
N Marathe, B Canavan
The study illustrates advantages of Fiberoptic Bronchoscopy, a new service started at St. Lukes General Hospital in patient care since April 2014. Retrospective review of Bronchoscopies and referrals to Tertiary care unit for Bronchoscopy, prior and after initiation of service at St. Lukes Hospital were studied. Total 106 procedures were performed out of which 103(98%) were for diagnostic purpose. Common Indications for bronchoscopy were functional airway assessment in 38 cases (35%) of chronic cough, 26 cases (24...
February 19, 2016: Irish Medical Journal
A Reynolds, J O'Driscoll, S Quinn, D Coughlan
The study illustrates advantages of Fiberoptic Bronchoscopy, a new service started at St. Lukes General Hospital in patient care since April 2014. Retrospective review of Bronchoscopies and referrals to Tertiary care unit for Bronchoscopy, prior and after initiation of service at St. Lukes Hospital were studied. Total 106 procedures were performed out of which 103(98%) were for diagnostic purpose. Common Indications for bronchoscopy were functional airway assessment in 38 cases (35%) of chronic cough, 26 cases (24...
2016: Irish Medical Journal
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