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Stenotic airway

Ayman Ads, Frederic Auerbach, Kelly Ryan, Abdel R El-Ganzouri
We report the successful use of the Air-Q laryngeal airway (Air-Q LA) as a ventilatory device and a conduit for tracheal intubation to rescue the airway in a patient with difficult airway and tracheal stenosis. This is the first case report of the device to secure the airway after two episodes of hypoxemia in the operating room and intensive care unit. Consent for submission of this case report was obtained from our institution's human studies institutional review board given that the patient died a few months after his discharge from the hospital before his personal consent could be obtained and before preparation of this report...
August 2016: Journal of Clinical Anesthesia
N-C Liu, V J Adams, L Kalmar, J F Ladlow, D R Sargan
BACKGROUND: A novel test using whole-body barometric plethysmography (WBBP) was developed recently to diagnose brachycephalic obstructive airway syndrome (BOAS) in unsedated French bulldogs. HYPOTHESIS/OBJECTIVES: The hypotheses of this study were: (1) respiratory characteristics are different between healthy nonbrachycephalic dogs and brachycephalic dogs; and among pugs, French bulldogs, and bulldogs; and (2) obesity and stenotic nares are risk factors for BOAS...
May 2016: Journal of Veterinary Internal Medicine
M Wierzbicka, M Tokarski, M Puszczewicz, W Szyfter
OBJECTIVE: To determine the long-term efficacy of submucosal corticosteroid injection plus dilatation for subglottic stenosis as a single modality treatment in granulomatosis with polyangiitis and relapsing polychondritis, as compared with idiopathic subglottic stenosis and traumatic subglottic stenosis. METHOD: Patients who underwent dilatation for autoimmune causes were identified. Corticosteroid injection into the submucosa of a stenotic segment was followed by serial dilatation...
July 2016: Journal of Laryngology and Otology
Thiago L I Serrano, Leopoldo Pfeilsticker, Vanessa Silva, Igor Hazboun, Jorge Paschoal, Rebecca Maunsell, Eulalia Sakano
INTRODUCTION: Nasal obstruction is an important condition that can lead to severe respiratory distress in newborns. There are several differential diagnoses, and one of them is congenital nasal pyriform aperture stenosis (CNPAS). CNPAS is a rare case of respiratory distress caused by excessive growth of the nasal process of the maxilla and leads to narrowing of the anterior third of the nasal cavity. Diagnosis, associated anomalies, and treatment strategies are reviewed by the following presentation of two cases...
January 2016: Allergy & Rhinology
Mafalda Trindade Soares, Carolina Sousa, Luísa Garanito, Filipe Freire
Sarcoidosis is a chronic granulomatous disease of unknown aetiology. It can affect any part of the organism, although the lung is the most frequently affected organ. Upper airway involvement is rare, particularly if isolated. Sarcoidosis is a diagnosis of exclusion, established by histological evidence of non-caseating granulomas and the absence of other granulomatous diseases. The authors report a case of a man with sarcoidosis manifesting as a chronic inflammatory stenotic condition of the upper respiratory tract and trachea...
2016: BMJ Case Reports
Mohamed Faisal, Hafaruzi Harun, Tidi M Hassan, Andrea Y L Ban, Sanjay H Chotirmall, Jamalul Azizi Abdul Rahaman
BACKGROUND: Tracheobronchial stenosis is a known complication of endobronchial tuberculosis. Despite antituberculous and steroid therapy, the development of bronchial stenosis is usually irreversible and requires airway patency to be restored by either bronchoscopic or surgical interventions. We report the use of balloon dilatation and topical mitomycin-C to successful restore airway patency. CASE PRESENTATION: We present a 24-year old lady with previous pulmonary tuberculosis and laryngeal tuberculosis in 2007 and 2013 respectively who presented with worsening dyspnoea and stridor...
2016: BMC Pulmonary Medicine
Gilles Dupré, Dorothee Heidenreich
Animals presenting with brachycephalic syndrome suffer from multilevel obstruction of the airways as well as secondary structural collapse. Stenotic nares, aberrant turbinates, nasopharyngeal collapse, soft palate elongation and hyperplasia, laryngeal collapse, and left bronchus collapse are being described as the most common associated anomalies. Rhinoplasty and palatoplasty as well as newer surgical techniques and postoperative care strategies have resulted in significant improvement of the prognosis even in middle-aged dogs...
July 2016: Veterinary Clinics of North America. Small Animal Practice
Christina L Costantino, Douglas J Mathisen
Idiopathic laryngotracheal stenosis (ILTS) is a rare inflammatory disease of unknown etiology. Infectious, traumatic and immunologic processes must first be excluded. The majority of patients affected are female who present with progressive symptoms of upper airway obstruction, which can extend over a number of years. ILTS is characterized by short segment, circumferential stenotic lesions, located particularly at the level of the cricoid. Bronchoscopic evaluation is essential for establishing the diagnosis and operative planning...
March 2016: Journal of Thoracic Disease
Sabine Pohl, Frauke S Roedler, Gerhard U Oechtering
Brachycephalic airway syndrome in dogs is typified by a variety of anatomical abnormalities causing a diverse spectrum of clinical signs of varying intensity. This variability makes the assessment of the surgical outcome after upper airway surgery difficult. Using a structured questionnaire, the present study investigated the dog owner-perceived severity and frequency of a broad spectrum of welfare-relevant impairments 2 weeks before and 6 months after brachycephalic dogs underwent a recently developed multi-level upper airway surgery...
April 2016: Veterinary Journal
Matthias Sigler, Julia Klötzer, Thomas Quentin, Thomas Paul, Oliver Möller
BACKGROUND: Stent implantation into the tracheo-bronchial system may be life-saving in selected pediatric patients with otherwise intractable stenosis of the upper airways. Following implantation, significant tissue proliferation may occur, requiring re-interventions. We sought to evaluate the effect of immunosuppressive coating of the stents on the extent of tissue proliferation in an animal model. METHODS: Bare metal and sirolimus-coated stents (Bx Sonic and Cypher Select, Johnson & Johnson, Cordis) were implanted into non-stenotic lower airways of New Zealand white rabbits (weight 3...
December 2015: Molecular and Cellular Pediatrics
Mi Jin Yoo, Soham Roy, Lee P Smith
INTRODUCTION: Congenital anterior glottic stenosis (web) is a rare condition usually presenting with airway obstruction, stridor or dysphonia. Symptomatic infants may require tracheotomy to bridge the neonatal period. Early open surgical reconstruction may have significant risks and failure may still result in tracheotomy. We introduce an endoscopic surgical approach with balloon dilation for primary management of congenital anterior glottic stenosis. METHODS: We present three cases of congenital anterior glottic stenosis in children 7, 14, and 90 days old presenting with stridor, dyspnea, and dysphonia...
December 2015: International Journal of Pediatric Otorhinolaryngology
Penelope Thaller, Catherine Blanchet, Maliha Badr, Renaud Mesnage, Nicolas Leboucq, Michel Mondain, Gilles Cambonie
BACKGROUND: Bronchogenic cyst is a congenital malformation, rarely located in the cervical region and almost never involved in a neonate with acute respiratory distress in the delivery room. CASE PRESENTATION: A female newborn with respiratory distress syndrome caused by a large left cervical mass. Intubation was difficult due to tracheal deviation. Magnetic resonance imaging confirmed a left cervical cyst displacing the trachea and esophagus laterally. Surgical excision was performed via a cervical approach on the 5th day, and pathological examination revealed a bronchogenic cyst...
2015: BMC Pediatrics
Marco Carifi, Domenico Napolitano, Morando Morandi, Danilo Dall'Olio
Although recurrent respiratory papillomatosis is a benign disease of the upper aerodigestive tract caused by infection with human papillomavirus, the disease process is unpredictable, ranging from mild disease and spontaneous remission to an aggressive disease with pulmonary spread and requirement for frequent surgical debulking procedures. It can present a protracted clinical course and cause potentially life-threatening compromise of the airways. Over recent decades, a number of alternative medical therapies to standard surgical treatment have been investigated, with modest outcomes overall...
2015: Therapeutics and Clinical Risk Management
Catherine K Hart, Michael J Rutter
In children with congenital heart disease, tracheobronchial compromise is uncommon but potentially life-threatening. Airway lesions in these patients may be congenital or acquired, and may be stenotic, compressive, or malacic in nature. We present an overview of the etiologies of tracheobronchial lesions typically seen in children with congenital heart disease and review management options for these lesions.
2015: Seminars in Thoracic and Cardiovascular Surgery. Pediatric Cardiac Surgery Annual
Carles Sánchez, Jorge Bernal, F Javier Sánchez, Marta Diez, Antoni Rosell, Debora Gil
PURPOSE: Lack of objective measurement of tracheal obstruction degree has a negative impact on the chosen treatment prone to lead to unnecessary repeated explorations and other scanners. Accurate computation of tracheal stenosis in videobronchoscopy would constitute a breakthrough for this noninvasive technique and a reduction in operation cost for the public health service. METHODS: Stenosis calculation is based on the comparison of the region delimited by the lumen in an obstructed frame and the region delimited by the first visible ring in a healthy frame...
June 2015: International Journal of Computer Assisted Radiology and Surgery
Pyng Lee
Endobronchial tuberculosis refers to tuberculous infection of the tracheobronchial tree. Diagnosis requires a high index of suspicion since symptoms are attributed to co-existing pulmonary tuberculosis and airway lesions are not detectable on chest radiograph. While computed tomography and bronchoscopy are useful for the evaluation of tracheobronchial stenosis or obstruction, goals of treatment remain in the eradication of tubercle bacilli and prevention of airway stenosis. Corticosteroids may halt progression of active disease to fibro-stenotic stage, however if tracheobronchial stenosis causing post-obstructive pneumonia, atelectasis and dyspnea has occurred, airway patency must be restored mechanically by surgery or bronchoscopic techniques...
January 2015: Indian Journal of Tuberculosis
Sharon Borik, Sabina Volodina, Rajiv Chaturvedi, Kyong Jin Lee, Lee N Benson
The aim of the study was to examine the role of three-dimensional rotational angiography (3DRA) in assessing vascular and airway narrowing in children with a bidirectional cavopulmonary anastomosis (BCPA). The course of children with single ventricle physiology is often complicated by left pulmonary artery (LPA) and/or bronchial stenosis and may be related to aortic compression. 3DRA may be useful in evaluating this complex anatomy and possible mechanisms for the observed obstruction. Clinical data and imaging (2D angiography and 3DRA) of children with a BCPA were reviewed retrospectively...
June 2015: Pediatric Cardiology
Sol Kil Oh, Ki Nam Park, Seung Won Lee
OBJECTIVES: The purpose of this study was to assess the long-term results of endoscopic dilatation of airway stenosis and to evaluate predictive factors for favorable results. METHODS: Fifty-four patients with tracheal and subglottic stenosis who underwent endoscopic dilatation with at least 12 months follow-up were enrolled in this study. We evaluated predictive factors for final treatment outcome such as stenosis length, location, characteristics, procedure type, and the severity of stenosis...
December 2014: Clinical and Experimental Otorhinolaryngology
Elliott D Kozin, Brian M Cummings, Derek J Rogers, Brian Lin, Rosh Sethi, Natan Noviski, Christopher J Hartnick
IMPORTANCE: Pediatric laryngotracheal reconstruction (LTR) remains the standard surgical technique for expanding a stenotic airway and necessitates a multidisciplinary team. Sedation wean following LTR is a critical component of perioperative care. We identified variation and communications deficiencies with our sedation wean practice and describe our experience implementing a standardized sedation wean protocol. OBJECTIVE: To standardize and decrease length of sedation wean in pediatric patients undergoing LTR...
January 2015: JAMA Otolaryngology—Head & Neck Surgery
E Young, R Pugh, R Hanlon, E O'Callaghan, C Wright, P Jeanrenaud, T M Jones
Despite widespread adoption of percutaneous dilatational tracheostomy within the critical care setting, there is still uncertainty regarding long-term complications, particularly in relation to missed or subclinical tracheal stenosis. In this study, all patients underwent tracheostomy using a single tapered dilator ≥ three months prior to enrollment and were evaluated using magnetic resonance imaging, spirometry and questionnaire. Tracheal area was recorded and deemed to be stenotic if a reduction of ≥10% was found...
November 2014: Anaesthesia and Intensive Care
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