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Upper airway

Leszek Kubin
Upper airway muscles subserve many essential for survival orofacial behaviors, including their important role as accessory respiratory muscles. In the face of certain predisposition of craniofacial anatomy, both tonic and phasic inspiratory activation of upper airway muscles is necessary to protect the upper airway against collapse. This protective action is adequate during wakefulness, but fails during sleep which results in recurrent episodes of hypopneas and apneas, a condition known as the obstructive sleep apnea syndrome (OSA)...
September 15, 2016: Comprehensive Physiology
Michael P Platt, Christopher D Brook, Jacob Kuperstock, John H Krouse
IgE-mediated allergy plays a well-established role in both nasal and pulmonary diseases due to the common epithelium and shared mediator responses of the upper and lower airways. This "unified airway" concept has also been described in other sites within the head and neck that contain similar respiratory mucosa: the middle ear and the larynx. This review will highlight the data suggesting a role for IgE-mediated allergic disease in chronic laryngopharyngeal and middle ear disease and the role for allergy testing to aid in diagnosis and treatment of these disorders...
October 2016: Current Allergy and Asthma Reports
Juan P Boriosi, Jens C Eickhoff, Kristi B Klein, Gregory A Hollman
BACKGROUND AND AIM: Both propofol and dexmedetomidine have been found to be safe and effective sedation for magnetic resonance imaging (MRI). Our program experienced an increase in patients arousing and experiencing an adverse airway event during propofol sedation for MRI in the first months of using a new 3T (Tesla) MRI scanner that was found to have a longer reverberation time compared to the previous 1.5 T MRI. In an effort to decrease patient arousal and adverse airway events during MRI, we administered a dexmedetomidine load prior to our standard propofol protocol...
October 25, 2016: Paediatric Anaesthesia
D Costa Santos, F Barros, M Frazão, M Maia
Face burns expose patients to a higher respiratory risk, and early prophylactic intubation before they enter the burn unit might be life-saving. However, unnecessary intubation may compromise their clinical evolution. Hence, the decision to perform pre-burn centre endotracheal intubation remains a clinical challenge. A retrospective study was developed to characterize the experience of the tertiary burn unit of the Hospital da Prelada with face burn patients arriving endotracheally-intubated between January 2009 and September 2013...
December 31, 2015: Annals of Burns and Fire Disasters
Suleiman M Momany, Ghaida AlJamal, Bassam Shugaa-Addin, Yousef S Khader
PURPOSE: To explore the validity of cone beam computed tomography (CBCT) as one of many predictive tools that can be used (alone or in conjunction) to help in identifying high-risk cases of obstructive sleep apnea (OSA) that should get the earliest possible referral to a sleep specialist for standard diagnostic polysomnography, and to identify imaging airway parameters that may be predictive of OSA severity. METHODS: Using a case-control design, 45 subjects matched by age and sex (22 OSA cases and 23 controls) were included in this study...
October 2016: American Journal of the Medical Sciences
Kun Qian, Christoph Janott, Vedhas Pandit, Zixing Zhang, Clemens Heiser, Winfried Hohenhorst, Michael Herzog, Werner Hemmert, Bjoern Schuller
OBJECTIVE: Obstructive Sleep Apnea (OSA) is a serious chronic disease and a risk factor for cardiovascular diseases. Snoring is a typical symptom of OSA patients. Knowledge of the origin of obstruction and vibration within the upper airways is essential for a targeted surgical approach. Aim of this paper is to systematically compare different acoustic features, and classifiers for their performance in the classification of the excitation location of snore sounds. METHODS: Snore sounds from 40 male patients have been recorded during Drug-Induced Sleep Endoscopy, and categorized by ENT experts...
October 21, 2016: IEEE Transactions on Bio-medical Engineering
Anna M Ciccone, Camilla Vanni, Giulio Maurizi, Antonio D'Andrilli, Stylianos Korasidis, Mohsen Ibrahim, Claudio Andreetti, Federico Venuta, Erino A Rendina
Idiopathic subglottic stenosis is the most challenging condition in the field of upper airway reconstruction. We describe a successful novel technique for enlarging the airway space at the site of the laryngotracheal anastomosis in very high-level reconstructions.
November 2016: Annals of Thoracic Surgery
Els De Schryver, Lara Derycke, Paloma Campo, Eline Gabriels, Guy F Joos, Thibaut Van Zele, Claus Bachert, Peter W Hellings, Philippe Gevaert
BACKGROUND: An important percentage of subjects diagnosed with chronic upper airway disease report alcohol-induced worsening of their symptoms. The prevalence and characteristics of respiratory reactions provoked by alcohol-containing drinks has not been fully investigated yet. OBJECTIVE: The aim of this study was to estimate the prevalence and characteristics of alcohol hyper-responsiveness in patients with chronic airway disease and healthy controls. Furthermore, nasal inflammation was evaluated in nasal polyp patients with and without hyper-responsiveness...
October 22, 2016: Clinical and Experimental Allergy: Journal of the British Society for Allergy and Clinical Immunology
Laszlo Kunos, Zsofia Lazar, Fruzsina Martinovszky, Adam D Tarnoki, David L Tarnoki, Daniel Kovacs, Bianka Forgo, Peter Horvath, Gyorgy Losonczy, Andras Bikov
PURPOSE: Obstructive sleep apnoea (OSA) is a prevalent disorder, characterised by collapse of the upper airways during sleep. The impact of sleep-disordered breathing on pulmonary function indices is however currently not well described. The aim of the study was to evaluate diurnal change in lung function indices in a cohort of patients with OSA and relate pulmonary function changes to disease severity. METHODS: 42 patients with OSA and 73 healthy control subjects participated in the study...
October 21, 2016: Lung
Isil Aras, Aylin Pasaoglu, Sultan Olmez, Idil Unal, Aynur Aras
OBJECTIVES: Purpose of the present study was to determine and compare possible changes in the dimensions of the pharyngeal airway, morphology of the soft palate, and position of the tongue and hyoid bone after single-step or stepwise mandibular advancement using the Functional Mandibular Advancer (FMA). PATIENTS AND METHODS: The sample included 51 peak-pubertal Class II subjects. In all, 34 patients were allocated to two groups using matched randomization: a single-step mandibular advancement group (SSG) and a stepwise mandibular advancement group (SWG)...
October 21, 2016: Journal of Orofacial Orthopedics, Fortschritte der Kieferorthopädie
Dr Gian Domenico Giusti, Dr Cecilia Rogari, Dr Alessio Gili, Dr Fulvio Nisi
BACKGROUND: Endotracheal intubation (ETI) for mechanical ventilation has a central role in the Intensive Care Unit (ICU). ETI is one of the main risk factors for the development of ventilator-associated pneumonia (VAP) as its presence reduces the natural defences of the upper airway and allows the micro-suction of secretions in the airways. In order to minimise such complications, it is fundamental to maintain a suitable pressure inside the tube cuff. AIM AND SCOPE: The main objective of the present study is to evaluate the effectiveness and reliability of palpation method, performed with the operators fingers, for detecting the tube cuff pressure...
October 18, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Tammy T Nguyen, Bethany Baker, Jeffrey D Ferguson
BACKGROUND: Ketamine is a cyclohexamine derivative that acts as a noncompetitive N-methyl D-aspartate receptor antagonist. Its use for procedural sedation is recommended by national clinical policy. However, its immunogenic potential is not well documented. CASE REPORT: We report a case of allergic reaction associated with the administration of intravenous ketamine for procedural sedation in a 16-year-old male. Minutes after administration, the patient developed a morbilliform, erythematous rash that extended to the upper and lower torso and resolved with intravenous diphenhydramine...
October 18, 2016: Journal of Emergency Medicine
S S Liu, J R Deng, D S Wang, X Gong, Y H Zhou, X M Gao
Objective: Nasopharynx is an important compartment of the upper airway. It is closely associated with the characteristic craniofacial skeletal pattern related to sleep breathing. The present study aimed to investigate the growth pattern of the nasopharynx during rapid puberty growth period. Methods: Thirty non-snoring children (aged 8 to 11 years old) were selected by means of questionnaires and clinical examination. Periodic yearly follow up using MRI, lateral cephalogram, and polysomnograph (PSG) was done in these children...
October 7, 2016: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Matthias Jacob, Daniel Chappell, Bernhard F Becker
Oxygen delivery to cells is the basic prerequisite of life. Within the human body, an ingenious oxygen delivery system, comprising steps of convection and diffusion from the upper airways via the lungs and the cardiovascular system to the microvascular area, bridges the gap between oxygen in the outside airspace and the interstitial space around the cells. However, the complexity of this evolutionary development makes us prone to pathophysiological problems. While those problems related to respiration and macrohemodynamics have already been successfully addressed by modern medicine, the pathophysiology of the microcirculation is still often a closed book in daily practice...
October 21, 2016: Critical Care: the Official Journal of the Critical Care Forum
Charles W Lanks, Timothy L Van Natta, David W Hsia
Localized tracheobronchial amyloidosis is a rare disease that results from submucosal deposition of insoluble amyloid proteins in the large airways. Amyloidosis affecting the larynx and subglottic space typically results in unilateral, nodular vocal cord infiltration. It rarely can present with bilateral vocal cord involvement and can progress to lifethreatening respiratory failure due to upper airway obstruction. In these patients, typical treatment modalities such as CO2 laser ablation are often ineffectual...
October 2016: Journal of Bronchology & Interventional Pulmonology
Hsueh-Yu Li, Yu-Lun Lo, Chao-Jan Wang, Li-Jen Hsin, Wan-Ni Lin, Tuan-Jen Fang, Li-Ang Lee
Surgical success for obstructive sleep apnea (OSA) depends on identifying sites of obstruction in the upper airway. In this study, we investigated sites of obstruction by evaluating dynamic changes in the upper airway using drug-induced sleep computed tomography (DI-SCT) in patients with OSA. Thirty-five adult patients with OSA were prospectively enrolled. Sleep was induced with propofol under light sedation (bispectral index 70-75), and low-dose 320-detector row CT was performed for 10 seconds over a span of 2-3 respiratory cycles with supporting a continuous positive airway pressure model...
October 20, 2016: Scientific Reports
B P C Hoppe, E de Jongh, A Griffioen-Keijzer, J M Zijlstra-Baalbergen, E P F IJzerman, F Baboe
Human metapneumovirus (hMPV) is a paramyxovirus that causes respiratory tract infections ranging from mild upper airway infection to severe pneumonia. Patients with haematological disease, especially haematopoietic stem cell transplantation (HSCT) recipients, are more likely to develop more severe infections. We describe three cases of hMPV infection in HSCT patients. The most reliable diagnostic procedure for hMPV is multiplex ligation-dependent probe amplification (MLPA) on a nasopharyngeal swab. Sensitivity and specificity of MLPA to detect hMPV is high and time to diagnosis is short...
October 2016: Netherlands Journal of Medicine
Kanika Gupta, Bhuvaneswari Venkatesan, Kiruba Shankar Manoharan, Vaithianathan Rajalakshmi, Maya Menon
Congenital high airway obstruction syndrome is a rare fetal anomaly with characteristic constellation of prenatal findings on ultrasound and MRI. The typical triad of imaging features are enlarged and echogenic lungs, flattening or inversion of diaphragm and fetal hydrops. Early prenatal recognition of congenital high airway obstruction syndrome by ultrasound and/or MRI is mandatory for the appropriate perinatal management. We report a case of a male fetus with typical imaging findings of congenital high airway obstruction syndrome on ultrasound and MRI at 19 weeks of gestation...
August 2016: Journal of Radiology Case Reports
Suruchi Ambasta, Priya Rudingwa, Pankaj Kundra, Rajiev Gnanasekar
No abstract text is available yet for this article.
October 2016: Indian Journal of Anaesthesia
Renata Rubinsztajn, Tadeusz Przybyłowski, Marta Maskey-Warzęchowska, Krzysztof Karwat, Ryszarda Chazan
: Body composition disorders are observed in chronic obstructive pulmonary disease (COPD) patients and have a significant impact the general condition and outcome in this disease. AIM: The aim of the study was to assess body composition in relation to airway obstruction severity in patients with COPD. MATERIALS AND METHODS: The study group consisted of 143 patients (58F, 85M) in the middle age The group was divided to two groups: group A FEV1<50% predicted and group B FEV1 ≥50% predicted; both groups were compared...
October 19, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
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