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https://www.readbyqxmd.com/read/29161192/patient-preferences-in-subglottic-stenosis-treatment-a-discrete-choice-experiment
#1
Matthew R Naunheim, Margaret L Naunheim, Vinay K Rathi, Ramon A Franco, Mark G Shrime, Phillip C Song
Objectives Subglottic stenosis can be addressed with several different surgical techniques, but patient preferences for these treatment modalities are poorly understood. Economic methods are increasingly being used to understand how patients make decisions. The objective of this pilot study was to assess preferences in subglottic stenosis treatment using patient-centric stated preference techniques. Study Design Discrete choice experiment (DCE). Setting Academic research facility. Subjects and Methods A computer-based DCE was administered in a monitored setting to volunteers from the general population...
November 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29121085/biomechanical-simulation-of-vocal-fold-dynamics-in-adults-based-on-laryngeal-high-speed-videoendoscopy
#2
Michael Döllinger, Pablo Gómez, Rita R Patel, Christoph Alexiou, Christopher Bohr, Anne Schützenberger
MOTIVATION: Human voice is generated in the larynx by the two oscillating vocal folds. Owing to the limited space and accessibility of the larynx, endoscopic investigation of the actual phonatory process in detail is challenging. Hence the biomechanics of the human phonatory process are still not yet fully understood. Therefore, we adapt a mathematical model of the vocal folds towards vocal fold oscillations to quantify gender and age related differences expressed by computed biomechanical model parameters...
2017: PloS One
https://www.readbyqxmd.com/read/29114887/cough-strength-and-expiratory-force-in-aspirating-and-nonaspirating-postradiation-head-and-neck-cancer-survivors
#3
Katherine A Hutcheson, Martha P Barrow, Carla L Warneke, Yiqun Wang, George Eapen, Stephen Y Lai, Denise A Barringer, Emily K Plowman, Jan S Lewin
OBJECTIVE: Expiratory functions that clear aspiration from the airway are compromised in patients with neurogenic dysphagia for whom cough and expiratory force may be impaired by the primary disease process. The relationship between expiratory function, cough, and aspiration is less clear in head and neck cancer (HNC) survivors for whom the disease process does not directly impact the lower respiratory system. Our objective was to compare mechanisms of airway clearance (expiratory force and cough) with aspiration status in postradiated HNC survivors...
November 8, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29114419/unanticipated-difficult-airway-in-a-neonate-are-we-prepared-for-this-chaos
#4
Priyanka Pradeep Karnik, Nandini Malay Dave, Madhu Garasia
Unanticipated difficult airway in a neonate is a challenging situation with many difficulties because of inherent anatomical variations. To complicate the situation there is a lack of appropriate equipment, expertise and established guidelines on the management of difficult airway in neonates and infants. There are few published reports regarding the use of available devices for emergency front-of-neck access. We report the case of airway management of a neonate with an unanticipated finding of subglottic stenosis...
October 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/29100647/subglottic-stenosis-in-granulomatosis-with-polyangiitis-the-role-of-laryngotracheal-resection
#5
Christina L Costantino, John L Niles, Cameron D Wright, Douglas J Mathisen, Ashok Muniappan
BACKGROUND: Granulomatosis with polyangiitis (GPA) is associated with development of subglottic stenosis in about one-fourth of all patients. Although endoscopic management is the primary treatment method for tracheobronchial stenosis, some patients have refractory disease, and tracheostomy is required. It is unclear if laryngotracheal resection and reconstruction (LTRR) can be safely performed in patients with GPA. METHODS: A retrospective review was performed of 11 patients with GPA undergoing LTRR...
November 1, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29098448/incidence-of-airway-complications-in-patients-using-endotracheal-tubes-with-continuous-aspiration-of-subglottic-secretions
#6
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/29092575/a-multiscale-analytical-model-of-bronchial-airway-acoustics
#7
Brian Henry, Thomas J Royston
Sound transmission and resulting airway wall vibration in a complex multiscale viscoelastic model of the subglottal bronchial tree was calculated using a modified one-dimensional (1D) branching acoustic waveguide approach. This is an extension of previous work to enable use of complex airway trees that are partially derived from subject-specific medical images, without the need for self-similarity in the geometric structure. The approach was validated numerically for simplified airway geometries, as well as experimentally by comparison to previous studies...
October 2017: Journal of the Acoustical Society of America
https://www.readbyqxmd.com/read/29075350/cricoid-malformation-and-endolaryngeal-submucosal-drilling-a-possible-technique
#8
A Zamfir-Chiru-Anton, A E Stanciu, D C Gheorghe
Cricoid malformations vary according to their severity and anatomic features. Some of them get a delayed diagnosis in spite of the complex medical care. Objective: To present a case with a laryngeal malformation and our surgery technique. Material, method: A case presentation of a cannulated child, who previously had a heart surgery, with difficult decannulation. RESULTS: The patient was considered to have an acquired subglottic stenosis due to his medical record. A cricoid cartilage malformation was elicited intraoperatively...
July 2017: Journal of Medicine and Life
https://www.readbyqxmd.com/read/29068802/emergency-ventilation-of-infant-subglottic-stenosis-through-small-gauge-lumen-using-the-ventrain-a-case-report
#9
Francisco J Escribá Alepuz, Javier Alonso García, J Vicente Cuchillo Sastriques, Emilio Alcalá, Pilar Argente Navarro
Postintubation subglottic stenosis is one of the most common causes of stridor in newborns and babies after prolonged mechanical ventilation. Management of this pathology is complex and requires highly trained personnel because it is associated with a high rate of airway-related mortality. This article presents the rescue of a difficult airway in a pediatric patient with subglottic stenosis with a new device available on the market, the Ventrain, offering certain advantages over those available until now.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4...
October 24, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29064319/short-versus-long-term-stenting-in-children-with-subglottic-stenosis-undergoing-laryngotracheal-reconstruction
#10
David F Smith, Alessandro de Alarcon, Niall D Jefferson, Meredith E Tabangin, Michael J Rutter, Robin T Cotton, Catherine K Hart
Objectives Suprastomal stents are routinely used in laryngotracheal reconstruction (LTR) to stabilize grafts and provide framework to sites of repair. However, the duration of stenting varies according to patient history and physician preference. We examined outcomes of short- versus long-term stenting in children with subglottic stenosis (SGS) undergoing LTR. Study Design Case series with chart review. Setting Tertiary care pediatric hospital. Subjects and Methods Thirty-six children <18 years old who underwent double-stage LTR for SGS from January 2012 to January 2015 were included...
October 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29063583/infrared-red-intubation-system-irris-guided-flexile-videoscope-assisted-difficult-airway-management
#11
M S Kristensen, E Fried, P Biro
BACKGROUND: Tracheal intubation with a flexible scope is a cornerstone technique in patients with severely difficult airways, but may fail. We report on a technique, Infrared Red Intubation System (IRRIS), that seems to facilitate the identification of the glottis. METHODS: The IRRIS is placed over the patient's cricothyroid membrane and emits blinking infrared light through the patient's skin into the subglottic space. When a flexible videoscope (one that does not filter infrared light) is introduced into the airway, it will display this as a blinking white light emerging from the glottis, retrograde transillumination, showing the pathway to the trachea...
October 24, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29050090/-laryngotracheal-resection-and-reconstruction-for-the-treatment-of-acquired-laryngotracheal-stenosis
#12
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
https://www.readbyqxmd.com/read/29050089/-a-retrospective-analysis-of-co-2-laser-and-microdebrider-for-the-treatment-of-severe-juvenile-on-set-recurrent-respiratory-papillomatosis
#13
Q W Yang, W Xu, W Guo, W X Cui, Y R Li, X Y Wang, J Yang, X Y Li
Objective: Juvenile on-set recurrent respiratory papillomatosis (JORRP) can be an aggressive and potentially life-threatening disease. To emphasize the importance of complication prevention in local excision surgery, the single-center experience of RRP treatment in a group of patients with relatively short recurrence-free-interval (>4 times/yrs) was reported. Methods: Data of 49 patients underwent papilloma resection during 2002-2013 were retrospectively analyzed. Combined techniques of laser microsurgery and microdebriders were used to remove papillomas, prevent the formation of scar tissue and improve respiratory distress...
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/29044543/investigating-the-effects-of-laryngotracheal-stenosis-on-upper-airway-aerodynamics
#14
Tracy Cheng, David Carpenter, Seth Cohen, David Witsell, Dennis O Frank-Ito
OBJECTIVE: Very little is known about the impact of laryngotracheal stenosis (LTS) on inspiratory airflow and resistance, especially in air hunger states. This study investigates the effect of LTS on airway resistance and volumetric flow across three different inspiratory pressures. METHODS: Head-and-neck computed tomography scans of 11 subjects from 2010 to 2016 were collected. Three-dimensional reconstructions of the upper airway from the nostrils to carina, including the oral cavity, were created for one subject with a normal airway and for 10 patients with LTS...
October 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29042707/the-effect-of-subglottic-secretion-drainage-on-the-incidence-of-ventilator-associated-pneumonia
#15
Marta Walaszek, Agnieszka Gniadek, Malgorzata Kolpa, Zdzislaw Wolaka, Alicja Kosiarska
BACKGROUND: Ventilator-Associated Pneumonia (VAP) is an undesired side effect of mechanical ventilation in intensive care units (ICUs). AIM: We evaluated whether endotracheal tubes with subglottic secretion drainage (SSD) would reduce the incidence of VAP among patients undergoing mechanical ventilation in an ICU. METHODS: The analysis of medical records of patients undergoing mechanical ventilation exceeding 48 h who were hospitalised in ICUs between 2007 and 2014 led to separating two groups of patients: those in whom no subglottic drainage was applied (NSSD) (records dating from 2007-2010) and those whose treatment involved endotracheal tubes with subglottic secretion drainage (SSD) (records dating from 2011-2014)...
October 17, 2017: Biomedical Papers of the Medical Faculty of the University Palacký, Olomouc, Czechoslovakia
https://www.readbyqxmd.com/read/29040487/pedunculated-liposarcoma-of-the-esophagus
#16
G B Salis, J C Albertengo, M Bruno, G Palau, R González Villaveirán, D Lombardo, V Villafañe, C Zorraquín, M Ghigliani
Polypoid tumours of the esophagus present diagnostic and therapeutic problems. Liposarcomas are infrequent among them. We report a recent case. A 73-year-old male patient was seen in May 1995 in the Ear, Nose and Throat (ENT) Department, Clinica Modelo de Morón, with intermittent dysphagia and dyspnoea due to recurrent vomiting. A laryngeal lineal tomography showed a subglottic obstruction due to extrinsic compression. The patient was referred to the Gastroenterology Department, where an upper gastrointestinal (upper GI) series demonstrated mega-esophagus with abundant retained food...
November 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/29038859/refashioned-lamb-tissue-as-an-animal-model-for-training-complex-techniques-of-laryngotracheal-stenosis-surgery
#17
Lluís Nisa, Pedro Teiga, Gustavo Barreto da Cunha, Biswanath Roy, Riza Onder Gunaydin, Kishore Sandu
Open reconstructive upper airway surgery for laryngotracheal stenosis (LTS), whether for subglottic or tracheal stenosis, constitutes a group of complex approaches. LTS requiring open reconstruction is overall rare and primarily performed at tertiary centres. This poses an obvious challenge for the acquisition and maintenance of surgical skills for this group of complex approaches. In this context, animal models provide a unique opportunity for open reconstructive airway surgery training. Such models ought to take into consideration ethical aspects, be easily available and easy to maintain, and have similar macroscopic anatomical features to the human laryngotracheal frame...
December 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29019852/modification-of-tracheal-cuff-shape-and-continuous-cuff-pressure-control-to-prevent-microaspiration-in-an-ex-vivo-pig-tracheal-two-lung-model
#18
Antoine Monsel, Marine Le Corre, Romain Deransy, Hélène Brisson, Charlotte Arbelot, Qin Lu, Jean-Louis Golmard, Olivier Langeron, Jean-Jacques Rouby
OBJECTIVES: Microaspiration of subglottic secretions plays a pivotal role in ventilator-associated pneumonia. Impact of endotracheal tube cuff material and shape on tracheal sealing performance remains debated. The primary objective was to compare the tracheal sealing performance of polyvinyl chloride tapered, cylindrical and spherical cuffs. Secondary objectives were to determine the impact of continuous cuff pressure control on sealing performance and pressure variability. DESIGN: Prospective randomized ex vivo animal study...
December 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28990664/hormone-receptors-analysis-in-idiopathic-progressive-subglottic-stenosis
#19
Ivana Fiz, Zeid Bittar, Cesare Piazza, Jan Constantin Koelmel, Federico Gatto, Diego Ferone, Francesco Fiz, Diana Di Dio, Alexander Bosse, Giorgio Peretti, Christian Sittel
OBJECTIVE: Idiopathic subglottic stenosis predominantly affects fertile and perimenopausal women. Estrogens and/or progesterone have been proposed as mediators of its pathogenesis by stimulating collagen deposition within the upper airway. We evaluated the presence and expression of estrogen-alpha (ER-α), estrogen-beta (ER-β), and progesterone receptors (PR) in idiopathic stenotic patients. STUDY DESIGN: A retrospective analysis on 42 surgical specimens from idiopathic stenosis female patients (mean age, 52...
October 9, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28988454/awake-serial-intralesional-steroid-injections-without-surgery-as-a-novel-targeted-treatment-for-idiopathic-subglottic-stenosis
#20
Ramon A Franco, Inna Husain, Lindsay Reder, Paul Paddle
OBJECTIVES/HYPOTHESIS: The fibrotic/erythematous appearance of the subglottis in idiopathic subglottic stenosis (iSGS) hints that it might respond to repeated intralesional steroid treatment similar to keloids. STUDY DESIGN: Retrospective cohort study. METHODS: Thirteen iSGS subjects (six treated in-office with serial intralesional steroid injections [SILSI] versus seven treated endoscopically in the operating room [OR] followed by awake SILSI) between October 2011 and April 2017...
October 8, 2017: Laryngoscope
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