The Journal of laryngology and otology
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Throat packs are employed in nasal surgery to prevent contamination of the upper aerodigestive tract. Their use is thought to reduce the risk of aspiration and post-operative nausea and vomiting. However, use of throat packs may also be accompanied by increased throat pain. In order to inform our clinical practice, the evidence base for throat pack insertion was reviewed. ⋯ Further, adequately powered trials are required involving patients undergoing rhinological procedures with a higher risk of blood contamination (e.g. functional endoscopic sinus surgery), in order to provide definitive evidence on the morbidity of throat packs in rhinological procedures.
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Review Case Reports
Case of coexisting, ipsilateral nonrecurrent and recurrent inferior laryngeal nerves.
We report an extremely rare case of coexisting, ipsilateral nonrecurrent inferior laryngeal nerve and recurrent inferior laryngeal nerve. ⋯ The surgeon must be aware of the possibility of coexisting, ipsilateral nonrecurrent inferior laryngeal nerve and recurrent inferior laryngeal nerve, and thus must trace the nerve in its entirety. Occasionally, what appears to be a nonrecurrent inferior laryngeal nerve will actually be a communicating branch between the recurrent inferior laryngeal nerve and the oesophageal or sympathetic ganglia. If such a neurological variant is present, the consequences of careless dissection could include not only vocal fold paralysis but also dysphagia (if the pharyngeal and oesophageal branches of nonrecurrent or recurrent inferior laryngeal nerve are injured).
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We evaluated the efficacy and safety of the extra-long Montgomery T tube for the management of major airway obstruction in tertiary care patients in Taiwan. ⋯ The extra-long Montgomery T tube is an effective and safe method for treating major airway obstruction in the supra-glottic to lower tracheal region.
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To evaluate the efficacy of bipolar radiofrequency volumetric tissue reduction, using Sutter technology, in the treatment of snoring and mild obstructive sleep apnoea. ⋯ One session of Sutter bipolar radiofrequency tissue volume reduction represents a viable method of treating snoring and mild obstructive sleep apnoea, with good results.
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Local extension of thyroid carcinoma can result in massive invasion of the trachea, causing severe airway compromise. The pre- and peri-operative management of such airway compromise is difficult but critical. We report the use of extracorporeal oxygenation support as an alternative peri-operative airway management option in such a situation. This approach facilitated curative surgery in a patient with papillary thyroid carcinoma invading the trachea. ⋯ Cardiopulmonary bypass oxygenation is a safe and effective alternative airway management option in patients with locally aggressive thyroid cancer.