European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
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Eur Arch Otorhinolaryngol · May 2009
Case ReportsA simple method to alleviate aspiration in the near-total laryngectomy patient.
Near-total laryngectomy is a surgical technique which grants the potential for postoperative speech without the need for prostheses or secondary surgical procedures. Aspiration can be a problem, however, that can require completion laryngectomy to resolve. A 60-year-old male underwent a near-total laryngectomy for recurrent laryngeal cancer. ⋯ At approximately 17 months, the patient developed recurrent intermittent aspiration of thin liquids and required reinjection of the shunt, with resolution of the aspiration. Calcium hydroxylapatite allows simple and effective alleviation of aspiration following near-total laryngectomy but requires repeated injection to maintain efficacy. Injection of calcium hydroxylapatite can be an effective alternative to completion laryngectomy in patients who aspirate following near-total laryngectomy.
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Eur Arch Otorhinolaryngol · May 2009
Preoperative clinical prediction of difficult laryngeal exposure in suspension laryngoscopy.
We investigated general and physical predictors of difficult laryngeal exposure in patients undergoing suspension laryngoscopy; 93 patients were included in this prospective study. The patients were classified as difficult laryngeal exposure group or non-difficult laryngeal exposure group based on the laryngeal view in suspension laryngoscopy. Twelve parameters (age, sex, body mass index, neck circumference, full mouth opening, modified mallampati index, hyoid-mental, thyroid-mental, horizontal thyroid-mental, vertical thyroid-mental, sternum-mental distance) that could predict difficult laryngeal exposure were evaluated. ⋯ Based on the multivariate analysis, neck circumference superior to 40 cm, hyoid-mental and sternum-mental distance with respectively a value less than 6.05 and 13.9 cm were independently associated with difficult laryngeal exposure. Muscular neck, hyoid-mental and sterno-mental distance should be considered clinical predictors of difficult laryngeal exposure. Measurements of physical variables at full extension position of the neck are more useful and reliable predictors than neutral position for the risk of difficult laryngeal exposure.
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Eur Arch Otorhinolaryngol · May 2009
Tracheostomy in young patients: indications and long-term outcome.
Diagnostic and treatment modalities have changed substantially over the past years in the field of pediatrics and neonatal medicine. As a result, the indications and outcome after tracheostomy in young patients have evolved. The aim of this study is to present our experience with pediatric tracheostomies and provide an up-to-date review of the literature with special focus on current trends. ⋯ Nowadays, the majority of patients are very young children with severe and chronic diseases. This fact accounts for the relatively low decannulation rates, long cannulation times and high mortality. The tracheostomy related mortality on the other hand, is comparatively low.
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Eur Arch Otorhinolaryngol · May 2009
Effects of cetirizine on isolated rat's tracheal smooth muscle.
Cetirizine (Zytec) is often used as a histamine receptor-1 (H(1)) antagonist in rhinitis patients who are suffering from sneezing and rhinorrhea. This H(1) antagonist is used as an oral tablet or nasal spray solution. The effect of H(1) antagonist on nasal mucosa in vivo is well known; however, the effect of the drug on tracheal smooth muscle has been rarely explored. ⋯ Zytec could inhibit electrical field stimulation induced spike contraction, and basal tension was increased at the same time. However, it alone had a minimal effect on the basal tension of trachea as the concentration increased. This study indicated that high concentrations of Zytec might actually inhibit parasympathetic function of the trachea.