Ann Oto Rhinol Laryn
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Ann Oto Rhinol Laryn · Aug 2005
Prediction of difficult laryngeal exposure in patients undergoing microlaryngosurgery.
Although difficult laryngeal exposure (DLE) is a common problem encountered during microlaryngosurgery, reliable predictors of DLE and grading systems of laryngeal exposure have been scarcely suggested in the field of laryngology. We propose a new classification of laryngeal exposure focusing on the extent of glottic visualization. ⋯ According to the proposed classification of laryngeal exposure, patients with obesity, a muscular neck, or retrognathia are likely to present DLE, and preoperative measurement of the predictors may be useful in preparing for microlaryngosurgery.
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Ann Oto Rhinol Laryn · Jul 2005
Case ReportsMelker cricothyrotomy kit: an alternative to the surgical technique.
Emergent cricothyrotomy is a potentially lifesaving procedure central to acute airway algorithms. In most cases in which cricothyrotomy is indicated, the acuteness of the airway precludes subspecialty consultation before performance of the procedure. ⋯ The wire-guided technique may add a margin of safety for a relatively inexperienced resident performing cricothyrotomy. Furthermore, a newly released version of the kit includes instrumentation for insertion of the Melker airway catheter by the classic surgical technique in addition to that required for the Seldinger technique, which may enable even a seasoned surgeon to secure the airway faster and more safely.
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Ann Oto Rhinol Laryn · Jul 2005
Use of the Pediatric Quality of Life Inventory to assess the health-related quality of life in children with recurrent respiratory papillomatosis.
The objective of this study was to use the Pediatric Quality of Life Inventory (PedsQL), a 23-question modular instrument designed to measure the health-related quality of life (HRQOL) in children and adolescents, to compare the HRQOL in children with recurrent respiratory papillomatosis (RRP) with the HRQOLs reported for healthy children and children with other chronic medical conditions. ⋯ Children with RRP report a lower quality of life than do those who are healthy, and a quality of life similar to that of those who have other chronic medical problems. The parent reports also reflect a lower quality of life for children affected by this disease, as compared with healthy children. The PedsQL demonstrated a statistically significant low HRQOL in children with RRP; however, the clinical implications of this finding appear trivial. A distinct, disease-specific survey for RRP, if developed, would have enhanced responsiveness and sensitivity to change (due to the natural course of the disease and/or surgical treatments).
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Ann Oto Rhinol Laryn · May 2005
Larynx and cervical trachea in humidification and heating of inhaled gases.
To evaluate the participation of the larynx and cervical trachea in conditioning inspired gases, we randomly allocated 16 mixed-breed dogs to two groups: group TT (tracheal tube; n = 8) and group LMA (laryngeal mask airway; n = 8). The dogs were anesthetized with pentobarbital sodium and mechanically ventilated for 3 hours. The parameters studied were temperature and absolute humidities of ambient, inhaled, and tracheal air. ⋯ The absolute humidity of tracheal air was greater in group LMA than in group TT (23 mg H2O * L(-1) and 14 mg H2O * L(-1), respectively; p < .0001). The difference in absolute humidity between the tracheal air and the inhaled air was higher in group LMA at all times (p < .0001). We conclude that the larynx and cervical trachea of the dog participate in humidification and heating of inhaled air by means of air contact with mucosa in this airway segment.
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Ann Oto Rhinol Laryn · Apr 2005
Chronic cough as a sign of laryngeal sensory neuropathy: diagnosis and treatment.
Chronic cough is often attributed to reflux, postnasal drip, or asthma. We present 28 patients who had chronic cough or throat-clearing as a manifestation of sensory neuropathy involving the superior or recurrent laryngeal nerve. They had been identified as having sudden-onset cough, laryngospasm, or throat-clearing after viral illness, surgery, or an unknown trigger. ⋯ Symptomatic relief was achieved in 68% of the patients. Sensory neuropathy of the recurrent laryngeal nerve or superior laryngeal nerve should be considered in the workup for chronic cough or larynx irritability. Symptomatic management of patients with cough and laryngospasm due to a suspected sensory neuropathy may include the use of antiseizure medications such as gabapentin.