Ann Oto Rhinol Laryn
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Ann Oto Rhinol Laryn · Nov 1991
Airway obstruction and high-frequency jet ventilation during laryngoscopy.
High-frequency jet ventilation has been reported as an effective method of ventilation during laryngoscopy, but may expose the patient to the risks of barotrauma or alveolar hypoventilation. The aim of the study was to evaluate the determining factors of pulmonary complications under high-frequency jet ventilation in 83 patients undergoing laryngoscopy for upper airway cancer. ⋯ Hypercapnia occurred in both upper and lower airway obstruction, while hypoxemia was principally observed in COPD patients. Emphasis is placed on monitoring by pulse oximetry, end-expiratory pressure, and PCO2 measurement, especially in patients with obesity, COPD, or upper airway obstruction.
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Ann Oto Rhinol Laryn · Oct 1991
Review Case ReportsTraction diverticulum of the hypopharynx following anterior cervical spine surgery. Case report and review.
Pharyngeal complications due to anterior cervical spine surgery (ACSS) are not rare. We describe the case of a traction diverticulum of the hypopharynx after ACSS, a complication that has not yet been reported. We discuss the possible mechanism. A review of the complications of ACSS that are of interest to the otolaryngologist is included.
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Twenty-one adult patients were surgically treated for severe subglottic stenosis refractory to endoscopic treatment. Patients were treated by anterior or anterior and posterior cricoid division with costal cartilage grafting. ⋯ Success of treatment was not dependent on cause of the stenosis or age or sex of the patient. There was a significantly better outcome (p less than .05) in patients with isolated subglottic stenosis versus those with combined glottic and subglottic stenosis.
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Both arytenoid subluxation and recurrent laryngeal nerve paralysis (RLNP) may result from injury to the larynx, and they may be difficult to distinguish clinically. A patient with arytenoid subluxation who was initially believed to have RLNP was treated with medialization laryngoplasty 1 year after the injury. ⋯ Computed tomographic findings and photographs from laryngoscopy of two patients with RLNP documented by intraoperative EMG evaluation are presented to help distinguish the clinical appearance of this disorder from arytenoid subluxation. An integrated approach to the diagnosis and treatment of arytenoid subluxation is presented.
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With new advances in pediatric otolaryngology, the awareness of difficulties with existing laryngoscope instruments has become more apparent. The following paper introduces four new pediatric laryngoscopes for use in premature infants, the neonate and infant, the toddler-size child, and the preadolescent-size child. ⋯ The need for continuous insufflation of oxygen during difficult as well as routine intubation is underscored with reference to the current anesthesia literature. Ventilating techniques in laryngoscopy for the non-respirator-dependent child are discussed.