Ann Oto Rhinol Laryn
-
Ann Oto Rhinol Laryn · Feb 1989
Model of a new generation of tracheostomy and endotracheal tubes. A preliminary study of sensors to monitor obstruction.
The feasibility of monitoring cannula obstruction was studied by conversion of the electrical resistance of substances that are capable of causing obstruction into audible auditory signals. Copper-nickel-gold electrodes were thermal pressed onto polyimide-based flexible films placed as 1-mm wide strips along the inner surface of tracheostomy and endotracheal tubes. ⋯ Quantitative estimates of responses from the IC output were computer averaged. Instantaneous obstruction detection was made possible by the immediate responsiveness of the device in the presence of obstruction.
-
Acute epiglottitis was diagnosed infrequently in adults until the late 1960s and early 1970s. Because it is relatively rare, it may present a problem to the physician who sees an adult with sore throat and dysphagia, but does not think of epiglottitis. ⋯ A discussion of the diagnosis and treatment of adult epiglottitis is presented. An adult with acute painful dysphagia should be considered to have epiglottitis until the diagnosis is proven otherwise.
-
Stenosis of the larynx and trachea is an unfortunate sequel to many thermal injuries. Numerous surgical techniques have been developed for correction of such problems, many involving use of a tracheal T-tube. We report a serious complication attributed to the use of such a tube. Factors contributing to this complication are analyzed and methods for avoiding similar near-catastrophes discussed.
-
Ann Oto Rhinol Laryn · Sep 1988
Comparative StudyMechanisms of pneumothorax following tracheal intubation.
To investigate the mechanism by which pneumothorax may occur as a complication of tracheal intubation, we submitted four cats to tracheotomy and three to tracheal intubation. To simulate the dissection of air along fascial planes following tracheotomy, we placed catheters in either the pretracheal or subcutaneous plane and applied positive pressure to the catheters. The cats undergoing tracheal intubation were ventilated with excessive positive pressure. ⋯ High positive pressures during mechanical ventilation led to pneumothorax and pneumomediastinum, and the mechanism was primarily the dissection of air along the perivascular sheaths of the pulmonary arteries, presumably due to rupture of perivascular alveoli. Dissection of air along the pretracheal fascia following tracheotomy produced pneumomediastinum but not pneumothorax. This suggests that pneumothorax occurring clinically is more likely a complication of assisted ventilation than a complication of tracheotomy surgery.
-
Ann Oto Rhinol Laryn · Jul 1988
Subperiosteal mastoid abscesses in chronic suppurative otitis media.
In Europe and America, acute mastoiditis usually appears as a complication of acute otitis media, and some patients develop subperiosteal mastoid abscesses. In Nigeria, however, most subperiosteal mastoid abscesses develop from chronic otitis media with cholesteatoma. ⋯ The ideal treatment for these cases is modified radical mastoidectomy. Radiographic investigation of the mastoid can be useful in the diagnosis of cholesteatoma in the presence of a subperiosteal mastoid abscess.