Ann Oto Rhinol Laryn
-
Ann Oto Rhinol Laryn · Apr 2014
Case ReportsA fish way out of water: case report of a unique airway foreign body.
Since the time of Chevalier Jackson, innumerable unique foreign bodies have been documented and removed. Advances in endoscopic airway management have revolutionized the types of foreign bodies that we are able to remove without open surgery. The literature on fish aspiration has mostly encompassed fish bones and parts, not whole live fish. ⋯ High-risk airway foreign bodies are always a challenge. When dealing with a live, lodged whole fish, one must have creative management ideas. Close coordination and excellent communication must occur between teams involved to optimize and maintain control of the situation for the best patient outcome.
-
Ann Oto Rhinol Laryn · Mar 2014
Effect of mandibular tori on glottic exposure during simulated suspension microlaryngoscopy.
Mandibular tori have been identified as a contributing factor in difficult exposure during intubation. However, no investigation has measured the effect of mandibular tori on glottic exposure during suspension microlaryngoscopy (SML). The objective of this study was to measure how the size and location of mandibular tori affect glottic exposure during simulated SML at different thyromental distances. ⋯ Larger size and more-posterior location of mandibular tori more significantly reduce glottic exposure during SML. The inner table of the mandible is the most relevant anatomic constraint on glottic exposure, which varies with the presence or absence of mandibular tori independent of thyromental distance.
-
Ann Oto Rhinol Laryn · Mar 2014
Case ReportsEmergent treatment of button batteries in the esophagus: evolution of management and need for close second-look esophagoscopy.
The evolving epidemiology of pediatric button battery ingestion is alarming. Currently, assessment of the degree of damage relies heavily on the initial esophagoscopy in a manner similar to the management of caustic ingestion. We have noted that use of this classic approach may delay the return to normal oral intake. Using several cases treated at our institution, we illustrate the value of "close second-look esophagoscopy" (CSLE) in expediting a return to normal oral intake after button battery ingestion. ⋯ The injury and healing of cases of button batteries in the proximal esophagus appear to be variable; caustic injury, electrical mucosal damage, and direct pressure are thought to be several contributory factors. Performing a CSLE within 2 to 4 days after battery removal may provide more useful prognostic information. In certain cases, downgrading of the injury may facilitate an earlier return to an oral diet, use of fewer diagnostic tests, and a shorter hospital stay. The utility and timing of imaging, management of diet and medications, and acceptable follow-up plans are discussed within the context of guiding future research.
-
We report development of a device and technique to manage laryngeal paralysis through minimal-access arytenoid adduction (for unilateral paralysis) and arytenoid abduction (for bilateral paralysis). ⋯ We confirm the feasibility of minimal-access arytenoid adduction and abduction through development of a new technique and device.
-
Ann Oto Rhinol Laryn · Feb 2014
Endoscopic and three-dimensional radiographic imaging of the pterygopalatine and infratemporal fossae: improving surgical landmarks.
We sought to define the surgical endoscopic anatomy of the pterygopalatine fossa (PPF) and infratemporal fossa (ITF) through endoscopic cadaver dissections and radiographic imaging analysis. ⋯ The pterygoid ridge is a novel and reliable osseous landmark that could assist surgeons during endoscopic surgery on the PPF and ITF. The neurovascular and muscular anatomic relationships were characterized for both the PPF and the ITF.