• Journal of Trauma and Injury
• /
• v.34 no.1
• /
• pp.57-60
• /
• 2021

Warfarin is used as part of the treatment of various diseases, and laboratory monitoring of its effects is required. Airway hematoma secondary to warfarin is rare, but can be fatal because of potential airway obstruction. Rapid definitive airway establishment is crucial if airway obstruction is suspected. This complication is more likely to occur in those with elevated coagulation laboratory values. However, we experienced a patient in whom a massive retropharyngeal hematoma caused airway obstruction after a non-severe motor vehicle collision. The patient had been taking warfarin, and had coagulation parameter values within the normal ranges. A major fracture or hemorrhage was not anticipated. Upon examination, a massive retropharyngeal hematoma was noted. Orotracheal intubation failed due to an airway obstruction. Emergency tracheostomy and an operation for hematoma removal were performed. Physicians must always consider the possibility of airway hematoma in warfarin-taking patients with normal coagulation values regardless of the severity of mechanism of injury.

• Sleep Medicine and Psychophysiology
• /
• v.12 no.2
• /
• pp.93-97
• /
• 2005

Nasal obstruction may cause or aggravate sleep disordered breathing but exact pathogenesis is not clear. The possible mechanism could be combination of alteration in upper airway aerodynaimcs, loss of nasal reflex or sensation, effect of mouth opening, and a genetic predisposition. Anatomical narrowing of nasal airway cause more rapid airflow and induce more negative inspiratory air pressure. So, it increases collapsibility of pharyngeal airway. Loss of nasal sensation to airflow block nasal reflex. Mouth opening decreases the activity of pharyngeal airway dilator muscles and narrowing the pharyngeal airway may occur. The treatment of nasal obstruction should be done according to the cause. The causes of nasal obstruction are various from problems of external nasal opening to nasopharynx. Relief of nasal obstruction may not cure sleep disordered breathing always. In some mild obstructive sleep apnea patients, treatment of nasal obstruction only may cure sleep disordered breathing. In some severe sleep apnea patients, treatment of nasal obstruction may increase compliance of continous nasal positive airway pressure.

• The Korean Journal of Emergency Medical Services
• /
• v.9 no.2
• /
• pp.79-88
• /
• 2005

The purpose of this study was to develope the Complete Airway Obstruction Maneuver Training Program and identify its effects on learning motivation, knowledge and skill of choking management in the primary school students. The subjects for the experimental group of 38 students and the control group of 39 students, all of whom are primary school students in Gwangju, the Republic of Korea. A non-equivalent control group pretest-posttest design was used and data were collected from November to December, 2003. During about 2 weeks, 2 times for a week with 80 minutes at a time, the complete airway obstruction maneuver training program was conducted in the experimental group. Experimental data were analyzed through SPSS/win 11.0 PC+, and the tests examining general characteristics between the experimental group and the control group were conducted through $x^2$-test. Fisher's exact probability test and t-test, and identifying the effect of the complete airway obstruction Maneuver training program was analysed through t-test and ANCOVA. The results of the study were as follows: 1. After intervention on the complete airway obstruction maneuver training program, Learning motivation in the experimental group was significantly higher than that of the control group. 2. After intervention on the complete airway obstruction maneuver training program, knowledge of choking management the experimental group was significantly higher than that of the control group(F=223.637, p=.000). 3. After intervention on the complete airway obstruction maneuver training program, skill of choking management the experimental group was significantly higher than that of the control group(t=46.800, p=.014). These findings suggest that the complete airway obstruction maneuver training program can facilitate learning motivation, knowledge and skill of choking management in the primary school students. Therefore it is considered that the complete airway obstruction maneuver training program can be utilized as a effective way to implement the 7th national curriculum for creative extra-activities.

• Korean Journal of Bronchoesophagology
• /
• v.9 no.1
• /
• pp.96-100
• /
• 2003

Retrophayngeal hematomas frequently develop in patients who had cervical vertebra fracture. The hematoma develops in the space between buccopharyngeal fascia and prevertebral fascia. But it rarely causes severe airway obstruction. We recently treated a patient who had dyspnea and dysphagia due to a retropharyngeal hematoma without any significant trauma history. First, tracheostomy was performed to maintain the airway. Then, incision and drainage was done under suspension laryngoscope. This case shows the fact that a retropharyngeal hematoma can result in severe airway obstruction even after a minor trauma.

• The Korean Journal of Emergency Medical Services
• /
• v.8 no.1
• /
• pp.33-45
• /
• 2004

The study is designed to develop an educational CD-Title for Basic Life Support. The study is conducted from July to December, 2002, Based on the course of program development suggested by Dick and Cray. the study followed the planning, development, education and evaluation of a program. The developed CD-Title consists of 8 parts. 1. Intro include Introduction, Adult CPR, Child CPR, Infant CPR, Adult Foreign-Body Airway Obstruction, Infant Foreign-Body Airway Obstruction, and Exercise in Menu at Right of screen. 2. Introduction consist of death process at cardiac arresst, chain of survival, introduction of CPR, respiratory & ciculatory anatomy and physiology. 3. Adult CPR consist of assessment responsiveness, activating EMS system, position victim, opening a airway, checking for breathing, rescue breathing, checking for sign of circulation, chest compression, 1 person & 2 persion adult CPR video. 4. Child & Infant CPR consist of, causes, assessment responsiveness, position victim, opening the airway, checking for breathing, rescue breathing, checking for sign of circulation, chest compression, activating EMS system, child & infant CPR video. 5. Adult Foreign-Body Airway Obstruction include assessment responsiveness, activating EMS system, position victim, opening a airway, checking for breathing, 2 rescue breathing, reopening the airway, 2 rescue breathing, finger sweep, 5 abdominal thrusts, unresponsiveness adult Foreign-Body Airway Obstruction video. 6. Infant Foreign-Body Airway Obstruction consist of, causes, assessment responsiveness, position victim, opening the airway, checking for breathing, 2 rescue breathing, reopening the airway, 2 rescue breathing, checking foreign-body object in oral cavity of victim, 5 back blow, 5 chest thsusts, activating EMS system, video. 7. 32 exercise consist of 8 Adult CPR, 12 Child & Infant CPR, 5 Adult Foreign-Body Airway Obstruction, 7 Infant Foreign-Body Airway Obstruction. Every part consist of animations to trigger students interests. This CD-Title will be useful education for first responders and lay rescuers.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.34 no.4
• /
• pp.460-467
• /
• 2008

Pierre Robin sequence as a symptom triad of micrognathia, glossoptosis, and cleft palate results in upper airway obstruction and feeding problems. If mild, it is often managed in the prone position. When positional treatment fails, however, surgical intervention such as tongue-lip adhesion, tracheostomy, and mandibular distraction osteogenesis is mandatory to relieve airway obstruction. There has been growing interest in the application of distraction osteogenesis for the management of craniofacial abnormalities. The mandibular distraction osteogenesis to newborns may prevent the airway obstruction, decrease the potential tracheostomy, and reduce the likehood of orthognathic surgery after growth. We experienced an infant with Pierre Robin sequence who showed mandibular hypoplasia, glossoptosis, incomplete cleft palate, intermittent cyanos is, depression of the chest, and respiratory difficulty associated with airway obstruction. We treated the airway obstruction by tongue-lip adhesion at 2 weeks of age, and treated the mandibular retrognathism and depression of the chest byusing internal mandibular distraction osteogenesis at 7 month of age. The mandible moved forwardly, the upper airway space was enlarged, and the antero-posterior distance of the mandible was elongated after the mandibular distraction. Mandibular distraction osteogenesis may be a promising technique to avoid the need of tracheostomy and orthognathic surgery, and to correct airway obstruction in infants with congenital craniofacial malformation.

• Tuberculosis and Respiratory Diseases
• /
• v.72 no.3
• /
• pp.310-317
• /
• 2012

Background: Airway obstruction and the extent of emphysema are reported to be responsible for reduced bone mineral density (BMD). Corresponding to different phenotypes of a pulmonary disease, different severity in extra pulmonary features may exist. We compared BMDs of subjects with or without airway obstruction and/or emphysema and investigated the relationships among BMD, the severity of airway obstruction, and the extent of emphysema. Methods: Using a university hospital database, we reviewed patients over 40 years old who performed spirometry, computed tomography of chest, and measurement of BMD of the lumbar (L) spine. According to the presence or absence of airway obstruction and/or emphysema, four groups were classified. Results: Among a total of 59 subjects, 33 (56%) had osteoporosis. The prevalence of osteoporosis in subjects with no airway obstruction and no emphysema, those with only emphysema, those with only airway obstruction, and those with both airway obstruction and emphysema were 42%, 57%, 64%, and 73%, respectively (p=0.047 by linear-by-linear association). The mean T-scores of BMD of L1 (p=0.032) and L1-4 spines were different among the four groups (p=0.034). Although the T-score of L1 BMD negatively correlated with the extent of emphysema (r=-0.275, p=0.035) and positively with each of body mass index (BMI) (r=0.520, p<0.001), forced expiratory volume in one second ($FEV_1$) (r=0.330, p=0.011), $FEV_1$/forced vital capacity (r=0.409, p=0.001), and forced expiratory flow at 25~75% of FVC ($FEF_{25-75%}$) (r=0.438, p=0.0001), respectively, multiple linear regression analysis indicated that BMI (p<0.001) and $FEF_{25-75%}$ were predictive of BMD (p=0.012). Conclusion: Low BMI and airway obstruction were strongly associated with reduced bone density rather than the extent of emphysema.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.42 no.1
• /
• pp.47-50
• /
• 2016

Patients with Pierre Robin sequence exhibit varying degrees of airway obstruction and feeding difficulty. In some patients, airway obstruction may be profound, warranting surgical intervention to maintain a patent airway. The purpose of this article is to highlight the advantages of the tongue-lip adhesion procedure for the management of airway obstruction in such patients compared to the currently available options.

• Journal of Dental Anesthesia and Pain Medicine
• /
• v.22 no.6
• /
• pp.457-464
• /
• 2022

Tracheostomy is a surgical procedure that is commonly used to treat upper airway obstruction. In particular, patients with head and neck cancer may require elective or emergency tracheostomy because of airway obstruction due to massive bleeding of the intraoral tumor mass and rapid growth of the tumor mass in the neck area. Here, we report four cases of tracheostomy in patients with head and neck cancer with narrowed airway space and difficulty in breathing. Based on these cases and a literature review, we recommend that oral and maxillofacial surgeons and dental anesthesiologists should cooperate closely and determine the appropriate timing to perform definitive airway management for such patients during palliative treatment, along with continuous evaluation of tumor location, risk of recurrence, and airway involvement.

• Korean Journal of Cleft Lip And Palate
• /
• v.8 no.2
• /
• pp.81-86
• /
• 2005

Cleft palate patients with congenital anomalies have an increased risk of airway problems following palatoplasty. Factors that were related included presence of associated congenital anomalies, duration of surgery, age at time of surgery, history of previous airway problem, and excessive pressure exerted on the base of the tongue by Dingman retractor. This report described a complication of post-operative Pneumonia after palatoplasty (Furlow technique), which resulted in a life-threatening acute airway obstruction in an infant with cleft palate. Patient has a history of previous mild airway problems. In addition to this problem, we speculate that Furlow technique involves more extensive surgical dissection than other techniques may increase risk for upper airway obstruction. Awareness of this risk permits identifying those patients prior to surgery so that they can be monitored and managed properly, minimizing the likelihood of major complications or possibility of death.