• Journal of Dental Anesthesia and Pain Medicine
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• 제22권5호
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• pp.349-356
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• 2022

Background: Awake fiberoptic intubation (AFOI) is the procedure of choice for securing the airway in patients with a difficult airway when undergoing surgeries under general anesthesia. An ideal drug would not only provide conscious sedation but also maintain spontaneous ventilation, smooth intubation conditions, and stable hemodynamics. We compared the effects of dexmedetomidine alone and dexmedetomidine in combination with fentanyl at a dose lower than the standard dose for achieving conscious sedation during AFOI in difficult airway patients undergoing oral cancer and dental surgeries. Methods: We included 68 adult patients undergoing AFOI. The patients were randomized in two groups, wherein Group D received intravenous dexmedetomidine 1 ㎍/kg and Group DF received dexmedetomidine 0.5 ㎍/kg and fentanyl 1 ㎍/kg. The outcomes measured were airway obstruction score, intubation scores, fiberoptic intubation comfort score, sedation score, and hemodynamic variables. Results: Low-dose dexmedetomidine with fentanyl showed similar results as those with the standard dose of dexmedetomidine in terms of airway obstruction, vocal cord movement, degree of cough, degree of limb movements, and intubation comfort. However, the sedation achieved and incidence of hypotension and bradycardia were higher in Group D than in Group DF. Conclusions: A low dose of dexmedetomidine-fentanyl provides satisfactory intubation conditions as those with a standard dose of dexmedetomidine in AFOI, thereby avoiding bradycardia, hypotension, and sedation.

• 대한기관식도과학회지
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• 제13권2호
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• pp.65-67
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• 2007

Congenital epiglottic cyst is rare cause of stridor in neonate and if managed inadequately, disaster such as death can occur. Diagnosis of congenital epiglottic cyst includes imaging studies and endoscopy. Fiberoptic or rigid endoscopic examination excludes other causes of stridor in neonate. Complete excision of cyst is treatment of choice under suspension laryngoscopic guidance. Here, we report a case of congenital epiglottic cyst and concomitant laryngomalacia presenting with seizure and respiratory difficulty in neonate with a review of literature.

• 대한기관식도과학회지
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• 제2권2호
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• pp.222-226
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• 1996

The increasing incidence of multiple primary carcinomas occuring in the upper aerodigestive tract is well documented, with the accepted incidence being as high as 20-30%. The fiberoptic endoscopy has also enabled visualization of areas previously inaccessible without general anesthesia. A prospective panendoscopic examination of the upper aerodigestive tract was peformed on 104 patients with squamous cell carcinoma of head & neck in our hospital between 1989 and 1994. Five second primary cancers (4.8% ：2 stomach, 2 esophagus, 1 lung cancers) were detected endoscopically. These finding should reinforce the belief that head & neck cancer is a panmucosal disease of the aerodigestive tract that silent second primary cancers are not uncommon. So every effort should be done to detect second primary cancers in head & neck squamous cell carcinomas. Panendoscopy has proved valuable in achieving that.

• Journal of Trauma and Injury
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• 제23권1호
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• pp.53-55
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• 2010

A thyroid cartilage fracture is a rare entity and can be overlooked easily. Such cases are difficult to diagnose, and assessment and treatment guidelines are difficult to determine. CT of the neck region may be useful when acute airway intervention is not required or when more information regarding the neck's anatomy is required for management decisions. We describe a case of a thyroid cartilage fracture with displacement. In the emergency department (ED), neck CT and fiberoptic nasopharyngoscopy were used to assess the status of the patient's (a male) vocal chords immediately. He remained unable to phonate continuously. After an immediate assessment, we decided to use steroid and conservative therapy. The patient had a good recovery and was without symptoms one month after injury. There is no question that early surgical repair of neck injuries affords the best results for airway and voice patency in most cases however, we suspect that surgical repair is not needed in all cases. Early recognition and an accurate therapy plan for a thyroid fracture with displacement are essential. Therefore, the emergency physician's immediate and careful decision based on endoscopy and neck CT is important for the patient's long-term recovery.