• 대한두개안면성형외과학회지
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• 제24권2호
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• pp.87-90
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• 2023

Endotracheal intubation is often necessary in the course of animal experiments, especially in craniofacial surgery. However, endotracheal intubation can be a major burden in this context. The authors performed simple and cost-saving method using a 200 µL yellow micropipette tip, and the success of this method was demonstrated by X-ray and autopsy. We used a total of 30 rats. After the rats were fixed with a plaster, the trachea and vocal cords were visualized with the tongue pulled back. Under direct visualization of the vocal cords, a curving micropipette tip was advanced into the trachea. This method can be learned quickly and applied successfully by general experimenters. We successfully intubated all 30 rats without any complications. The success rate of micropipette tip intubation was 100%. This procedure was performed by one experimenter within 2 to 3 minutes after induction of anesthesia. We demonstrated its superiority by X-ray and autopsy. Herein, we describe endotracheal intubation of rats using micropipette tips. To the best of our knowledge, this method is novel and represents the simplest and most efficient means of intubation in rats, providing an alternative to conventional endotracheal intubation.

• 대한기관식도과학회지
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• 제17권1호
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• pp.65-67
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• 2011

Pyriform sinus perforation is a rare complication of endotracheal intubation. It most commonly occurs at the hands of the less experienced physician in emergency situations. It can occur after traumatic intubation and is potentially lethal. The site most commonly perforated is the pharynx, posterior to the cricopharyngeal muscle; the second most common site is the pyriform sinus. We report a case of pyriform sinus perforation after endotracheal intubation, which was successfully treated with primary closure.

• 한국응급구조학회지
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• 제16권2호
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• pp.75-89
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• 2012

Purpose : This research was designed to provide basic data for advanced pre-hospital airway management by comparing the time to ventilation and success rate for tracheal intubation performed with Macintosh laryngoscope and intubating Laryngeal Mask Airway(ILMA) in a manikin. Methods : All participants were novice users among EMT-Paramedic students and were divided into two groups: (1) the group for Macintosh laryngoscope guided tracheal intubation(MLG-TI) (2) the group for ILMA guided tracheal intubation(ILMA-TI). After an introductory lecture and demonstration, each group made an attempt ten tracheal intubation to compare the ventilation time and success rate for tracheal intubation. Results : 1) There was significant difference in the time to ventilation through MLG-TI, the time to first and second ventilation through ILMA-TI of the 10 attempts. 2) The time to first ventilation through ILMA-TI was significantly shorter than that of ventilation through MLG-TI. 3) There was no significant difference between the time to ventilation through MLG-TI and the time to second ventilation through ILMA-TI. 4) The success rates of ILMA-TI were significantly higher than those of MLG-TI. Conclusion : ILMA-TI can be an alternative method for MLG-TI in advanced pre-hospital airway management.

• Journal of Dental Anesthesia and Pain Medicine
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• 제24권5호
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• pp.361-366
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• 2024

Orthognathic surgery often requires intraoral orthodontic appliances that are fixed directly to the bone, which can complicate nasotracheal intubation if the devices protrude into the nasal cavity. This case report describes a 19-year-old man scheduled for elective orthognathic surgery who experienced recurrent cuff tears of the endotracheal tube during nasotracheal intubation due to protruding orthodontic screws in the palate. Despite initial attempts at nasotracheal intubation through the left nostril, the cuff of the 7.0 mm internal diameter (ID) Ring, Adair & Elwyn (RAE) tube repeatedly ruptured, with identical rupture patterns observed. Facial CT revealed that the orthodontic screws had protruded into both nasal cavities with significant visibility in the sagittal, coronal, and transverse views. Fiberoptic examination of the left nasal passage identified a firm protrusion below the inferior turbinate, corresponding to the location of the screw, which likely caused the cuff tears. Intubation was successfully performed via the right nostril during the fiberoptic examination. This case highlights the critical importance of evaluating intraoral corrective devices using comprehensive craniofacial imaging before anesthesia induction, as well as conducting fiberoptic examinations during intubation to avoid complications and ensure patient safety.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권3호
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• pp.197-201
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• 2010

Introduction: In a surgery of the oral cavity, nasotracheal intubation is often carried out to secure the surgical field. By passing a tracheal tube through the nasal cavity to the pharynx, the nasotracheal intubation can lead to complications that do not occur with oral intubation, such as nasal bleeding and submucosal aberration etc. The purpose of this study is to examine the method of CT evaluation and pretreatment for a safe nasotracheal intubation. Materials and Methods: Among 30 patients who orthognathic surgery was performed at Chung-Ang University Hospital during the period August 2009 to October 2009, 30 patients were included. The 30 patients were divided into two groups; 15 patients intubated with CT evaluation with pretreatment, and the other 15 patients intubated with no pretreatment. We evaluated nasal bleeding of the two groups during nasotracheal intubation. Results: CT evaluation with pretreatment group had a significantly lower incidence of nasal bleeding than the group with no pretreatment. Conclusion: CT evaluation with pretreatment helps to minimize nasal bleeding during nasotracheal intubation.

• Journal of Dental Anesthesia and Pain Medicine
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• 제19권5호
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• pp.301-306
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• 2019

Mounier-Kuhn syndrome (MKS) is a disease characterized by dilation of the trachea and mainstem bronchi. Due to the risk of airway leakage, pulmonary aspiration, and tracheal damage, MKS can be fatal in patients undergoing tracheal intubation. Moreover, MKS may not be diagnosed preoperatively due to its rarity. In this case, a patient undergoing neurosurgery was incidentally diagnosed with MKS during general anesthesia. During anesthesia induction, difficulties in airway management led the anesthesiologist to suspect MKS. Airway leakage was resolved in this case using oropharyngeal gauze packing. Anesthesiologists should be aware of the possibility of MKS and appropriate management of the airways.

• Journal of Yeungnam Medical Science
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• 제24권2호
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• pp.162-169
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• 2007

현미경 하 후두 미세 수술에서 10% lidocaine 술 전 분무가 혈역학적으로 어떠한 영향을 미치는 지를 보기 위하여 대상 환자 50명을 각 25명씩 두 군으로 나누어 대조군과 10% lidocaine 분무군으로 하였다. 마취 유도 후 대조군에서는 근이완제 투여 후 3분 30초에 기관내 삽관을 시행하였으며, 연구군은 근이완제 투여 2분 후 인후두 점막과 기관내에 lidocaine 1.5 mg/kg을 분무하였고 다시 1분 30초 후에 기관내 삽관을 시행하였다. 수축기 및 이완기 혈압과 심박수를 마취 유도 전에 측정하여 기준치(T0)로 삼았으며 기관내 삽관 후 1분(T1), 3분(T2), 5분(T3), 현수 후두경 거치 후 1분(T4), 3분(T5), 5분(T6), 10분(T7)에 각각 측정하여 기록하였다. 동맥압과 심박수가 기관내 삽관후 3분까지 그리고 현수 후두경 거치 후 3분까지 대조군에 비하여 10% lidocaine 분무군에서 유의하게 낮음을 보아 기관내 삽관 전 10% lidocaine 분무는 기관내 삽관과 현수 후두경으로 인한 심혈관계 자극을 효과적으로 완화시킴을 알 수 있다.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.206-209
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• 2023

Purpose: Since its implementation, flexible fiberoptic bronchoscopy (FBS) has played an important role in the diagnosis and treatment of tracheobronchial tree and pulmonary disease. Although FBS is often performed by endoscopists, it has also been performed by surgeons, albeit rarely. This study investigated FBS from the surgeon's perspective. Methods: This retrospective study included patients who underwent FBS performed by a single thoracic surgeon between March 2017 and December 2021. Accordingly, the epidemiology, purpose, results, and complications of FBS were analyzed. Results: A total of 47 patients received FBS, whereas 13 patients underwent repeat FBS. Their mean age was 60.7 years. The main organs injured involved the chest (n=22), brain (n=9), abdominal organ (n=7), cervical spine (n=4), extremities (n=4), and face (n=1). The average Injury Severity Score was 22.5. Indications for FBS included atelectasis or haziness on chest x-ray (n=34), pneumonia (n=17), difficult ventilator management (n=7), percutaneous dilatory tracheostomy (n=3), blood aspiration (n=2), foreign body removal (n=2), and intubation due to a difficult airway (n=1). The findings of FBS were mucous plugs (n=36), blood and blood clots (n=16), percutaneous dilatory tracheostomy (n=3), foreign bodies (n=2), granulation tissue at the tracheostomy site (n=2), tracheostomy tube malposition (n=1), bronchus spasm (n=1), difficult airway intubation (n=1), and negative findings (n=5). None of the patients developed complications. Conclusions: FBS is an important modality in the trauma field that allows for the possibility of diagnosis and therapy. With sufficient practice, surgeons may safely perform FBS at the bedside with relative ease.

• Journal of Chest Surgery
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• 제44권3호
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• pp.260-265
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• 2011

Tracheobronchial ruptures (TBR) rarely complicate surgical procedures under general anesthesia. Seemingly uneventful intubations can result in injury to the trachea, which often manifests as hemoptysis and subcutaneous emphysema. We present 2 patients with postintubation TBR who were treated surgically and discuss considerations in the management of this potentially lethal injury.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권3호
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• pp.231-233
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• 2017

Wolf-Hirschhorn syndrome is a rare hereditary disease that results from a 4p chromosome deletion. Patients with this syndrome are characterized by craniofacial dysgenesis, seizures, growth delay, intellectual disability, and congenital heart disease. Although several cases have been reported, very little information is available on anesthetic management for patients with Wolf-Hirschhorn syndrome. We encountered a case requiring anesthetic management for a 2-year-old girl with Wolf-Hirschhorn syndrome. The selection of an appropriately sized tracheal tube and maintaining intraoperatively stable hemodynamics might be critical problems for anesthetic management. In patients with short stature, the tracheal tube size may differ from what may be predicted based on age. The appropriate size ( internal diameter ) of tracheal tubes for children has been investigated. Congenital heart disease is frequently associated with Wolf-Hirschhorn syndrome. Depending on the degree and type of heart disease, careful monitoring of hemodynamics is important.