• Title/Summary/Keyword: Upper airway Obstruction

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A Case of Pediatric Subglottic Stenosis caused by Subglottic Cyst (성문하부 낭종으로 인한 소아 성문하부 협착 1예)

  • Oh, Hyeon Seok;Lee, Hye Ran;Lee, Jae Yong;Kim, Jae Wook
    • Korean Journal of Head & Neck Oncology
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    • v.34 no.2
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    • pp.77-80
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    • 2018
  • Subglottic cysts have been reported as a relatively rare problem of pediatrics who have a history of premature birth and period of intubation. They may cause significant upper airway obstruction and many cases require tracheostomy to airway management. Endoscopic marsupialization by microinstruments or laser has been standard primary treatment but a high recurrence rate has been reported. A 19-month-old child presented with stridor who has history of ventilation via an endotracheal intubation in the newborn period for 7 days. Radiologic examinations were performed for aggravated dyspnea symptom and subglottic cystic mass was found, then it was marsupialized at operation room and tracheostomy was done at the same time. After decannulation of tracheostomy tube, there is no recurrence of cyst nor upper airway obstruction for 29 months. We report this case with a review of literature.

Acute airway obstruction resulting in Pneumonia after palatoplasty: A Case Report (구개성형술후 폐렴을 동반한 급성 기도 폐색: 증례보고)

  • Ra, Ju-Il;Koo, Hyun-Mo;Jeong, Jong-Sun;Park, Chul-Hui;Kim, Hyeon-Min;Song, Min-Seok
    • Korean Journal of Cleft Lip And Palate
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    • v.8 no.2
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    • pp.81-86
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    • 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.

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A Case of Pulmonary Edema Due to the Severe Airway Obstruction by the Burglary Attack (노상 강도가 목을 심하게 압박한 후 발생된 폐부종 1예)

  • Park, Sang Won;Kim, Young Ji;Kim, Sang Hoon;Ahn, Youngsoo
    • Tuberculosis and Respiratory Diseases
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    • v.56 no.5
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    • pp.532-535
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    • 2004
  • Acute fulminating pulmonary edema was developed in 20 year old female following an acute airway obstruction due to a burglary attack on neck with bare hands. The pathogenesis of pulmonary edema is related to the alveolar and capillary damage induced by the severe negative pressure generated by attempting to inspire against the closed upper airway. This female responded to fluid restriction and oxygen supply. To our knowledge, pulmonary edema caused by man has never been reported in the literature.

Multidisciplinary correction of anterior open bite relapse and upper airway obstruction

  • Gracco, Antonio;Perri, Alessandro;Siviero, Laura;Bonettid, Giulio Alessandri;Cocilovo, Francesco;Stellini, Edoardo
    • The korean journal of orthodontics
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    • v.45 no.1
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    • pp.47-56
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    • 2015
  • A 27-year-old man presented an anterior open bite relapse. He had low tongue posture positioned anteriorly at rest and during swallowing and reported chronic difficulty in nose breathing. Head cone-beam computed tomography revealed nasal septum deviation, right turbinate hypertrophy, and left maxillary sinus congestion, which were thought to contribute to the breathing problem, encourage the improper tongue posture, and thereby cause the relapse. Multidisciplinary treatment involving an otorhinolaryngologist, an orthodontist, and a periodontist resolved the upper airway obstruction and corrected the malocclusion. The follow-up examination after 3 years 5 months demonstrated stable results.

A Case Report on Treatment of Obstructive Sleep Apnea Patient Using Intraoral Removable Appliance (구강내 장치를 이용한 수면 무호흡 환자의 치료 증례)

  • Kang, Kook-Jin;Oh, Kang-Seob;Lee, Si-Hyung
    • Sleep Medicine and Psychophysiology
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    • v.5 no.2
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    • pp.210-215
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    • 1998
  • OSA(Obstructive Sleep Apnea) is a condition with repeated obstruction of the upper airway while sleeping. This obstruction of the upper airway may result if sleep-induced physiologic change in muscle activity is superimposed on various structural defects of the upper airway. Macroglossia, micrognathia, retrognathia, and decreased airway lumen have all been implicated in OSA. There are a variety of surgical and nonsurgical treatment modalities currently available for OSA. Recently the uvulopalatopharyngoplasty has achieved widespread use, but success rates vary and long-term effects are still unknown. Current nonsurgical treatment methods can be cumbersome and uncomfortable with variable responses. For this case. we diagnosed as OSA by using polysomnographic analysis and cephalometric analysis, and delivered intraoral removable appliance which is more conservative, reversible and easy to use for patient. And we got results that Apnea Index(AI) decreased from 14.4 to 3.1, Total Respiratory Disturbance Index(Total RDI) decreased from 18.1 to 7.0 and removal of chronic headache in daytime.

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A study on the correlation between airway space and facial morphology in Class III malocclusion children with nasal obstruction (비폐쇄를 보이는 III급 부정교합아동의 기도 공간 형태와 안모 골격 형태와의 상관관계 연구)

  • Jung, Ho-Lim;Chung, Dong-Hwa;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.37 no.3 s.122
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    • pp.192-203
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    • 2007
  • Objective: The aim of this study was assessment of the relationship between airway space and facial morphology in Class III children with nasal obstruction. Methods: For this study, 100 Class III children (50 boys and 50 girls) were chosen. All subjects were refered to ENT, due to nasal obstruction. Airway space measurements and facial morphology measurements were measured on lateral cephalometric radiograph. Pearson correlation analysis was used to assess the relationship between airway space and facial morphology Results: Ramal height, SNA, SNB, PFH, FHR and facial plane angle were positively related to upper PAS, and sum of saddle angle, articular angle, and genial angle, SN-GoGn, Y-axis to SN and FMA negatively related to upper PAS. Genial angle, FMA were positively related to lower PAS, and articular angle, facial depth, PFH and FHR negatively related to lower PAS. PCBL, ramal height, Mn. body length, Mn. body length to ACBL, facial depth, facial length, PFH and AFH were positively related to tonsil size. Sum of saddle angle, articular angle, genial angle, facial length, AFH, FMA and LFH were positively related to tongue gap, and IMPA and overbite was negatively related to tongue gap. Upper PAS, related to size of adenoid tissue, was mainly related to posterior facial dimension following a vertical growth pattern of face and mandibular rotation. Lower PAS and tonsil size, related to anterior-posterior tongue base position, were significantly related to each other. Lower PAS was related to growth pattern of mandible, and tonsil size was related to size of mandible and horizontal growth pattern of face. Tongue gap was related to anterior facial dimension following a vertical growth pattern of face. Conclusion: Significant relationship exists between airway space and facial morphology.

A plunging ranula in a child with holoprosencephaly: a case of unique pathophysiology and difficult airway management

  • Watanabe, Takuma;Yokoyama, Atsushi;Shimizu, Satoshi;Bessho, Kazuhisa
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.48 no.4
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    • pp.232-236
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    • 2022
  • A ranula is a pseudocyst that originates from the sublingual gland after trauma. Acute cases of ranulas that progress rapidly and cause respiratory distress are rare. Holoprosencephaly is a complex brain malformation caused by incomplete cleavage of the prosencephalon. Children with holoprosencephaly may experience upper airway obstruction due to the associated dentoalveolar malformations and oromotor dysfunctions. We present the case of an eight-year-old female patient with holoprosencephaly and a plunging ranula that manifested as an acute course due to difficult airway management. She required gastrostomy for oromotor dysfunctions related to feeding and swallowing and difficulty managing oral secretions. The sublingual gland and ranula were removed under general anesthesia. Postoperatively, urgent reintubation and close monitoring in the intensive care unit were required due to upper airway obstruction. We successfully managed the patient with close cooperation of a pediatrician and an anesthetist, and no recurrence was observed at the one-year follow-up. A ranula can be caused by trauma to the floor of the mouth in association with lingually inclined mandibular teeth, a type of dentoalveolar compensation seen in maxillary hypoplasia associated with holoprosencephaly. Careful consideration is needed in such cases since airway management can be difficult due to postoperative swelling and oromotor dysfunctions.

High Flow Nasal Cannula Assisted Tracheostomy for Securing Airways in Patients with Acute Respiratory Distress Induced by Glottic Cancer (급성 호흡곤란이 발생한 성문암 환자에서 기도 확보를 위한 고유량 비강 캐뉼라 보조 기관절개술)

  • Hong, Seung Woo;Lee, Dong Kun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.31 no.1
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    • pp.31-34
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    • 2020
  • Tracheostomy is considered as a first treatment, when oral intubation seems to be difficult in patient who present severe upper airway obstruction. Generally, tracheostomy is performed in supine position. But if airway obstruction is severe enough to cause dyspnea, low oxygen saturation and inability to maintain supine position, tracheostomy should be performed in sitting position. The authors report a case of successful tracheostomy using high flow nasal cannula which help to maintain stable oxygen saturation and respiration in patients with laryngeal cancer.

Experimental Study of the Influence of the Upper Airway Obstruction on the Blood Gas Analysis (인위적인 기도협착이 동맥혈액가스에 미치는 영향)

  • 정해영;김중환;조영상
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1979.05a
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    • pp.8.2-8
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    • 1979
  • Acute obstruction of the upper airway from trachea, a foreign body or Iaryngospasm may lead to death in a few minutes. The immediate restoration of an adequate airway in these patients may be lifesaving. Spontaneous respiration by means of a needle inserted into the trachea was studied in 21 rabbits using 16, 18, and 20 gauge extrcatheters. The results are as follows; 1) Airway resistance was markedly increased in all experimental animals. consequently tidal volume was also significantly decreased, but this seems to be compensatory by increased of respiratory frequency in l6G group. 2) Blood gas analysis revealed adequate pulmonary ventilation through the constricted airway (about 1/3 of normal sized trachea) during 60 minutes. In the other hand, hypercarbia, hypoxemia, and metabolic acidosis were developed in the group with severe constriction of the upper airway (about 1/4-1/6 of normal sized trachea). 3) The further study is postulated to confirm the the possibility of application of needle trcheostomy in man, but the rabbits were tolerable to the constricted airway with a small sized needle (l6G) into the trachea for 60 minutes.

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