• Title/Summary/Keyword: upper airway obstruction

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Superiorly Based Flap Tracheostomy (Superiorly based flap을 이용한 기관절개술)

  • 정필상;이정구;정필섭;김영훈
    • Korean Journal of Bronchoesophagology
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    • v.1 no.1
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    • pp.129-135
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    • 1995
  • The superiorly based flap tracheostomy(SBFT) has been advocated as an new technique of tracheostomy to manage a wide variety of causes of upper airway obstruction. This technique has particular applicability in patients who require long term tracheostomy such as in bilateral vocal cord paralysis and severe obstructive sleep apnea. SBFT has numerous advantages such as shortening of the gap between the skin and trachea : construction of a self-sustaining tract ; circumferential mucocutaneous junction to reduce infection, granulation tissue, bleeding, and stenosis of the tract : avoidance of the laryngotracheal damage : easy placement of a tracheostomal stent to promote speech, coughing and swallowing. Most of all, this technique can reduces the suprastomal buckling by the support of the superiorly based tracheal flap, and thus prevents the stenosis of suprastomal airway. The disadvantage of SBFT is more time-consuming procedure than the conventional tracheostomy, A retrospective analysis of 8 patients undergoing SBFT between June, 1994 and March, 1995 in Dankook University Hospital was performed to present the surgical technique and com-plication rates. The average duration of follow up was 11 months. The complications were consisted of a wound infection and a sternal granulation. The other complications including wound dehiscence, tracheitis, pneumonia, tracheal granulation, sternal narrowing and subglottic stenosis were not experienced.

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A Case of Bilateral Vocal Fold Paralysis from Acromegaly (말단 비대증 환자에서 발생한 양측성대마비 1예)

  • Park, Min-Woo;An, Soo-Youn;Roh, Dong-Hwan;Kwon, Tack-Kyun
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.20 no.1
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    • pp.68-70
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    • 2009
  • Acromegalic patients can develop mild upper airway obstruction. However, the limitation of both vocal folds mobility developing dyspnea is rare. We report a case with bilateral vocal cord paralysis associated with acromegaly. The patient visited our clinic presenting dyspnea showing bilateral vocal cord hypomobility in laryngoscopy. The patient underwent a tracheostomy and a transsphenoidal resection of the pituitary adenoma. Thereafter, laser cordotomy with medial arytenoidectomy was done for the permanent treatment of glottal obstruction. The tracheotomy canula was successfully removed one month after the surgery.

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Airway Expandible Metallic Stent Implantation in Children with Tracheal or Bronchial Stenosis (기관 또는 기관지 협착을 가진 소아에서의 스텐트 적용)

  • Jang, Ju Young;Kim, Hyo-Bin;Lee, So Yeon;Kim, Ja Hyung;Park, Seong Jong;Shin, Ji Hoon;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.48 no.5
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    • pp.512-517
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    • 2005
  • Purpose : In adults, endoscopic tracheobronchial balloon dilatation and stenting have become valuable methods to establish and maintain an adequate airway lumen when tracheomalacia or neoplastic growth compromise the airways. But in children, only a few cases were reported due to technical problems. We report six children who were treated with stent implantation and describe the use and safety of airway stents. Methods : Six patients with severe airway obstruction were treated. We investigated the underlying medical problems, stenotic site, symptomatic improvement and complications, and the size and location of stent. Results : The median age of the six patients was 21 months. Three of them were mechanically ventilated and one had an endotracheal tube to maintain the patency of airway. Diagnoses were : congenital tracheal stenosis with or without bronchomalacia, granulation tissue formation after right upper lobectomy by bronchial carcinoid or after prolonged intubation, endobronchial tuberculosis, and airway compression by mediastinal undifferentiated sarcoma. Nitinol stents were implanted in the airway guided by bronchoscopy and fluoroscopy simultaneously. Three cases were placed in trachea, the others were in the bronchus. After stent implantation, all patients showed marked improvements of their airway obstructive symptoms. Four patients are doing well, although two expired due to underlying diseases. Four patients had granulation tissue formation around stents, but that was tolerable after removing the stent. Conclusion : We suggest that the use of expandible metallic stent implantation can offer safe therapeutic option even in extremely severe, life threatening and inoperable airway stenosis in children.

A Case of Convulsive Seizure Following Spinal Anesthesia in a Geriatric Patient with COPO (만성 폐쇄성 폐질환자에서 척추 마취후 발생한 경련발작 1례)

  • Suh, III-Sook
    • Journal of Yeungnam Medical Science
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    • v.5 no.2
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    • pp.213-219
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    • 1988
  • In the geriatric patient with COPD, incidence of postoperative pulmonary complication is higher than young patient. Therefore, some anesthesiologists preferred spinal anesthesia to general anesthesia for surgery of the perineum, lower extrimities, and pelvic extra peritoneal organs. But, during spinal anesthesia, the same careful observation is requiered as during general anesthesia. We experienced a case of the convulsive seizure at about 1 hour after spinal anesthesia for open prostatectomy in a 76-year-old male patient wit COPD. It was suspected that his convulsive seizure be resulted from hypercapnea combined with hypoxia following upper airway obstruction. This patient was treated successfully by ultrashort acting barbiturate and controlled ventilation.

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A CASE OF PIERRE ROBIN SYNDROME (Pierre Robin 증후군의 일예)

  • Byeun, Ki-Jeong
    • The Journal of the Korean dental association
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    • v.15 no.8
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    • pp.607-610
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    • 1977
  • When micrognathia (Small jaw) and glossoptosis (Falling backward of the tongue) occur in the newborn, there is a grave danger of upper airway obstruction. These deformities are frequently associated with an incomplete cleft of the palate, and the entity has been referred to as the Pierre Robin Syndrome. This is to report a case of Pierre Robin Syndrome of 40 day old Korean male infant, whose birth weight was about 3.6kg, and gestation period was 39 weeks. From birth, dyspnea and feeding difficulty were developed. The authors treated the patient by surgical procedure (glossopexy). The post operative course was uneventful.

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Comparison of Sleep Parameter according to Apnea-Hypopnea Index

  • Jin, Bok-Hee
    • Korean Journal of Clinical Laboratory Science
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    • v.44 no.4
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    • pp.205-209
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    • 2012
  • Obstructive sleep apnea (OSA) is the most common type of sleep apnea and is caused by obstruction of the upper airway. It is characterized by repetitive pauses in breathing during sleep despite the effort to breathe. Apnea is closely related to clinical findings and respiratory disturbance index (RDI). The total subjects were 42 (male 26, female 16) and examined by polysomography (PSG) in terms of RDI above 5 and below 5 at Mok-Dong Hospital in Ewha Womans University from January to June, 2012. The study revealed the followings: The comparison of clinical findings and RDI above 5 showed significant increase in age, BMI, and snoring sound although lowest $SpO_2$ level decreased. The correlation coefficient analysis between clinical findings and RDI showed statistically significant correlation in age, BMI, lowest $SpO_2$ although snoring sound and average $SpO_2$ showed statistically insignificant correlation.

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How to Diagnose Obstructive Sleep Apnea Syndrome: From The Viewpoint of Medical and Dental Features (임상가를 위한 특집 2 - 어떻게 평가할 것인가? -의학적 및 치의학적 관점에서-)

  • Auh, Q-Schick
    • The Journal of the Korean dental association
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    • v.48 no.3
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    • pp.184-189
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    • 2010
  • Snoring is a very common sleep disorder. Approximate 20~30 percent of population and 40~60 percent of middle and old age population are reported to have symptoms of snoring. Snoring patients do not frequently recognize snoring until spouse or colleague has noticed. Hence, for most people snoring has been not a serious health issue but one of bad sleeping habits. However, it recently draws social attention because most patients with diagnosed "Obstructive Sleep Apnea Syndrome" cased by obstruction of the upper airway are reported snoring. In this point, the author attempts to review the clinical aspects and treatments about snoring and "Obstructive Sleep Apnea Syndrome" in the medical and dental perspective.

Treatment of Laryngeal Web (Laryngeal web의 치료)

  • 조중환;유태현;박현수
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1977.06a
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    • pp.7.2-7
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    • 1977
  • Laryngeal web was first reported by Fleischmann in 1822, and it causes upper airway obstruction and abnormalities of phonation. Congenital webs result from an arrest of development of the larynx around the tenth week of fetal life. Acquired webs may result from cicatrical strictures of infectious lesion, traumatic and postoperative wounds. The most common site of webbing is glottic, followed by subglottic and supraglottic. We have experienced a case of simultaneous glottic and supraglottic laryngeal webs probably due to tuberculous lesions in 28 aged male who was treated by endolaryngeal microsurgery.

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A Case of Tracheostomy Cannula Inserted in the Trachea for 10 Years (10년간 기관에 삽관되어 있었던 기관 절개관 1례)

  • 김중환;오경균;정완교;이상기;김정배;길동석;서정하
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.5.4-6
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    • 1983
  • A tracheostomy is performed to relieve an upper airway obstruction, to facilitate bronchial toilet, to decrease dead space, to assist ventilation and as an elective procedure in head and neck surgery. Many complications are associated with tracheostomy, both in the actual performance of the operation and in the postoperative management. Recently the authors report one case ; a two years old children got a severe burn on face and neck and received tracheostomy and have carried tracheostomy cannula for 10 years, at last the cannula was worn out and the 12 years old boy came to the hospital.

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Missing teeth after maxillofacial trauma: a case report and management protocol

  • Ramaraj, P.N.;Mahabaleshwara, C.H.;Rohit, Singh;Abhijith, George;Vijayalakshmi, G.
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.6
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    • pp.422-427
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    • 2020
  • Management of maxillofacial trauma includes primary care, in which diagnosis and management of dentoalveolar injury play a vital role. Due to the impact sustained during a maxillofacial injury (whether direct or indirect), dentoalveolar injuries can occur, leading to fracture and displacement of teeth and associated alveolar bone into the surrounding soft tissues and associated structures, such as the maxillary sinus, nasal cavity, upper respiratory tract, tracheobronchial tree, or gastrointestinal tract. Undiagnosed displaced teeth may cause complications such as airway obstruction. This paper reports a case of displaced teeth in the nasal cavity and gastrointestinal tract and highlights the management protocol for displaced teeth secondary to maxillofacial trauma.