Nihon Jibiinkoka Gakkai kaiho
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Acute epiglottitis causes sudden upper airway obstruction that may become lethal, and must be diagnosed and treated quickly and precisely. We review clinical features of 71-cases of acute epiglottitis in 6 years, focusing in cases requiring emergency airway management. Retrospective analysis was done for 1) age and gender, 2) month of onset, 3) symptoms, 4) smoking history, 5) diabetes history, 6) cause and background, 7) first medical institution visit, 8) duration from symptom onset to hospital visit, 9) oropharyngeal findings, 10) laryngendoscopic findings, 11) pharyngeal culture, and 12) deterioration after hospitalization. ⋯ Even if the first medical findings are mild, it is necessary to respond to patients with the possibility to deterioration in mind. Five cases required emergency airway management-3 with tracheostomy and 2 cases with endotracheal intubation. If symptoms of laryngeal edema, oxygen desaturation, and dyspnea are present, emergency airway management should be prepared soon after hospitalization.
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Nippon Jibiinkoka Gakkai Kaiho · Jul 2006
[Effects of one-way speaking valve placement on swallowing physiology for tracheostomized patients: impact on laryngeal clearance].
Tracheostomy placement affects swallowing function, increasing the risk of aspiration. Recent studies suggest that because of increased risk of swallowing disturbance associated with tracheostomy, one-way speaking valve placement may help to reduce aspiration in tracheostomized patients. We hypothesize that airflow exhaled through the laryngeal cavity using the one-way speaking valve may improve the clearance of residual bolus from the upper airway, thus preventing bolus penetration and aspiration. ⋯ Valve Valve placement significantly improved laryngeal clearance and the incidence of penetration during swallowing. placement did not, however, significantly affect pharyngeal bolus residue, laryngeal elevation, pharyngeal delay or aspiration. Factors associated with the resumption of oral feedings were sufficient laryngeal elevation during swallow and the prevention of laryngeal penetration and aspiration. We concluded that one-way speaking valve placement improves laryngeal clearance and prevents laryngeal penetration, resulting in better oropharyngeal swallowing physiology and oral feeding.
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Nippon Jibiinkoka Gakkai Kaiho · Nov 2005
[Effect of the external nasal dilator breathe right and nasal cycle influence].
The external nasal dilator Breathe Right is a nonprescription disposable mechanical device worn over the bridge of the nose that supports the outer walls of the nasal vestibule to increase cross-sectional nasal valve area and enhance air flow through the nose. When worn, the device applies a gentle outward pull to the outside walls of the nasal vestibule that helps prevent collapse of the lateral walls of the nasal vestibule. The device appears similar to an adhesive bandage with two polyester springs attached lengthwise to the nonadhesive side of the backing material. ⋯ Interestingly, the change in the C-notch decreased gradually with time. One possible mechanism may be the change in compliance between the skin under the Breathe Right and the nasal mucous membrane. The nasal cycle did not significantly influence the effect of Breathe Right.
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Nippon Jibiinkoka Gakkai Kaiho · Dec 2004
[Tracheoesophageal puncture with tracheal tube and flexible endoscope].
Tracheoesophageal shunt phonation is one method of voice restoration after total laryngectomy. Singer and Blom reported an endoscopic technique for voice restoration after laryngectomy, but this is not easy for all cases, because introducing nonflexible endoscope is difficult due to of scarring in the neck and reconstruction with free jejunum. We conducted tracheoesophageal puncture with a tracheal tube and flexible endoscope, finding this useful for all cases of secondary shunt procedures.