Articles: thyroid-cartilage-surgery.
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A case of 42-year-old man with postintubation subglottic stenosis underwent primary thyrotracheal anastomosis. Since trachea had been incised longitudinally for previous tracheostomy, tracheal resection came to be longer. ⋯ After the operation, he suffered from the tracheal collapse at the incised portion of the trachea One week after intubation, tracheal patency was achieved. We recommend horizontal incision for tracheostomy in patient with subglottic stenosis, when the following surgical approach is considered.
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Arch. Otolaryngol. Head Neck Surg. · Jul 2008
Chondrolaryngoplasty under general anesthesia using a flexible fiberoptic laryngoscope and laryngeal mask airway.
To describe a surgical and anesthetic technique for chondrolaryngoplasty ("tracheal shaving") involving external translaryngeal needle insertion under general anesthesia, using a flexible fiberoptic bronchoscope and laryngeal mask airway. ⋯ Chondrolaryngoplasty with translaryngeal needle placement to identify the level of the anterior commissure is a safe, effective surgical technique that minimizes the most significant risks of the surgical procedure.
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We examined the pressures produced by a construction intended for emergency ventilation through a needle cricothyroidotomy. This construction consisted of a standard hospital wall oxygen supply, flowmeter, oxygen tubing and a three-way tap. We measured the flow achieved through a transtracheal catheter and compared the construction to a Manujet jet ventilator and to a Sanders injector. ⋯ The flow through the transtracheal catheter was almost three times higher when the flowmeters were fully opened than when they were opened to the 15 l x min(-1) mark (44.5 vs 15.8 l x min(-1), respectively; p < 0.0001). When the flowmeters were fully opened the pressure measured before the catheter was over four times higher than when they were only opened to the 15 l x min(-1) mark (285.3 vs 66.4 kPa, respectively; p < 0.0001). This system of ventilation is inferior to a Manujet in terms of robustness and calibration throughout its range of pressures and flows, but seems appropriate for emergency use in the absence of a purpose-made jet ventilator.
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Anesthesia and analgesia · Jan 2008
Comparative StudyA comparison of two emergency cricothyroidotomy kits in human cadavers.
We compared two emergency cricothyroidotomy kits designed to avoid lesions during insertion, one based on the Seldinger technique (ST), the other based on the concept of a mechanical detection of the posterior wall of the larynx, with regard to insertion time, success rate, and complication rate. ⋯ In this model, despite a shorter insertion time, the NT produced more lesions and more failures than the ST.