Investigation of cyanotic/apneic episodes and sleep-related upper airway obstruction by long-term non-invasive bedside recordings

Laryngomalacia is the most common cause of stridor in infants. Severely affected children are at risk of feeding difficulties, apnoeic episodes and cor pulmonale secondary to upper airway obstruction. The aim of this study was to assess the outcome of aryepiglottoplasty. This is a simple surgical procedure that relieves the obstruction by dividing the aryepiglottic folds. Thirty children had an aryepiglottoplasty at the Royal Liverpool Children’s Hospital between January 1995 and June 2001. The case notes of all 30 children were reviewed for age, sex, age at operation, indications, operative technique, complications and long-term outcomes. Complete resolution of stridor was obtained in 83 per cent of patients, with an improvement in a further 7 per cent. Post-operative complications included lower respiratory tract infections (13 per cent) and vomiting (7 per cent). In conclusion, simple endoscopic aryepiglottoplasty remains an effective way of treating upper airway obstruction in children. Its high resolution and low complication rate make it a safe, first choice procedure for treatment of moderate to severe laryngomalacia.

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Non-invasive ventilation in children with upper airway obstruction

International Journal of Pediatric Otorhinolaryngology ◽

10.1016/j.ijporl.2008.12.003 ◽

2009 ◽

Vol 73 (4) ◽

pp. 551-554 ◽

Cited By ~ 10

Author(s):

R. Wormald ◽

A. Naude ◽

H. Rowley

Keyword(s):

Airway Obstruction ◽

Upper Airway ◽

Upper Airway Obstruction ◽

Invasive Ventilation ◽

Non Invasive ◽

Non Invasive Ventilation

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Histopathological Confirmation of Polyneuropathy in 11 Dogs With Laryngeal Paralysis

Journal of the American Animal Hospital Association ◽

10.5326/0460161 ◽

2010 ◽

Vol 46 (3) ◽

pp. 161-167 ◽

Cited By ~ 33

Author(s):

Kelley M. Thieman ◽

D.J. Krahwinkel ◽

Michael H. Sims ◽

G. Diane Shelton

Keyword(s):

Airway Obstruction ◽

Axonal Degeneration ◽

Disease Process ◽

Upper Airway ◽

Nerve Fibers ◽

Upper Airway Obstruction ◽

Laryngeal Paralysis ◽

Long Term Prognosis ◽

Histopathological Studies

Acquired laryngeal paralysis (LP) is an important cause of upper airway obstruction in dogs. We hypothesize that LP may be part of a generalized polyneuropathy complex. Electro-diagnostic studies were performed in six dogs, and histopathological studies of muscle and nerve biopsies were obtained from 11 dogs diagnosed with acquired LP. Abnormalities in electrodiagnostic procedures were consistent with a generalized polyneuropathy. Loss of large-caliber nerve fibers and axonal degeneration were identified in nerve biopsies, and neurogenic atrophy was observed in muscle specimens. Abnormalities in electrodiagnostic studies and histopathology provide evidence that LP may be part of a generalized polyneuropathy. Establishing a diagnosis of a more involved disease process is relevant for long-term prognosis.

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Acute Upper Airway Obstruction Secondary to Retained Respiratory Secretions in a Patient with SARS-CoV-2 Respiratory Failure Treated with Prolonged CPAP

Journal of Anaesthesia and Critical Care Reports ◽

10.13107/jaccr.2020.v06i03.155 ◽

2020 ◽

Vol 6 (3) ◽

Keyword(s):

Respiratory Failure ◽

Airway Obstruction ◽

Ventilatory Support ◽

Upper Airway ◽

Upper Airway Obstruction ◽

Avoidable Mortality ◽

Non Invasive ◽

Non Invasive Ventilation ◽

Life Threatening ◽

Novel Coronavirus

SARS-CoV-2 is a novel coronavirus which can cause respiratory failure requiring ventilatory support. We describe the first documented case of life-threatening upper airway obstruction due to retained secretions around a nasogastric (NG) tube in a patient suffering from this disease who was managed with prolonged continuous positive airways pressure (CPAP). This case highlights the need for awareness around the development of an upper airway mass due to tenacious secretions in SARS-CoV-2 positive patients and the need to develop preventative strategies in order to prevent avoidable mortality. Keywords: Airway obstruction; CPAP; SARS-CoV-2; Coronavirus; Nasogastric tube; Non-invasive ventilation.

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Relief of Upper Airway Obstruction Using a Cervical Splint for Young Patients with Cerebral Palsy

Journal of Clinical Pediatric Dentistry ◽

10.17796/1053-4628-42.4.10 ◽

2018 ◽

Vol 42 (4) ◽

pp. 295-298

Author(s):

Hyoju Son ◽

Soohyeon Kim ◽

Jaeho Lee ◽

Chungmin Kang ◽

Seunghye Kim

Keyword(s):

Cerebral Palsy ◽

Oxygen Saturation ◽

Airway Obstruction ◽

Young Patients ◽

Upper Airway ◽

Upper Airway Obstruction ◽

Dental Clinic ◽

Spastic Quadriplegia ◽

Chief Complaints

13-year old boy with spastic quadriplegia cerebral palsy visited dental clinic with chief complaints of mouth breathing and malocclusion. His mouth was constantly open at the resting position, with his mandible and tongue displaced downward. He breathed through his mouth, making a constant gurgling sound, a sign of upper airway obstruction. To enhance his mandible position, vertical chin cap was first considered, but it was not sufficient to reduce the gurgling sound or ease breathing. Then, cervical splint was considered, which effectively decreased the gurgling sound by repositioning his mandible to the anterior-superior position. Oxygen saturation was increased when the cervical splint was used. Cervical splint can effectively assist breathing in patients with cerebral palsy, but it should be carefully applied as long-term use can result in unexpected complications. Under instruction by a physician regarding proper usage, a cervical splint can be applied to assist breathing in patients with cerebral palsy.

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