Paediatric tracheostomy: an analysis of 40 cases

1999 ◽  
Vol 113 (7) ◽  
pp. 645-651 ◽  
Author(s):  
S. P. Dubey ◽  
J. P. Garap
Keyword(s):  
Paediatric Patient ◽  
Airway Obstruction ◽  
General Anaesthesia ◽  
Surgical Procedures ◽  
Disease Process ◽  
Upper Airway ◽  
Significant Morbidity ◽  
Maximum Duration ◽  
Operative Complications ◽  
One Year

AbstractTracheostomy in the paediatric patient has been associated with significant morbidity and mortality compared to that in the adult. A retrospective analysis was made of 40 patients up to the age of 12 years having tracheostomies. Upper airway obstruction made up the commonest (32 patients, or 80 per cent) indication for paediatric tracheostomy in our series where males slightly outnumbered females. The majority (31 patients, or 77.5 per cent) underwent the operation under general anaesthesia with endotracheal intubation. Thirty-four (85 per cent) patients underwent ‘planned’ tracheostomies and six (15 per cent) underwent ‘crash’ procedures. Thirteen (32.5 per cent) patients were under the age of one year when tracheostomies were performed. The maximum duration of tracheostomies was between one week to within a month and after one month to within three months; each containing 11 (27.5 per cent) patients.Sixty-four different surgical procedures were performed on these patients in which laryngoscopy and bronchoscopy were the commonest procedures. Nine (22.5 per cent) had early post-operative and 14 (35 per cent) had late post-operative complications. Among these 40 children with tracheostomies, one (2.5 per cent) died due to a tracheostomy-related cause and 10 (25 per cent) due to the primary disease process itself. Tracheostomies performed to provide access for general anaesthesia for other surgical procedures were associated with a better prognosis.

scholarly journals An unusual cause of upper airway obstruction in a child during general anaesthesia

2014 ◽  
Vol 58 (2) ◽  
pp. 222 ◽  
Author(s):  
Sugata Dasgupta ◽  
Soumi Das ◽  
Dipasri Bhattacharya ◽  
Sonia Agarwal
Keyword(s):  
Airway Obstruction ◽  
General Anaesthesia ◽  
Upper Airway ◽  
Upper Airway Obstruction

Treatment of Posttransplant Lymphoproliferative Disorder Presenting as Protracted Infectious Mononucleosis with Rituximab

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4999-4999
Author(s):  
Alan Kwok Shing Chiang
Keyword(s):  
Airway Obstruction ◽  
Clinical Improvement ◽  
Infectious Mononucleosis ◽  
Lymphoproliferative Disorder ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Nuclear Antigen ◽  
Posttransplant Lymphoproliferative Disorder ◽  
Liver Transaminases ◽  
One Year

Abstract Two young children who received living related-donor orthotopic liver transplantation for congenital biliary atresia developed persistent and progressive symptoms of fever, hepatosplenomegaly, upper airway obstruction, swollen eyes and face, malaise and cervical lymphadenopathy consistent with infectious mononucleosis within one year post-transplantation. Significant anemia, elevated liver transaminases and hypergammaglobulinaemia were observed. Serological assays did not detect any antibodies to Epstein-Barr virus (EBV) pre-transplantation indicating seronegative status. Both patients showed recent seroconversion to EBV (viral capsid antigen IgM and IgG positive but EBV nuclear antigen negative) at the peak of the clinical symptoms. The diagnosis of primary EBV-driven posttransplant lymphoproliferative disorder (PTLD) was established. Lowering or withdrawal of tacrolimus for a period of 2–3 weeks did not lead to any discernible clinical improvement. Both children were treated with four weekly doses of rituximab of 375 mg/m2/dose. They developed infusion reaction of fever, vomiting and unstable blood pressure within half hour of first dose of rituximab requiring stoppage of the drug administration. Subsequent doses were tolerated much better without adverse events. Clinical improvement was gradually observed over the next few weeks with resolution of fever, upper airway obstruction, decreasing liver transaminases and improvement of general condition. Complete resolution of infectious mononucleosis and normalization of hematological and biochemical parameters was achieved over a period of 6 months. No recurrence of PTLD was observed up to one year after treatment with rituximab.

Upper Airway Obstruction Associated with Regional Enteritis

1979 ◽  
Vol 88 (1) ◽  
pp. 95-99 ◽  
Author(s):  
James H. Kelly ◽  
Max L. Goodman ◽  
William W. Montgomery ◽  
Thomas J. Mulvaney
Keyword(s):  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Airway Obstruction ◽  
Inflammatory Process ◽  
Disease Process ◽  
Upper Airway ◽  
Regional Enteritis ◽  
Upper Airway Obstruction ◽  
Laryngeal Edema ◽  
Cricoarytenoid Joint

Two patients are presented with upper airway obstruction associated with regional enteritis (Crohn's disease). Two mechanisms for this obstruction are proposed. The first is involvement of the cricoarytenoid joint with the inflammatory process and the second is extensive edema of the upper airway due to submucosal involvement with the disease process. We were unable to find any previous reports of upper airway obstruction associated with regional enteritis. The data from these patients suggests that Crohn's disease should be included in the differential diagnosis of chronic persistent laryngeal edema.

Failure to control the airway in a patient with Hunter's syndrome

1998 ◽  
Vol 112 (4) ◽  
pp. 380-382 ◽  
Author(s):  
Luis Gaitini ◽  
Milo Fradis ◽  
Sonia Vaida ◽  
Geoffrey Collins ◽  
Millian Croitoru ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
General Anaesthesia ◽  
Simple Procedure ◽  
Fatal Outcome ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Storage Diseases ◽  
Hunter's Syndrome

AbstractHunter's syndrome is due to recessively inherited mucopolysaccharide storage diseases. The anaesthetic complications in this syndrome are related to the organs involved in the disease, but pertain especially to upper airway obstruction problems. We report a patient with Hunter's syndrome who, while under general anaesthesia for a simple procedure (the introduction of bilateral grommets), suffered a fatal outcome.

Histopathological Confirmation of Polyneuropathy in 11 Dogs With Laryngeal Paralysis

2010 ◽  
Vol 46 (3) ◽  
pp. 161-167 ◽  
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.

Nasal polyposis: unusual indication for tracheostomy

2004 ◽  
Vol 118 (4) ◽  
pp. 305-306 ◽  
Author(s):  
Swati Kumar ◽  
Eslam Osman ◽  
Jonathan A. J. Deans ◽  
John Scally
Keyword(s):  
Airway Obstruction ◽  
Nasal Obstruction ◽  
Rare Case ◽  
Nasal Polyposis ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Significant Morbidity ◽  
First Case ◽  
Emergency Tracheostomy ◽  
History Of

A rare case of nasal polyposis requiring urgent tracheostomy is reported. A70-year-old male presented to the hospital with stridor. He had a 10-year history of nasal obstruction. A large proliferative mass was found to be occupying both the nasal cavities. An emergency tracheostomy and biopsy of the lesion was performed. A computerized axial scan (CT) demonstrated that the lesion occupied the pharynx reaching up to the laryngeal inlet. To our knowledge this is the first case reported in the literature. Upper airway obstruction from nasal polypsis uncommon but can cause significant morbidity if not appropriately managed.

Acute upper airway obstruction caused by massive oedema of the tongue: unusual complication of sialoendoscopy

2009 ◽  
Vol 123 (12) ◽  
pp. 1402-1403 ◽  
Author(s):  
P Baptista ◽  
C V Gimeno ◽  
F Salvinelli ◽  
V Rinaldi ◽  
M Casale
Keyword(s):  
Airway Obstruction ◽  
General Anaesthesia ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Unusual Complication ◽  
Major Salivary Gland ◽  
Airway Control ◽  
Inflammatory Conditions ◽  
Life Threatening ◽  
The Right

AbstractObjective:To underline the importance of accurate clinical evaluation of major salivary gland obstructions, in order to choose the right surgical approach and to reduce the risk of complications.Case report:We report a case of an unusual, previously unreported upper airway obstruction caused by massive swelling of the tongue following a successful sialoendoscopy, performed for treatment of submandibular sialolithiasis under general anaesthesia.Conclusions:Sialoendoscopy has gained popularity and is an accepted method for diagnosis and treatment of most inflammatory conditions of the major salivary glands. It can be performed as an out-patient procedure under local anaesthesia, and is not usually associated with significant complications. However, in the presence of larger stones (>4 mm) of the submandibular gland, we suggest that interventional sialoendoscopy should be performed under general anaesthesia with optimal airway control, in order to manage the major risk of perforations and ductal lesions enabling spread of saline solution into the mouth tissues and causing life-threatening swelling of the floor of the mouth and tongue.

Nebulized Adrenaline in the Postoperative Management of Brachycephalic Obstructive Airway Syndrome in a Pug

2017 ◽  
Vol 53 (2) ◽  
pp. 107-110 ◽  
Author(s):  
Jenny Ellis ◽  
Elizabeth Ann Leece
Keyword(s):  
Quality Of Life ◽  
Airway Obstruction ◽  
Surgical Procedures ◽  
Postoperative Period ◽  
Upper Airway ◽  
Postoperative Management ◽  
Laryngeal Edema ◽  
Life Threatening ◽  
Tracheostomy Tubes

ABSTRACT Brachycephalic obstructive airway syndrome is a common problem in certain breeds, and may necessitate surgical procedures, such as rhinoplasty, palatoplasty, laryngeal sacculectomy, and/or arytenoid laryngoplasty, to improve the quality of life. However, laryngeal edema may necessitate the use of temporary tracheostomy tubes postoperatively to maintain a patent airway. This case demonstrates that administration of nebulized adrenaline in the immediate postoperative period where upper airway obstruction is life threatening can be used to reduce edema, therefore avoiding the need for tracheostomy.

Fatal upper airway obstruction in a pig after general anaesthesia

2021 ◽  
Author(s):  
A. Mirra ◽  
M. Arnold ◽  
D. Casoni ◽  
E. Gámez Maidanskaia ◽  
L.G. Garcia Casalta ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
General Anaesthesia ◽  
Upper Airway ◽  
Upper Airway Obstruction

Emergency tracheal catheterization for jet ventilation: a role for the ENT surgeon?

2005 ◽  
Vol 119 (3) ◽  
pp. 235-236 ◽  
Author(s):  
T D A Standley ◽  
H L Smith
Keyword(s):  
Respiratory Failure ◽  
Airway Obstruction ◽  
General Anaesthesia ◽  
Laryngeal Carcinoma ◽  
Upper Airway ◽  
Cricothyroid Membrane ◽  
Failed Intubation ◽  
Jet Ventilation ◽  
Life Saving ◽  
Partial Upper Airway Obstruction

Stridor causing respiratory failure is an ENT and anaesthetic emergency requiring prompt management to secure a clear airway. We describe a case of subacute partial upper airway obstruction due to a large laryngeal carcinoma in an 81-year-old male resulting in respiratory failure. The patient became apnoeic after gaseous induction of general anaesthesia, and after two failed intubation attempts an emergency transtracheal airway catheter was placed by the surgeon under direct vision below the cricothyroid membrane, as this had tumour involvement. The patient was subsequently manually jet-ventilated with ease until a formal tracheostomy was made. Where difficulties with tracheal anatomy are encountered due to the presence of pathology, the insertion of a temporary airway catheter for jet ventilation by the surgeon can buy valuable time and be life-saving.

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