scholarly journals Acute upper airway obstruction due to tonsillitis necessitating emergency cricothyroidotomy

2021 ◽  
Vol 14 (7) ◽  
pp. e242500
Author(s):  
Binu Ravindran ◽  
Feby Korandiarkunnel Paul ◽  
Prasad Vyakarnam
Keyword(s):  
Airway Obstruction ◽  
Intensive Therapy ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Clinical Scenario ◽  
Intensive Therapy Unit ◽  
Out Of Hours ◽  
Hospital Transfer ◽  
Airway Anomalies ◽  
Nose And Throat

A 17-year-old man was admitted to Accident & Emergency out of hours with unilateral tonsillar enlargement covering more than 75% of his oropharyngeal inlet. He appeared calm and stable on initial presentation, but in a short span of time rapidly deteriorated, leading to near complete airway obstruction necessitating an emergency awake cricothyroidotomy. Tracheostomy and tonsillectomy were done after this, he was ventilated postoperatively in intensive therapy unit and discharged home in a week. This is a rare clinical scenario in a patient presenting with palatine tonsillitis. A few subtle points in the history and examination alerted the team and prevented a risky inter hospital transfer for ear, nose and throat review. This is the first reported case in UK of palatine tonsillitis not due to infectious mononucleosis presenting with acute upper airway obstruction in a patient with no airway anomalies. It may also have been a varied presentation of COVID-19.

scholarly journals Classification of directionally specific vagus nerve activity using an upper airway obstruction model in anesthetized rodents

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
P. Sabetian ◽  
Y. Sadat-Nejad ◽  
Paul B. Yoo
Keyword(s):  
Airway Obstruction ◽  
Upper Airway ◽  
Low Noise ◽  
Upper Airway Obstruction ◽  
Gaussian Kernel ◽  
Recording Electrode ◽  
Cuff Electrode ◽  
Nerve Cuff ◽  
Svm Model ◽  
Nerve Cuff Electrode

AbstractElectrical signals from the peripheral nervous system have the potential to provide the necessary motor, sensory or autonomic information for implementing closed-loop control of neuroprosthetic or neuromodulatory systems. However, developing methods to recover information encoded in these signals is a significant challenge. Our goal was to test the feasibility of measuring physiologically generated nerve action potentials that can be classified as sensory or motor signals. A tetrapolar recording nerve cuff electrode was used to measure vagal nerve (VN) activity in a rodent model of upper airway obstruction. The effect of upper airway occlusions on VN activity related to respiration (RnP) was calculated and compared for 4 different cases: (1) intact VN, (2) VN transection only proximal to recording electrode, (3) VN transection only distal to the recording electrode, and (4) transection of VN proximal and distal to electrode. We employed a Support Vector Machine (SVM) model with Gaussian Kernel to learn a model capable of classifying efferent and afferent waveforms obtained from the tetrapolar electrode. In vivo results showed that the RnP values decreased significantly during obstruction by 91.7% ± 3.1%, and 78.2% ± 3.4% for cases of intact VN or proximal transection, respectively. In contrast, there were no significant changes for cases of VN transection at the distal end or both ends of the electrode. The SVM model yielded an 85.8% accuracy in distinguishing motor and sensory signals. The feasibility of measuring low-noise directionally-sensitive neural activity using a tetrapolar nerve cuff electrode along with the use of an SVM classifier was shown. Future experimental work in chronic implant studies is needed to support clinical translatability.

Upper Airway Obstruction in Paediatrics

1985 ◽  
Vol 3 (3) ◽  
pp. 721-738
Author(s):  
Elliot J. Rhine ◽  
Gary G. Johnson
Keyword(s):  
Airway Obstruction ◽  
Upper Airway ◽  
Upper Airway Obstruction
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