Tracheoesophageal Voice Restoration following Laryngotracheal Separation Procedure

2005 ◽  
Vol 114 (8) ◽  
pp. 634-637 ◽  
Author(s):  
Rahul K. Shah ◽  
Elie E. Rebeiz
Keyword(s):  
The Other ◽  
Separation Procedure ◽  
Vocal Function ◽  
Secondary Procedure ◽  
Voice Restoration ◽  
Alaryngeal Speech ◽  
Laryngotracheal Separation ◽  
Life Threatening ◽  
Intractable Aspiration ◽  
Tracheoesophageal Puncture

Objectives: Laryngeal dysfunction leading to incompetence and intractable aspiration can be a life-threatening problem. Laryngotracheal separation (LTS) can be used to prevent aspiration, but results in aphonia. The options for alaryngeal speech following LTS are limited. Methods: We performed tracheoesophageal puncture (TEP) and insertion of a Blom-Singer valve in 3 patients in an attempt to restore their voice after LTS for chronic aspiration. Results: Two patients had intractable aspiration (5 and 14 years) after full-course radiotherapy for laryngeal cancer, and 1 patient had aspiration after a stroke. In the first patient TEP was done as a secondary procedure, and in the other 2 patients it was done at the time of the LTS. The TEP was successful in providing these patients with phonation ability after their LTS procedure. There was no morbidity from these procedures. Conclusions: Creation of a TEP after an LTS procedure is relatively simple and relatively safe, and allows for the control of aspiration while maintaining vocal function.

Indications for the Tracheoesophageal Diversion Procedure and the Laryngotracheal Separation Procedure

1988 ◽  
Vol 97 (5) ◽  
pp. 471-475 ◽  
Author(s):  
David W. Eisele ◽  
C. Thomas Yarington ◽  
Roger C. Lindeman
Keyword(s):  
Respiratory Tract ◽  
Surgical Procedures ◽  
Respiratory System ◽  
Separation Procedure ◽  
Upper Respiratory Tract ◽  
Protective Function ◽  
Laryngotracheal Separation ◽  
Intractable Aspiration ◽  
Upper Respiratory ◽  
Surgical Separation

Impaired protective function of the larynx can lead to intractable aspiration, a severe and potentially fatal disorder. If medical therapy fails to prevent intractable aspiration, surgical separation of the upper respiratory tract from the digestive tract is necessary to prevent recurrent contamination of the respiratory system in these patients. Two such surgical procedures are the tracheoesophageal diversion procedure and the laryngotracheal separation procedure. Our approach to patients with intractable aspiration and the indications for the use of these surgical procedures for the prevention of aspiration are discussed.

Secondary Voice Restoration After Laryngotracheal Separation (LTS) for Dysphagia with Intractable Aspiration

Dysphagia ◽  
2015 ◽  
Vol 30 (6) ◽  
pp. 695-701 ◽  
Author(s):  
Katrien Bonte ◽  
Wouter Huvenne ◽  
Marie De Loof ◽  
Philippe Deron ◽  
Annick Viaene ◽  
...  
Keyword(s):  
Voice Restoration ◽  
Laryngotracheal Separation ◽  
Intractable Aspiration

Laryngotracheal Separation for Intractable Aspiration

1988 ◽  
Vol 97 (5) ◽  
pp. 466-470 ◽  
Author(s):  
Carl H. Snyderman ◽  
Jonas T. Johnson
Keyword(s):  
Tracheal Ring ◽  
Effective Technique ◽  
Recurrent Pneumonia ◽  
Laryngeal Function ◽  
Laryngeal Surgery ◽  
Laryngotracheal Separation ◽  
Neurologic Disorders ◽  
Life Threatening ◽  
Intractable Aspiration ◽  
Laryngeal Anatomy

Intractable aspiration may be a life-threatening problem for patients with altered laryngeal function secondary to neurologic disorders or abnormal laryngeal anatomy. Multiple surgical procedures have been devised to deal with this problem. An effective technique involves the creation of a tracheostoma and closure of the larynx at the first or second tracheal ring. Laryngotracheal separation is relatively easy to perform and potentially reversible. Experience with this technique in six patients who required laryngeal separation for intractable aspiration is described. The procedure was successful in preventing aspiration and recurrent pneumonia associated with neurologic dysfunction, unresectable neoplasm, and conservation laryngeal surgery. One patient of one has had a successful reconstruction.

Location of the Vibratory Segment in Tracheoesophageal Speakers

1985 ◽  
Vol 93 (3) ◽  
pp. 355-361 ◽  
Author(s):  
Stephen J. Wetmore ◽  
Stephenie P. Ryan ◽  
James C. Montague ◽  
Kathleen Krueger ◽  
Kathleen Wesson ◽  
...  
Keyword(s):  
Alimentary Tract ◽  
Cervical Vertebrae ◽  
Cervical Esophagus ◽  
Viable Option ◽  
Voice Restoration ◽  
Alaryngeal Speech ◽  
Pharyngoesophageal Segment ◽  
Speech Rehabilitation ◽  
Esophageal Speech ◽  
Tracheoesophageal Puncture

The Singer-Blom tracheoesophageal puncture procedure for surgical-prosthetic voice restoration has proved to be a viable option for alaryngeal speech rehabilitation. Following tracheoesophageal puncture, occlusion of the tracheostoma shunts pulmonary air through the Blom-Singer prosthesis into the cervical esophagus. The pulmonary air passing through the cervical esophagus and into the hypopharynx causes a portion of the upper alimentary tract to vibrate in a manner similar to that of the pharyngoesophageal segment during the production of esophageal speech. To study the location and shape of the vibratory segment in tracheoesophageal speakers, videofluoroscopy and simultaneous voice recording were performed with 16 patients. To analyze the vibratory segment(s), photographs were made of the videotaped image white it was stopped during the patients' production of the /a/ sound. The most frequent location of the vibratory segment was in the lower third of the neck, which corresponds to cervical vertebrae C5 through C7. Five of the subjects had two separate vibratory segments and two other subjects had long vibratory segments. The vibratory segment(s) in tracheoesophageal speakers was found to be similar to the vibratory segment(s) in esophageal speakers.

scholarly journals Tracheoesophageal Puncture for Voice Restoration Following Laryngotracheal Separation

1994 ◽  
Vol 104 (9) ◽  
pp. 1163???1166 ◽  
Author(s):  
David H. Darrow ◽  
K. Thomas Robbins ◽  
Stephen N. Goldman
Keyword(s):  
Voice Restoration ◽  
Laryngotracheal Separation ◽  
Tracheoesophageal Puncture

Clinical Outcome of Laryngotracheal Separation for Intractable Aspiration Pneumonia

ORL ◽  
2001 ◽  
Vol 63 (5) ◽  
pp. 321-324 ◽  
Author(s):  
Takayo Yamana ◽  
Hiroya Kitano ◽  
Masakazu Hanamitsu ◽  
Kazutomo Kitajima
Keyword(s):  
Clinical Outcome ◽  
Aspiration Pneumonia ◽  
Laryngotracheal Separation ◽  
Intractable Aspiration

scholarly journals Management of severe intraoperative hemorrhage during intraventricular neuroendoscopic procedures: the dry field technique

2019 ◽  
Vol 131 (3) ◽  
pp. 931-935 ◽  
Author(s):  
Joachim Oertel ◽  
Stefan Linsler ◽  
Akos Csokonay ◽  
Henry W. S. Schroeder ◽  
Sebastian Senger
Keyword(s):  
Endoscopic Surgery ◽  
Intraventricular Hemorrhage ◽  
Tumor Resection ◽  
The Other ◽  
Tumor Removal ◽  
Reliable Technique ◽  
Bleeding Source ◽  
Field Technique ◽  
Life Threatening ◽  
Life Threatening Complication

OBJECTIVEThe unexpected intraoperative intraventricular hemorrhage is a rare but feared and life-threatening complication in neuroendoscopic procedures because of loss of endoscopic vision. The authors present their experience with the so-called “dry field technique” (DFT) for the management of intraventricular hemorrhages during purely endoscopic procedures. This technique requires the aspiration of the entire intraventricular CSF to achieve clear visualization of the bleeding source.METHODSMore than 500 neuroendoscopic intraventricular procedures were retrospectively analyzed over the last 24 years for documented severe hemorrhages, which were treated by the application of the DFT.RESULTSThe technique was required in 6 cases, including tumor resection/biopsy, cyst resection, and intraventricular lavage. Additionally, the technique was applied as part of the planned strategy in 3 cases of endoscopic tumor removal. The hemorrhage was stopped in all cases and no associated postoperative deficits occurred.CONCLUSIONSAlthough severe hemorrhages are rare, the neurosurgeon needs to be aware of them and has to establish strategies for their management. Most hemorrhages can be stopped by constant irrigation and coagulation. In the other rare cases, the DFT is a safe, reliable technique and can be easily incorporated into endoscopic surgery.

Drug Intolerance: Age Related Aspects

2021 ◽  
Author(s):  
Maria Grakhova ◽  
Olga Rychkova ◽  
Anastasia Braun ◽  
Almira Sagitova ◽  
Maria Nesterova
Keyword(s):  
Ace Inhibitors ◽  
Clinical Manifestations ◽  
The Other ◽  
Drug Intolerance ◽  
Age Related ◽  
Life Threatening ◽  
Group 3 ◽  
Dichotomous Variables ◽  
Pathological Reaction ◽  
Effect Of Age

Aim: Identification of age-specific drug intolerance. Materials and methods: The study was conducted over the period from 2017 to 2020 and included 200 outpatient medical history forms of people diagnosed as having an unspecified pathological reaction to a drug or medication. All drug reactions are reported by patients own statements and were allocated to dichotomous variables. The results were analyzed by nonparametric statistics. Results: Three groups of patients: 18-44 years (n=49); 45-60 years (n=60); 61 and over (n=91). The odds of incomprehensible reactions were 2.2 times higher in patients in group 3 than in patients in the other groups. Group 3 patients were 12 times more likely to have an itchy reaction to medications than patients in the other groups. Group 1 patients were 3 times more likely to have urticaria than patients in groups 2 and 3. The odds of drug intolerance to ACE inhibitors were 2.6 times higher in group 3 patients than in patients in other groups. When comparing clinical manifestations of drug intolerance to penicillin- and cephalosporin-type antibiotics, no significant differences were found in all patients. The presence of allergies and somatic pathology of 3 or more systems did not significantly affect the possibility of reactions of varying severity to 3 or more drugs in these groups. Conclusions: Patients age has no effect on the possibility of reactions to certain groups of drugs. The exception was ACE inhibitors, which is most likely due to the higher frequency of prescribing antihypertensive therapy in patients in this age group. The aggravation of clinical manifestations and the occurrence of polypharmacy are not associated with age and comorbid background. It should be noted that correlation between age and non-life-threatening clinical manifestations of drug intolerance was revealed, which indicates the absence of reliable effect of age on the possibility of anaphylactic shock or angioedema.

Shanghai’s Leading Indigenous and Expat Jazz Musicians

Jazz in China ◽  
2018 ◽  
pp. 187-209
Author(s):  
Eugene Marlow
Keyword(s):  
New York ◽  
New York City ◽  
Los Angeles ◽  
York City ◽  
The Other ◽  
The Political ◽  
Other Hand ◽  
Life Threatening

This chapter focuses on jazz musicians in Shanghai. Once called the “Paris of the East,” today Shanghai represents the economic and entrepreneurial center of China; Beijing is the political heart of China. Both cities have their own vibe: Beijing—spread out like Los Angeles, is clogged by an increasing number of cars and life-threatening smog; Shanghai—compact like Manhattan, New York City, is cosmopolitan and eclectic. Both cities boast their own jazz scene. Beijing is full of expats and the jazz bands tend to be more uniformly Asian. Shanghai, on the other hand, reflects a much greater international mix of musicians.

Clinical approach

2010 ◽  
pp. 420-422
Author(s):  
Christopher J. Ellis
Keyword(s):  
Hospitalized Patients ◽  
The Other ◽  
Clinical Approach ◽  
Common Cause ◽  
Inflammatory Conditions ◽  
Life Threatening

Infection is most often suspected when patients present with pyrexia and is certainly the most common cause of this presentation, whether in hospitalized patients or those in the community. The other principal causes of fever are primary inflammatory conditions and malignancy, but infections are likely to be most rapidly progressive and acutely life-threatening and hence must be the physician’s first concern....

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