The Epidemiology of Upper Airway Injury in Patients Undergoing Major Surgical Procedures

Aging of population brings related social problems, such as muscle attenuation and regeneration barriers with increased aging. Muscle repair and regeneration depend on muscle stem cells (MuSCs). Obstructive sleep apnea (OSA) rises in the aging population. OSA leads to hypoxia and upper airway muscle injury. However, little is known about the effect of increasing age and hypoxia to the upper airway muscle. The genioglossus (GG) is the major dilator muscle to keep the upper airway open. Here, we reported that muscle fiber and MuSC function declined with aging in GG. Increasing age also decreased the migration and proliferation of GG MuSCs. p53 and p21 were high expressions both in muscle tissue and in GG MuSCs. We further found that hypoxia inhibited GG MuSC proliferation and decreased myogenic differentiation. Then, hypoxia enhanced the inhibition effect of aging to proliferation and differentiation. Finally, we investigated that hypoxia and aging interact to form a vicious circle with upregulation of p53 and p21. This vicious hypoxia plus aging damage accelerated upper airway muscle injury. Aging and hypoxia are the major damage elements in OSA patients, and we propose that the damage mechanism of hypoxia and aging in GG MuSCs will help to improve upper airway muscle regeneration.

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Nasal and Facial Reconstruction in a Dog Following Severe Trauma

Journal of the American Animal Hospital Association ◽

10.5326/0390407 ◽

2003 ◽

Vol 39 (4) ◽

pp. 407-415 ◽

Cited By ~ 6

Author(s):

Janet A. Welch ◽

Steven F. Swaim

Keyword(s):

Surgical Procedures ◽

Granulation Tissue ◽

Upper Airway ◽

Severe Trauma ◽

Nasal Passage ◽

Traumatic Amputation ◽

Rubber Tubing ◽

Novel Technique ◽

Cosmetic Appearance ◽

Oronasal Fistula

Successful reconstruction of the nasomaxillary region requires closure of oronasal communication and maintenance of a patent upper airway. A dog with traumatic amputation of the nasomaxillary region was presented for reconstructive surgery. Staged surgical procedures were performed with the goal of closing the oronasal fistula, reapposing facial tissues, forming a granulation bed in each nasal passage, and harvesting and placing mucosal grafts in the nasal passages. A novel technique for developing a granulation tissue bed for mucosal grafts using silicone rubber tubing was employed. The end result of the reconstructive surgeries was a relatively cosmetic appearance with patent nasal openings.

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Upper Airway Injury and Its Management

Seminars in Thoracic and Cardiovascular Surgery ◽

10.1053/j.semtcvs.2008.02.003 ◽

2008 ◽

Vol 20 (1) ◽

pp. 8-12 ◽

Cited By ~ 20

Author(s):

Michael G. Corneille ◽

Ronald M. Stewart ◽

Stephen M. Cohn

Keyword(s):

Upper Airway ◽

Airway Injury

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Delayed Upper-Airway Injury after Accidental Alkaline Ingestion

Case Reports in Emergency Medicine ◽

10.1155/2014/503205 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3

Author(s):

Matthew F. Ryan ◽

Mindy Fernandez ◽

Karen Laauwe

Keyword(s):

Emergency Department ◽

Chest Pain ◽

Upper Airway ◽

Acute Injury ◽

Upper Endoscopy ◽

Shortness Of Breath ◽

X Ray ◽

Airway Injury ◽

Chest X Ray ◽

Alkaline Cleaning

A 62-year-old man presented to the emergency department one week after accidentally drinking an alkaline cleaning agent stored in unlabeled bottle. The day of the incident the patient presented to an outside hospital where he was admitted for an upper endoscopy of the esophagus which was found to be negative for acute injury. An initial chest X-ray taken the day of the incident was also found to be normal. After discharge the patient continued to have a sore throat and marked dysphagia which caused him to vomit repeatedly. Moreover, the patient began to develop chest pain with associated shortness of breath. We present a case of delayed airway injury and tracheal thickening and associated chest pain after alkaline ingestion and we discuss herein the pathophysiology and management of alkaline ingestions.

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Paediatric tracheostomy: an analysis of 40 cases

The Journal of Laryngology & Otology ◽

10.1017/s0022215100144743 ◽

1999 ◽

Vol 113 (7) ◽

pp. 645-651 ◽

Cited By ~ 30

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.

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Permeabilization surgery of the upper respiratory tract and its effects on sleep fragmentation and REM sleep

Romanian Journal of Rhinology ◽

10.1515/rjr-2017-0006 ◽

2017 ◽

Vol 7 (25) ◽

pp. 47-56 ◽

Cited By ~ 1

Author(s):

Ionut Tanase ◽

Claudiu Manea ◽

Codrut Sarafoleanu

Keyword(s):

Sleep Disorders ◽

Surgical Procedures ◽

Rem Sleep ◽

Slow Wave Sleep ◽

Upper Airway ◽

Sleep Fragmentation ◽

Upper Respiratory Tract ◽

Upper Airways ◽

Falling Asleep ◽

Before And After

AbstractUsually, patients with sleep disorders may complain of tiredness, fatigue, daytime sleepiness, difficulty in concentrating, and can reach up to falling asleep in inappropriate situations – condition known as the Pickwick syndrome. To avoid these unpleasant symptoms, a series of surgical procedures regarding the anatomical structures involved in sleep apnea were developed.The article is a general review regarding the sleep disorders and the influence of upper airways permeability on the quality of sleep and the sleep staging distribution. Also, we present some preliminary data obtained in a clinical study underwent in CESITO Centre “Sfanta Maria” Hospital, Bucharest, involving patients with sleep pathology that had polysomnographic evaluations before and after various surgical procedures of nasal and pharyngeal permeabilization.AIMS.To determine that permeabilization surgery of the upper airway tract may be used successfully in order to decrease the sleep fragmentation and increase the time of slow-wave sleep.CONCLUSION.6 months after the permeabilization surgery of the upper airway tract, the polysomnography reveals that the arousals index decreased and the sleep architecture undergoes changes that consist in decreasing the Stage 1 and Stage 2 sleep, therefore REM sleep reaches a better score.

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