scholarly journals A comparative analysis of outcomes after surgical reconstruction of stenoses in the upper respiratory tract in children

2021 ◽  
Vol 25 (4) ◽  
pp. 235-243
Author(s):  
A. Yu. Razumovsky ◽  
Z. B. Mitupov ◽  
V. E. Rachkov ◽  
N. S. Stepanenko ◽  
A. V. Adler ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Plastic Surgery ◽  
Costal Cartilage ◽  
Treatment Technique ◽  
Upper Respiratory Tract ◽  
Surgical Time ◽  
Significant Difference ◽  
Upper Respiratory ◽  
Group 2 ◽  
Group 1

Introduction. Definition " upper respiratory tract stenosis " (URTS) includes a large number of nosologies. The most common are cicatricial stenoses, in particular, post-intubation ones as well as bilateral paralysis of the larynx. An important issue for nowadays is choosing the curative modality for such patients.Purpose. To compare outcomes after treating children with URTS.Material and methods. The authors have assessed results of treatment of 110 patients who had reconstructive surgery in 2010-2019. Patients were divided into two groups depending on the nosology: stenosis of the upper respiratory tract (n = 71) and bilateral paralysis of the larynx (n-39). In each group, four types of surgeries were performed: costal cartilage plasty, plasty with T-tube (TT), a modified version of plasty with TT, plasty with a stent. The choice of treatment technique was determined mostly by the tendency to make this or that type of surgery in authors' departments, as well as by the nosology, severity of the disease and patient's age. Decannulation terms, surgical time, early and late postoperative complications as well as relapse-free period were assessed.Results. 66% patients were decannulated in Group 1; in Group 2 - 69%. Group 1 a statistically reliable comparison was possible between the following techniques: costal cartilage plasty and laryngeal stent plasty (p > 0.005) as well as plasty with TT implantation and the proposed modified technique (p > 0.005). While using Mann-Whitney test and Log Rank, the authors found out that in Group 1 there were no significant difference in surgical time, relapse-free period and stenosis degree (p > 0.005). However, decannulation terms after plastic surgery of the larynx with costal cartilage implantation are longer than after plastic surgery with stent implantation (p < 0.005). In Group 2, the authors compared three abovementioned curative modalities, excluding laryngeal plasty with TT implantation. Thus, surgical time for costal cartilage plasty is longer, if to compare to other two techniques (p < 0.005). There is also no significant difference in decannulation terms and relapse-free periods between all three techniques (p > 0.005).Conclusion. The results obtained have demonstrated the effectiveness of long-term stenting with TT placement in children, mainly with cicatricial stenoses, and in older children. The trial also revealed that laryngoplasty with costal cartilage in children with bilateral laryngeal paralysis is an effectiveness choice too.

scholarly journals RELATIONSHIP BETWEEN CLASS I-II MALOCCLUSIONS AND UPPER RESPIRATORY TRACT DISEASES

2021 ◽  
Vol 21 (3) ◽  
pp. 173-177
Author(s):  
А. Stasiuk ◽  
Е.Е. Vyzhenko ◽  
Yu. K. Sokolohorska-Nykina ◽  
V. D. Kuroyedova
Keyword(s):  
Respiratory Tract ◽  
Morphological Changes ◽  
Class I ◽  
Upper Respiratory Tract ◽  
Average Value ◽  
Group I ◽  
Significant Difference ◽  
Upper Respiratory ◽  
Group 2 ◽  
Distal Occlusion

In recent years, there has been an increase in the prevalence of dental anomalies among children, and sagittal occlusion anomalies range from 33 to 67% of them. Quite high prevalence of distal occlusion causes morphological changes in the structure of the dentition that lead not only to functional impairment in the dentofacial system, but also in the entire oropharyngeal area. This forces scientists to search for new methods for the diagnosis and differential diagnosis of the conditions. The purpose of this study is to determine and compare anatomical dimensions (anteroposterior size and volume) of the upper respiratory tract in patients with occlusion pathology class I and II on the basis of cone-beam computed tomography. We measured the width of the upper, lower part of the pharynx according to the McNamara method, and the volume on 46 tomograms of patients with dentoalveolar anomalies aged from 8 to 29 years, who were divided into two groups according to the ANB angle into classes I and II. The patients of the group I had the average volume of 10.1 ± 1.27 cm3. According to the McNamara method, the width of the upper pharynx was 17.41 ± 0.44 mm, and width of the lower pharynx was 10.1 ± 0.73 mm. The patients of group 2 showed that the average value of the airpassageways volume was 9.3 ± 0.71 cm3. There was a statistically significant difference in the reduction of the width of the upper pharynx (р˂0, 05). Decrease in the width of the lower respiratory tract in the 1st and 2nd groups in the patients aged 15-29 years may be associated with changes in the cervical spine, resulting from postural disorders of the locomotive apparatus, which increases with age and affects the severity of the dental anomaly and the narrowing of the airways in the lower part.

scholarly journals Clinical efficiency of treatment of cough in pediatric practice

2019 ◽  
pp. 194-198 ◽  
Author(s):  
G. Yu. Evstifeeva ◽  
O. Yu. Trusova ◽  
E. I. Danilova ◽  
V. V. Sumenko
Keyword(s):  
Respiratory Tract Infections ◽  
Comparison Group ◽  
Upper Respiratory Tract ◽  
Pediatric Practice ◽  
Upper Respiratory ◽  
Group 2 ◽  
Significant Regression ◽  
Tract Infections ◽  
Efficacy Of Treatment ◽  
Group 1

Cough is one of the most common reasons why parents bring their children to the pediatrician. The article presents the results of a study of the clinical efficacy of treatment of dry cough using Sinecod syrup. A total of 60 children aged 3–15 years with the upper respiratory tract infections and complaints of dry (non-productive) cough were enrolled in the study. In Group 1 (the main group), the children received Sinecod syrup in addition to the standard therapy, in Group 2 (the comparison group) children received Stoptussin-Phyto syrup. The effectiveness of treatment was evaluated based on the clinical examination findings. On Day 8–11 after the first examination, Group 2 showed a decrease in the severity of day and night cough according to VAS by more than 4 points compared with Group 2. Significant regression of the severity of day and night cough in the studied groups was only observed in patients from Group 1. Sleep disorders of the patients normalized.

Multiple Births and Congenital Anomalies in Tokyo Metropolitan Hospitals, 1979-1990

1992 ◽  
Vol 41 (4) ◽  
pp. 253-259 ◽  
Author(s):  
K. Kato ◽  
K. Fujiki
Keyword(s):  
Respiratory Tract ◽  
Cardiovascular System ◽  
Musculoskeletal System ◽  
Congenital Anomalies ◽  
Multiple Births ◽  
Multiple Birth ◽  
Upper Respiratory Tract ◽  
Tokyo Metropolitan ◽  
Significant Difference ◽  
Upper Respiratory

AbstractThe rate of multiple births and the incidence of congenital anomalies in Tokyo Metropolitan Hospitals were studied during the period 1979-1990. The number of twins was 968 pairs (8.23 per 1,000 deliveries) and of triplets 18 sets (15.3 per 100,000 deliveries) among 117,672 deliveries including 1,587 stillbirths after 16 weeks gestation. Multiple birth rates increased yearly. Stillbirth rates in twins and triplets were 5.5% and 16.7% respectively, which were both significantly higher than that in singletons (1.3%). The number of congenital anomalies was 42 in 1,936 twins (2.17%), 2 in 54 triplets (3.7%) and 1721 in 116,686 singletons (1.47%). The most common defects in twins were those of the cardiovascular system (0.72% in twins vs 0.52% in singletons) and of the musculoskeletal system (0.72% in twins vs 0.50% in singletons), followed by upper respiratory tract and/or mouth conditions (0.67% in twins vs 0.35% in singletons), all of which had no significant difference in frequency between twins and singletons. Though some anomalies had a significantly higher frequency in twins than in singletons, the concordance rate in the like-sexed twins was very low.

scholarly journals A RANDOMISED CONTROL STUDY TO COMPARE THE EFFICACY OF CEFUROXIME, CLARITHROMYCIN, AND LEVOFLOXACIN IN THE MANAGEMENT OF PAEDIATRIC UPPER RESPIRATORY TRACT INFECTION

2021 ◽  
pp. 103-106
Author(s):  
GOUTHAMI PADUGUNDLA ◽  
JYOTHIRMAYEE V ◽  
BETHALA RAVALI ◽  
JAGILLAPURAM ARUNDHATHI ◽  
THAKUR SRILATHA ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Age Distribution ◽  
Age Groups ◽  
Efficacy Rate ◽  
Pool Data ◽  
Upper Respiratory Tract ◽  
Cure Rate ◽  
Significant Difference ◽  
Upper Respiratory ◽  
Tract Infections

Background: The upper respiratory infections cause considerable morbidity mainly in children due to the fact that they mainly affect children. Accordingly, a study was conducted on antibiotics to compare the effectiveness of clarithromycin, cefuroxime, and levofloxacin for treating upper respiratory tract infections (URTI) in children. Methods: A prospective observational study for a period of 6 months was conducted in the pediatrics department of RVM hospital. Outpatients under the age of 14 years given antibiotics for the treatment of URTI were included in the study. A total of 99 study subjects were included in the study, divided into three groups each containing 33 sample sizes (clarithromycin, cefuroxime, and levofloxacin). Patient data was collected using a form and verbal consent was obtained from patients/patient representatives, and drugs were given using the lottery method. Follow-up was done and noted for the 3rd, 5th, 7th day through telephonic calls, and the collected data were evaluated using statistical analysis. Results: Pool data from 99 patients shows that many patients belong to 0–5 years age groups (age distribution), and males were more than female (gender distribution). Clarithromycin (cure rate 3 days) and cefuroxime (cure rate 5 days) showed an equal rate of cure percentage (94%), while levofloxacin for 3–5 days with a 3% failure rate. A significant difference of p<0.05 (p=0.000) was observed and no adverse events were noted. Conclusion: The study findings showed, out of 3 drugs, clarithromycin and cefuroxime showed an equal efficacy rate of 94%, but clarithromycin showed shorter duration of outcome, i.e., 3 days. Hence, clarithromycin is effective than the other two drugs in the treatment of URTI.

One-stage nasal and multi-level pharyngeal surgery for obstructive sleep apnoea: safety and efficacy

2005 ◽  
Vol 119 (4) ◽  
pp. 272-276 ◽  
Author(s):  
Kenny P Pang
Keyword(s):  
Sleep Apnoea ◽  
Upper Respiratory Tract ◽  
Safety And Efficacy ◽  
Surgical Success ◽  
One Stage ◽  
Obstructive Sleep ◽  
Upper Respiratory ◽  
Multi Level ◽  
Group 2 ◽  
Group 1

A collapsible airway is often the common denominator in sleep-disordered breathing (SDB). The upper respiratory tract includes the nasal passage, nasopharynx, oral cavity, oropharynx, base-of-tongue region and the hypopharynx. It is believed that the highest amount of resistance in the upper respiratory tract is in the nasal cavities, and particularly the nasal valve. Most authors believe that when considering surgical options for patients with obstructive sleep apnoea (OSA) it is imperative to correct nasal pathology together with the other sites of airway obstruction. In this retrospective study, I sought to investigate the safety and efficacy of one-stage nasal and multi-level pharyngeal surgery. I compared two groups of patients: group 1, receiving one-stage nasal and multi-level pharyngeal surgery; and group 2, receiving only multi-level pharyngeal surgery. In group 1, nine out of 12 patients (75 per cent) met the criteria for surgical success, with a mean pre-operative apnoea-hypopnoea index (AHI) decreasing from 36.3 to 8.9 post-operatively (p<0.0002), while in group 2, 25 out of 40 patients met the surgical success criteria (62.5 per cent), with their mean AHI decreasing from 52.6 to 10.2 (p<0.0000). When comparing the surgical success rates between the two groups, it was not statistically significant, at p>0.106. There were no postoperative respiratory-related complications despite having bilateral nasal Merocel (tampon) packing in place (in group 1), and none of the patients in either group had any desaturation, hypoxaemia, apnoea or OSA-related complications. This series suggests that, with adequate post-operative monitoring, it is both safe and efficacious to perform both nasal and multi-level pharyngeal surgery in the one surgical session.

scholarly journals The Effect of Patient-Specific Instrumentation Incorporating an Extramedullary Tibial Guide on Operative Efficiency for Total Knee Arthroplasty

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Oh-Ryong Kwon ◽  
Kyoung-Tak Kang ◽  
Juhyun Son ◽  
Dong-Suk Suh ◽  
Dong Beom Heo ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Patient Specific ◽  
Surgical Time ◽  
Patient Specific Instrumentation ◽  
Significant Difference ◽  
Total Knee ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

This retrospective study was to determine if patient-specific instrumentation (PSI) for total knee arthroplasty (TKA) leads to shortened surgical time through increased operating room efficiency according to different tibial PSI designs. 166 patients underwent primary TKA and were categorized into three groups as follows: PSI without extramedullary (EM) tibial guide (group 1, n=48), PSI with EM tibial guide (group 2, n=68), and conventional instrumentation (CI) group (group 3, n=50). Four factors were compared between groups, namely, operative room time, thickness of bone resection, tibial slope, and rotation of the component. The mean surgical time was significantly shorter in the PSI with EM tibial guide group (group 2, 63.9±13.6 min) compared to the CI group (group 3, 82.8±24.9 min) (P<0.001). However, there was no significant difference in the PSI without EM tibial guide group (group 1, 75.3±18.8 min). This study suggests that PSI incorporating an EM tibial guide may lead to high operative efficiency in TKA compared to CI. This trial is registered with KCT0002384.

scholarly journals Comparison of perioperative parameters in one-handed rotational phacoemulsification versus conventional phacoemulsification and femtosecond laser-assisted cataract surgery

2021 ◽  
Vol 14 (12) ◽  
pp. 1868-1875
Author(s):  
Samuele Gigliola ◽  
◽  
Alfredo Niro ◽  
Carmela Palmisano ◽  
Pasquale Puzo ◽  
...  
Keyword(s):  
Endothelial Cell ◽  
Femtosecond Laser ◽  
Cataract Surgery ◽  
The Other ◽  
Dissipated Energy ◽  
Surgical Time ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

AIM: To compare perioperative parameters of one-handed rotational phacoemulsification technique (one-handed phaco-roll) with each of other two techniques, “Divide et Conquer” and femtosecond laser-assisted cataract surgery (FLACS) METHODS: In this retrospective and comparative cohort study, eyes with uncomplicated cataract (nuclear density grade 2 to 3) treated routinely with one-handed phaco-roll (n=23; Group 1) or “Divide et Conquer” (n=23; Group 2) or FLACS (n=23; Group 3) were enrolled. Intraoperative parameters including effective phaco-time (EPt), ultrasound time (USt), aspiration time, surgical time, phacoemulsification (phaco)-power, balanced salt solution (BSS) use, cumulative dissipated energy (CDE) were recorded and compared. Clinical outcomes including best corrected visual acuity (BCVA), corneal endothelial cell density (ECD), endothelial cell loss (ECL), central corneal thickness (CCT) and central macular thickness (CMT), were assessed and compared pre-operatively and at 1mo after surgery. RESULTS: Aspiration and surgical time, and BSS used were lower in Group 1 (P<0.01) than other groups. EPt, phaco-power and CDE were lower in Group 1 (P<0.05) than Group 2 but not significantly different from Group 3. In Group 1, USt was lower (P<0.05) than Group 2 but higher (P<0.05) than Group 3. BCVA improved in all groups without significant difference between Group 1 and the other ones. No significant differences regarding all post-operative morphologic outcomes (ECD, ECL, CCT, CMT) were reported. No clinical complications occurred. CONCLUSION: One-handed phaco-roll seems to be less time-consuming than “Divide et Conquer” and FLACS and less energy-consuming than “Divide et Conquer”. Furthermore, one-handed phaco-roll seems to have an equal safety profile compared to the other two techniques.

Comparison of the upper respiratory tract width at the level of the adenoid in patients with normal and abnormal breathing route

2018 ◽  
Vol 14 (2) ◽  
pp. 13-26
Author(s):  
Anna Duda ◽  
Wojciech Stós
Keyword(s):  
Respiratory Tract ◽  
Control Group ◽  
Study Group ◽  
Upper Respiratory Tract ◽  
Control Groups ◽  
Limit Values ◽  
Significant Difference ◽  
Abnormal Breathing ◽  
Upper Respiratory ◽  
And Control

This study assesses the upper respiratory tract width at the level of the adenoid in patients with a normal (nasal) and abnormal (oral or mixed) breathing route. <b>Aim</b>. To compare the upper respiratory tract width in the study group (abnormal breathing route) and control group (normal breathing route) and to determine the cut-off point and mean limit values in order to conduct a differential diagnosis between a habitual and constitutional breathing route. <b>Material and methods</b>. The study included 221 patients treated at the Aquadent-Ortoestetyka Clinic in Kielce. Based on the medical history taken, clinical examination and subjective evaluation of the upper respiratory tract width according to Holmberg 112 patients were enrolled into the study group and 109 patients into the control group. The upper respiratory tract width was measured with two different linear methods: a modified method by Holmberg. and Linder-Aronson, and the Linder-Aronson and Henricson method (AD1-PNS, AD2-PNS).<b> Results</b>. In the study group the mean value of the Holmberg measurement is 4.25 mm, and in the control group – 14.1 mm. Mean values of AD1- PNS and AD2-PNS measurements in the study group are 8.1 mm and 9.5 mm, respectively, and they can be regarded as mean limit values. The 6 mm Holmberg measurement is the cut-off value between the study and control groups, and it should be monitored. In relation to the Holmberg measurement a difference between the study and control groups is 9.85 mm. Regarding AD1-PNS and AD2-PNS measurements a difference between the study and control groups is 11.4 mm and 10.0 mm, respectively.<b> Conclusions</b>. The upper respiratory tract width at the level of the adenoid shows a statistically significant difference between the study and control groups. It may indicate significant narrowing of the upper respiratory tract at the level of the adenoid in the study group or a different type of morphology of the facial skeleton. Limit values obtained in the study allow differentiation of a habitual and constitutional breathing route. <b>(Duda A, Stós W. Comparison of the upper respiratory tract width at the level of the adenoid in patients with normal and abnormal breathing route. Orthod Forum 2018; 14: 106-18)</b>.

scholarly journals Evaluation of Clinical Parameters in FMT-Application of a Vibrant Soundbridge® at the Short Incus Process Compared to Conventional FMT-Application

2020 ◽  
pp. 1-4
Author(s):  
Markus Pirlich ◽  
Andreas Dietz ◽  
Markus Pirlich ◽  
Viktor Kunz
Keyword(s):  
Pure Tone ◽  
Revision Rate ◽  
University Hospital ◽  
Complication Rates ◽  
Vibrant Soundbridge ◽  
Surgical Time ◽  
Pure Tone Audiogram ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

Background: The application of the Floating Mass Transducer (FMT) of a Vibrant Soundbridge (VSB) to the short incus process is intended to reduce both the surgery time and the complication and revision rate compared to other forms of application. In addition to collecting these parameters, the aim of this study is to investigate the primary audiological outcome of patients with an FMT application to the short process compared to the conventional methods. Methods: The present study retrospectively examined a total of n=36 patients who received a VSB between 01/2015 and 08/2018 at the ENT University Hospital Leipzig. In n=12 patients (group 1) the FMT was coupled to the short process, in n=24 patients (group 2) to other ear structures. The audiological results were evaluated pre- and postoperatively in the pure tone audiogram according to the recommendations of the AAO-HNS (1995) and the intelligibility (Freiburger, monosyllabic) was measured at 65 dB in the speech audiogram. In addition, the revision and complication rates as well as the surgical time were evaluated. Results: The audiological outcome of group 2 was significantly better postoperatively in both the pure tone (p<.001) and speech audiogram (p=.012). The surgery time of group 1 was significantly shorter (p=.002), but with a slightly increased revision rate (p=.519). The complication rate of group 2 was slightly higher, with no statistically significant difference to group 1 (p=.185). Conclusions: The FMT application on the short ambos process does not seem to offer any advantage in terms of audiological outcome, but at the same time is associated with a significantly shorter surgery time. There are no statistically significant differences in revision and complication rates.

scholarly journals Functional outcome of long proximal femoral nail versus short proximal femoral nail in peritrochanteric fractures

2021 ◽  
Author(s):  
Sanjeev Gupta ◽  
Pallav Gupta ◽  
Gagandeep Singh Raina ◽  
Manoj Kumar ◽  
Gagandeep Singh
Keyword(s):  
Blood Loss ◽  
Functional Outcome ◽  
Proximal Femoral Nail ◽  
Surgical Time ◽  
Femoral Nail ◽  
Significant Difference ◽  
Intramedullary Implant ◽  
Group 2 ◽  
Surgical Duration ◽  
Group 1

Background: Proximal femoral nail (PFN) is an intramedullary implant which has been commonly used in the fixation of intertrochanteric fractures. However, controversy comes about the effect of nail length on fracture union and other complications. A comparative evaluation of surgical treatment and functional outcome of patients with peritrochanteric fractures treated with short versus long PFN.Methods:  Total of 100 patients have been included in study out of which 57 belonged to group 1 and were operated with short PFN and rest 43 were group 2 operated with long PFN. Patients were followed up for 6 months and were compared on various parameters.Results: There is no significant difference noted in the two group. However, the surgical duration and blood loss for short PFN was significantly less as compared to long PFN.Conclusions: Short PFN is better implant for peritrochantric fractures both stable and unstable with quicker surgical time and lesser blood loss.

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