scholarly journals Anesthetic Management of a Juvenile Hyaline Fibromatosis Patient With Trismus and Cervical Movement Limitation

2021 ◽  
Vol 68 (2) ◽  
pp. 117-118
Author(s):  
Asako Yasuda ◽  
Noriko Miyazawa ◽  
Emiko Inoue ◽  
Tomoaki Imai ◽  
Yoshiki Shionoya ◽  
...  
Keyword(s):  
Anesthetic Management ◽  
Assisted Ventilation ◽  
Gingival Hyperplasia ◽  
Lower Lip ◽  
Endotracheal Tubes ◽  
Oral Airway ◽  
Nasopharyngeal Airway ◽  
Juvenile Hyaline Fibromatosis ◽  
Airway Devices ◽  
Rare Autosomal Recessive Disease

Juvenile hyaline fibromatosis (JHF) is a rare autosomal recessive disease characterized by the presence of tissue nodules, joint contractures, and gingival hyperplasia. With a 1-year-9-month-old female patient scheduled for a gingivectomy and excision of a lower lip mass under general anesthesia, it was anticipated that airway management would be difficult because of trismus and limited cervical movement. Intubation with video-laryngoscopic assistance could not be achieved because gingival hyperplasia and trismus prevented blade insertion and manipulation. Therefore, 2 endotracheal tubes were used: 1 used as a nasopharyngeal airway for assisted ventilation, and 1 used for intubation along with a flexible fiberoptic scope. This case demonstrated a useful method for managing ventilation and intubation in patients with JHF, particularly when the use of oral airway devices is difficult.

Oral manifestations of juvenile hyaline fibromatosis: a case report

2005 ◽  
Vol 29 (4) ◽  
pp. 347-351 ◽  
Author(s):  
Manal Al-Malik ◽  
Ziad Rehbini ◽  
Ali Eltayeb
Keyword(s):  
Autosomal Recessive ◽  
Autosomal Recessive Disease ◽  
Gingival Tissue ◽  
Gingival Hyperplasia ◽  
Osteolytic Lesions ◽  
Feeding Difficulties ◽  
Gingival Hypertrophy ◽  
Juvenile Hyaline Fibromatosis ◽  
Dental Needs ◽  
Rare Autosomal Recessive Disease

Hyaline fibromatosis is a rare autosomal recessive disease of connective tissue, characterised by an accumulation of hyaline in the skin as well as various organs. The clinical features include: multiple cutaneous nodules, joint contractures, osteolytic lesions and gingival hypertrophy. This paper reports the case of an 11-year-old boy, who was referred to our dental clinic complaining of pain in his mouth. On examination, the patient had gross maxillary and mandibular gingival hyperplasia, which caused severe feeding difficulties. He also had severe dental decay, mal-positioned teeth and limited mouth opening.Treatment was done under general anesthesia to remove excess gingival tissue and extract the severely decayed teeth. Histological examination confirmed the diagnosis of juvenile hyaline fibromatosis. It was concluded that patients with this condition have special dental needs. Early diagnosis of the affected children is important in order to start early preventive dental therapy.

Anaesthetic equipment

2019 ◽  
pp. 71-100
Author(s):  
Richard Craig
Keyword(s):  
Near Infrared ◽  
Supraglottic Airway ◽  
Endotracheal Tubes ◽  
Practical Advice ◽  
Anaesthetic Equipment ◽  
Supraglottic Airway Devices ◽  
Perioperative Monitoring ◽  
Airway Equipment ◽  
Bis Monitor ◽  
Airway Devices

This chapter presents anaesthetic equipment used in paediatric anaesthesia. Airway equipment is described in detail with specific examples. This includes a description of the variety of supraglottic airway devices, endotracheal tubes, laryngoscopes for direct and indirect visualization of the larynx, breathing systems, ventilators, and modes of ventilation. Equipment for perioperative monitoring of the paediatric patient is reviewed. Practical advice regarding monitoring neonates and small babies is given particular attention. The use of the bispectral index (BIS) monitor and near-infrared spectroscopy (NIRS) are discussed. New advances in pulse oximetry that enable better monitoring with low perfusion states and motion are included.

Anesthetic Management in Juvenile Hyaline Fibromatosis: Case Report

2012 ◽  
Vol 40 (2) ◽  
pp. 108-113
Author(s):  
Saban Yalcin ◽  
Harun Aydogan ◽  
Halil Nacar ◽  
Mahmut Alp Karahan
Keyword(s):  
Case Report ◽  
Anesthetic Management ◽  
Juvenile Hyaline Fibromatosis

scholarly journals Bi-national survey of intraoperative cuff pressure monitoring of endotracheal tubes and supraglottic airway devices in operating theatres

2019 ◽  
Vol 47 (4) ◽  
pp. 378-384 ◽  
Author(s):  
Julie Lee ◽  
Heather Reynolds ◽  
Anita M Pelecanos ◽  
André AJ van Zundert
Keyword(s):  
New Zealand ◽  
Cuff Pressure ◽  
Public Hospitals ◽  
Supraglottic Airway ◽  
Intracuff Pressure ◽  
Pressure Monitoring ◽  
Endotracheal Tubes ◽  
Supraglottic Airway Devices ◽  
Zealand College ◽  
Airway Devices

Correct intracuff pressure of endotracheal tubes and supraglottic airway devices is required to avoid complications such as sore throat, dysphagia and dysphonia, while maintaining an adequate airway seal. However, intracuff pressure monitoring of airway devices during general anaesthesia may not receive the attention it deserves. The aim of this survey was to investigate the current practice regarding intraoperative cuff pressure monitoring in hospitals across Australia and New Zealand. An online ten-question survey was disseminated by the Australian and New Zealand College of Anaesthetists Clinical Trials Network to a randomised selection of 1000 Australian and New Zealand College of Anaesthetists Fellows working in private and public hospitals of varying sizes. There were 305 respondents in total, but not all respondents answered all questions. In total, 67 of 304 respondents (22.0%) did not have access to a cuff pressure manometer at their main site of work, and of these, 30 (9.9%) expressed that they would like access to one in their daily practice. Of 288 respondents, 122 (40.0%) reported that they used cuff pressure monitoring as part of their routine practice, but 95 (33.0%) measured the cuff pressure at induction only. For supraglottic airway devices, only 44 of 250 respondents (17.6%) aimed for a cuff pressure of 40–60 cmH2O. Of 255 respondents, 101 (39.6%) aimed for a cuff pressure of 20–30 cmH2O for endotracheal tubes. These findings indicate that educational programmes are required to increase the availability and use of cuff pressure monitoring devices for both endotracheal tubes and supraglottic airway devices across Australia and New Zealand.

An Airway Management Device: The Laryngeal Mask Airway—A Review

1998 ◽  
Vol 13 (1) ◽  
pp. 32-43 ◽  
Author(s):  
Clifford A. Schmiesing ◽  
John G. Brock-Utne
Keyword(s):  
Laryngeal Mask Airway ◽  
Airway Management ◽  
Endotracheal Tube ◽  
Face Mask ◽  
Laryngeal Mask ◽  
Emergency Airway ◽  
Oral Airway ◽  
Accepted Part ◽  
Airway Devices ◽  
New Generation

The laryngeal mask airway (LMA) is an airway management device that has become an accepted part of anesthetic practice in both pediatric and adults surgical patients. It is inserted without the use of a laryngoscope or muscle relaxants into the hypopharynx forming a low pressure seal around the glottis. The LMA provides a better airway than a face mask with or without an oral airway. Insertion techniques are quickly learned and are described in this review. Since the LMA forms a less secure seal than an endotracheal tube (ETT), several important limitations and contraindications exist. This includes patients at high risk for regurgitation of gastric contents into the lungs causing pulmonary aspiration and patients requiring high ventilatory pressures or prolonged ventilation. These contraindications have limited its introduction and utilization in the intensive care unit (ICU). The LMA is a helpful tool in the management of both the expected and unexpected difficult airway, where it may serve both as an emergency airway and as a conduit to intubation of the trachea with an ETT over a fiberoptic bronchoscope (FOB) or gum elastic bougie. A lifesaving airway has been provided by the LMA where no other means of achieving ventilation were possible in patients, including neonates, trauma victims, woman undergoing cesarean section, and in the setting of cardiac arrest. There are very few reported uses of the LMA in the ICU. We believe that familiarity with the LMA's design, use, and limitations by critical care practitioners will increase its use in emergency airway management and in the ICU. The LMA may prove to be the first of a new generation of airway devices placed into the hypopharynx to provide an alternative to the endotracheal tube and mask airway.

Getting started

2021 ◽  
pp. 343-360
Author(s):  
Mincho Marroquin-Harris
Keyword(s):  
Venous Access ◽  
Anaesthetic Machine ◽  
Supraglottic Airway ◽  
Positive Pressure ◽  
Endotracheal Tubes ◽  
Supraglottic Airway Devices ◽  
Anaesthetic Gases ◽  
Airway Equipment ◽  
Airway Devices

This chapter provides a basic overview of anaesthetic equipment and its safe use. Topics include the provision of anaesthetic gases, the basic components of the anaesthetic machine, breathing systems, positive-pressure ventilation, and airway equipment including laryngoscopes, endotracheal tubes and supraglottic airway devices. Methods of long-term venous access are discussed.

Airway Basics: Functional Airway Management

2019 ◽  
Author(s):  
Gilbert S Tang
Keyword(s):  
Oral Cavity ◽  
Upper Airway ◽  
Stomach Contents ◽  
Lower Airway ◽  
Lymphoid Tissues ◽  
Pediatric Airway ◽  
Endotracheal Tubes ◽  
Advanced Airway ◽  
Cord Injury ◽  
Airway Devices

The anesthesiologist maintains patency of the airway through the use of various airway techniques, from simple maneuvers such as jaw thrust and chin lift, to the insertion of oropharyngeal or nasopharyngeal airways, to the placement of advanced airway devices such as supraglottic airways and endotracheal tubes. Understanding the structure, function and anatomic relationships of the airway provides the foundation to evaluate the patient and determine a safe plan for airway management.The nose and mouth are the beginning point of the airway, which can be divided into the upper airway consisting of nasal cavity, nasopharynx, oral cavity, oropharynx, hypopharynx and larynx, and the lower airway consisting of the trachea, bronchi and subdivisions of the bronchi. The airway is the conduit from which air flows to and from the alveoli, where oxygenation and ventilation occurs. It plays important functions in trapping airborne contaminants, producing mucus and secretions, permitting olfactory and general sensation, warming and humidifying the air, providing immunologic defense from infection through lymphoid tissues, allowing a mechanism for vocalization, creating a functional separation between the swallowing and breathing, and protecting from aspiration of oral and stomach contents. This review contains 2 tables and 34 references. Key words: airway, intubation, pharynx, larynx, kiesselbach’s plexus, vocal cord injury, swallow, cough, laryngospasm, bronchospasm, obstruction, aspiration, pediatric airway

Cuffed endotracheal tubes in cats

2020 ◽  
Vol 25 (3) ◽  
pp. 1-3
Author(s):  
David Yates ◽  
Albert Holgate
Keyword(s):  
Endotracheal Tube ◽  
Gas Flow ◽  
Assisted Ventilation ◽  
Flow Rates ◽  
Endotracheal Tubes ◽  
Cuffed Endotracheal Tube ◽  
Volatile Agents

A cuffed endotracheal tube may improve the airway seal in anaesthetised feline patients, compared to use of an uncuffed tube. This may improve capnography and decrease theatre pollution with volatile agents. However, two significant risks are associated with the technique. First, over-inflation of the cuff could occur, with associated iatrogenic tracheal damage; this may be prevented by use of a cuff manometer for inflation. Second, as a result of the improved seal, barotrauma may be more likely with high gas flow rates and assisted ventilation.

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