scholarly journals Balloon Dilatation of Laryngotracheal Stenosis: Hospital Ampang Experience

2020 ◽  
Vol 16 (2) ◽  
Author(s):  
LY Loo ◽  
Mawaddah A ◽  
Shahrul H ◽  
Khairullah A
Keyword(s):  
Balloon Dilatation ◽  
Upper Airway ◽  
Causative Factor ◽  
Segment Length ◽  
Total Intravenous Anaesthesia ◽  
Laryngotracheal Stenosis ◽  
Intravenous Anaesthesia ◽  
Before And After ◽  
Grave Problem ◽  
Methods Of Treatment

The upper airway is a crucial structure. It becomes a grave problem should it be narrowed. Several methods of treatment were rendered for patients with laryngotracheal stenosis. We share our experience with the combination total intravenous anaesthesia and apneic pause technique with or without steroid injection. Four cases of laryngotracheal stenosis were observed in Hospital Ampang: two adult and two paediatric cases. Age, gender, causative factor, stenosis segment length, grade or severity were observed before and after dilatation, number of dilatation were observed and compared. The outcome measures are decannulation and avoidance of tracheostomy. All cases had improvement of symptoms. Half or 50% of the patient required repeated balloon dilatations. The paediatric cases successfully avoided tracheostomy while the adult cases successfully decannulated with no complication from the procedure. Balloon dilatation by total intravenous anaesthesia coupled with apneic method is a safe and effective method of treatment for the narrowed airway.

scholarly journals Utilization potential of intraluminal optical coherence tomography for the Eustachian tube

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hayoung Byun ◽  
Yeon Hoon Kim ◽  
Jingchao Xing ◽  
Su-Jin Shin ◽  
Seung Hwan Lee ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Eustachian Tube ◽  
Balloon Dilatation ◽  
Optical Coherence ◽  
Cross Sectional ◽  
Anatomical Structures ◽  
Complex Anatomy ◽  
Before And After ◽  
Tubal Lumen ◽  
Oct Image

AbstractImaging the Eustachian tube is challenging because of its complex anatomy and limited accessibility. This study fabricated a fiber-based optical coherence tomography (OCT) catheter and investigated its potential for assessing the Eustachian tube anatomy. A customized OCT system and an imaging catheter, termed the Eustachian OCT, were developed for visualizing the Eustachian tube. Three male swine cadaver heads were used to study OCT image acquisition and for subsequent histologic correlation. The imaging catheter was introduced through the nasopharyngeal opening and reached toward the middle ear. The OCT images were acquired from the superior to the nasopharyngeal opening before and after Eustachian tube balloon dilatation. The histological anatomy of the Eustachian tube was compared with corresponding OCT images, The new, Eustachian OCT catheter was successfully inserted in the tubal lumen without damage. Cross-sectional images of the tube were successfully obtained, and the margins of the anatomical structures including cartilage, mucosa lining, and fat could be successfully delineated. After balloon dilatation, the expansion of the cross-sectional area could be identified from the OCT images. Using the OCT technique to assess the Eustachian tube anatomy was shown to be feasible, and the fabricated OCT image catheter was determined to be suitable for Eustachian tube assessment.

Laryngeal Movement Disorders and Their Management

2016 ◽  
Vol 1 (3) ◽  
pp. 75-82 ◽  
Author(s):  
Thomas Murry ◽  
Claudio F. Milstein
Keyword(s):  
Movement Disorders ◽  
Upper Airway ◽  
Management Options ◽  
Current Information ◽  
Voice Changes ◽  
A Minor ◽  
The Voice ◽  
Methods Of Treatment

This review describes the current information related to laryngeal neuropathic disorders and the possible management options available. Voice changes may range from severe hoarseness due to choking and coughing to a mild intermittent dysphonia possibly accompanied by unusual breathing. Neither the sound of the voice nor the lack of hoarseness should suggest that the problem itself is a minor one. Laryngeal neuropathic disorders may be the outcome of inflammation, irritation, infection, or a combination of these that causes a disruption in normal sensation. When sensory mediators no longer function normally, breathing, phonation, and even swallowing changes may be affected. Clinicians must be aware of the numerous sensory related disorders in the upper airway and currently accepted methods of treatment.

scholarly journals Midazolam-Flumazenil Topical Anaesthesia for Microlaryngoscopy with Jet Ventilation

1997 ◽  
Vol 25 (4) ◽  
pp. 358-364
Author(s):  
W. Rushatamukayanunt ◽  
T. Tritrakarn
Keyword(s):  
Treated Group ◽  
Muscle Relaxants ◽  
Total Intravenous Anaesthesia ◽  
Topical Anaesthesia ◽  
Parallel Study ◽  
Jet Ventilation ◽  
Double Blind ◽  
Intravenous Anaesthesia ◽  
Single Intravenous Injection ◽  
High Incidence

A comparison between midazolam and midazolam-flumazenil for total intravenous anaesthesia in combination with topical anaesthesia and muscle relaxants was performed in a double-blind, parallel study in 40 patients scheduled for microlaryngoscopy with or without bronchoscopic procedures using jet ventilation with oxygen. A single intravenous injection of midazolam 0.3 mg/kg, lignocaine spray and muscle relaxants provided adequate anaesthesia and good operative conditions throughout the procedures, which took 20 to 30 minutes. Patients who had placebo at the end of the procedures had a longer recovery and a high incidence of airway obstruction (20%). Administration of flumazenil provided prompt awakening in 19 of 20 patients (95%) within five minutes, resulting in rapid and favourable recovery without resedation or other side-effects, while only three of 20 (15%) patients in the placebo-treated group had improved consciousness within five minutes. The simplicity and reliability of the midazolam-flumazenil technique is attractive. We consider it worthy of further investigation for wider application in clinical practice.

Ventilatory dynamics during transient arousal from NREM sleep: implications for respiratory control stability

1996 ◽  
Vol 80 (5) ◽  
pp. 1475-1484 ◽  
Author(s):  
M. C. Khoo ◽  
S. S. Koh ◽  
J. J. Shin ◽  
P. R. Westbrook ◽  
R. B. Berry
Keyword(s):  
Respiratory Control ◽  
Upper Airway ◽  
Nrem Sleep ◽  
Before And After ◽  
Stage 2 Sleep ◽  
Repeated Administrations ◽  
Time Courses ◽  
Control Stability ◽  
Airway Dynamics ◽  
Normal Adults

The polysomnographic and ventilatory patterns of nine normal adults were measured during non-rapid-eye-movement (NREM) stage 2 sleep before and after repeated administrations of a tone (40-72 dB) lasting 5 s. The ventilatory response to arousal (VRA) was determined in data sections showing electrocortical arousal following the start of the tone. Mean inspiratory flow and tidal volume increased significantly above control levels in the first seven breaths after the start of arousal, with peak increases (64.2% > control) occurring on the second breath. Breath-to-breath occlusion pressure 100 ms after the start of inspiration showed significant increases only on the second and third postarousal breaths, whereas upper airway resistance declined immediately and remained below control for > or = 7 consecutive breaths. These results suggest that the first breath and latter portion of the VRA are determined more by upper airway dynamics than by changes in the neural drive to breathe. Computer model simulations comparing different VRA time courses show that sustained periodic apnea is more likely to occur when the fall in the postarousal increase in ventilation is more abrupt.

Disoprofol (ICI 35868) for Total Intravenous Anaesthesia

1983 ◽  
Vol 27 (2) ◽  
pp. 113-116 ◽  
Author(s):  
R. J. Fragen ◽  
E. H. J. H. Hanssen ◽  
P. A. F. Denissen ◽  
L. H. D. J. Booij ◽  
J. F. Crui.
Keyword(s):  
Total Intravenous Anaesthesia ◽  
Intravenous Anaesthesia
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