Faculty Opinions recommendation of Use of the Pentax-AWS in 293 patients with difficult airways.

2015 ◽  
Author(s):  
Michael Aziz
Keyword(s):  
Difficult Airways

scholarly journals Comparative Evaluation of Adenoids, Upper Airway, and Tongue Using “Predictors of Difficult Airways” in Class II Division 1 and Division 2 Cases with Class I Cases: Prospective In Vivo Observational Study

2021 ◽  
pp. 030157422096341
Author(s):  
Smita Mangesh Choudhari ◽  
Sunita Shrivastav
Keyword(s):  
Significant Positive Correlation ◽  
Upper Airway ◽  
Class Ii ◽  
Class I ◽  
Positive Correlation ◽  
Division 1 ◽  
Difficult Airways ◽  
Mandibular Protrusion ◽  
Division 2 ◽  
Class Ii Division 1

Introduction: Altered nasorespiratory function leads to altered craniofacial growth. Thus, airway evaluation is important for preventive, interceptive, and corrective orthodontic treatment. The aim of this study was to evaluate and compare adenoids, the upper airway, the tongue, and mandibular dimensions using “predictors of difficult airways” in class II division 1 and class II division 2 cases with class I cases. Method: Sixty subjects of age 15 to 18 years were divided into 3 groups (group 1: class I cases; group 2: class II division 1 cases; and group 3: class II division 2 cases) based on cephalometric parameters, with 20 cases in each group. Cephalometric evaluation of adenoids and the nasopharyngeal airway was done using the Handelman–Osborne area method. Upper and lower airway evaluation was done using McNamara’s linear method. “Predictors of difficult airways” were used for evaluation of the airway, which included nasal competency, the Mallampati scale, mandibular length, mandibular protrusion, and the thyromental distance. Results: The present study found a significant positive correlation between the grades of nasal competency and percentage adenoid wall area, and a significant negative correlation between the grades of nasal competency and the upper airway. There was a significant positive correlation between the grades of nasal competency and mandibular length, and a significant positive correlation between the grades of mandibular protrusion and mandibular length. There was a significant positive correlation between the grades of the thyromental distance and mandibular length. Conclusion: It was concluded that the “predictors of difficult airways” would be helpful in early diagnosis and identification of potential risk factors that may cause “breathing disorders”–related malocclusions and later on increase the risk of developing OSA.

The Radiographic “Air Sign” in Neonatal Mandibular Distraction Osteogenesis

2021 ◽  
pp. 229255032110485
Author(s):  
Tyler Safran ◽  
Abdulaziz Alabdulkarim ◽  
Rafael Galli ◽  
Mirko S. Gilardino
Keyword(s):  
Airway Obstruction ◽  
Distraction Osteogenesis ◽  
Mandibular Advancement ◽  
Mandibular Distraction ◽  
Risk Of Failure ◽  
Mandibular Distraction Osteogenesis ◽  
Objective Sign ◽  
Difficult Airways

Timing of extubation on post-mandibular distraction osteogenesis (MDO) surgery is critical, given that at baseline these infants have difficult airways and failed extubation requires either re-intubation of an already complex airway with a fragile, recently osteotomized mandible, or adjunctive airway measures such as CPAP that may apply unwanted pressure to the surgical site. Thus, the goal is to plan extubation when the risk of failure is minimal. Currently, there is a void in the literature addressing the timing of extubation post-MDO and no objective sign of extubation readiness has been elucidated. This study describes a simple clinical pearl to assist in the evaluation of extubation readiness in these patients. Postoperatively, we obtain weekly radiographs to assess distractor stability and advancement, and to assess for the “Air Sign”. The Air Sign describes a radiolucent space (air) visualized in the oropharynx on lateral radiographs, likely indicating that the tongue based airway obstruction has been relieved by mandibular advancement.

scholarly journals Successful tracheal intubation with video laryngoscope when awake fiberoptic bronchoscopy failed in a patient with hypopharyngeal mass

2017 ◽  
Vol 4 (1) ◽  
pp. 35-37
Author(s):  
Somnath Goyal ◽  
Anita Kulkarni
Keyword(s):  
Computed Tomography ◽  
Fiberoptic Bronchoscopy ◽  
Video Laryngoscope ◽  
Clinical Scenario ◽  
Tube Insertion ◽  
Feeding Jejunostomy ◽  
Difficult Airways ◽  
Difficult Endotracheal Intubation ◽  
Carcinoma Of Hypopharynx ◽  
Ryle’S Tube

Video laryngoscope is one of best alternative in managing difficult airways. Our patient presented with left side neck pain and hoarseness of voice for three months, dysphagia to solids for two months. Computed tomography revealed large hypopharyngeal mass and a diagnosis of carcinoma of hypopharynx was made. As endoscopic Ryle’s tube insertion by gastroenterologist was unsuccessful so he was posted for Feeding jejunostomy under general anaesthesia. We anticipated difficult endotracheal intubation. Our first attempt to secure airway with awake fiberoptic bronchoscopic intubation was unsuccessful. Using an alternative method with bougie and video laryngoscopy, the trachea was successfully intubated. In rare clinical scenario fiberoptic bronchoscopic intubation may fail, hence we need to be prepared with the backup plan for airway management. A video laryngoscope might be useful in such situations.

Outcomes of intubation in difficult airways due to head and neck pathology

2009 ◽  
Vol 119 (S3) ◽  
pp. S242-S242 ◽  
Author(s):  
Tim A. Iseli ◽  
Claire E. Iseli ◽  
J. Blake Golden ◽  
Virginia L. Jones ◽  
Arthur M. Boudreaux ◽  
...  
Keyword(s):  
Head And Neck ◽  
Head And Neck Pathology ◽  
Difficult Airways

scholarly journals Facilitating Airway Surgery in a Morbidly Obese Patient Using Transnasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE)

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Si-Jia Lee ◽  
Kelvin Howyow Quek
Keyword(s):  
Obese Patient ◽  
Normal Weight ◽  
Morbidly Obese ◽  
Airway Surgery ◽  
Laryngeal Surgery ◽  
Morbidly Obese Patient ◽  
Obese Population ◽  
Obese Subjects ◽  
Difficult Airways ◽  
Surgical Field

Transnasal Humidified Rapid Insufflation Ventilatory Exchange (THRIVE) is a relatively new noninvasive oxygenation technique with a broad range of applications. It is used in the treatment of type one respiratory failure, as a preoxygenation tool, as a rescue and temporising measure in difficult airways, and as step-down oxygen therapy in patients after extubation. Its use has also been described in laryngeal surgeries, but they mainly involved normal-weight subjects or were used as a bridging oxygenation therapy before definitive airway is secured. The major benefits of using THRIVE in obese subjects undergoing laryngeal surgery include a tubeless and uninterrupted surgical field. This advantage is especially crucial in obese patients as they tend to have limited oropharyngeal space, rendering a shared airway technically challenging for surgeons. However, concerns of potential difficult airway and shorter safe apnoeic time in the obese population limit its use. In this case, we report its use as the sole oxygenation strategy in a morbidly obese patient undergoing airway surgery. Our experience suggests that THRIVE can provide a conducive operating field and adequate oxygenation in short apnoeic laryngeal procedures in the obese population, without causing excessive hypercarbia.

scholarly journals A Comparative Study of Intubation Performance between Channelled vs. Non-Channelled Blade of King Vision Video Laryngoscope in Orotracheal Intubation

2021 ◽  
Vol 8 (12) ◽  
pp. 732-736
Author(s):  
Shalini Bajpai
Keyword(s):  
Comparative Study ◽  
Statistical Difference ◽  
Orotracheal Intubation ◽  
Video Laryngoscope ◽  
Intubation Time ◽  
Anaesthesia Practice ◽  
Measured Time ◽  
Difficult Airways

BACKGROUND Video laryngoscope is an important tool for orotracheal intubation in anaesthesia practice particularly in difficult airways. It provides an indirect view of glottis without the need of alignment of oropharyngeal-laryngeal axis. We compared the intubation characteristics of channelled versus non-channelled blades of King VisionTM Video Laryngoscope. METHODS In this study 60 patients were randomly allocated to two groups; group C were intubated with channelled and group NC with non-channelled blade of King Vision. We measured time for glottis visualisation and intubation time using both blades. Percentage of glottis opening (POGO), insertion attempts, intubation attempts, and ease of intubation were also assessed. RESULTS The time for glottis visualisation was 8.5 ± 3 seconds for group C and 7 ± 2 seconds for group NC. Intubation time was 24 ± 8.5 seconds for group C and 44 ± 5 seconds for NC. There was no statistical difference in POGO, insertion attempts, intubation attempts and ease of intubation between the two groups. CONCLUSIONS We concluded that the time for glottis recognition is longer but intubation time is shorter when using King Vision video laryngoscope channelled blade as compared to non-channelled blade. KEYWORDS Video Laryngoscope, King Vision, Channelled, Non-Channelled

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