- Simulation training for urgent postnatal fetal tracheal balloon removal: Two learning methods. [Randomized Controlled Trial]Eur J Obstet Gynecol Reprod Biol. 2023 Feb; 281:92-98.EJ
- CONCLUSIONS: There was no difference between video training and in-person training with regards to the time taken to locate the FETO balloon in the trachea and to simulate its removal.
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- Tracheostomy and venovenous extracorporeal membrane oxygenation for difficult airway patient with carinal melanoma: A case report and literature review. [Case Reports]
- CONCLUSIONS: In a difficult airway patient with severe airway obstruction, emergency tracheostomy for rigid bronchoscopy access and standby VV-ECMO can be life-saving, and ECMO can be weaned smoothly after tumor excision. During anesthesia for patients with tracheal tumors causing critical airway obstruction, spontaneous ventilation should be maintained at least initially, and ECMO deployment should be prepared for high-risk patients, such as those with obstructive symptoms, obstructed tracheal lumen > 50%, or distal trachea location.
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- The effect of tracheal occlusion in congenital diaphragmatic hernia in the nitrofen rat lung explant model. [Journal Article]Pediatr Surg Int. 2022 Dec 23; 39(1):61.PS
- CONCLUSIONS: The TO model in lung explants mimics the outcomes of current surgical models of TO and further studies can reveal the cellular and molecular effects of TO in CDH lungs.
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- Gamma Irradiation Processing on 3D PCL Devices-A Preliminary Biocompatibility Assessment. [Journal Article]
- Additive manufacturing or 3D printing applying polycaprolactone (PCL)-based medical devices represents an important branch of tissue engineering, where the sterilization method is a key process for further safe application in vitro and in vivo. In this study, the authors intend to access the most suitable gamma radiation conditions to sterilize PCL-based scaffolds in a preliminary biocompatibilit…
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- Bronchial Leiomyoma: Importance of Preoperative Biopsy for Lung Preserving Surgery. [Case Reports]
- Tracheobronchial leiomyoma is a rare tumor of the airway. They arise from the lower respiratory tract tissue of the bronchi, trachea, and lung. Symptomatology is based on the degree of endoluminal bronchial obstruction, and surgical resection is generally the mainstay of treatment. We present the case of a 33-year-old male who suffered from chronic cough and breathlessness for two years caused by…
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- Aerodynamic-induced Effects of Artificial Subglottic Stenosis on Vocal Fold Model Phonatory Response. [Journal Article]J Voice. 2022 Dec 07 [Online ahead of print]JV
- CONCLUSIONS: Consistent with previous computational studies, this study found that aerodynamic, acoustic, and vibratory responses of self-oscillating VF models were largely unaffected by SGS until approximately 80% to 90% obstruction, and significantly affected at higher obstructions. This suggests that Grades I and II stenoses are unlikely to introduce subglottic airway aerodynamic disturbances that are sufficient in and of themselves to significantly alter phonatory output. The SGS model introduces a framework for future benchtop studies involving subglottic and supraglottic airway constrictions.
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- Overall Survival of Small-cell Lung Cancer Patients With Malignant Central Airway Obstruction Who Received Chemotherapy Without Undergoing Transbronchial Interventions: A Single-institution Retrospective Study. [Journal Article]Anticancer Res. 2022 Dec; 42(12):6113-6119.AR
- CONCLUSIONS: The prognosis of SCLC patients with MCAO who receive chemotherapy without undergoing TBI is not inferior to that of SCLC patients without MCAO.
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- In utero Treatment of Congenital High Airway Obstruction Syndrome via Fetal Laryngoscopy and EXIT Procedure. [Case Reports]Fetal Diagn Ther. 2022; 49(9-10):385-393.FD
- CONCLUSIONS: The primary goal of fetoscopic airway evaluation and intervention is not necessarily to perform definitive stabilization of the airway but rather to achieve sufficient decompression of the trachea to reverse fetal hydrops and salvage pulmonary development. In utero fetoscopic treatment may allow for prolongation of the pregnancy with delivery at or near term via EXIT procedure for definitive neonatal airway stabilization.
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- Emergency application of extracorporeal membrane oxygenation in a pediatric case of sudden airway collapse due to anterior mediastinal mass: A case report and review of literature. [Case Reports]Ulus Travma Acil Cerrahi Derg. 2022 Dec; 28(12):1747-1753.UT
- Mediastinal masses can compress the respiratory or cardiovascular system, especially when anteriorly located. Obtaining histological material for diagnosis poses a challenge due to the major risk of cardiorespiratory collapse following anesthetic procedure. Our case shows the utility of rescue with venovenous extracorporeal membrane oxygenation (VV-ECMO) after occurrence of such an event and demo…
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- Cricoid Cartilage Hypertrophy as the Cause of Larynx Stenoses: Case Report and Updated Literature Review. [Journal Article]
- Aerodigestive obstruction due to cricoid hypertrophy is a rare and potentially life-threatening condition. We present a two-year-old female patient who displayed repetitive respiratory infections, swallowing disorder, and malnutrition without any eye signs or symptoms of airway alterations. We described a patient with aerodigestive obstruction generating a marked narrowing of the trachea immediat…
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- Ventilation challenge in rigid bronchoscopy: Laser tube as an alternative management in patients with lung cancer and central airway obstruction. [Journal Article]
- CONCLUSIONS: The use of the laser tube allows the monitoring of gas exchange, which controls hypoxemia. Thanks to the double cuff put distally to the tracheal obstruction or in the contralateral bronchus to the obstructed one, the laser tube prevents the flooding of blood from debulking below the stenosis. Rigid bronchoscopy with laser tube will expand its use in the future.
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- Bronchoscopy Laser and Silicone Y-Stents as Emergency Airway Management in Central Airway Stenosis Due to Secondary Thyroid Carcinoma: A Case Report. [Case Reports]
- Total airway obstruction in thyroid cancer is rare and has high morbidity and mortality. Airway management in such cases is challenging, especially in cases in which thyroid masses cannot be totally resected. It is important to choose the appropriate airway treatment modality. Currently, therapeutic rigid bronchoscopy procedures and endoluminal lasers, as well as airway stent insertion, are a man…
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- StatPearls: Laryngotracheal Stenosis [BOOK]StatPearls. StatPearls Publishing: Treasure Island (FL)BOOK
- Laryngotracheal stenosis (LTS) is a narrowing of the upper airway between the larynx and the trachea with potentially devastating consequences, including respiratory failure, cardiopulmonary arrest, and death. The upper airway is comprised of the larynx, glottis, subglottic region, and trachea. The trachea is a cylindrical-shaped tube with an anterior cartilaginous wall formed by c-shaped rings a…
- Morbidity in children after fetoscopic endoluminal tracheal occlusion for severe congenital diaphragmatic hernia: Results from a multidisciplinary clinic. [Journal Article]J Pediatr Surg. 2023 Jan; 58(1):14-19.JP
- CONCLUSIONS: These North American data show that prenatal tracheal occlusion, in conjunction with a long-term multidisciplinary CDH clinic, is associated with acceptable long-term survival and morbidity in children after FETO.
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- Successful extracorporeal membrane oxygenation in a patient with central airway obstruction due to an endotracheal mass. [Journal Article]
- Extracorporeal membrane oxygenation (ECMO) assists blood circulation and gas exchange via a heart-lung machine. ECMO is used mainly in intensive care units as bridging therapy until heart and respiratory failure can be addressed or until transplantation can be performed. ECMO is sometimes used during surgery under general anaesthesia, depending on the patient's underlying diseases and the nature …
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- The clinical application of flexible bronchoscopy in a neonatal intensive care unit. [Journal Article]
- CONCLUSIONS: Flexible bronchoscopy is safe and effective for diagnosing and differentiating neonatal respiratory disorders in neonatal intensive care units.
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- Successful surgıcal management of a giant neck teratoma in a newborn Baby: A case report. [Case Reports]
- Neck tumors in newborns are very rare. Teratomas usually include all three germ cell layers, as well as tissues that are not native to the anatomic site of genesis. Teratomas of the head and neck make up a smaller percentage of congenital teratomas. Because of the external compression that oropharyngeal or neck masses produce, they can cause serious airway obstruction. In addition, the larynx or …
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- Benign but fatal: management of endotracheal Rosai-Dorfman disease with acute onset. [Journal Article]Thorax. 2023 Feb; 78(2):211-213.T
- Rosai-Dorfman disease (RDD) is a non-malignant condition mainly manifesting as a proliferation of histiocytes in lymph nodes. Endotracheal RDD (ERDD) with an acute onset presentation is extremely rare. There are few case reports of ERDD mainly concerning its pathology, diagnostics and bronchoscopic treatment, without providing sufficient clinical information from a comprehensive perspective. As a…
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- StatPearls: Upper Airway Obstruction [BOOK]StatPearls. StatPearls Publishing: Treasure Island (FL)BOOK
- The upper airway consists of the nasal cavities, oral cavity, pharynx, and larynx. The pharynx is further subdivided into the nasopharynx, oropharynx, and hypopharynx. The larynx is divided into three regions, dependent on their relationship to the vocal cords (glottis). These areas are the supraglottis, glottis, and subglottis. The supraglottis consists of the epiglottis, the arytenoids, the ary…
- Vascularized Tracheal Transplantation: A Twenty Month Follow Up. [Journal Article]Laryngoscope. 2022 Oct 14 [Online ahead of print]L
- CONCLUSIONS: Twenty months after single-staged vascularized tracheal transplantation, the trachea is functional and the patient breathes without the need for a tracheostomy or stent. Single-staged long-segment tracheal transplantation is a viable option for tracheal defects that are not amenable to conventional reconstructive techniques.
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- Tracheobronchopathia Osteochondroplastica: A Rare, Underrecognized Entity. [Case Reports]
- Tracheobronchopathia Osteochondroplastica (TO) is an extremely rare condition characterized by the presence of nodules made of bone and cartilage within the submucosa of the tracheobronchial wall. These protuberant nodules inside the trachea and bronchi can lead to airway obstruction, resulting in patients who experience recurrent respiratory systems and infections. The exact etiology is unknown.…
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- Tracheal Sound Analysis. [Journal Article]
- Tracheal sound sensors provide multiple respiratory signals that are valuable for studying upper airway characteristics. This chapter reviews the original work and ongoing research on tracheal sound analysis in relation to upper airway obstruction during sleep. Past and current research suggest that being associated with other sleep study recording sensors and advanced signal processing technique…
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- StatPearls: Subglottic Stenosis [BOOK]StatPearls. StatPearls Publishing: Treasure Island (FL)BOOK
- Subglottic stenosis can be defined as the narrowing of the upper airway, which lies between the vocal folds and the lower border of the cricoid cartilage. Normally, the subglottic lumen is 4.5 mm to 5.5 mm in a full-term neonate, while a 3.5 mm lumen is normal in a premature neonate. A subglottic diameter of 4 mm or less in a full-term neonate is considered as narrow. Causes of subglottic stenosi…
- Traumatic injuries to the trachea and bronchi: a narrative review. [Review]
- CONCLUSIONS: Definitive diagnosis of traumatic tracheo-bronchial injuries usually involves direct visualization through liberal use of bronchoscopy in addition to cross-sectional imaging to evaluate for associated injuries, notably to the great vessels and esophagus. Important considerations for management include concerns for airway obstruction, uncontrolled air leak, and mediastinitis. Early repair of injuries recognized acutely is favored in attempts to prevent the development of airway stenosis. Key operative principles include exposure, conservative debridement to preserve length when possible, creation of a tension-free anastomosis, preservation of the blood supply, and creation of a tracheostomy, particularly in polytrauma patients. An interposition muscle flap is also required, specifically in the setting of combined esophageal and airway injuries. Patients with penetrating injuries tend to have more favorable outcomes, possibly on account of fewer concomitant injuries. Selective non-operative management is also an option in the subset of patients with iatrogenic injuries to the posterior membranous wall of the trachea, and includes broad-spectrum antibiotics and surveillance bronchoscopy.
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- Using ketamine in a patient with a near-occlusion tracheal tumor undergoing tracheal resection and reconstruction: A case report. [Case Reports]
- CONCLUSIONS: Ketamine showed great advantages in the anesthesia of upper TRR by providing analgesia with minimal respiratory depression or airway collapse.
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- StatPearls: Nasopharyngeal Airway [BOOK]StatPearls. StatPearls Publishing: Treasure Island (FL)BOOK
- Basic airway management in both the pediatric and adult populations includes assessing and managing airway patency, oxygen delivery, and ventilation. All efforts should be taken to maintain a patient’s airway via non-invasive methodology unless indications for invasive airway management are apparent. Non-invasive airway supplementation includes passive oxygenation (nasal cannula, non-rebreather, …
- Sudden unexpected death in a 17-year-old boy due to unacknowledged adamantinoma-like Ewing sarcoma. [Case Reports]
- A 17-year-old male with no previous medical history was admitted 2 days before his death to a local hospital after mild dyspnea. Electrocardiography, chest radiography, and blood analysis revealed no abnormalities. Blood oxygen saturation was 99%, and SARS-CoV-2 nasopharyngeal swabs tested negative; thus, he was discharged without prescriptions. After 2 days, the subject died suddenly during a po…
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- StatPearls: Choking [BOOK]StatPearls. StatPearls Publishing: Treasure Island (FL)BOOK
- Choking or foreign body airway obstruction occurs when a foreign body such as food, coins, or toys partially or completely obstruct the passage of air from the upper airway into the trachea. Choking affects either in the very young or the elderly[1]. In the young, the foreign body is likely to be food or a toy, while in the elderly it is almost always food. There is a bimodal distribution in the …
- Alfentanil and propofol induced anesthesia for patients with huge endotracheal tumor undergoing fiberoptic bronchoscopic interventional therapy: case report. [Case Reports]
- CONCLUSIONS: For patients with huge tracheal tumor that to be handled with fiberoptic bronchoscopic interventional therapy, general anesthesia with spontaneous breath induced by alfentanil and propofol is preferable. The most important, when complete airway blockade occurs during the process, pushing the tumor and reopening the respiratory tract with fiberoptic bronchoscope is a fairly effective solution to enable patients to be reoxygenated.
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- StatPearls: Bacterial Tracheitis [BOOK]StatPearls. StatPearls Publishing: Treasure Island (FL)BOOK
- Bacterial tracheitis was first described in medical literature in the 1920s, despite the name not being coined until much later. The disease was initially referred to as acute laryngotracheobronchitis. Bacterial tracheitis, also known as bacterial croup, acute laryngotracheobronchitis, or membranous croup, is a potentially lethal infection of the subglottic trachea. It is often a secondary bacter…