scholarly journals Retrospective Analysis of Pediatric Tracheostomy

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Mehmet Akdag ◽  
Zeynep Baysal ◽  
Ayfer Gozu Pirinccioglu ◽  
Aylin Gul ◽  
Fazıl Emre Ozkurt ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Patient Population ◽  
Chart Review ◽  
Genetic Diseases ◽  
Upper Airway ◽  
Retrospective Chart Review ◽  
Upper Airway Obstruction ◽  
Prolonged Intubation ◽  
Significant Difference ◽  
The Difference

Purpose. This paper reviews analyses for tracheostomy within our patient population over the last 6 years. Methods. We conducted a retrospective chart review of consecutive patients undergoing tracheostomy at the tertiary Dicle University Medical hospital, Turkey, from January 2006 to December 2012. Patient age, sex, emergency, planned tracheostomy, indications, complications, and decannulation time were all assessed. Results. Fifty-six (34 male, 22 female) adult Pediatric patients undergoing tracheostomy between 2006 and 2013 were investigated. The most common indication for tracheostomy was upper airway obstruction (66.7%), followed by prolonged intubation (33.3%). Mean decannulation times after tracheostomy ranged between 1 and 131 days, the difference being statistically significant (P=0.040). There was no significant difference in terms of mean age (9.8±6.0; P=0.26). There was also no statistical difference between emergency and planned tracheotomies (P=0.606). Conclusion. In our patient population, there was a significant decline in the number of tracheotomies performed for prolonged intubation and an increasing number of patient tracheostomy for upper airway obstruction. According to the literature, permanent decannulation rates were slightly higher with an increase in genetic diseases such as neuromuscular disease.

scholarly journals Age at Decannulation after Pediatric Tracheostomy.

2020 ◽  
pp. 1-8
Keyword(s):  
Airway Obstruction ◽  
Medical Records ◽  
Chart Review ◽  
Pediatric Patients ◽  
Upper Airway ◽  
Retrospective Chart Review ◽  
Upper Airway Obstruction ◽  
Neurological Condition ◽  
Neurological Conditions

Background: Parents of tracheostomized infants often enquire when their children will undergo decannulation. However, there are few studies on the decannulation of children who are tracheotomized in infancy. Therefore, this study investigated when decannulation should be performed in children by retrospectively analysing medical records. Methods: We performed a retrospective chart review of tracheostomy, decannulation and tracheostoma closure in 48 children who underwent tracheostomy before the age of 3 years. The indications for tracheostomy included upper airway obstruction, neurological conditions, cardiopulmonary conditions, craniofacial conditions and trauma. Result: Nineteen (33.3%) patients were decannulated during the follow-up period: 12 had upper airway obstruction, four had cardiopulmonary conditions, one had a neurological condition and two had craniofacial conditions. The average age at tracheostomy was 13.6 months. The average age at the start of the decannulation therapy was 5.4 years. The average age at decannulation was 7.2 years. The average age at tracheostoma closure was 9.2 years. Conclusion: This description of ages at decannulation after pediatric tracheostomy may be useful when explaining the prognoses and timelines of decannulation to parents and caretakers of pediatric patients who need to undergo tracheostomy.

Mouth and nose resistance in newborn kittens and puppies

1981 ◽  
Vol 51 (3) ◽  
pp. 641-645 ◽  
Author(s):  
J. P. Mortola ◽  
J. T. Fisher
Keyword(s):  
Mechanical Properties ◽  
Airway Obstruction ◽  
Flow Rate ◽  
Muscle Tone ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Upper Airways ◽  
Airway Patency ◽  
The Difference ◽  
Adult Cats

Newborn mammals, including infants, have difficulties in mouth breathing when the nasal passages are occluded. In this study we examined the possibility that differences in the passive mechanical properties of the upper airways could fully explain this behavior. Steady inspiratory flows through the upper airways in anesthetized supine newborn kittens and puppies resulted in upper airway obstruction, even at flows less than those occurring during resting breathing, suggesting that in the unanesthetized condition muscle tone plays an important role in maintaining upper airway patency. Mouth (Rm) and nose (Rn) resistances have been measured during steady expiratory flows with nostrils closed and mouth passively open or nostrils open and mouth closed. In all the newborns, Rn was substantially smaller than Rm. In contrast, the Rn/Rm in adult dogs is greater than unity. In adult cats Rn/Rm is above or below unity depending upon the flow rate, but the ratio is always larger than in newborn kittens. The difference between newborns and adults is entirely due to the small Rn of the newborn, as Rm is not greater in the newborn than in the adult. We conclude that the obligatory nose breathing behavior of newborns is not fully explained by the passive mechanical properties of the upper airways.

Airway Obstruction in Children with Infectious Mononucleosis

1995 ◽  
Vol 74 (9) ◽  
pp. 630-638 ◽  
Author(s):  
Daniel L. Wohl ◽  
Jon E. Isaacson
Keyword(s):  
Airway Obstruction ◽  
Infectious Mononucleosis ◽  
Epstein Barr Virus ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Clinical Severity ◽  
Prolonged Intubation ◽  
Barr Virus ◽  
Inflammatory Edema ◽  
Epstein Barr

Epstein-Barr Virus (EBV) infection generally has a benign clinical course. Upper airway obstruction is a known complication requiring the otolaryngologist's attention. EBV is usually associated with adolescence but has been increasingly documented in younger children. We review 36 pediatric admissions for infectious mononucleosis over a 12-year period at our institution, 11 of which required consultation for airway obstruction. Airway management was based on clinical severity and ranged from monitored observation, with or without nasopharyngeal stenting, to prolonged intubation or emergent tonsilloadenoidectomy. A rare case of a four-year-old with near total upper airway obstruction secondary to panpharyngeal and transglottic inflammatory edema prompted this review and is reported. The otolaryngologist must recognize the potential severity of EBV-related airway compromise and be prepared to manage it.

The effect of polysomnography on pediatric adenotonsillectomy postoperative management

2005 ◽  
Vol 132 (2) ◽  
pp. 263-270 ◽  
Author(s):  
Anthony A. Rieder ◽  
Valerie Flanary
Keyword(s):  
Length Of Stay ◽  
Airway Obstruction ◽  
Complication Rate ◽  
Chart Review ◽  
Pediatric Patients ◽  
Upper Airway ◽  
Retrospective Chart Review ◽  
Postoperative Management ◽  
Postoperative Course

OBJECTIVE: We retrospectively investigated the effect and predictability of preoperative polysomnography (PSG) on the postoperative course of younger pediatric patients undergoing adenotonsillectomy. STUDY DESIGN AND SETTING: A retrospective chart review was performed for patients 3 years of age and younger who had undergone adenotonsillectomy between July 1997 and July 2002 at the Children's Hospital of Wisconsin. RESULTS: Two hundred eighty-two patients were identified. Forty-three patients had preoperative PSG. No correlation between the severity of PSG results and postoperative course was identified. CONCLUSIONS: The role of PSG in upper airway obstruction and OSA remains controversial. This study suggests that although the complication rate may be higher in this younger population, these complications do not appear to have a large impact on their length of stay. SIGNIFICANCE: This study suggests that the 3-years-and-younger group, in the absence of other comorbidities, can safely undergo adenotonsillectomy without undergoing preoperative PSG. EBM raing: C.

scholarly journals Nasopharyngeal Tuberculosis in a Patient Presenting With Upper Airway Obstruction

2010 ◽  
Vol 25 (1) ◽  
pp. 20-22
Author(s):  
Cristina S. Nieves ◽  
Rubiliza D. Onofre ◽  
Fortuna Corazon A. Aberin-Roldan ◽  
Rene Louie C. Gutierrez
Keyword(s):  
Case Report ◽  
Airway Obstruction ◽  
Rare Case ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Government Hospital ◽  
Keywords Tuberculosis ◽  
Design Case ◽  
The Difference ◽  
Nasopharyngeal Masses

Objective:  To report a rare case of upper airway obstruction from multiple pharyngeal masses due to nasopharyngeal tuberculosis in a 22-year-old male. Methods: Design:  Case Report Setting:  Tertiary Government Hospital Patient:  One   Result: A 22-year-old Filipino male with upper airway obstruction from multiple pharyngeal masses was diagnosed to have nasopharyngeal tuberculosis by histopathology. He improved after six months of anti-tuberculosis medications. Conclusion: Tuberculosis should not be overlooked in the differential diagnoses of nasopharyngeal masses because of the difference in its management, and swift and adequate cure, compared to other nasopharyngeal pathologies. Keywords:  tuberculosis, nasopharynx, mycobacteria, hypopharyngeal mass, upper airway obstruction

scholarly journals Coexistence of Upper Airway Obstruction and Primary and Secondary Enuresis Nocturna in Children and the Effect of Surgical Treatment for the Resolution of Enuresis Nocturna

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
Gül Soylu Özler ◽  
Serkan Özler
Keyword(s):  
Airway Obstruction ◽  
Upper Airway ◽  
Strong Relationship ◽  
Upper Airway Obstruction ◽  
Etiologic Factor ◽  
Enuresis Nocturna ◽  
Improvement Rate ◽  
The Difference ◽  
Group 2 ◽  
Group 1

Objective.The aim of this study is to investigate the coexistence of upper airway obstruction (UAO) and primary enuresis nocturna (PEN) and secondary enuresis nocturna (SEN) in children. Besides, the efficacy of surgery on resolution of enuresis nocturna is evaluated.Materials and Methods.The children with PEN and SEN were included in the first group and investigated for UAO in the Department of Otorhinolaryngology. During the same period, children who had been planned for an operation to treat UAO over 5 years old were included in the second group and were evaluated in the Department of Urology for PEN and SEN before the operation.Results.A hundred patients completed the study (50 patients in Group 1, 50 patients in Group 2). According to the otolaryngologic examination, 20 of 25 PEN patients and 9 of 25 SEN patients also had UAO. The difference was statistically different (P<0.05). The second group consisted of fifty patients on the surgery list for upper airway obstructive pathologies. Coexistence of PEN and SEN is found in 12 and 3 of children, respectively. These ratios were statistically significant (P<0.05). The improvement rate of PEN and SEN after operation in the second group was 83.3% and 33.3%, respectively. The difference was statistically significant (P<0.05).Conclusion.There is a strong relationship between PEN and UAO, but it cannot be declared for SEN patients. UAO should be kept in mind as a possible etiologic factor for PEN.

scholarly journals Comparing Recurrence and Retreatment of Three Doses of Bevacizumab in Treating Severe Retinopathy of Prematurity

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Jay Chopra ◽  
Charline Boente
Keyword(s):  
Retinopathy Of Prematurity ◽  
Chart Review ◽  
Intravitreal Bevacizumab ◽  
Retrospective Chart Review ◽  
Initial Response ◽  
Slight Variation ◽  
Demographic Information ◽  
Significant Difference ◽  
Spss Software ◽  
The Difference

Purpose: To determine recurrence and retreatment patterns after treatment of severe retinopathy of Prematurity (ROP) with either 0.5 mg, 0.25 mg, or 0.125 mg of intravitreal bevacizumab for retinopathy of prematurity. Methods: In this retrospective chart review, data was examined for babies who had severe ROP and were treated with intravitreal bevacizumab doses of either 0.500 mg, 0.250 mg, or 0.125 mg at Riley Hospital for Children in Indianapolis from 2014 to 2021. Data collected included demographic information, past medical history, and characteristics of ROP. The data was statistically analyzed using SPSS software. Results: One eye was analyzed for each baby. Out of 85 babies, 79 babies were included in the study. 26 babies were treated with 0.125 mg bevacizumab, 37 with 0.25 mg, and 16 with 0.5 mg. All babies showed initial response to the bevacizumab, with 61 babies (77.2%) receiving retreatment with laser for either recurrence or persistent avascular retina. While the babies treated with lower doses had higher percentages of retreatment (23 babies (88.5%) in the 0.125 mg, 29 babies (78.4%) in the 0.25 mg, and 9 babies (56.3%) in the 0.5 mg group), the difference was not statistically significant (p=0.069). Most of the retreatments were due to recurrence of ROP (0.125 mg: 20 (87.0%), 0.25 mg: 19 (65.5%), 0.50 mg: 8 (88.9%)) (p=0.339). On average, the babies in the 0.125 mg group were retreated with laser at 3.4 weeks earlier gestational age and 4.7 weeks sooner after initial treatment than the higher dosing groups, however, this difference was not statistically significant (p=0.181, p=0.287). Conclusion: The outcomes comparing three doses of intravitreal bevacizumab for severe ROP showed a slight variation in recurrence and retreatment patterns but no statistically significant difference in our study. 

scholarly journals The Role of laryngeal ultrasound in comparison with cuff leak test in prediction of post extubation stridor

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
S W Nashed ◽  
N M Elsharnouby ◽  
M A Abdulnaiem ◽  
S M Eltaher
Keyword(s):  
Airway Obstruction ◽  
Cuff Pressure ◽  
Prolonged Mechanical Ventilation ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Leak Test ◽  
Prolonged Intubation ◽  
Cuff Leak ◽  
Air Column ◽  
Laryngeal Ultrasonography

Abstract Background Endotracheal intubation is commonly used in (ICU) for different causes. However, intubation/extubation may lead to the development of complications such as post-extubation stridor (PES), one of the most frequent causes of reintubation, prolonged mechanical ventilation, and increased morbidity in the ICU patients. PES and upper-airway obstruction are multifactorial in etiology and can occur as a result of laryngotracheal edema, intubation trauma, excessive cuff pressure with mucosal ulceration, and prolonged intubation with secondary inflammation and granuloma formation. Objective: The aim of this study was to evaluate the value of laryngeal ultrasonography versus cuff leak test in predicting post-extubation stridor. Patients and Methods Our study included fifty patients admitted to the critical care department, Misr University for Science and Technology Hospitals from the period of November 2017 to July 2018 intubated for different causes for a minimum of 24 h. excluded patients primarily intubated for the upper airway obstruction, patients with laryngeal carcinoma, Previous tracheostomy, neck radiotherapy. All patients will undergo for laryngeal ultrasonography versus cuff leak test to predict post-extubation stridor. Results In our study CLT identified PES patients with a sensitivity of 75%. But with low PPV of 50% for leakage volume of (132.5 mm ) . Laryngeal ultrasound showed a sensitivity of 50% for those patients with air column width before deflation less than 10.955 mm and ACWD 0.905 mm with PPV of 11.8% and 14.3% for air column width and ACWD respectively Conclusion Both CLT (Cuff leak test) and laryngeal US (ultrasound) might have sensitivity in predicting PES and should be used with caution in this regard.

scholarly journals Aspiration before and after Supraglottoplasty regardless of Technique

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Jeffrey C. Rastatter ◽  
James W. Schroeder ◽  
Stephen R. Hoff ◽  
Lauren D. Holinger
Keyword(s):  
Retrospective Study ◽  
Airway Obstruction ◽  
Outcome Measures ◽  
Upper Airway ◽  
Upper Airway Obstruction ◽  
Pediatric Hospital ◽  
Inclusion Criteria ◽  
Significant Difference ◽  
Before And After ◽  
New Onset

Objective. To determine the incidence of preoperative and postoperative aspiration in infants who undergo supraglottoplasty. To determine the effect of cold steel and CO2laser supraglottoplasty on aspiration in infants with severe laryngomalacia.Design. Retrospective study.Setting. Tertiary pediatric hospital.Patients. Thirty-nine patients who underwent CO2laser-assisted supraglottoplasty (CLS) or cold steel supraglottoplasty (CSS) for severe laryngomalacia.Main Outcome Measures. Aspiration and upper-airway obstruction.Results. Thirty-nine patients met inclusion criteria (18 males, 21 females). Eighteen patients underwent CSS and 21 patients underwent CLS. 10/39 (25.6%) of the patients had preoperative aspiration, and 2/10 (20%) resolved after supraglottoplasty. New onset aspiration was found in 4/13 (30.8%) in the CSS group and 9/16 (56.3%) in the CLS group.Conclusions. There is no significant difference in the rate of postoperative new-onset aspiration or relief of upper-airway obstruction in the CLS or CSS, is temporary and can be managed with thickened diet or temporary tube feedings. The rate of persistent postoperative aspiration was statistically similar regardless of the method of surgery.

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