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Tracheostomy
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
Tracheotomy refers to a surgical opening in the trachea. It is used to bypass the upper (pharyngeal and laryngeal) airway and to permit air entry into the trachea and bronchi. When the opening has formed a mature track from the tracheal lumen to the skin of the neck (i.e. it includes a ‘stoma’), this is a tracheostomy, but the terms are used interchangeably. Tracheotomy in children may be lifesaving.
Data and Picture Interpretation Stations: Cases 1–45
Published in Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar, ENT OSCEs, 2023
Peter Kullar, Joseph Manjaly, Livy Kenyon, Joseph Manjaly, Peter Kullar, Joseph Manjaly, Peter Kullar
A tracheostomy is a surgical procedure whereby an opening is made in the anterior trachea in order to facilitate ventilation. Emergency tracheostomy is undertaken in the context of acute airway obstruction e.g. foreign body aspiration, Ludwig angina, obstructive laryngeal cancer, or where endotracheal intubation is not possible. Indications for elective tracheostomy include ventilatory wean, as a part of head and neck cancer treatment, subglottic stenosis and chronic aspiration. Early complications include bleeding, infection and pneumothorax. Late complications include subglottic stenosis and tracheoinnominate fistula (a rare but potentially life-threatening complication that presents with significant bleeding).
Upper Airway Obstruction and Tracheostomy
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Effects of tracheostomy: Laryngeal bypass – loss of cough and phonationReduction in respiratory dead spaceLoss of nasal mucosa filtration and humidificationIncreased risk of infectionTube acts as foreign body leading to local inflammation
Successful decannulation of patients with traumatic spinal cord injury: A scoping review
Published in The Journal of Spinal Cord Medicine, 2022
Gordon H. Sun, Stephanie W. Chen, Mark P. MacEachern, Jing Wang
Scoping reviews are a newer type of systematic review used to reconnoiter and summarize the key concepts and range of evidence, providing insight into the volume, methodology, and knowledge gaps pertaining to a topic of interest, often guiding the direction of future research.20 As such, scoping reviews are generally used in cases in which the existing body of research has either not been comprehensively reviewed or is too complex or heterogenous for a targeted systematic review.21 The objective of this review is to identify and summarize the published literature on the clinical outcomes of SCI patients who undergo decannulation, outlining overall understanding of the decision-making process behind decannulation in this patient population, publication trends, and commonly used definitions and outcome metrics. For the purpose of this review, the term “tracheostomy” will be used instead of “tracheotomy,” reflecting the terminology used by the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) consensus statement.
Tracheotomy as a predictor of remission and demise for juvenile-onset recurrent respiratory papillomatosis
Published in Acta Oto-Laryngologica, 2022
Zijie Niu, Yang Xiao, Lijing Ma, Xiaoli Qu, Yuge Wang, Sihan Zhou, Jun Wang
The disease often appears in the vocal cords, false vocal cords, epiglottic larynx, and subglottis. The main clinical manifestation is hoarseness. If papillomas obstruct the airway seriously, it could cause dyspnea and even threaten children’s life. The laryngeal cavity of young children is narrow, which increases the probability of dyspnea. Tracheotomy is a classic treatment to keep the airway adequate in emergency and enhance the safety during the operation [2]. Nonetheless, tracheotomy disrupts airway mucosa, which will increase the squamo-columnar junction, provide a site suitable for seeding of virus particles and papillomas, and even promote lower airway dissemination of papillomas [3,4]. The pros and cons of tracheotomy seem to be recognized, and it has become an accepted view that tracheotomy should be avoided in patients with JORRP and every effort should be made to remove the tracheal cannula when it is unavoidable [5]. Although it has been reported that tracheotomy may be associated with poor prognosis [6], there is relatively limited information assessing the exact impact of tracheotomy on prognosis for JORRP.
Relapsing polychondritis: state-of-the-art review with three case presentations
Published in Postgraduate Medicine, 2021
Bogna Grygiel-Górniak, Hamza Tariq, Jacob Mitchell, Azad Mohammed, Włodzimierz Samborski
Case 3: Case 3: A 38-year-old woman diagnosed with RPC in 2011 was admitted to Rheumatology Clinic. She had been diagnosed with immune thrombocytopenia (ITP) and systemic lupus with class III lupus nephropathy. RPC’s first symptoms started 1 year before hospital admission, and she complained of hoarseness of voice, nonproductive cough, dyspnea, stridor, wheezing, and polyarticular arthritis. Magnetic resonance of the neck showed stenosis of the larynx in the subglottic region. A diagnostic and therapeutic tracheotomy was successfully implemented. The histopathological examination of the trachea showed inflammatory changes without signs of neoplastic infiltration. She was diagnosed with RPC, and glucocorticosteroids (GCs – methylprednisolone 12 mg orally QD) with azathioprine (50 mg BID) were implemented. A year later, azathioprine was replaced with methotrexate (10 mg once a week with increased dose till 20 mg once a week) due to its ineffectiveness. The patient was hospitalized several times at the Otolaryngology Department to dilate the stenotic trachea with methylprednisolone’s local injections. The symptoms intensified in 2014 with increased hoarseness, costochondritis, scleritis of the left eye, recurrent swelling, and pain in the left auricle. She complained of extraocular muscle pain and inflammation. An ophthalmologist diagnosed the patient with scleritis in the left eye’s anterior and posterior segments.