• Proceedings of the IEEK Conference
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• 2007.07a
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• pp.279-280
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• 2007

Airway wall thickness is an important bio-marker for evaluation of pulmonary diseases such as stenosis, bronchiectasis. Nevertheless, an image-based analysis of the airway tree can provide precise and valuable airway size information, quantitative measurement of airway wall thickness in CT images involves various sources of error and uncertainty. So we have developed an accurate airway wall measurement technique for small airways with three-dimensional (3-D) approach. To illustrate performance of these techniques, we used airway phantom that consisted of 4 acryl tubes with various inner and outer diameters. Results show that evaluation of interpolation and deconvolution methods of airways in 3-D CT images, and significant improvement over the full-width-half-maximum method for measurement of not only location of the luminal and outer edge of the airway wall but airway wall thickness.

• Journal of Dental Anesthesia and Pain Medicine
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• v.23 no.4
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• pp.179-192
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• 2023

Obstructive sleep apnea (OSA) is a common sleep-breathing disorder associated with significant comorbidities and perioperative complications. This narrative review is aimed at comprehensively overviewing preoperative risk evaluation and perioperative management strategies for patients with OSA. OSA is characterized by recurrent episodes of upper airway obstruction during sleep leading to hypoxemia and arousal. Anatomical features, such as upper airway narrowing and obesity, contribute to the development of OSA. OSA can be diagnosed based on polysomnography findings, and positive airway pressure therapy is the mainstay of treatment. However, alternative therapies, such as oral appliances or upper airway surgery, can be considered for patients with intolerance. Patients with OSA face perioperative challenges due to difficult airway management, comorbidities, and effects of sedatives and analgesics. Anatomical changes, reduced upper airway muscle tone, and obesity increase the risks of airway obstruction, and difficulties in intubation and mask ventilation. OSA-related comorbidities, such as cardiovascular and respiratory disorders, further increase perioperative risks. Sedatives and opioids can exacerbate respiratory depression and compromise airway patency. Therefore, careful consideration of alternative pain management options is necessary. Although the association between OSA and postoperative mortality remains controversial, concerns exist regarding adverse outcomes in patients with OSA. Understanding the pathophysiology of OSA, implementing appropriate preoperative evaluations, and tailoring perioperative management strategies are vital to ensure patient safety and optimize surgical outcomes.

• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.43-51
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• 1998

Background： Three-dementional imaging with spiral CT(3D spiral CT) is a well established imaging modality which has been investigated in various clinical settings. However the 3D spiral CT in upper airway disease is rarely reported and its results are still obscure. Objectives： To access the usefulness of 3D spiral CT imaging in patients with upper airway diseases. Materials and Methods We performed 3D spiral CT in fourteen patients In whom upper airway diseases were clinically suspected. Nine of these patients had upper airway stenosis, two had laryngeal cartilage fracture, and three had laryngo-hypopharyngeal cancer. For evaluation of location and extent of the lesions, we compared the findings of 3D imaging with those of air tracheogram, conventional 2D CT images, endoscopic and operative findings. Results： In case of stenosis, 3D spiral CT provide significant useful information, particularly the site and length of the stenotic segment. But, it was difficult to define the fracture of the laryngeal framework and to detect the cartilagenous invasion by head and neck cancer using the 3D imaging. Conclusion : The 3D spiral CT was an useful adjunctive method to assess some kind of upper airway disease but not in others. So, we should compare the findings of 3D images with those of other diagnostic tools for accurate diagnosis of the upper airway disease.

• Journal of Dental Anesthesia and Pain Medicine
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• v.22 no.6
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• pp.457-464
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• 2022

Tracheostomy is a surgical procedure that is commonly used to treat upper airway obstruction. In particular, patients with head and neck cancer may require elective or emergency tracheostomy because of airway obstruction due to massive bleeding of the intraoral tumor mass and rapid growth of the tumor mass in the neck area. Here, we report four cases of tracheostomy in patients with head and neck cancer with narrowed airway space and difficulty in breathing. Based on these cases and a literature review, we recommend that oral and maxillofacial surgeons and dental anesthesiologists should cooperate closely and determine the appropriate timing to perform definitive airway management for such patients during palliative treatment, along with continuous evaluation of tumor location, risk of recurrence, and airway involvement.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.1
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• pp.77-78
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• 2017

• The Korean Journal of Emergency Medical Services
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• v.8 no.1
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• pp.33-45
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• 2004

The study is designed to develop an educational CD-Title for Basic Life Support. The study is conducted from July to December, 2002, Based on the course of program development suggested by Dick and Cray. the study followed the planning, development, education and evaluation of a program. The developed CD-Title consists of 8 parts. 1. Intro include Introduction, Adult CPR, Child CPR, Infant CPR, Adult Foreign-Body Airway Obstruction, Infant Foreign-Body Airway Obstruction, and Exercise in Menu at Right of screen. 2. Introduction consist of death process at cardiac arresst, chain of survival, introduction of CPR, respiratory & ciculatory anatomy and physiology. 3. Adult CPR consist of assessment responsiveness, activating EMS system, position victim, opening a airway, checking for breathing, rescue breathing, checking for sign of circulation, chest compression, 1 person & 2 persion adult CPR video. 4. Child & Infant CPR consist of, causes, assessment responsiveness, position victim, opening the airway, checking for breathing, rescue breathing, checking for sign of circulation, chest compression, activating EMS system, child & infant CPR video. 5. Adult Foreign-Body Airway Obstruction include assessment responsiveness, activating EMS system, position victim, opening a airway, checking for breathing, 2 rescue breathing, reopening the airway, 2 rescue breathing, finger sweep, 5 abdominal thrusts, unresponsiveness adult Foreign-Body Airway Obstruction video. 6. Infant Foreign-Body Airway Obstruction consist of, causes, assessment responsiveness, position victim, opening the airway, checking for breathing, 2 rescue breathing, reopening the airway, 2 rescue breathing, checking foreign-body object in oral cavity of victim, 5 back blow, 5 chest thsusts, activating EMS system, video. 7. 32 exercise consist of 8 Adult CPR, 12 Child & Infant CPR, 5 Adult Foreign-Body Airway Obstruction, 7 Infant Foreign-Body Airway Obstruction. Every part consist of animations to trigger students interests. This CD-Title will be useful education for first responders and lay rescuers.

• Tuberculosis and Respiratory Diseases
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• v.55 no.3
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• pp.239-249
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• 2003

Multi-detector row CT (MDCT) provides faster speed, longer coverage in conjunction with thin slices, improved spatial resolution, and ability to produce high quality muliplanar and three-dimensional (3D) images. MDCT has revolutionized the non-invasive evaluation of the central airways. Simultaneous display of axial, multiplanar, and 3D images raises precision and accuracy of the radiologic diagnosis of central airway disease. This article introduces central airway imaging with MDCT emphasizing on the emerging role of multiplanar and 3D reconstruction.

• Journal of Chest Surgery
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• v.23 no.3
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• pp.577-583
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• 1990

Subglottic stenosis is a disorder characterized by narrowing of the airway below the glottis. In children, the stenosis is usually due to scar formation secondary to prolonged airway intubation, rather than to external trauma. The location and extent of the stenosis are highly variable, consequently, corrective measures need to be selected to suit the individual problem. Conservative treatment is adequate for lesser degrees of stenosis but those with more severe scarring require external laryngeal surgery. We managed 2 children with subglottic stenosis due to prolonged intubation after open heart surgery who needed a resectional surgery of the stenotic upper airway. The preoperative evaluation and surgical technique for subglottic stenosis were reviewed.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.1
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• pp.79-80
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• 2017

• Archives of Plastic Surgery
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• v.48 no.1
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• pp.61-68
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• 2021

Background This study evaluated changes in nasal airway function following Le Fort I osteotomy with maxillary impaction according to the Nasal Obstruction Symptom Evaluation (NOSE) scale. Methods This cohort study included 13 patients who underwent Le Fort I osteotomy with maxillary impaction. Nasal airway function was evaluated based on the NOSE scale preoperatively and at 3 months postoperatively. The change in the NOSE score was calculated as the preoperative score minus the postoperative score. If the normality assumptions for changes in the NOSE score were not met, a nonparametric test (the Wilcoxon signed-rank test) was used. Differences in NOSE score changes according to patient characteristics and surgical factors were evaluated using the Kruskal-Wallis test and the Mann-Whitney test. Results Patients ranged in age from 18 to 29 years (mean ±standard deviation [SD], 23.00±3.87 years). Three were men and 10 were women. Eleven patients (84%) had an acquired dentofacial deformity with skeletal class III malocclusion. The preoperative NOSE scores ranged from 40 to 90 (mean±SD, 68.92±16.68), and the postoperative NOSE scores ranged from 25 to 80 (53.84±18.83). The cohort as a whole showed significant improvement in nasal airway function following maxillary impaction (P=0.028). Eleven patients (84%) had either improved (n=8) or unchanged (n=3) postoperative NOSE scores. However, nasal airway function deteriorated in two patients. Patient characteristics and surgical factors were not correlated with preoperative or postoperative NOSE scores. Conclusions Nasal airway function as evaluated using the NOSE scale improved after maxillary impaction.