• Clinics in Shoulder and Elbow
• /
• v.10 no.1
• /
• pp.136-139
• /
• 2007

Shoulder arthroscopic surgeries are an accepted technique for many shoulder disease and have many advantages over open surgeries. To date, shoulder arthroscopic surgery have been rare complications that compromise patient airway, caused by the leakage of irrigation fluid out of the shoulder joint space into the surrounding soft tissues and then the neck and the pharynx. This report presents a case of life-threatening airway obstruction due to extra-articular saline collection during arthroscopic rotator cuff repair. In concluding we should hourly check the patient's neck swelling undergoing shoulder arthroscopic surgery, because anesthetized patients cannot complain of the airway problem may progress until it becomes life-threatening.

• Journal of Veterinary Science
• /
• v.21 no.2
• /
• pp.27.1-27.10
• /
• 2020

The efficacies of a supraglottic airway device (SGAD) and an endotracheal tube (ETT) in cats under general anesthesia with volume-controlled ventilation (VCV) were compared. Thirty healthy cats were randomly allocated for airway control using either an SGAD or an ETT. Five tidal volumes (6, 8, 10, 12, and 14 mL/kg) were randomly tested, and respiratory rates were adjusted to achieve a minute ventilation of 100 mL/kg/min. The dose of propofol necessary to insert the SGAD or ETT, the static respiratory pressure, leakage during VCV, and end tidal CO₂ (ETCO₂) were recorded. Dosages of propofol and static respiratory measurements for the SGAD and ETT groups were compared using a t-test. The distribution of leakages and hypercapnia (ETCO₂ > 45 mmHg) were compared using Fisher's exact test. A significance level of p < 0.05 was established. No significant difference in dose of propofol was observed between the SGAD and ETT groups (7.1 ± 1.0, 7.3 ± 1.7 mg/kg; p = 0.55). Static resistance pressure of the SGAD (22.0 ± 8.1 cmH₂O/L/sec) was significantly lower than that of the ETT (36.6 ± 12.9 cmH₂O/L/sec; p < 0.01). Of the 75 trials, leakage was more frequent when using an SGAD (8 events) than when using an ETT (1 event; p = 0.03). Hypercapnia occurred more frequently with SGAD (18 events) than with ETT (3 events; p < 0.01). Although intubation with an ETT is the gold standard in small animal anesthesia, the use of an SGAD can reduce airway resistance and the work of breathing. Nonetheless, SGAD had more dead space and the tidal volume for VCV needs adjustment.

• The korean journal of orthodontics
• /
• v.39 no.3
• /
• pp.136-145
• /
• 2009

Objective: CBCT has become popular for orthodontic diagnosis and treatment planning in recent times. The 3D pharyngeal airway space needs to be analysed using a 3D diagnostic tool. The aim of this study was to analyse the pharyngeal airway of different craniofacial morphology using CBCT. Methods: The sample compromised 102 subjects divided into 3 groups (Class I, II, III) and 6 subgroups according to normal or vertical craniofacial patterns. All samples had CBCT (VCT, Vatech, Seoul, Korea) taken for orthodontic treatment. The pharyngeal airway was assessed according to the reference planes: aa plane (the most anterior point on the anterior arch of atlas), $CV_2$ plane, and $CV_3$ plane (most infero-anterior point on the body of the second & third cervical vertebra). The intergroup comparison was performed with one-way ANOVA and duncan test as a second step. Results: The results showed the pharyngeal airway and anteroposterior width of group 2 (Class II) in aa plane, $CV_2$ plane, $CV_3$ plane were significant narrower than in group 3 (Class III). There was no significant difference between vertical and normal craniofacial patterns except for the anteroposterior pharyngeal width of Group 1 (Class I) in aa plane. Conclusions: Subjects with Class II patterns have a significantly narrower pharyngeal airway than those with Class III. However there was no difference in pharyngeal airway between vertical and normal craniofacial morphology.

• Proceedings of The Korean Cleft Lip And Palate Association
• /
• 1997.06a
• /
• pp.26-26
• /
• 1997

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.41
• /
• pp.58.1-58.8
• /
• 2019

Background: The aim of this study is to investigate the relationship between gender-specific and obesity-related airway anatomy in patients with obstructive sleep apnea (OSA) by using cephalometric analyses. Methods: We retrospectively evaluated 206 patients with suspected OSA undergoing polysomnography and anthropometric measurements such as body mass index, neck circumference, and waist-hip ratio. We checked lateral cephalometry to measure tissue landmarks including angle from A point to nasion to B point (ANB), soft palate length (SPL), soft palate thickness (SPT), retropalatal space (RPS), retrolingual space (RLS), and mandibular plane to hyoid (MPH). Results: Male with OSA showed significantly increased SPL (P = .006) compared with controls. SPL and MPH had significant correlation with apnea-hypopnea index (AHI) and central obesity. Female with OSA showed significantly increased ANB (P = .013) and SPT (P = .004) compared with controls. The receiver operating characteristic curves revealed that SPT in male and ANB and SPT in female were significant in model 1 (AHI ≥ 5) and model 2 (AHI ≥ 15). MPH was also significant for male in model 2. Conclusion: Male and female with OSA had distinct anatomic features of the upper airway and different interactions among soft palate, mandible, and hyoid bone.

• The korean journal of orthodontics
• /
• v.50 no.2
• /
• pp.129-135
• /
• 2020

Objective: This study aimed to evaluate the immediate effects of mandibular posterior displacement on the pharyngeal airway space (PAS) by using cephalometric evaluations and to investigate how the surrounding structures are schematically involved. Methods: In this retrospective study, 38 subjects with functional Class III malocclusion and two lateral cephalograms were selected. The first lateral cephalogram was taken with the mandible in the habitual occlusal position, and the second in anterior edge-to-edge bite. Paired t-test was used to analyze changes in the PAS, hyoid bone, tongue, and soft palate, followed by mandibular posterior displacement. Pearson's correlation analysis was used to determine the relationship between the amount of mandibular posterior displacement and other variables. Results: A statistically significant decrease was observed in the PAS following mandibular posterior displacement. Along with mandibular posterior displacement, the tongue decreased in length (p < 0.001) and increased in height (p < 0.05), while the soft palate increased in length, decreased in thickness, and was posteriorly displaced (p < 0.001). The hyoid bone was also posteriorly displaced (p < 0.05). There was no correlation between the amount of mandibular posterior displacement and the measured variables. Conclusions: The PAS showed a statistically significant decrease following mandibular posterior displacement, which was a consequence of retraction of the surrounding structures. However, there were individual variances between the amount of mandibular posterior displacement and the measured variables.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.25 no.2
• /
• pp.96-98
• /
• 2014

Injection laryngoplasty is simple and useful procedure in patient with vocal cord paralysis even under local anesthesia. For approaching vocal cord level, flexibility of neck mobility is required to operate injection laryngoplasty but it is relatively difficult to approach vocal cord in patient who has cervical fixations. Laryngeal mask airway (LMA) can be helpful:We use a LMA (I-gel$^{TM}$) during intubation without neck extension on flat supine position under general anesthesia and have a good operation filed. LMA with swivel connector give surgeons better surgical vision and make insertion of fibroscope easily during operation. Hyaluronic acid injection was done use needle (25 G, 5 cm) via percutaneous cricothyroid space : This procedure can be useful method for patients who suffer from not only weak voice but also dysphagia and aspiration high vagal palsy patient after spine surgery or uncooperative with awake injection laryngoplasty.

• The korean journal of orthodontics
• /
• v.39 no.2
• /
• pp.72-82
• /
• 2009

Objective: The purpose of this study was to investigate the structural changes of the hyoid bone and upper airway after orthognathic surgery for skeletal class III anterior open bite patients, and make comparisons with normal occlusion. Methods: Pre- and post-operative computed tomography (CT) examinations were performed on 12 skeletal class III anterior open bite patients who were treated with mandibular setback osteotomy. Using the V-works $4.0^{TM}$ program, 3-dimensional images of the total skull, mandible, hyoid bone, and upper airway were evaluated. Results: In the Class III open bite group, the hyoid bone were all positioned anteriorly, compared to the Normal group (p < 0.05). The angle between the hyoid plane and mandibular plane in the Class III openbite group before surgery was greater than in the Normal group (p < 0.05), and the difference increased after surgery (p < 0.01). In the Class III openbite group, the volume of the upper airway decreased after surgery (p < 0.001) and the volume of the upper airway was smaller than the Normal group before and after surgery (p < 0.001). Conclusions: The narrow upper airway space in skeletal Class III openbite patients decreased after mandibular setback osteotomy. This may affect the post-surgical stability.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.28 no.1
• /
• pp.52-54
• /
• 2017

Vocal polyps are benign laryngeal lesions which arise from the Reinke's space abd hoarseness is the most common symptom. However, airway compromised is rarely presented in the vocal polyp. A rare case of large subglottic polyp causing dyspnea is reported. Tracheostomy was performed under local anesthesia and then the mass was resected under general anesthesia using a laryngofissure approach. The dyspnea and hoarseness disappeared after surgery immediately. The histopathological findings indicated a diagnosis of vocal cord polyp with chronic inflammatiuon. We consider that tracheostomy is the safest and most useful procedure to guarantee the upper airway in cases of large vocal polyp showing dyspnea. We hereby report a case of huge subglottic polyp in which a tracheostomy and laryngofissure was required for removing the subglottic mass successfully.

• Clinical and Experimental Pediatrics
• /
• v.63 no.1
• /
• pp.3-7
• /
• 2020

High-flow nasal cannula (HFNC) is a relatively safe and effective noninvasive ventilation method that was recently accepted as a treatment option for acute respiratory support before endotracheal intubation or invasive ventilation. The action mechanism of HFNC includes a decrease in nasopharyngeal resistance, washout of dead space, reduction in inflow of ambient air, and an increase in airway pressure. In preterm infants, HFNC can be used to prevent reintubation and initial noninvasive respiratory support after birth. In children, flow level adjustments are crucial considering their maximal efficacy and complications. Randomized controlled studies suggest that HFNC can be used in cases of moderate to severe bronchiolitis upon initial low-flow oxygen failure. HFNC can also reduce intubation and mechanical ventilation in children with respiratory failure. Several observational studies have shown that HFNC can be beneficial in acute asthma and other respiratory distress. Multicenter randomized studies are warranted to determine the feasibility and adherence of HFNC and continuous positive airway pressure in pediatric intensive care units. The development of clinical guidelines for HFNC, including flow settings, indications, and contraindications, device management, efficacy identification, and safety issues are needed, particularly in children.