• Title/Summary/Keyword: Airway space

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Pharyngeal Airway Dimensions in Skeletal Class II Young Adolescents : Cephalometric Study (측모두부 방사선사진을 이용한 골격성 II급 부정교합 청소년의 성장 단계별 상기도부의 계측 분석)

  • Cheon, Minkyoung;Yang, Sunmi;Kim, Jaehwan;Kim, Seonmi;Choi, Namki
    • Journal of the korean academy of Pediatric Dentistry
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    • v.45 no.1
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    • pp.98-108
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    • 2018
  • This study aimed to evaluate the nasopharyngeal and oropharyngeal dimensions of the patients with skeletal class II division 1 or division 2 patterns during the pre-peak, peak, and post-peak growth periods for comparison with a skeletal class I control group (79 for pre-peak, 40 for peak, 40 for post-peak). Total 159 lateral cephalograms (70 for skeletal class I, 51 for skeletal class II, division 1, and 38 for skeletal class II, division 2) were selected. The growth of anteroposterior dimension of the pharyngeal airway were statistically significant among growth periods. The dimension for the nasopharyngeal and oropharyngeal airway space was the smallest in the division 1 skeletal class II group followed by class II division 2 and skeletal class I.

Retropharyngeal space abscess due to spread of odontogenic infection: two cases report (치성감염의 확산으로 인한 후인두간극농양: 증례보고)

  • Jung, Tae-Young;Chae, Byung-Moo;Jeong, Yong-Seon;Park, Sang-Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.4
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    • pp.314-319
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    • 2010
  • Odontogenic infections are a normally locally confined, self-limiting process that is easily treated by antibiotic therapy and local surgical treatment. However, it may spread into the surrounding tissues through a perforation of the bone, and into contiguous fascial spaces or planes like the primary or secondary fascial spaces. If the infection extends widely, it may spread into the lateral pharyngeal and retropharyngeal space. The retropharyngeal space is located posterior to the pharynx. If an odontogenic infection spreads into this space, severe life-threatening complications will occur, such as airway obstruction, mediastinitis, pericarditis, pleurisy, pulmonary abscess, aspiration pneumonia and hematogenous dissemination to the distant organs. The mortality rate of mediastinitis ranges from 35% to 50%. Therefore, a rapid evaluation and treatment are essential for treating retropharyngeal space abscesses and preventing severe complications. Recently, we encountered two cases of a retropharyngeal space abscess due to the spread of an odontogenic infection. In all patients, early diagnosis was performed by computed tomography scanning and a physical examination. All patients were treated successfully by extensive surgical and antibiotic therapy.

TREATMENT OF FASCIAL SPACE ABSCESS IN THE OROMAXILLOFACIAL REGION WITH INTRACANAL DRAINAGE (두경부악안면 근막극 농양 환아에 있어서 근관내 배농을 통한 치료)

  • Park, Jae-Oh;Yang, Kyu-Ho
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.4
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    • pp.623-629
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    • 1999
  • The definition of fascial spaces are latent spaces between fascial planes. If infections which spread from dental origin to soft tissue are mild, they are restricted by fascial planes. But, when infections are severe, fascial spaces are often used as a natural pathway which spread to the deep cervical region. If they are not treated at early stage, they may result in the fatal complications as followings; airway obstruction, septicemia, cerebral abscess, and thrombophlebitis etc. The early treatment of fascial space abscess is very important for young children. These case reports present the successful result of fascial space abscess treatment through intracanal drainage without surgical excision. It is proven that the treatment through intracanal drainage has some benefits to the surgical excision, which are as follows: 1) It is economic to the patients or their parents avoiding admission. 2) The treatment procedure is more simple. 3) Childrens can avoid the fearful environment.

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Electron Microscopic Changes in the Epithelial Damage Of the Maxillary Mucosa Induced by Platelet Activating Factor (혈소판 활성인자에 의한 상악동 점막상피의 손상에 대한 전자현미경적 변화)

  • 정필섭
    • Korean Journal of Bronchoesophagology
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    • v.4 no.2
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    • pp.182-187
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    • 1998
  • Platelet activating factor (PAP) has been known as implicating as one of potent inflammatory mediators and reported 0 be involved in inflammation and allergy. PAF induces ciliary dysfunction and epithelial damage of human paranasal sinus mucosa in vitro. However, several recent papers have reported that PAF may not readily damage the airway epithelium. The aim of this study was to investigate the ultrastructural evidence to elucidate the pathogenesis of epithelial damage induced by PAF. Sixteen $\mu\textrm{g}$ g of PAF was applied into the maxillary sinuses of 6 rabbits. Rabbits were divided into 2 subgroups along with time interval at 1st and 3rd experimental day, and sinus mucosae were taken for the histopathologic study using electron microscopy. At 1st day, epithelial cells showed no ultrastructural change. Ultrastructures of the cilia were well preserved. Subepithelial space showed no evidence of the infiltration of inflammatory cells. Intravascular platelet aggregation and swelling of endothelial cells were evident. At 3rd day, epithelial cells showed vacuolar degeneration. Fusion of cilia forming giant cilia and focal loss of cilia were evident. Eosinophils were infiltrated in subepithelial and intraepithelial space. Swelling of endothelial cells, and migration of inflammatory cells into the connective tissue were evident. This study implies that epithelial damage induced by PAF may be secondary to the cytotoxicity of mobilized eosinophils rather than direct cytotoxicity of PAF.

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Nasotracheal intubation in pediatrics: a narrative review

  • Jieun Kim;Sooyoung Jeon
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.24 no.2
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    • pp.81-90
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    • 2024
  • Nasotracheal intubation (NTI) plays an important role in pediatric airway management, offering advantages in specific situations, such as oral and maxillofacial surgery and situations requiring stable tube positioning. However, compared to adults, NTI in children presents unique challenges owing to anatomical differences and limited space. This limited space, in combination with a large tongue and short mandible, along with large tonsils and adenoids, can complicate intubation. Owing to the short tracheal length in pediatric patients, it is crucial to place the tube at the correct depth to prevent it from being displaced due to neck movements, and causing injury to the glottis. The equipment used for NTI includes different tube types, direct laryngoscopy vs. video laryngoscopy, and fiberoptic bronchoscopy. Considering pediatric anatomy, the advantages of video laryngoscopy have been questioned. Studies comparing different techniques have provided insights into their efficacy. Determining the appropriate size and depth of nasotracheal tubes for pediatric patients remains a challenge. Various formulas based on age, weight, and height have been explored, including the recommendation of depth-mark-based NTI. This review provides a comprehensive overview of NTI in pediatric patients, including the relevant anatomy, equipment, clinical judgment, and possible complications.

THE RETROSPECTIVE STUDY OF INTRAFASCIAL INFECTION FROM ODONTOGENIC INFECTION IN ORAL AND MAXILLOFACIAL REGION (구강악안면영역의 치성감염으로 인한 근막간극 감염에 대한 회귀적 연구)

  • Kim, Sung-Hyuck;Lee, Jae-Hoon
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.1
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    • pp.42-49
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    • 2007
  • Infections in oral and maxillofacial region are relativley common and self-limiting, but in some cases, infections spread to adjacent hard and soft tissue and to cause any complication, even threaten life. So we made retrospective study of patients with interfascial infection who had been hospitalized and been treated by surgical treatment in Dankook university about 10 years. We reviewed the charts of patient with interfascial infection from 1995 to 2005. The result were as follows: 1. In gender & age distribution, male(54.2%) & fouth decade were most frequently. 2. The most common cause of infection was dental caries(55.2%) and the most of involving teeth was lower posterior teeth(44.1%). 3. Submandibular space is most frequently involving space and most infection involved mainly one space. 4. The patients with systemic disease were 38.2%. Diabetic mellitus was 87.2% of systemic diease. The admission period was 19.5 days in systemic disease. 5. The most microorganism in culture was Streptococcus Viridans(36.2%) in all patient. Klebsiella Pneumoniae was found most in Diabetic Mellitus. 6. The patient were mainly treated I&D on admission day. Of them 5(1.1%) patients were received tracheostomy. 7. Serum albumin, CRP and body weight are associated with Nutritional Risk Index(NRI). High risk patient group according to NRI classification showed higher rate of complications & mortality. 8. The patients with complication were 28(6.7%) persons. 4(0.9%) patients were expired. Nutritional Risk Index was helpful to predict the prognosis. When interfascial infection starts to spread, we must pay attention to airway management. Fluid therapy with nutritional may support to healing of wound.

Comparison of Respiratory Mechanics and Gas Exchange Between Pressure-controlled and Volume-controlled Ventilation (압력조절환기법과 용적조절환기법의 호흡역학 몇 가스교환의 비교)

  • Jeong, Seong-Han;Choi, Won-Jun;Lee, Jung-A;Kim, Jin-A;Lee, Mun-Woo;Shin, Hyoung-Shik;Kim, Mi-Kyeong;Choe, Kang-Hyeon
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.5
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    • pp.662-673
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    • 1999
  • Background : Pressure-controlled ventilation (PCV) is frequently used recently as the initial mode of mechanical ventilation in the patients with respiratory failure. Theoretically, because of its high initial inspiratory flow, pressure-controlled ventilation has lower peak inspiratory pressure and improved gas exchange than volume-controlled ventilation (VCV). But the data from previous studies showed controversial results about the gas exchange. Moreover, the comparison study between PCV and VCV with various inspiration : expiration time ratios (I : E ratios) is rare. So this study was performed to compare the respiratory mechanics and gas exchange between PCV and VCV with various I : E raitos. Methods : Nine patients receiving mechanical ventilation for respiratory failure were enrolled. They were ventilated by both PCV and VCV with various I : E ratios (1 : 2, 1 : 1.3 and 1.7 : 1). $FiO_2$, tidal volume, respiratory rate and external positive end-expiratory pressure (PEEP) were kept constant throughout the study. After 20 minutes of each ventilation mode, arterial blood gas, airway pressures, expired $CO_2$ were measured. Results : In both PCV and VCV, as the I : E ratio increased, the mean airway pressure was increased, and $PaCO_2$ and physiologic dead space fraction were decreased. But P(A-a)$O_2$ was not changed. In all three different I : E ratios, peak inspiratory pressure was lower during PCV, and mean airway pressure was higher during PCV. But $PaCO_2$ level, physiologic dead space fraction and P(A-a)$O_2$ were not different between PCV and VCV with three different I : E ratios. Conclusion : There was no difference in gas exchange between PCV and VCV under the same tidal volume, frequency and I : E ratio.

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THE PROBLEMS OF EXPANDABLE METALLIC STENT FOR THE TREATMENT OF SUBGLOTTIC TRACHEAL AND TRACHEOSTOMAL STENOSIS (성문하 기관 및 기관누공 협착증에 대한 팽창성 금속 스텐트의 문제점)

  • 홍기환;정경호;김중호;한영민
    • Korean Journal of Bronchoesophagology
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    • v.2 no.2
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    • pp.213-221
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    • 1996
  • To evaluate the clinical effectiveness of expandable metallic stents, the stents were implanted under endoscopic guidance with local anesthesia or general anesthesia for maintenance of the constructed subglottic space of trachea. The nine patients with respiration difficulty were subjected for expandable stents. The stenosis of upper airway were due to the framework problem of subglottic trachea and tracheostoma after total laryngectomy. Stents were constructed of 0.4 m stainless steel win in a zigzag configuration of 8 bends. A single stent was 20 m in diameter when fully expanded and 20 mm long. The stents were placed accurately to the stenotic site and followed to the 5 month after stent placement. The stenotic area became narrowed with overgrowing of granuloma in all patients and the metallic stents were removed and the stenotic area reconstructed surgically. As conclusion, this technique for the treatment of the subglottic trachea showed simple and safe, but highly recurred due to overgrowing of granuloma. We suggest that the expandable metallic stent is not encouraging in this study.

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Management of obstructive sleep apnea in a Treacher Collins syndrome patient using distraction osteogenesis of the mandible

  • Damlar, Ibrahim;Altan, Ahmet;Turgay, Berk;Kilic, Soydan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.6
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    • pp.388-392
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    • 2016
  • In this study, we present the surgical treatment of obstructive sleep apnea in a child with Treacher Collins syndrome. A 10-year-old girl with a past history of Treacher Collins syndrome presented to our clinic with her parents for respiratory distress and insomnia. The patient was referred to a sleep laboratory where she was diagnosed with obstructive sleep apnea, which was a consequence of her Treacher Collins syndrome. The patient underwent mandibular distraction osteogenesis under general anesthesia. The mandible was expanded by 15 mm using internal bilateral distractors. After distraction osteogenesis, the patient's respiratory problems resolved, and she was able to sleep comfortably. Distraction osteogenesis was an effective method of advancing the mandible, increasing the upper airway space and ultimately preventing obstructive sleep apnea syndrome in patients with Treacher Collins syndrome.

A Case of Tracheostomy Cannula Inserted in the Trachea for 10 Years (10년간 기관에 삽관되어 있었던 기관 절개관 1례)

  • 김중환;오경균;정완교;이상기;김정배;길동석;서정하
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1983.05a
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    • pp.5.4-6
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    • 1983
  • A tracheostomy is performed to relieve an upper airway obstruction, to facilitate bronchial toilet, to decrease dead space, to assist ventilation and as an elective procedure in head and neck surgery. Many complications are associated with tracheostomy, both in the actual performance of the operation and in the postoperative management. Recently the authors report one case ; a two years old children got a severe burn on face and neck and received tracheostomy and have carried tracheostomy cannula for 10 years, at last the cannula was worn out and the 12 years old boy came to the hospital.

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