• Title/Summary/Keyword: Upper Airway

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Desflurane Inhalation Provide Cardiovascular Stability During Intubation but Prevention of Rocuronium Injection Pain

  • Ko, Hyun-Min;Hong, Hun-Pyo;Yoon, Ji-Young;Yoon, Ji-Uk;Lee, Do-Won;Kim, Cheul-Hong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.13 no.3
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    • pp.117-120
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    • 2013
  • Background: Desflurane has very short induction time because its physical characteristics. But its pungent odor and tendency to irritate the upper airway make it unsuitable for induction of anesthesia. This study was performed to determine what time is prefer to start the desflurane inhalation. Methods: Forty adults (17-45 years) were enrolled in a randomized, double-blind study. Twenty start desflurane inhalation just after loss of consciousness, and the others received desflurane after intubation. We monitored vital signs, BIS, desflurane concentration, rocuronium injection pain response, and airway irritation signs. Results: The demographic data were not different two groups. Early inhalation group showed more stable cardiovascular response than that of late inhalation group. But rocuronium injection pain response and airway irritation sings were not different between two groups. Conclusions: Early inhalation of desflurane (6 vol%) just after loss of consciousness attenuates cardiovascular responses during intubation.

A Longitudinal Study of the Growth Changes on Nasopharynx and Adenoid of the Korean with Normal Occlusion (정상 교합자의 비인두와 Adenoid 성장에 관한 누년적 연구)

  • JI, Myung-Ju;Park, Kyung-Duk;Sung, Jae-Hyun
    • The korean journal of orthodontics
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    • v.26 no.4
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    • pp.373-387
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    • 1996
  • The purpose of this study was to evaluate the growth pattern of nasopharyx and adenoid and to obtain useful measurements for evaluating the fuction of the nasal breathing. The biennial serial cephalometric radiographs of 33 samples(19 male, 14 female) with normal occlusion from 8.5 years to 18.5 years of age were used in this study. The distances, areas and ratios on nasopharynx and adenoid were measured and analyzed in each age and sex. The results of this study might be summarized as follows ; 1. The mean value and standard deviation of each measurement was obtained in each age and sex. 2. The nasopharyngeal height and the nasopharyngeal depth increased significantly by 14.5 years of age in male and 12.5 years of age in female(p<0,05), 3. The relative nasal airway area showed the minimal value at 8.5 years of age and showed significant increase from 10.5 years to 12.5 years of age in male and from 12.5 years to 14,5 years of age in female(p<0.05). 4. In the correlation analysis between the measurements on the nasal airway and the measurement of relative nasal airway area, the measurements of Ad2-PNS, Ad2-PNS/Ho'-PNS and Upper pharynx appeared singnificant correlation with the measurement of relative nasal airway area(p<0.01).

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A Case of Bronchial Obstruction due to Occult Aspiration of a Tooth (치아흡인에 의한 기관지 폐쇄 1예)

  • Chang, Jung-Hyun;Kim, Se-Kyu;Chung, Kyung-Young;Min, Dong-Won;Shin, Dong-Hwan;Lee, Hong-Leoyl;Kim, Sung-Kyu;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.40 no.4
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    • pp.442-448
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    • 1993
  • Foreign body aspiration, although not an uncommon problem in children, is unusual in adults and is overlooked as a cause of airway obstruction. Small foreign bodies that lodge in the peripheral airway are often asymptomatic initially and can result in respiratory symptoms several years later. Especially in the cases of otherwise healthy subjects, even though manifested overt respiratory symptoms, diagnosis can be delayed due to lack of history of aspiration or unnoticed aspiration. A 57-year-old male was admitted to Yonsei University College of Medicine Severance hospital due to left upper chest pain for five months. on the past history he had been diagnosed as bronchiectasis about 20 years ago. He showed radiologically bead-like bronchostenosis and a calcific density protruding into the lumen of left upper lobar bronchus. Bronchoscopically broncholith was revealed with the finding of endobronchial obstruction of each upper and lingular division of left upper lobar bronchus due to mucoid impaction and surrounding inflammed bronchial mucosa. The preoperative diagnosis was broncholithiasis due to chronic inflammatory process. Lung perfusion scan shows absence of perfusion in left upper lobe. So left upper lobectomy was performed. But from the pathologic specimen an incisor tooth was emerged. Later a history of tooth extraction thirty years ago at dental clinic was found. We report a case of bronchial obstruction due to occult aspiration of a tooth with a review of the literatures.

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A CEPHALOMETRIC STUDY ON THE AIRWAY SIZE ACCORDING TO THE TYPES OF THE MALOCCLUSION (부정교합 유형에 따른 기도의 크기)

  • Lee, Yong-Seung;Kim, Jong-Chul
    • The korean journal of orthodontics
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    • v.25 no.1 s.48
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    • pp.19-29
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    • 1995
  • This study was performed to compare the size of soft palate, tongue and airway according to the types of the malocclusion and evaluate the correlation between the size of soft palate, tongue, airway and dentofacial skeleton respectively. The sample of this study was 98 malocclusion female patients between the ages 12 and 17 years. The lateral cephalometric radiographs were taken and the distance, angle, ratio and area of the dentofacial skeleton, soft palate, tongue and airway were measured and evaluated statistically. The results obtained were as follows: 1. There was significant difference in SNB, ANB, facial angle, facial convexity, A-B plane angel, Y axis to FH, SN-MP, Wits appraisal, ODI and APDI according to the types of malocclusion. 2. The hyoid bone was more posteriorly positioned in Class II malocclusion group than other two groups and superio-inferior position of the hyoid bone was not different according to the malocclusion types. 3. The nasopharyngeal area of Class II and Class III malocclusion group was smaller than that of Class I malocclusion group, and the pharyngeal area of Class II malocclusion group was smaller than that of Class I and Class III maocclusion group. There was no difference of the area of the soft palate, tongue, oropharynx and hypopharynx according to malocclusion types. 4. The ramal height and mandibular body length(Go-Me) showed positive correlation with the area of tongue, nasopharynx, oropharynx, and pharynx. SNA did not correlated with the area of tongue and airway but SNB showed positive correlation with the area of hypopharynx and pharynx. The anterior, posterior facial height, upper and lower central incisor position to facial plane showed positive correlation with tongue area.

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Sleep-Disordered Breathing in Children (소아에서의 수면호흡장애)

  • Shin, Chol
    • Sleep Medicine and Psychophysiology
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    • v.10 no.2
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    • pp.88-92
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    • 2003
  • Sleep-disordered breathing (SDB), including snoring, sleep apnea and upper airway resistance syndrome are common problems in children. The pathophysiological mechanism of SDB in children is unclear but may include hypoxemia and changes in sleep architecture. Children with SDB show reduced neurocognitive function, and memory and attentional capacity. Furthermore, these children show increased problematic behaviour and reduced school performance. Whether early recognition and treatment of SDB in children may improve neurocognitive function and school performance remains to be fully evaluated in the future.

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Airway Expandible Metallic Stent Implantation in Children with Tracheal or Bronchial Stenosis (기관 또는 기관지 협착을 가진 소아에서의 스텐트 적용)

  • Jang, Ju Young;Kim, Hyo-Bin;Lee, So Yeon;Kim, Ja Hyung;Park, Seong Jong;Shin, Ji Hoon;Hong, Soo-Jong
    • Clinical and Experimental Pediatrics
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    • v.48 no.5
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    • pp.512-517
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    • 2005
  • Purpose : In adults, endoscopic tracheobronchial balloon dilatation and stenting have become valuable methods to establish and maintain an adequate airway lumen when tracheomalacia or neoplastic growth compromise the airways. But in children, only a few cases were reported due to technical problems. We report six children who were treated with stent implantation and describe the use and safety of airway stents. Methods : Six patients with severe airway obstruction were treated. We investigated the underlying medical problems, stenotic site, symptomatic improvement and complications, and the size and location of stent. Results : The median age of the six patients was 21 months. Three of them were mechanically ventilated and one had an endotracheal tube to maintain the patency of airway. Diagnoses were : congenital tracheal stenosis with or without bronchomalacia, granulation tissue formation after right upper lobectomy by bronchial carcinoid or after prolonged intubation, endobronchial tuberculosis, and airway compression by mediastinal undifferentiated sarcoma. Nitinol stents were implanted in the airway guided by bronchoscopy and fluoroscopy simultaneously. Three cases were placed in trachea, the others were in the bronchus. After stent implantation, all patients showed marked improvements of their airway obstructive symptoms. Four patients are doing well, although two expired due to underlying diseases. Four patients had granulation tissue formation around stents, but that was tolerable after removing the stent. Conclusion : We suggest that the use of expandible metallic stent implantation can offer safe therapeutic option even in extremely severe, life threatening and inoperable airway stenosis in children.

Bronchial Atresia with Collapse of the Right Upper Lobe -A Case Report (우상엽의 허탈을 동반한 기관지 폐쇄증 -1례 보고)

  • 김성호;장인석
    • Journal of Chest Surgery
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    • v.30 no.8
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    • pp.843-846
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    • 1997
  • Congenital bronchial atresia is one of the rare bronchopulmonary anomalies which is thought to be caused by a vascular insult of uncertain timing during fefal development. It is defined as an anomaly which does not have communication between a segmental or lobar bronchus a'nd the main airway. Because of the collateral ventilation, almost all of these cases show hyperlucency of the involved segment or lobe in chest roentgenogram. We report an extremely rare case of congenita bronchial atresia with collapse of the right upper lobe which was treated by surgical resection.

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Extranodal NK/T cell Lymphoma, nasal type: clinical, radiological, histological features for early diagnosis (원발성 비성 NK/T 세포 림프종: 조기 진단을 위한 임상적, 방사선학적, 조직학적 특징)

  • Park, Kyung-Ran;Han, Seon-Hee;Kim, Hyun-Sil;Lee, Seung-Jun;Cha, In-Ho;Kim, Hyung-Jun
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.36 no.6
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    • pp.497-501
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    • 2010
  • Primary nasal type natural killer (NK)/T cell (NKTC) lymphoma, a specific form of malignant lymphoma, has a higher geographic incidence in Oriental, Mexican, and South American populations than the Western population. In Koreans, it comprises 9-12% of all cases of non-Hodgkin's lymphoma. This type of lymphoma has also been named as angiocentic lymphoma and lethal midline granuloma because the most common site is the upper airway area and its clinical aggressiveness presents with a necrotic and destructive pattern. NKTC lymphoma can also be detected in different organs (testis, spleen, parotid gland, skin, gastroinstinal tract, central nervous system, lungs, bone marrow, etc.) other than the upper airway including the oral cavity. The lymphoma detected in the oral cavity shows various destructive and inflammatory changes, similar to the signs of inflammation and infection from periodontitis and pulpal disease, making a diagnosis difficult with just the clinical signs. For early detection, clinical, radiological, and pathological examinations are required. This report describes the clinical, radiological and histological characteristics with a case report for the early detection of NKTC lymphoma in the oral cavity.

Case of making maxillary palatal augmentation complete denture for patient with dysphagia after partial glossectomy (부분 혀 절제술로 인해 연하 장애가 있는 환자에서 상악 구개 증대 총의치 제작 증례)

  • Kim, Hyung-Seok;Park, Ji-Young;Yim, Sun-Young;Heo, Yu-Ri;Son, Mee-Kyoung
    • Journal of Dental Rehabilitation and Applied Science
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    • v.34 no.3
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    • pp.239-245
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    • 2018
  • If complication arises after glossectomy which leads to trouble in forming food bolus or transfer of the food, it is possible that either food bolus may block the airway or dysphagia may occur as the food bolus goes down into the airway. To solve the issue, palatal augmentation prosthesis could be used. In this case, the patient with an oral cancer is having difficulties swallowing food after glossectomy. Through taking impressions of polishing surface of his denture referring his tongue movement, the complete denture for the upper jaw was created using the concept of palatal augmentation prosthesis. This new upper denture increases the palatal-tongue contact pressure, allowing the patient to perform better swallowing and better pronunciation.

A Case of Life-Threatening Arteriovenous Malformation Treated with Transcutaneous Embolization (경피적 색전술로 치료한 치명적 동정맥기형)

  • Choi Eun-Chang;Kim Eun-Seo;Kim Shi-Chan;Kim Young-Ho;Kim Dong-Ik
    • Korean Journal of Head & Neck Oncology
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    • v.12 no.2
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    • pp.224-229
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    • 1996
  • Head and neck arteriovenous malformation usually forms huge mass, cause profuse bleeding or potenially compromise the airway. This bleeding is vulnerable to be uncontrollable and life­threatening. Sometimes it has a high mortality. Although surgical resection is possible in some cases, the morbidity such as a defects of soft tissue is very high and its reconstruction is very difficult. The authors report an 11 year old female patient in whom occlusion of arteriovenous malformation with glue after transcutaneous embolization made a satisfactory results. At the beginning, she was transferred for massive oral bleeding. The bleeding was persistent and it was not possible to remove the packing in spite of many times of embolizations through feeding arteries. The massive bleeding trom the left upper alveolar mucosa compromised the airway and tracheotomy was done. Whenever the hypovolemic shock was occurred in a short time, blood transfusion and cardiopulmonary resucitation were done. To embolize the vascular mass of arteriovenous malformation, as a final trial before operation, the spinal needle was administered through the left upper gingiva under the fluoroscopy. The glue was injected on the target. The bleeding was stopped and we have noticed the absence of nidus on follow-up angiography after 3 weeks. We experienced that some cases of arteriovenous malformation in head & neck revealing the bleeding could be treated with transcutaneous embolization instead of surgical resection.

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