• Title/Summary/Keyword: Upper Airway

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THE CONTROL METHOD OF CONTINUOUS GINGIVAL BLEEDING IN A DISABLED PATIENT WITH BLEEDING DISORDER : REPORT OF A CASE (출혈성 장애환자에서 지속적인 치은출혈시 지혈법 : 증례보고)

  • Son, Jeong-Seog;Oh, Ji-Hyeon;Yoo, Jae-Ha;Kim, Jong-Bae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.10 no.1
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    • pp.31-37
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    • 2014
  • The general local cause of gingival bleeding is the vessel engorgement and erosion by odontogenic infection. Abnormal gingival bleeding is also associated with systemic causes. Bleeding disorders in which continuous gingival bleeding is encountered include the followings : vascular abnormalities, platelet disorders, hypoprothrombinemia and other coagulation defects. There are classic methods for gingival bleeding control, such as, direct pressure, electrocoagulation, suture, crushing and application of hemostatic agents. If the continuous gingival bleeding is not stopped in spite of the conventional methods, the life of patient is threatened owing to upper airway obstruction, syncope, vomiting and hypovolemic shock. Therefore, the rapid and correct hemostatic method is very important in the emergency condition. This is a case report of continuous gingival bleeding control by primary endodontic drainage & suture in a disabled patient with systemic bleeding disorders.

Effects of Dysphagia Treatment Applied to Infants with Pierre Robin Syndrome - Single Subject Research Design

  • Kim, Mikyung;Kim, Deokju
    • International Journal of Advanced Culture Technology
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    • v.8 no.1
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    • pp.1-12
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    • 2020
  • Pierre Robin syndrome is characterized by micrognathia, glossoptosis, and cleft palate. Infants with Pierre Robin syndrome causes feeding difficulty, upper airway obstruction, and other symptoms. This study aims to examine the effects of applying dysphagia treatment to infants with Pierre Robin syndrome. The study participant was an infant who was born four weeks premature and referred for dysphagia treatment approximately 100 days after birth. At the initial assessment, the infant showed oral sensory sensitivity, a high level of facial and masticatory muscle tension, and a low stability of the chin and cheeks with almost no normal "sucking-swallowing-breathing" pattern. We set the baseline period and intervention period using the AB design. During the baseline period, non-nutritive sucking training using a rubber nipple was conducted without implementing an oral stimulation intervention. During the intervention period, non-nutritive sucking training and an oral stimulation intervention were performed. After the intervention period, the infant's daily oral intake and oral intake per time significantly increased compared to that during the baseline period. We observed that the oral intake time of the infant decreased during the intervention period compared to that in the baseline period, which indicated an improvement in control over the chin, tongue, and lip movements, a change in muscular tension, and stabilization of the "sucking-swallowing-breathing" pattern. We provided dysphagia treatment before breastfeeding, it was positive effects such as normal development of the infant, transition from tube feeding to bottle feeding, and enhancement of overall oral motor function.

Management Principles of Bilateral Vocal Fold Immobility (양측성 성대 마비의 치료 원칙)

  • Kim, Tae-Wook;Son, Young-Ik
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.20 no.2
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    • pp.118-125
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    • 2009
  • Bilateral vocal fold immobility (BVFI) is a challenging condition which may result from diverse etiologies including vocal fold paralysis, synkinesis, cricoarytenoid joint fixation, and interarytenoid scar. Most patients present with dyspnea and stridor, but sometimes with a breathy dysphonia. Careful history taking, laryngoscopic evaluation under general anesthesia or awaken status, laryngeal EMG, and imaging studies with CT and/or MRI are helpful for providing a precise diagnosis and planning appropriate managements. In children, congenital neurological disorder is one of the most common etiologies, and spontaneous recovery has been reported in more than 50% of cases. Therefore, observation for more than 6 months while securing the upper airway with tracheostomy if needed is a generally accepted rule before deciding any destructive procedure to be undertaken. In children with advanced posterior glottic stenosis, laryngotracheal reconstruction with rib cartilage graft should be considered. In contrast to children, BVFI most commonly occurs as sequalae of surgical complication in adults. Diverse static or dynamic procedures can be applied; posterior cordotomy, vocal fold lateralization, endoscopic or open arytenoidectomy, arytenoid abduction, and reinnervation, electrical laryngeal pacing, which need to be carefully selected according to each patient's needs and pathophysiology of BVFI.

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Tracheobronchial Polyps Following Thermal Inhalation Injury

  • Shin, Beomsu;Kim, Mikyeong;Yoo, Hongseok;Kim, Se Jin;Lee, Ji Eun;Jeon, Kyeongman
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.5
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    • pp.237-239
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    • 2014
  • The early pulmonary consequences of inhalation injury are well documented; however, little is known about delayed pulmonary complications following thermal inhalation injury. Although thermal injury below the vocal cords is rare because of effective heat dissipation in the upper airway, inflammatory endobronchial polyps have previously been reported as a delayed complication associated with inhalation injury. We report an extraordinary case of tracheobronchial polyps in patients with smoke inhalation injury. This report shows the delayed development and natural course of tracheobronchial polyps following thermal injury.

Microvascular Reconstruction of the Cranial Base Defects (두개저 결손의 미세수술적 재건술)

  • Minn, Kyung-Won;Kim, In-Chul;Lee, Min-Goo
    • Archives of Reconstructive Microsurgery
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    • v.8 no.1
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    • pp.71-76
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    • 1999
  • Until recently, the cranial base tumors were deemed unresectable due to the inability to diagnose the extent of the involvement accurately and to approach and excise the tumor safely. With refinements in CT and NMR scanning and development of craniofacial techniques, reconstruction becomes absolutely crucial in allowing successful resection of these tumors. Resection of these tumors may sometimes result in massive and complex extirpation defects that are not amendable to local tissue closure. In such cases, the free tissue transfer was a useful alternative because it can provide large amount of well-vascularized tissues and reliable separation of intracranial space from bacterial flora of the upper airway. The microvascular free tissue transfer was used in 9 patients at our center to reconstruct the cranial base defects. Of these, 8 were free rectus muscle flaps, and 1 was free latissimua dorsi muscle flap. There were 1 case of partial flap loss and 1 case of postoperative wound infection. The large, complex defects were successfully reconstructed by one stage operation and the functional and aesthetic results were satisfactory with acceptable complication rates.

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Bronchoplasty -A report of 5 cases (기관지 성형술 5례 보고)

  • Kim, Eung-Jung;Kim, Yong-Jin
    • Journal of Chest Surgery
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    • v.18 no.3
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    • pp.497-505
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    • 1985
  • Bronchoplastic techniques represent the ideal surgical therapy for benign endobronchial tumors as well as tumors of low-grade malignant potential, such as bronchial adenomas, and for repair of traumatic airway injuries and benign strictures. This approach is also applicable to a select group of patients with carcinoma of the lung, with long-term survival being comparable to that achieved by standard pneumonectomy. Five bronchoplastic procedures were performed at Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital during 7 months periods from Dec. 1984 to Jun. 1985. Of the 5 patients, 3 patients were male and 2 patients were female and ages ranged from 8 years to 55 years old. The final diagnoses of 5 patients were as followed; traumatic bronchostenosis, endobronchial tuberculoma, carcinoid tumor, tuberculous bronchostenosis and traumatic bronchial fracture. Operative procedures of 5 patients were as followed; resection and end-to-end anastomosis of right main bronchus, left lower lobectomy and wedge resection of bronchus, left upper sleeve lobectomy, right middle and lower sleeve lobectomy and resection and end-to-end anastomosis of left main bronchus. And 2 lungs and 3 lobes could be preserved by these bronchoplastic procedures. There was no post-operative complication or mortality and all patients are being followed up without specific problem.

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Sinusitis and Adenoid size is related to Snoring in children (코골이를 주소로 내원한 환자의 부비동염과 아데노이드 비후와의 관계)

  • Lee, Hai-Ja
    • The Journal of Pediatrics of Korean Medicine
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    • v.17 no.1
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    • pp.17-27
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    • 2003
  • Background: Snoring in children, is associated Kith adenotonsillar hypertrophy and sinusitis which contribute to upper airway obstruction, so we studied the sinusitis and adenoid size of snoring children with plain radiography Materials and method: Fifty patients having snoring, nasal obstruction in our hospital between November 2001 and November 2002 were studied using plain radiology PNS(water's view) and Neck lateral view(adenoid size with A/N ratio) Results: 1. In oriental medicine, Hu-Bi means laryngopharyngeal edema and obstruction, laryngopharyngeal disease are due to Hwa-Yeoul( fire and hot), sinus disease are due to Fung-Han(wind and cold) and Fung-Yeoul(wind and hot). 2. Age ranged from 2 to 17 year-old ( mean age: 6 years), 5-7 year-old were 18 patients (36%). Age of on set, 25 patients were 1-4 year-old (50%). 3. Of the 50 snoring patients, 37 patients were sinusitis(74%), 20 patients had enlarged adenoid(40%). Of the 20 large adenoid patients, 19 patients were sinusitis(95%). 4. Of the 50 snoring patients, size of tonsil were flowed. Fifteen were severe(3+), 17 patients were moderate(2+) and 15 patients were mild(1+). Of the 20 enlarged adenoid patients, size of tonsil flowed. Five were severe(3+), 11 patients were moderate(2+) and 4 patients were mild(1+). Conclusion : Of the 50 Snoring patients, 37 patients showed sinusitis(74%), 32 patients showed large tonsil(64%), 20 patients showed large adenoid(40%).

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Lung torsion after tracheoesophageal fistula repair in an infant

  • Yang, Eun Mi;Song, Eun Song;Jang, Hae In;Jeong, In Seok;Choi, Young Youn
    • Clinical and Experimental Pediatrics
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    • v.56 no.4
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    • pp.186-190
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    • 2013
  • Lung torsion is a very rare event that has been reported in only 9 cases in the pediatric literature but has not yet been reported in Korean infants. We present a case of lung torsion after tracheoesophageal fistula repair in an infant. Bloody secretion from the endotracheal tube and chest radiographs and computed tomographic scan results indicated lung torsion. Emergency exploration indicated $180^{\circ}$ torsion of the right upper lobe (RUL) and right middle lobe (RML). After detorsion of both lobes, some improvement in the RUL color was observed, but the color change in the RML could not be determined. Although viability of the RML could not be proven, pexy was performed for both the lobes. Despite reoperation, clinical signs and symptoms did not improve. The bronchoscopy revealed a patent airway in the RUL but not in the RML. Finally, the RML was surgically removed. The patient was discharged on the 42nd day after birth.

A CASE OF FOREIGN BODY ASPIRATION CONFUSED WITH ENDOBRONCHIAL TUBERCULOSIS (기관지 결핵으로 오인된 틀니조각 흡인 1례)

  • 김치홍;김보경;문진성;김선명
    • Korean Journal of Bronchoesophagology
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    • v.2 no.2
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    • pp.238-243
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    • 1996
  • Aspiration of foreign bodies into the tracheobronchial tree is unusual in adults and it may result in Proximal airway obstruction and acute life-threatening asphyxia. It can be diagnosed by history of aspiration or visualizing the foreign body by chest roentgenogram or bronchoscopy. But it is rarely considered in adults with subacute or chronic respiratory symptoms without a definite history which suggests an aspiration. A 70-year-old woman was admitted to the hospital due to productive cough for two months and dyspnea which aggravated since the day before admission. Chest X-ray showed Pneumonic infiltration on left upper lobe and right lower lobe. Despite several days of conventional therapy, the patient complained of severe dyspnea and wheezing. We performed chest CT to rule out endobronchial stenosis, and it revealed the narrowing of left main stem bronchus compatible with endobronchial tuberculosis. Fiberoptic bronchoscopy for confirmation disclosed a $3.2{\times}0.7{\times}0.2$cm sized foreign body located longitudinally at the left main stem bronchus. We removed it with alligator forcep and it proved In be a piece of artificial denture. The patient remembered losing it while severe coughing on the day before admission. The microscopic examination of bronchial washing fluid revealed numerous acid fast bacilli. After removal of the foreign body, the patient showed marked improvement in symptom and pulmonary function test. Here we report a case of Pulmonary aspiration of foreign body which is confused with endobronchial tuberculosis with a review of the literature.

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Tracheal Stenosis after Tracheostomy Treated Successfully with Papillotome Electrocautery

  • Oh, Sun Hee;Lee, Seong Ju;Kim, Dae Sung;Na, Moon Jun;Choi, Eugene;Kwon, Sun Jung;Cho, Hyun Min;Son, Ji Woong
    • Tuberculosis and Respiratory Diseases
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    • v.75 no.2
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    • pp.79-82
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    • 2013
  • Tracheal Stenosis after Tracheostomy Treated Successfully with Papillotome Electrocautery A 39-year-old woman presented with symptoms of dyspnea. Ten years previously, she had received a tracheostomy because of the decision to not continue taking an anticonvulsant drug. Presently, chest computed tomography showed diffuse stenosis and focal web at the cervical trachea. We performed bronchoscopy and found a two-thirds reduction of the upper trachea due to the web-like fibrotic stenosis. Papillotome electrocautery removed the stenotic lesion. Endobronchial electrocautery is a valuable tool with potential for therapy of an endobronchial obstructing airway lesion. We report this case to introduce the successful treatment with papillotome electrocautery.