• Tuberculosis and Respiratory Diseases
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• 제77권5호
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• pp.215-218
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• 2014

Tracheal invasion is an uncommon complication of thyroid cancer, but it can cause respiratory failure. A rigid bronchoscope may be used to help relieve airway obstruction, but general anesthesia is usually required. Tracheal balloon dilatation and stent insertion can be performed without general anesthesia, but complete airway obstruction during balloon inflation may be dangerous in some patients. Additionally, placement of the stent adjacent to the vocal cords can be technically challenging. An 86-year-old female patient with tracheal invasion resulting from thyroid cancer was admitted to our hospital because of worsening dyspnea. Due to the patient's refusal of general anesthesia and the interventional radiologist's difficulty in completing endotracheal stenting, we performed endotracheal tube balloon dilatation and argon plasma coagulation. We have successfully treated tracheal obstruction in the patient with thyroid cancer by using endotracheal tube balloon inflation and a flexible bronchoscope without general anesthesia or airway obstruction during balloon inflation.

• Journal of Chest Surgery
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• 제26권8호
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• pp.664-666
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• 1993

A technique for insertion of a long silicone T-tube in patient with critical stenosis and high-risk resection and primary anastomosis of long segment of the distal trachea is presented. It was not easy to insert a long T-tube by existing methods because of flexibility of a T-tube and tightness of stenosis. So we used a silastic endotracheal tube and guiding wire as stylet of a T-tube. During insertion, ventilation was normally maintained through the lumen of endotracheal tube. This provided rapid relief from airway obstruction and asphyxation and is a easy, safe and effective method to restore patency of the major airways.

• Korean Journal of Ophthalmology
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• 제32권6호
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• pp.445-450
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• 2018

Purpose: To compare the tear film lipid layer thickness (LLT) between patients with incomplete nasolacrimal duct obstruction (NLDO) and normal controls and to analyze the changes in tear film LLT and blinking pattern after silicone tube intubation in NLDO patients. Methods: We reviewed the medical records of 68 eyes in 52 incomplete NLDO patients who underwent silicone tube intubation from January 2017 to July 2017. The LLT, blinking pattern, and Meibomian gland image were measured with the LipiView II ocular surface interferometer. The Meibomian gland drop-out ratio was measured using the polygon selection tool in the Image J program. Tear meniscus height, which is the other lacrimal indicator, was assessed with spectral-domain optical coherence tomography. Results: Tear meniscus height was significantly decreased after silicone tube intubation (p < 0.01). Preoperative minimum, maximum, and average LLT values were $62.4{\pm}24.0$, $86.7{\pm}17.9$, and $71.7{\pm}23.3nm$, respectively. Significant changes in the minimum, maximum, and average LLT ($74.8{\pm}23.6$, $98.8{\pm}11.0$, and $91.6{\pm}16.1nm$, respectively) were observed after silicone tube intubation (p < 0.001, p = 0.001, and p < 0.001). The partial blinking/total blinking ratio in 20 seconds and the Meibomian gland drop-out ratio showed no significant change after silicone tube intubation. Conclusions: Overall, the LLT was increased after silicone tube intubation. Silicone tube intubation may be helpful in maintaining LLT with a normalized of amount of tears.

• 대한안과학회지
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• 제59권11호
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• pp.1001-1008
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• 2018

목적: 눈물길미세내시경을 이용한 실리콘관삽입술과 기존의 코내시경만으로 시행한 방법 간의 성공률을 비교하고자 하였다. 대상과 방법: 2014년 1월부터 2017년 6월까지 본원에서 실리콘관삽입술을 시행한 환자들을 대상으로 하였다. 술 전 눈물소관 관류검사와 눈물주머니조영술로 진단하였다. 술 후 3개월 때 실리콘관을 제거하였고 4, 12개월 때 성공률을 내시경 사용에 따라 두 군으로 나눠 분석하였다. 결과: 총 55명, 80안으로 술 전 진단에서 사용군은 부분폐쇄 26안, 완전폐쇄 14안, 미사용군은 부분폐쇄 35안, 완전폐쇄 5안이었다(p=0.018). 술 후 4, 12개월 때 성공률은 사용군에서는 87.5%, 80.0%, 미사용군에서는 72.0%, 62.1%였다(p=0.546, p=0.565). 부분폐쇄에서 사용군과 미사용군의 성공률은 4개월 때 92.3%, 82.9%, 12개월 때 71.4%, 62.9% (p=0.448, p=1.000), 완전폐쇄에서 성공률은 4개월 때 78.6%, 60.0%, 12개월 때 72.7%, 33.3%였다(p=0.570, p=0.505). 눈물길미세내시경의 사용과 폐쇄의 위치 및 정도의 차이가 술 후 4, 12개월 때 성공률에 유의한 영향을 미침을 확인하였다(p=0.001, p=0.022). 결론: 눈물길미세내시경을 이용한 실리콘관삽입술은 기존의 것에 비하여 성공률이 유의하게 높지는 않았으나, 코눈물길의 구조를 실시간으로 확인하여 적절한 진단 및 치료가 동시에 가능하다. 완전폐쇄로 진단되었던 환자들에게도 좋은 성공률을 보여 그 적용 범위를 확대시켜 비침습적인 치료를 시행할 수 있을 것이다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제17권2호
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• pp.135-138
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• 2017

Intraoperative airway obstruction is perplexing to anesthesiologists because the patient may fall into danger rapidly. A 74-year-old woman underwent an emergency incision and drainage for a deep neck infection of dental origin. She was orally intubated with a 6. 0 mm internal diameter reinforced endotracheal tube by video laryngoscope using volatile induction and maintenance anesthesia (VIMA) with sevoflurane, fentanyl ($100{\mu}g$), and succinylcholine (75 mg). During surgery, peak inspiratory pressure increased from 22 to $38cmH_2O$ and plateau pressure increased from 20 to $28cmH_2O$. We maintained anesthesia because we were unable to access the airway, which was covered with surgical drapes, and tidal volume was delivered. At the end of surgery, we found a longitudinal fold inside the tube with a fiberoptic bronchoscope. The patient was reintubated with another tube and ventilation immediately improved. We recognized that the tube was obstructed due to dissection of the inner layer.

• Journal of Chest Surgery
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• 제18권1호
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• pp.128-139
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• 1985

Seven patients [six women and one man] with obstruction of hepatic portion of inferior vena cava was operated on, from May, 1969 to January, 1985. Of seven patients, six were undergone corrective operation for IVC obstruction and another one was not operated because of far advanced liver cirrhosis. The occlusions were found at or close to the level of diaphragm and they were membranous or diffuse with or without thrombi. Most of their symptoms were referable to either inferior vena caval or hepatic venous obstruction and onset of the symptoms was usually gradual, beginning between the age of their thirties and forties. Most of the patients showed marked elevation of peripheral venous pressure of lower extremity [29-40 cm H2O] preoperatively, which decreased significantly after corrective operation [17-30 cm H2O]. Venous catheterization for pressure study and venography were essential for confirming the diagnosis. Of six cases, in which corrective operations were done, Transatrial membranotomy with or without IVC dilatation were performed in five cases [case 1, 2, 3, 5, 6], using cardiopulmonary bypass and in another one case, bypass operation between IVC, distal to obstruction, and RA was done using Dacron tube graft under the thoracoabdominal incision. All survived and their conditions were improved.

• 대한기관식도과학회지
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• 제16권1호
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• pp.47-50
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• 2010

Fracture of tracheostomy tube with subsequent migration into the tracheobronchial tree is rare, but tracheobronchial foreign body in child carries the potentially fatal risk of respiratory obstruction, We report a case of a 5-year-old girl who had aspirated a fractured tracheostomy tube which was removed under rigid bronchoscope.

• 대한핵의학회지
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• 제21권2호
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• pp.207-211
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• 1987

A prospecitive study was performed to evaluate the efficacy of Radionuclide Hysterosalpingography (RNHSG), that was modified by McCalley, et al. for the evaluation of fallopian tube. Using spontaneous migration of Tc99m labelled human albumin microsphers (HAM) and images got with Gamma camera, the study was made in 20 gynecological patients (44 tubes) in an effort to confirm the anatomical patency or obstruction as well as functional one at the Department of Obstetrics and Gynecology, National Medical Center from January 1, 1986 to July 31, 1986. The efficacy was also compared with that of contrast hysterosalpingography and surgical observation. Results obtained were as follows; 1) The Radionuclide Hysterosalpingography appeared to be a simple and accurate procedure as a mean with which anatomical tubal patency, as well as functional patency can be detected, although it's some limit in showing anatomical details of uterine cavity and tubes in comparison with contrast hysterosalpingography. 2) The predicted value of tubal obstruction was 82.4%. and that of tubal patency was 88.9% respectively. Overall efficacy (percent of tube correctly classified) of Radionuclide Hysterosalpingography was 88.6%. 3) There was no nuclide related complication during and after the procedure.

• 대한기관식도과학회지
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• 제3권1호
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• pp.61-69
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• 1997

A total of 55 patients underwent surgical managements for postintubation tracheal stenosis from July 1975 through March 1997. All but 8 had received ventilatory assistance. The patients had S cuff lesions, 17 stoma lesions, 7 at both levels, 5 at subglottic lesions. Thirty two patients underwent the sleeve tracheal resection and end-to-end anastomosis. Five patients performed a wedge resection and end-to-end anastomosis. Twenty two patients received the Montgomery T-tube for relief of airway obstruction. Simple excision of granulation tissue was done in 7 patients. Rethi procedures(anterior division of cricoid cartilage, partial wedge resection of lower thyroid cartilage and T-tube molding) were performed in 2 subglottic stenosis patients. And the other subglottic patient was received permanent tracheal fenestration at 1975. The tracheoesophageal fistula patient was done sleeve tracheal resection and end-to-end anastomosis with interrupted double layer closure of esophageal fistula site. Cervical approach was used in 49 cases, cervicomediastinal in 13 cases and median stemotomy In 6 cases. Techniques for obtaining tension-free anastomosis included a cervical neck flexion(15-30$^{\circ}$) in all sleeve resection patients and laryngeal release in one. The length of resection was 1.5 to 5.0 on A total of 41 patients(74.5%) had good(24 patients) or satisfactory(17 patients) results. But in ten cases, the restenosis of anastomosis site which is the most common complication was developed Two of them underwent a second reconstruction and 8 patients required T-tube insertion for airway maintenance. Three patients(5.4%) died. The causes of death were tracheo-innominate artery fistula(2) and sudden obstruction of airway(1).

• 한국임상수의학회지
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• 제40권2호
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• pp.124-129
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• 2023

A 5-year-old neutered male domestic short-haired cat presented with acute dyspnea characterized by open-mouth breathing and stridor for 2 days. Direct visualization via laryngoscopy revealed diffuse laryngeal swelling and severe thickening of the vocal folds bilaterally; thus, the upper respiratory tract was obstructed owing to severe edema. Neutrophil infiltration was found on fine needle aspiration of the larynx cytology, and no discrete mass with polyp or neoplasia was identified on diagnostic imaging. The cat was diagnosed with acute obstructive laryngitis, and a tracheostomy tube was immediately installed. After 17 days of treatment with steroids, doxycycline and azithromycin, the swollen larynx gradually improved, and there was no recurrence of laryngitis or respiratory obstruction. A feline upper respiratory polymerase chain reaction panel revealed Mycoplasma felis infection; however, it could not be determined whether it was pathogenic or opportunistic. Herein, we report a case of obstructive laryngitis in a cat. When respiratory obstruction due to acute laryngitis is identified, a good prognosis is expected with rapid and appropriate treatment.