PubMed Health⌕ Search

Biomedical subjects

Anthony A Rieder

Publications and source records attributed to Anthony A Rieder.

4 recordsLinked to original sources

The effect of polysomnography on pediatric adenotonsillectomy postoperative management.

OBJECTIVE: We retrospectively investigated the effect and predictability of preoperative polysomnography (PSG) on the postoperative course of younger pediatric patients undergoing adenotonsillectomy. STUDY DESIGN AND SETTING: A retrospective chart review was performed for patients 3 years of age and younger who had undergone adenotonsillectomy between July 1997 and July 2002 at the Children's Hospital of Wisconsin. RESULTS: Two hundred eighty-two patients were identified. Forty-three patients had preoperative PSG. No correlation between the severity of PSG results and postoperative course was identified. CONCLUSIONS: The role of PSG in upper airway obstruction and OSA remains controversial. This study suggests that although the complication rate may be higher in this younger population, these complications do not appear to have a large impact on their length of stay. SIGNIFICANCE: This study suggests that the 3-years-and-younger group, in the absence of other comorbidities, can safely undergo adenotonsillectomy without undergoing preoperative PSG. EBM raing: C.

Adenoidectomy↗

Does successful segmental tracheal resection require releasing maneuvers?

OBJECTIVES: Tracheal resection is a well-established option for the management of airway stenosis. Releasing maneuvers have been described to reduce anastomotic tension. The aim of this study is to report on a series of tracheal resections performed without the use of these maneuvers. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary hospital. METHODS: All patients undergoing tracheal resection by the first author over a 6-year period were reviewed. RESULTS: Patients (n = 17; 7 men and 10 women, ages 23-76) were managed with tracheal resection and anastomosis without stenting or postoperative tracheotomy. 16/17 (94%) patients had successful treatment of their stenosis. 1/17 (6%) failed and 1/17 (6%) required dilation. There was no postoperative swallowing dysfunction. CONCLUSIONS: Segmental tracheal resection without releasing maneuvers was successful in 16/17 (94%) patients. SIGNIFICANCE: Though extrapolation from this series may be limited, future practitioners may consider forgoing additional releasing maneuvers for tracheal resection in many cases.

Adult↗

Pediatric myasthenia gravis and velopharyngeal incompetence.

OBJECTIVE: To determine the clinical course of velopharyngeal incompetence in children with myasthenia gravis (MG). METHODS: A 30-year retrospective study was performed using the medical records of 538 children who presented with velopharyngeal inadequacy (VPI) to a tertiary care academic pediatric center. Children with velopharyngeal incompetence due to myasthenia gravis were identified and their clinical courses were reviewed. RESULTS: Four children were identified with velopharyngeal incompetence associated with myasthenia gravis. All four children required intervention for improvement of speech intelligibility. A speech prosthesis was the uniform intervention. CONCLUSION: Neonatal myasthenia gravis patients should be followed long-term as symptoms may recur as speech impairment. In addition, a high index of suspicion for this entity is required for early diagnosis due to the highly variable presentation and clinical course.

Adolescent↗

Normal endoscopic anatomy of the pharynx and larynx.

The pharynx and larynx are readily visualized in ambulatory settings during endoscopic examination. Although these organs may be perceived as the portal to the lungs or upper digestive tract, endoscopists could refine their technical and diagnostic acumen by becoming more familiar with this special area of anatomy. Further, an anatomic description of these structures may augment the generalist's understanding of their physiologic functioning. The basic skills required for examining the pharynx and larynx are generally quite easy to obtain. This article reviews the endoscopic anatomy and basic physiology of this region and offers suggestions for improving technique.

Anesthesia↗