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Biomedical subjects

R E Whited

Publications and source records attributed to R E Whited.

8 recordsLinked to original sources
PubMed1985

A study of post-intubation laryngeal dysfunction.

A canine model of intubation has been established to further investigate the laryngeal injury occurring from an indwelling endotracheal tube. Ulcerations are produced by the shaft of the tube as it rubs and presses against the contact points in the cricoarytenoid region. This injury results in a progressive soft tissue inflammatory response in the posterior larynx. The injury and the associated tissue response leads to a limited arytenoid excursion which manifests functionally as airway compromise and aspiration in the postextubation phases.

Animals↗
PubMed1985

A study of endotracheal tube injury to the subglottis.

An endotracheal tube presses against distinct pressure points within the airway. These areas are the shaft of the tube against the arytenoids and posterior cricoid and the cuff-tube tip in the trachea. An ulcerative injury occurs at these interfacing points from motion occurring between tube and tissue. Minimizing this inherent movement is possible by tube modification and, in the presented animal model, prevents injury.

Animals↗
PubMed1984

Experimental and clinical reconstructive surgery of the larynx and trachea.

Laboratory study was undertaken to define the healing patterns of intramural bone and cartilage grafts in the canine trachea. These studies indicate that with solid intramural grafting, both displacement and resorption prevent predictably successful graft incorporation. With graft failure, intraluminal stenting maintained separation of the cricotracheal incisional margins so that strap musculature adhered and subsequently fibrosed to provide a rigid and expanded anterior wall. The concept of direct strap-muscle intramural grafting for tracheal expansion was applied in a clinical setting using eight patients having extensive laryngotracheal stenosis. Successful reconstruction occurred in seven of the eight patients.

Animals↗
PubMed1984

A prospective study of laryngotracheal sequelae in long-term intubation.

A series of 200 patients having endotracheal intubation between 2 and 24 days were studied prospectively. The data was organized into 3 groups as follows: Group I: 2 to 5 days intubation, (50); Group II: 6 to 10 days intubation, (100); and Group III: 11 to 24 days intubation, (50). For the Group I population, the most significant injury is in the posterior commissure of the larynx which in this site leads to acute and chronic sequelae. At these intubation times, cuff site injury has not been prominent. Despite the selection of patients for conversion to tracheotomy in order to prevent complications, there is an increased incidence of significant sequelae in Group II population. A most noticeable trend accompanying the increased incidence is the changing nature of the resultant stenosis to include continuous damage from the posterior glottis through the cervical trachea. These trends become evident in those patients having intubation times greater that 7 days. In Group III population, the increased incidence, as well as the severity of post-intubation complications become clearly evident. Conversion to tracheotomy before serious organ disruption occurs at these prolonged intubation times is preventative.

Adult↗
PubMed1983

Posterior commissure stenosis post long-term intubation.

A prospective study of 200 patients having long-term endotracheal intubation has been completed. This study has defined the events in stenosis evolution for the two varieties of scarring in the posterior commissure of the larynx. An overall stenosis incidence of 6% for this long-term intubated patient population has been found. In the majority of patients the posterior commissure stenosis is a component of more complex injury. The importance of tube tissue interfacing in the posterior commissure and the role of ongoing movement of both a shearing and blunt nature is of increasing significance as intubation time lengthens. Changing the character of this interface by the addition of a small posterior air cushion on the endotracheal tube can minimize ongoing trauma in the posterior endolarynx.

Adult↗
PubMed1979

Anterior table frontal sinus fractures.

Frontal sinus fractures cover a spectrum of injury. A series of 52 primarily treated patients from the University of Cincinnati Medical Center is presented. Initial systematic management was applied to these patients and consisted of complete radiographic evaluation supplemented by wound care and cosmetic restoration when needed. All patients were followed on a long-term basis; both clinically and radiographically. Results to date are that 49 patients have had an uneventful post-traumatic course with re-establishment of normal sinus aeration. From the cosmetic standpoint no contour revisions have been needed and only two patients required elective scar revision. Three patients developed chronic suppurative sinus disease within the first post-traumatic year which was readily diagnosed and managed without complication by osteoplastic frontal sinusotomy and adipose obliteration.

Adolescent↗
PubMed1978

Laryngeal fracture in the multiple trauma patient.

The Cincinnati General Hospital experience with early diagnosis and repair of laryngeal fractures in the multiple trauma patient is presented. The results demonstrate the feasibility and value of early laryngeal diagnosis and repair in these severely traumatized patients.

Adult↗