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PubMed1989

[Percutaneous transtracheal ventilation using Nu-Trake cricothyreotomy instruments and tracheoscopic follow-up examination].

Practicability and efficiency of the cricothyreotomy set Nu-Trake was investigated in corpses (n = 10) in the institute of Pathology and clinically in laryngectomy patients (n = 5) including endoscopical controls. The practicability proved to be good, the time needed to perform the coniotomy did not last longer than 2 minutes. But complications in the investigation on the corpses could not be avoided. These were missing the lumen of the trachea, perforation of the pars membranacea tracheae and fracture of the cricoid. The clinical investigation demonstrated a sufficient oxygenation and ventilation in all patients during the whole investigation period (30 min). This can be explained by the diameter of 7.2 mm of the used tube. Endoscopic controls showed a sufficient distance of the tip of the tubes from the pars membranacea tracheae and almost no bleeding within the trachea. Similar as with other coniotomy-technics the cricothyreotomy with the Nu-Trake set bears the risk of typical complications which have to be overcome by training of this important measure of emergency.

Aged↗
PubMed1995

[Invasion of cricoid cartilage by T2-T3 laryngeal cancer].

This paper reports a study of microscopic infiltration of the cartilage of the cricoid carried out in 335 patients with T2-T3 carcinomas of the larynx who had undergone total laryngectomy. The results of the investigation revealed microscopic infiltration of the cricoid cartilage in 12% (14/335) of the cases examined. The incidence, however, was much higher in those cases of extension to the hypoglottis (28% vs 5%, p < 0.0001) or in cases of an even greater extension of the tumor (13% vs 7%). In the 161 patients with neoplasias situated in the glottis, there was cricoid invasion in 30 cases regardless of the tumor class. However, with regard to cases with extension to the hypoglottis, a higher incidence of cricoid infiltration (20% vs 8%, p < 0.002) for all T classes was observed. As for as those cases with neoplasias in the supraglottis are concerned, there were no patients classified T2 (0/50) with cricoid infiltration against 8% in T3 subjects (10/124). In these subjects extension to the hypoglottis led to microscopic invasion of the cricoid cartilage in a greater number of patients (31% vs 3%, p < 0.0001). These observations confirm that microscopic infiltration of the cartilagenous skeleton of the larynx, especially of the cricoid, is relatively frequent. Factor of even higher risk are occurrence in the glottis and, in all the situations examined, extension to the hypoglottis. In addition, except in cases of vestibular T2, there is a 5 to 8% possibility of microscopic infiltration of cricoid cartilage even in the absence of clinical signs of hypoglottic invasion.(ABSTRACT TRUNCATED AT 250 WORDS)

Carcinoma↗
PubMed2006

Evaluation of the efficacy of supraglottoplasty in obstructive sleep apnea syndrome associated with severe laryngomalacia.

OBJECTIVE: To evaluate the clinical and polysomnographic evolution of patients with severe laryngomalacia who underwent supraglottoplasty. DESIGN: Retrospective study. SETTING: University hospital. PATIENTS: Seven children with severe laryngomalacia. MAIN OUTCOME MEASURES: The patients were evaluated with a questionnaire given to their parents and with polysomnographic examination before and 3 months after surgery. The clinical data of respiratory and swallowing symptoms as well as the parameters of minimum oxygen saturation and respiratory disturbance index were evaluated after bilateral supraglottoplasty and compared with the preoperative data. RESULTS: Two patients had pharyngolaryngomalacia and required tracheotomy. Four patients had a marked improvement of respiratory and deglutition symptoms. Polysomnographic data showed a significant improvement in the respiratory disturbance index after surgery (P<.05) but not in the minimum oxygen saturation level. However, this improvement was only partially achieved in 3 patients, in whom there were associated airway or neurologic changes. No serious surgical complications were observed. CONCLUSION: Supraglottoplasty led to a marked improvement in all 5 patients without pharyngolaryngomalacia, but the 2 patients with pharyngolaryngomalacia required tracheotomy.

Arytenoid Cartilage↗
PubMed1984

Congenital cricopharyngeal achalasia treatment by dilatations.

An infant with cricopharyngeal achalasia, recurrent aspiration pneumonia, and severe failure to thrive was fed for 5 months through a nasogastric tube. She responded promptly to dilatations of the spastic cricopharyngeal muscle. Normal oral feedings followed the treatment with progressive weight gain and no further pulmonary complications over a follow-up period of 1 1/2 years. Dilatations were used in the infant described here, in analogy to the well-known success of treatment by dilatations in infants with achalasia of the lower esophagus.

Cricoid Cartilage↗