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At least 775 records · Page 43Linked to original sources
PubMed1989

Acute upper airway obstruction in rheumatoid arthritis of the cricoarytenoid joints.

We have reported two cases of acute, life-threatening upper airway obstruction due to previously unrecognized rheumatoid arthritis of the cricoarytenoid joints with severe acute and chronic deformities of the larynx. Attempted endotracheal intubation with the rigid laryngoscope failed in each case, resulting in the need for emergency tracheostomy. We recommend the use of the fiberoptic bronchoscope for elective or emergency endotracheal intubations in patients with severe rheumatoid arthritis involving the cervical spine and the larynx.

Acute Disease↗
PubMed1987

A comparison between two emergency cricothyroidotomy instruments.

As part of a training programme for younger doctors, two commercially available, emergency cricothyroidotomy sets were evaluated. Prior to the surgical procedure, half of the doctors in each group received an audiovisual lesson. In a simulated but realistic emergency situation, involving autopsy material, cricothyroidotomy was performed utilizing either the "Nutrake" or the "Gentofte" system. The audiovisual lesson increased the speed and the success rate of the doctors performing this procedure as well as strengthening their confidence. Both systems allowed positive pressure ventilation. The participating doctors achieved a higher success rate at a faster speed with the "Nutrake" set.

Catheterization↗
PubMed1980

Cricopharyngeal myotomy in motor neurone disease.

Twenty-five patients with dysphagia caused by neurological disorders, mainly motor heurone disease, underwent cricopharyngeal myotomy. Nineteen patients showed slight to dramatic improvement of swallowing for variable periods of time. There were five postoperative deaths. The results indicate that this simple procedure is of benefit to a substantial proportion of patients with neurological causes of dysphagia.

Adult↗
PubMed1988

Morphometric study of the growth of the subglottis after interruption of the circular structure of the cricoid.

In young rabbits the growth of the subglottis was studied over a period of 20 weeks after interruption of the circularity of the cricoid on the ventral side. In all cases the cricoid developed into a U-like structure which did not cause an airway narrowing. However, a cricoid lesion combined with an injury to the soft tissue lining led up to a subglottic stenosis. It was concluded that when the soft tissue layer is undamaged, an intact circular structure of the cricoid is not compulsory for the normal development of the subglottis.

Animals↗
PubMed1989

Congenital subglottic stenosis: the elliptical cricoid cartilage.

Various malformations of the cricoid cartilage produce congenital subglottic stenosis. The elliptical cricoid cartilage first was demonstrated histopathologically in horizontal sections of six postmortem specimens and now has been identified clinically in ten patients. The clinical diagnosis of the elliptical cricoid cartilage, suggested by anteroposterior soft tissue neck films, is confirmed at direct laryngoscopy. Delineation of the precise location, extent, and histopathology of subglottic stenosis provides the basis for rational management.

Child, Preschool↗
PubMed1984

Cricopharyngeal muscle hypertrophy: radiologic-anatomic correlation.

There is a divergence of opinion concerning the cricopharyngeal muscle defect commonly seen in the pharyngoesophageal area on barium esophagram. Some observers believe this defect is the result of neuromuscular dysfunction with the demonstration of the unrelaxed muscle bundle; however, others believe it is the result of actual hypertrophy of the cricopharyngeal muscle. Radiologic and pathologic study of 24 unselected autopsy cases revealed cricopharyngeal hypertrophy in 13 cases by radiologic criteria. Histologic examination revealed that the cricopharyngeal muscle thickness was uniformly greater in these cases than in the radiographically normal cases. The cricopharyngeal muscle defect is associated with actual hypertrophy of the cricopharyngeal muscle in many cases.

Autopsy↗
PubMed1975

Traumatic avulsion of the trachea associated with cricoid fracture.

A 15-year-old girl sustained a cricoid fracture, avulsion of the trachea, and bilateral cord paralysis in a automobile injury. An airway was established by intubation, and primary repair was performed on the day of injury. A postoperative stricture was successfully managed by endoscopic dilatation and injection of triamcinolone into the stricture. Function of one vocal cord appears to be returning 6 months after the injury, and the patient is leading an active life.

Adolescent↗
PubMed1990

Acute airway management. Role of cricothyroidotomy.

Thirty-four cases of emergency cricothyroidotomy performed formed from September 1984 through January 1988 are reviewed. Thirty-one of the cases were required out of 2,200 acute-trauma patients. The indication for cricothyroidotomy was inability to establish an airway by intubation usually in a situation of possible neck injury or severe facial trauma. Fourteen of the patients died as a result of their injuries, 13 of these in the first several hours after injury. The 20 surviving patients are studied in two groups: eleven patients whose cricothyroidotomy remained in place until decannulation (group I) and nine patients who underwent tracheostomy subsequent to cricothyroidotomy (group II). Clinical follow-up included physical examination in all survivors and endoscopic evaluation in twelve patients. Three minor complications were discovered in each of the two groups and two major complications were noted in group II. The major complications included a case of tracheal stomal stenosis requiring tracheal resection and a case of partially obstructing tracheal granulation tissue requiring endoscopic resection. This study supports the use of emergency cricothyroidotomy in situations in which intubation is not successful or thought to be safe. Data is also presented that suggests that tracheostomy subsequent to emergency cricothyroidotomy does not necessarily reduce airway-related morbidity in these patients.

Airway Obstruction↗
PubMed1990

[Bilateral paralysis of the vocal cords treated with endolaryngeal arytenoidectomy].

Bilateral paralysis of the vocal cords is a serious condition in which even slight oedema of the mucosa may endanger the patient's life. Bilateral paralysis of the vocal cords is most frequently due to thyroid operations but intubation, neuritis etc are among the other causes. Tracheostomy is nearly always necessary. In an attempt to render removal of the tracheal cannula possible with retention of vocal function, the authors have performed endolaryngeal arytenoidectomy. This intervention was carried out in 28 patients. In 23 of these the cannula could be removed while various conditions prevented removal of the cannula in the remaining five patients. The authors consider that arytenoidectomy is a good form of treatment of bilateral paralysis of the vocal cords involving only a slight risk. Thereafter, there are good chances for removal of the cannula with simultaneous retention of vocal function.

Adolescent↗
PubMed1988

Cricothyroid membrane puncture: oxygenation and ventilation in a dog model using an intravenous catheter.

A method for pediatric airway support was evaluated for the situation when mask ventilation or intubation is impossible. Mongrel dogs were sedated, intubated, and allowed to breathe room air for 30 min. Baseline variables were recorded, and the airway obstructed. After 2 to 3 min of hypoxia, arterial blood gas and hemodynamic data were again recorded. A percutaneous cricothyroid membrane puncture (PCMP) was then performed with a 12-ga iv catheter. Studies were carried out both in the presence and absence of spontaneous ventilatory efforts. With spontaneous ventilation, continuous low flow (1.0 L/min) oxygen insufflation provided oxygenation for 30 min and reversed increases in mean arterial pressure, pulmonary artery pressure (PAP), and systemic and pulmonary vascular resistance that had been produced by the obstruction. Respiratory acidosis occurred but was well tolerated. With paralyzed animals, whose ventilation was supported by a self-inflating bag with 10.0 L/min of oxygen, all hemodynamic variables except PAP returned to normal, oxygenation was excellent, and PaCO2 values were maintained at steady, but elevated levels. Complications included bilateral tension pneumothorax in one animal. This experimental study supports anecdotal experiences where PCMP has been used and has proven lifesaving when standard resuscitative measures to establish a clear airway have failed.

Airway Obstruction↗