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Anesthesia Progress Jun 2020Epiglottitis is most commonly caused by bacterial infection resulting in inflammation and edema of the epiglottis and neighboring supraglottic structures. Acute...
Epiglottitis is most commonly caused by bacterial infection resulting in inflammation and edema of the epiglottis and neighboring supraglottic structures. Acute infection was once found predominantly in children ages 2 to 6 years old, but with the introduction of the Haemophilus influenzae B (HiB) vaccine the incidence of cases in adults is increasing. Typical clinical presentation of epiglottitis includes fever and sore throat. Evidence of impending airway obstruction may be demonstrated by muffled voice, drooling, tripod position, and stridor. Radiographs can be helpful in diagnosing epiglottitis; however, they should not supersede or postpone securing the airway. An airway specialist such as an otolaryngologist, anesthesiologist, or intensivist should ideally evaluate the patient immediately to give ample time for preparing to secure the airway if necessary. All patients with epiglottitis should be admitted to the intensive care unit for close monitoring.
Topics: Adult; Child; Child, Preschool; Epiglottis; Epiglottitis; Humans
PubMed: 32633776
DOI: 10.2344/anpr-66-04-08 -
Minerva Anestesiologica Mar 2018Supraglottic airway devices (SADs) have become an essential tool in airway management. Over the past three decades, these devices have been increasingly adopted as an... (Review)
Review
Supraglottic airway devices (SADs) have become an essential tool in airway management. Over the past three decades, these devices have been increasingly adopted as an alternative to face mask ventilation and/or endotracheal intubation. The range of proposed uses and features has increased significantly. They are used in pre- and in-hospital settings, elective and emergency anesthesia, in spontaneously breathing and ventilated patients, as conduits for intubation, as a bridge to extubation and for airway rescue. With SADs, serious complications such as aspiration and loss of airway are rare and largely preventable. Adequate operator experience, familiarity with the selected device, attention to details and careful patient selection are fundamental to safety and proficiency. In this review, we explore the increasing proposed uses for SADs and discuss possible complications and the management of these.
Topics: Airway Management; Contraindications; Epiglottis; Humans; Intubation, Intratracheal; Resuscitation
PubMed: 29027772
DOI: 10.23736/S0375-9393.17.12112-7 -
Tidsskrift For Den Norske Laegeforening... Sep 2020Acute epiglottitis in adults is a rare, potentially life-threatening condition caused by a bacterial infection in the epiglottis. Typical symptoms are fever, sore...
BACKGROUND
Acute epiglottitis in adults is a rare, potentially life-threatening condition caused by a bacterial infection in the epiglottis. Typical symptoms are fever, sore throat, and respiratory distress caused by upper airway obstruction. Proper treatment is needed for a good outcome.
CASE PRESENTATION
We here present a 54-year-old female patient with acute epiglottitis. Her airway was secured by endotracheal intubation and she received antimicrobial therapy. She developed an abscess around the epiglottis that needed surgical drainage and tracheotomy. However, she fully recovered after nine days in hospital.
INTERPRETATION
Acute epiglottitis in adults is a potentially life-threatening condition. The prognosis is good with proper treatment including selective airway intervention, antimicrobial therapy, and close monitoring.
Topics: Acute Disease; Adult; Epiglottis; Epiglottitis; Female; Humans; Intubation, Intratracheal; Middle Aged; Pharyngitis
PubMed: 32998500
DOI: 10.4045/tidsskr.20.0382 -
Journal of Clinical and Diagnostic... Aug 2013Lymphangiomas are congenital lesions of the lymphatic system which are most commonly found in the head and neck, with over 90 % of lesions manifesting in children who...
Lymphangiomas are congenital lesions of the lymphatic system which are most commonly found in the head and neck, with over 90 % of lesions manifesting in children who are less than 2 years of age. Haemolymphangiomas are rare variant of lymphangioma, with the presence of red blood cells within the lymphatic channels. Laryngeal sites are usually in continuity with foci of disease in the neck. In general, symptoms are non-specific and they vary with the site and size of the mass. Usually, they occur before 2 years of age. Isolated cases of lymphangiomas with involvement of epiglottis are rare and only a few cases have been reported so far. We are reporting the case of a six-year-old girl who presented with a mass in the epiglottis.
PubMed: 24086903
DOI: 10.7860/JCDR/2013/5571.3244 -
European Annals of Otorhinolaryngology,... May 2021
Topics: Epiglottis; Granuloma; Humans
PubMed: 33069596
DOI: 10.1016/j.anorl.2020.06.027 -
Ear, Nose, & Throat Journal Sep 2021
Topics: Aged; Cysts; Epiglottis; Epiglottitis; Humans; Laryngeal Diseases; Laryngeal Muscles; Larynx; Male; Medical Illustration
PubMed: 32133889
DOI: 10.1177/0145561320910676 -
Sleep Medicine Reviews Dec 2021This study's objective is to systematically review the literature on natural sleep endoscopy (NSE), including the set-up, different scoring systems, visualized collapse... (Review)
Review
This study's objective is to systematically review the literature on natural sleep endoscopy (NSE), including the set-up, different scoring systems, visualized collapse patterns during natural sleep, additional measurements, and comparison of upper airway collapse between NSE and drug-induced sleep endoscopy (DISE). A computerized search on Medline, Web of Science and the Cochrane library was conducted, obtaining 39 hits. Ten prospective studies were included in which NSE was performed in adults with obstructive sleep apnea (OSA). This study's findings suggest the soft palate to be the most frequent site of obstruction (58.8 %), followed by the tongue base (43.2 %), lateral walls (29.9 %), and epiglottis (22.4 %), which is in line with previous findings during DISE. Based on this literature review, the authors conclude that at this stage high quality, comparative research between DISE and NSE is missing. To adequately compare findings between OSA patients, endoscopic classification of upper airway collapse should be standardized. Non-invasive predictive tools to determine pharyngeal collapse are currently under investigation and may obviate the need for invasive endoscopy. This review highlights the contribution of NSE in validating such novel diagnostic methods and in studying upper airway mechanics in a research setting, yet larger and adequately powered studies are needed.
Topics: Adult; Airway Obstruction; Endoscopy; Epiglottis; Humans; Prospective Studies; Sleep; Sleep Apnea, Obstructive
PubMed: 34418668
DOI: 10.1016/j.smrv.2021.101534 -
BioMed Research International 2015Recent years have witnessed an increased use of ultrasound in evaluation of the airway and the lower parts of the respiratory system. Ultrasound examination is fast and... (Review)
Review
Recent years have witnessed an increased use of ultrasound in evaluation of the airway and the lower parts of the respiratory system. Ultrasound examination is fast and reliable and can be performed at the bedside and does not carry the risk of exposure to ionizing radiation. Apart from use in diagnostics it may also provide safe guidance for invasive and semi-invasive procedures. Ultrasound examination of the oral cavity structures, epiglottis, vocal cords, and subglottic space may help in the prediction of difficult intubation. Preoperative ultrasound may diagnose vocal cord palsy or deviation or stenosis of the trachea. Ultrasonography can also be used for confirmation of endotracheal tube, double-lumen tube, or laryngeal mask placement. This can be achieved by direct examination of the tube inside the trachea or by indirect methods evaluating lung movements. Postoperative airway ultrasound may reveal laryngeal pathology or subglottic oedema. Conventional ultrasound is a reliable real-time navigational tool for emergency cricothyrotomy or percutaneous dilational tracheostomy. Endobronchial ultrasound is a combination of bronchoscopy and ultrasonography and is used for preoperative examination of lung cancer and solitary pulmonary nodules. The method is also useful for real-time navigated biopsies of such pathological structures.
Topics: Epiglottis; High-Energy Shock Waves; Humans; Intubation, Intratracheal; Laryngeal Masks; Mouth; Perioperative Care; Trachea; Tracheal Diseases; Tracheostomy; Ultrasonography; Vocal Cords
PubMed: 26788507
DOI: 10.1155/2015/754626 -
Cartilage Jul 2019The larynx sometimes requires repair and reconstruction due to cancer resection, trauma, stenosis, or developmental disruptions. Bioengineering has provided some... (Review)
Review
The larynx sometimes requires repair and reconstruction due to cancer resection, trauma, stenosis, or developmental disruptions. Bioengineering has provided some scaffolding materials and initial attempts at tissue engineering, especially of the trachea, have been made. The critical issues of providing protection, maintaining a patent airway, and controlling swallowing and phonation, require that the regenerated laryngotracheal cartilages must have mechanical and material properties that closely mimic native tissue. These properties are determined by the cellular and proteomic characteristics of these tissues. However, little is known of these properties for these specific cartilages. This review considers what is known and what issues need to be addressed.
Topics: Arytenoid Cartilage; Bioengineering; Cartilage; Cricoid Cartilage; Epiglottis; Female; Humans; Larynx; Male; Proteomics; Regenerative Medicine; Thyroid Cartilage; Tissue Engineering; Tissue Scaffolds; Trachea; Young Adult
PubMed: 29322878
DOI: 10.1177/1947603517749921 -
European Annals of Otorhinolaryngology,... Feb 2013Laryngomalacia is the most common laryngeal disease of infancy. It is poorly tolerated in 10% of cases, requiring assessment and management, generally surgical. Surgery... (Review)
Review
Laryngomalacia is the most common laryngeal disease of infancy. It is poorly tolerated in 10% of cases, requiring assessment and management, generally surgical. Surgery often consists of supraglottoplasty, for which a large number of technical variants have been described. This surgery, performed in an appropriate setting, relieves the symptoms in the great majority of cases with low morbidity. However, few data are available concerning the objective results: preoperative and postoperative objective assessment of these infants is therefore necessary whenever possible. Noninvasive ventilation (NIV) may be indicated in some infants with comorbid conditions or failing to respond to surgical management.
Topics: Anesthesia, General; Diagnosis, Differential; Epiglottis; France; Humans; Infant; Infant, Newborn; Laryngomalacia; Laryngoscopy; Laser Therapy; Lasers, Gas; Microsurgery; Postoperative Care; Preoperative Care; Respiratory Sounds; Tracheotomy; Treatment Outcome
PubMed: 22835508
DOI: 10.1016/j.anorl.2012.04.003