Child, Preschool ; Humans ; Infant ; Airway Obstruction/complications* ; Laryngostenosis/surgery* ; Tracheostomy

Adult ; Airway Obstruction ; etiology ; Anesthetics ; adverse effects ; Humans ; Male ; Polyps ; complications ; Tonsillar Neoplasms ; complications ; Young Adult

Airway Obstruction ; diagnosis ; etiology ; Aspergillosis ; complications ; diagnosis ; Humans ; Laryngeal Diseases ; complications ; diagnosis ; microbiology ; Larynx

Infants with laryngotracheal anomalies are clinically manifested as stridor or noisy breathing, choking, hoarseness, feeding difficulties, and cyanotic spells, followed by developmental and growth retardation and other health issues; in severe cases, patients may present with severe dyspnea, which is associated with high mortality. A timely diagnosis as well as appropriate strategy for laryngotracheal anomalies is still challenging for pediatric otolaryngologists. This consensus statement, evolved from expert opinion by the members of the Pediatric Otorhinolaryngology Professional Committee of the Pediatrician Branch of the Chinese Medical Doctor Association, provides comprehensive recommendations and standardized guidance for otolaryngologists who manage infants and young children with laryngotracheal anomalies in evaluation and treatment based on symptomatology, physical and laboratory examinations.
Humans ; Child ; Infant ; Child, Preschool ; Laryngostenosis/surgery* ; Airway Obstruction/complications* ; Hoarseness/complications* ; Consensus ; Respiratory Sounds

Airway Obstruction ; complications ; etiology ; physiopathology ; Asphyxia ; etiology ; physiopathology ; Fibroma ; complications ; pathology ; Humans ; Infant, Newborn ; Oropharyngeal Neoplasms ; complications ; pathology ; Rare Diseases

Due to modern methods, thyroid surgery is generally considered quite safe. However, post-thyroidectomy hematomas, although rare, can be life-threatening and unpredictable complications of thyroid surgery. Most postthyroidectomy hematomas occur within 24 hours of surgery, with delayed hematomas occurring after one post-operative week being exceedingly rare. Herein, we report a case of delayed post-thyroidectomy hematoma with respiratory distress occurring on the eighth post-operative day in a patient who was not taking anticoagulants and had no hematologic diseases. Although most bleeding occurs within 24 hours, caution should be used even in such patients who are considered low-risk.
Airway Obstruction* ; Anticoagulants ; Hematologic Diseases ; Hematoma* ; Hemorrhage ; Humans ; Postoperative Complications ; Thyroid Gland ; Thyroidectomy

Postoperative residual neuromuscular blockade or residual paralysis in the postanesthesia care unit is associated with postoperative complications such as muscle weakness, difficulty in breathing, airway obstruction, and hypoxemia. Residual paralysis can be defined by inadequate neuromuscular recovery as measured by objective neuromuscular monitoring. The train-of-four ratio threshold less than or equal to 0.9 is considered to indicate inadequate neuromuscular recovery. Careful management of residual paralysis may decrease the occurrence of adverse events associated with residual neuromuscular blockade. In this review, the clinical implications of residual neuromuscular blockade are summarized.
Airway Obstruction ; Anoxia ; Muscle Weakness ; Neuromuscular Blockade* ; Neuromuscular Monitoring ; Paralysis ; Postoperative Complications ; Respiration

Obstructive sleep apnea syndrome (OSAS) is endangering human health seriously now. We had reviewed some typical animal model which had at least one OSAS character of intermittent hypoxia and/or hypercapnia, upper airway obstruction and sleep structure disorder. However, all of these models could not simulate clinical and pathological features of OSAS completely. Establishing a suitable animal model to study OSAS and related diseases is very important.
Airway Obstruction ; etiology ; Animals ; Disease Models, Animal ; Humans ; Hypercapnia ; etiology ; Hypoxia ; etiology ; Sleep Apnea, Obstructive ; complications

BACKGROUND: There is a greater incidence of complications such as desaturation, laryngospasm, airway obstruction and vomiting during tracheal extubation than intubation. We survey to ascertain current tracheal extubation practice and to estimate the incidence of problems associated with extubation and suggest the recommendation about extubation practice. METHODS: We sent an anonymous questionnaire to resident and staffs of anesthesiology departments in five different area. These anesthesiologists were asked to complete and return anonymously in the stamped, addressed envelope provided. We received 130 replies from 134 questionnaires (97%). RESULTS: We found that 38% of respondents use awake extubation and only 1% use it for deep extubation. Eighty-two percent would use reversal agents at extubation. More than 75% usually extubated at the end of inspiration. The administration of 100% oxygen before extubation was 'always' used in every case by 81% of anesthesiologists. Many respondents are extubating elective, emergency surgery, and obese patients in the supine position regardless of patients situation and not following the traditional practice of extubating in the head-down and left lateral position. Every respondent had experienced average 4.1 extubation complications during last 3 months. The incidences of postoperative complications such as excessive coughing (15.3%), irritability (13.8%), desaturation (9.9%), airway obstruction (8.7%) were relatively high in our survey. CONCLUSIONS: We should need to discuss and establish recommendation how they are trained in extubation on the basis of more surveys and reported experiences.
Airway Extubation ; Airway Management ; Airway Obstruction ; Anesthesiology ; Anonyms and Pseudonyms ; Cough ; Surveys and Questionnaires ; Emergencies ; Humans ; Incidence ; Intubation ; Laryngismus ; Oxygen ; Postoperative Complications ; Supine Position ; Vomiting

OBJECTIVETo summarize the clinical features of vascular malformations complicated with airway obstruction and to evaluate the therapeutic methods of these disease.

METHODSForty-seven children with airway obstruction and dyspnea (25 males, 22 females) were treated from Jun 1985 to Dec 2007, and their clinical data were retrospectively analyzed. Among 47 patients, there were 27 cases of venous malformations, 17 cases of macrocystic lymphatic malformations, and 3 cases of microcystic lymphatic malformations. Injection with absolute alcohol were performed in 20 patients with venous malformations, whereas both surgery and injection were performed in 7 patients with extensive or multiple lesions. Seventeen patients with macrocystic lymphatic malformations were treated with pingyangmycin injection. While surgery combined with pingyangmycin injection were used in other 3 patients with microcystic lymphatic malformations. According to the degree of airway obstruction and therapeutic conditions, tracheal intubation was performed in 27 patients, urgent preoperative tracheotomy was performed in 3 patients, prophylactic tracheotomy was performed in 2 patients, and postoperative tracheotomy was performed in 1 patient.

RESULTSTracheal intubation was remained for 24 to 48 hours in 30 patients, whose intubation was removed successfully in 29 patients except 1 patient who occurred dyspnea after removal of tracheal intubation resulting in tracheotomy. Tracheal cannula was successfully removed in all 6 patients 3 weeks to 4 months after the tracheotomy. There were 9 patients treated once, whereas injections were repeated 2 to 5 times in 38 patients. Necrosis of mucosa occurred in 2 cases after the injection with absolute alcohol, while temporary hemoglobinuria one occurred in 1. There were 5 cases of light or mediate fever after the pingyangmycin injection who recovered well after the symptomatic treatment. Follow-up lasted 1 to 23 years, 38 patients cured, 9 patients valid, and no patient invalid.

CONCLUSIONSIt is suggested that sclerotherapy should be the first choice in the treatment of vascular malformations complicated with airway obstruction, in which absolute alcohol should be used in venous malformations compared to pingyangmycin in lymphatic malformations. Combined therapy should be carried out in patients with extensive lesions in order to shorten the course of treatment and to get good therapeutic result.

Adolescent ; Airway Obstruction ; complications ; Child ; Child, Preschool ; Combined Modality Therapy ; Female ; Humans ; Infant ; Male ; Treatment Outcome ; Vascular Malformations ; complications ; therapy