Acute laryngeal obstruction is one of the most common diseases in Department of ENT, and it can cause suffocation without prompt treatment. Methods by using Nasopharyngofiberoscope guided tracheal intubation treatment of a case of acute laryngeal obstruction patients in a timely manner. This method is well tolerated, less trauma, high success rate, in the shortest time to improve the patient's ventilation, for the next step of the treatment to win the time.
Airway Obstruction ; surgery ; Humans ; Intubation, Intratracheal ; Larynx ; physiopathology

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

The beauty of the laryngeal mask is that it forms an air tight seal enclosing the larynx rather than plugging the pharynx, and avoid airway obstruction in the oropharynx. The goal of its development was to create an intermediate form of airway management face mask and endotracheal tube. Indication for its use includes any procedure that would normally involve the use of a face mask. The laryngeal mask airway was designed as a new concept in airway management and has been gaining a firm position in anesthetic practice. Despite wide spread use the definitive role of the laryngeal mask airway is yet to be established. In some situations, such as after failed tracheal intubation or in oral surgery its use is controversial. There are several unresolved issues, for example the effect of the laryngeal mask on regurgitation and whether or not cricoids pressure prevents placement of mask. We review the techniques of insertion, details of misplacement, and complications associated with use of the laryngeal mask. We then attempt to clarify the role of laryngeal mask in air way management during anesthesia, discussing the advantages and disadvantages as well as indications and contraindications of its use in oral and maxillofacial surgery.
Airway Management ; Airway Obstruction ; Anesthesia ; Beauty ; Intubation ; Laryngeal Masks ; Larynx ; Masks* ; Neck ; Oropharynx ; Pharynx ; Surgery, Oral

Noninvasive continuous positive airway pressure (CPAP) for the ventilation treatment of obstructive sleep apnea-hypopnea syndrome (OSAHS) is the first-line treatment method. This article aims to describe the effect of surgical operation especially for the UPPP in the individualized comprehensive treatment of OSAHS and the importance of surgical technique. Lower compliance is the bottleneck of CPAP therapy in clinical application, for the OSAHS patients with treatment failure in CPAP or those cannot accept CPAP therapy, when with no other ideal instrument therapeutics, accurate diagnosis of position in airway obstruction with an adequate surgical operation is the treatment,of choice. Surgical operation is particularly important either as a fore-lying means to improve the CPAP treatment compliance or as an independence treatment method of OSAHS. The pharyngeal cavity is the most common obstructive plane in patients with OSAHS. The operation of traditional UPPP aiming at the expansion of pharyngeal cavity is the classics surgery to solve obstruction in this plane, the lower operation effective rate is the main reason of restriction in its development. How to improve the effective rate of surgical treatment of OSAHS is our surgical goal. The effective rate of surgical operation treatment in OSAHS rely on the following sides: to follow the OSAHS individualized comprehensive treatment principle, reasonable choice of surgical operation indication, the precise localization diagnosis of upper airway obstruction, adequate surgical operation and skilled surgical techniques.
Airway Obstruction ; Continuous Positive Airway Pressure ; Humans ; Palate ; surgery ; Pharynx ; surgery ; Sleep Apnea, Obstructive ; surgery ; Treatment Failure

OBJECTIVETo investigate the feasibility of mandibular distraction osteogenesis (MDO) in the treatment of airway obstruction in Pierre Robin syndrome (PRS).

METHODSFrom 2007 to 2009, 8 newborns with PRS were treated with MDO. The mandibular distractors were fixed after bilateral oblique mandibular osteotomy. The distraction was started one day after operation, three times a day. The distraction distance was 1.2 mm per day until it reached about 12 -20 mm (mean 15 mm).

RESULTSThe distraction was successfully completed in 8 cases with no complication. The distraction distance reached 15 mm, as we expected. The discontinuity cyanosis, inspiratory dyspnea, dystithia were improved after distraction.

CONCLUSIONSMDO is feasible and safe for the treatment of airway obstruction in PRS.

BACKGROUND: Tracheal extubation can be performed while patients are deeply anesthetized or when they are awake. Each technique has its own advantages and disadvantages. But necessity for deep extubating conditions, and what level of anesthesia is adequately deep, is still controversial. Clinical conditions of patients or the preference of the anesthesiologist has dictated the choice of extubation technique. METHOD: Anesthesia was induced and maintained as usual manners. The 49 healthy children between 3 and 12 year of age undergoing tonsillectomy and adenoidectomy were randomly assigned to group 1(extubation at 1 MAC of enflurane) and group 2(awake extubation). SpO2 and airway-related complications(cough, breath-holding, airway obstruction, and laryngospasm) were observed for 5 minutes after extubation with 100% O2 by mask, and SpO2 and heart rate were measured for 90 seconds during transportation to the recovery room with room air breathing. RESULTS: The total incidence of airway-related complications in group 2 were higher than in group 1. However, group 1 showed severer complications than in group 2 such as airway obstruction and laryngospasm. There was no differences between the two groups in SpO2 and heart rate changes with 100% O2 mask just after extubation and during transportation. Group 1 showed higher SpO2 than group 2 upon arrival in the recovery room. CONCLUSION: We concluded that in healthy children undergoing elective oral surgery, airway-related complications are likely to be influenced more by the skill, experience and preference of the anesthesiologist than by the method alone.
Adenoidectomy ; Airway Extubation ; Airway Obstruction ; Anesthesia ; Child* ; Heart Rate ; Humans ; Incidence ; Laryngismus ; Masks ; Recovery Room ; Respiration ; Surgery, Oral ; Tonsillectomy ; Transportation

Objective:To discuss the clinical characteristic and treatment of laryngeal cysts in infants. Methods:The clinical data of 19 patients diagnosed with laryngeal cysts in Department of Otolaryngology, Sichuan Provincial Maternity and Child Health Care Hospital from November 2017 to April 2023 were retrospectively analyzed. Results:All of the 19 patients were diagnosed as laryngeal cysts, with clinical manifestations included respiratory distress, inspiratory dyspnea, difficulty in feeding and low and weak crying, etc. All of them were cured after surgical treatment. Conclusion:Misdiagnosis and missed diagnosis of laryngeal cysts are prone to occur in infants and young children. After diagnosis, patients should undergo early surgical treatment to remove airway obstruction and improve ventilation.
Pregnancy ; Infant ; Child ; Humans ; Female ; Child, Preschool ; Retrospective Studies ; Laryngeal Diseases/surgery* ; Airway Obstruction/surgery* ; Laryngoscopy ; Cysts/surgery* ; Dyspnea/surgery*

Macroglossia can create dental and skeletal instability after orthodontic treatment or orthognathic surgery for mandibular prognathism. In relevant literature, partial glossectomy is suggested for a good post-treatment prognosis. Most of the published partial glossectomy cases are two-staged surgery, because of concern about postoperative airway obstruction. As orthognathic surgical techniques and fixation method develop, however, concerns about postoperative airway obstruction have lessened. In this case, mandibular setback surgery and partial glossectomy were performed simultaneously, leading to stable recovery without any postoperative respiratory problems. After surgical technique to preserve the tongue tip, we achieved good outcomes without postoperative side effects of lingual hypoesthesia, pronunciation disorder and dyskinesia. We report this case with a literature review.
Airway Obstruction ; Dyskinesias ; Glossectomy* ; Hypesthesia ; Macroglossia ; Orthognathic Surgery* ; Prognathism* ; Prognosis ; Tongue

BACKGROUND: To study the effect of chloral hydrate oral premedication on sedation and arterial oxygen saturation in noncyanotic and cyanotic congenital heart disease children. METHODS: 18 noncyanotic congenital heart disease patients and 18 cyanotic congenital heart disease patients scheduled for cardiac surgery were premedicated orally with chloral hydrate 50 mg/kg. Arterial oxygen saturations were measured with pulse oximeter before and after oral premedication and sedation effects evaluated. RESULTS: In noncyanotic group oxygen saturation decreased from 98.7+/-0.95% (mean+/-?SD) before premedication to 97.8+/-1.15% after premedication with statistical significance but without meaning. 16 of the 18 patients (89%) were adequately sedated without airway obstructions. In cyanotic group oxygen saturation increased with statistical insignificance from 73.5+/-10.9% before premedication to 74.0+/-13.9% after premedication. 15 of the 18 patients(83%) were adequately sedated. Effects on oxygen saturation in cyanotic group patients were quite variable with 3 of the patients revealing more than 10% decrease in oxygen saturation. CONCLUSIONS: Chloral hydrate has a good sedative effects on congenital heart disease children but its effects on oxygen saturation were variable and close monitoring followed by oxygen administration is recommended in cyanotic heart patients.
Airway Obstruction ; Child* ; Chloral Hydrate* ; Heart ; Heart Defects, Congenital* ; Humans ; Hypnotics and Sedatives ; Oxygen* ; Premedication ; Thoracic Surgery

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