No abstract available.
Epiglottis ; Humans

Epiglottic abscess may result from a coalescent epiglottic infection or secondary infection of an epiglottic mucocele. The lesion has the possibility of compressing the potential airway and thus warrants rapid assessment and treatment. The authors experienced three cases of the epiglottic abscess and report them with a review of literature.
Abscess* ; Coinfection ; Epiglottis ; Mucocele

Adult ; Epiglottis ; abnormalities ; Female ; Humans

Schwannoma of the larynx are rare benign tumor. Most laryngeal schwannomas were seen at the aryepiglottic fold or the false vocal cords. But there were extremely rare reports about schwannoma of the epiglottis. We report an unusual case of epiglottic schwannoma with the literature.
Epiglottis ; Larynx ; Neurilemmoma ; Vocal Cords

BACKGROUND: The Flexiblade laryngoscope has a unique structure that is composed of a blade and a handle with a trigger. When the trigger of the Flexiblade laryngoscope is squeezed, the hyoepiglottic ligament is depressed, the epiglottis is moved anteriorly, and then the laryngoscopic grade is improved. This study was designed to compare the Flexiblade laryngoscope with the conventional Macintosh blade laryngoscope in the laryngoscopic view in endotracheal intubation. METHODS: Following induction of general anesthesia, the laryngoscopic grades of 110 patients were evaluated while five different blade positions of the Flexiblade laryngoscope and a laryngoscopy with the Macintosh blade were performed. The laryngoscopic grades which were described by Cormack and Lehane were classified from 1 to 4. RESULTS: With the Macintosh blade laryngoscope, 98.2% of the patients were grade one and two, and 98.2% of the patients was laryngoscopic grade one and two with partial depression of the trigger of the Flexiblade laryngoscope. The laryngoscopic grade of maximal depression of the Flexiblade trigger had similar results to partial depression of the trigger. However, the partial depression of the Flexiblade laryngoscope showed better laryngoscopic views than the maximal depression of the Flexiblade laryngoscope or the Macintosh blade laryngoscope, respectively. In the overall success rate of endotracheal intubation and using the adjusting maneuvers, the Flexiblade laryngoscope was superior to the Macintosh blade laryngoscope. CONCLUSIONS: The Flexiblade laryngoscope is comparable to the Macintosh blade laryngoscope for endotracheal intubation, therefore, the Flexiblade laryngoscope can be recommended as the first choice for endotracheal intubation.
Anesthesia, General ; Depression ; Epiglottis ; Humans ; Intubation, Intratracheal* ; Laryngoscopes* ; Laryngoscopy ; Ligaments

There are a few reports about bradycardia or asystole caused by direct laryngoscopy. However, we encountered severe bradycardia in response to suspension laryngoscopy for laryngeal polypectomy after safely completing tracheal intubation using a direct laryngoscope with a curved blade. The tip of the curved blade of the direct laryngoscope is positioned at the vallecula (between the base of the tongue and the pharyngeal surface of the epiglottis) during tracheal intubation, while the blade tip of the suspension laryngoscope lifts the laryngeal surface of the epiglottis or supraglottic area during surgery. Therefore, suspension laryngoscopy can be said more vagotonic than curved-blade direct laryngoscopy. Because of the possibility of bradycardia induced by suspension laryngoscopy, clinicians must be careful about severe bradycardia even after safely completing intubation using direct laryngoscopy.
Bradycardia ; Epiglottis ; Heart Arrest ; Intubation ; Laryngoscopes ; Laryngoscopy ; Piperidines ; Tongue

OBJECTIVE: To investigate the improvement of dysphagia after balloon dilatation and balloon swallowing at the vallecular space with a Foley catheter in stroke patients. METHODS: This study was conducted between May 1, 2012 and December 31, 2015, and involved 30 stroke patients with complaints of difficulty in swallowing. All patients underwent videofluoroscopic swallowing study (VFSS) before and after vallecular ballooning. VFSS was performed with a 4 mL semisolid bolus. For vallecular ballooning, two trainings were performed for at least 10 minutes, including backward stretching of the epiglottis and swallowing of a balloon located in the vallecular space, by checking the movement of the Foley catheter tip in real time using VFSS. RESULTS: After examination of the dysphagia improvement pattern before and after vallecular ballooning, laryngeal elevation (x-axis: pre 2.62±1.51 mm and post 3.54±1.93 mm, p=0.038; y-axis: pre 17.11±4.24 mm and post 22.11±3.46 mm, p=0.036), pharyngeal transit time (pre 5.76±6.61 s and post 4.08±5.49 s, p=0.043), rotation of the epiglottis (pre 53.24°±26.77° and post 32.45°±24.60°, p<0.001), and post-swallow pharyngeal remnant (pre 41.31%±23.77% and post 32.45%±24.60%, p=0.002) showed statistically significant differences. No significant difference was observed in the penetration-aspiration scale score (pre 4.73±1.50 and post 4.46±1.78, p=0.391). CONCLUSION: For stroke patients with dysmotility of the epiglottis and post-swallowing residue, vallecular ballooning can be considered as an alternative method that can be applied without risk of aspiration in dysphagia treatment.
Catheters ; Deglutition ; Deglutition Disorders* ; Dilatation ; Epiglottis ; Fluoroscopy ; Humans ; Methods ; Stroke*

Aged ; Epiglottis ; microbiology ; pathology ; Humans ; Larynx ; microbiology ; pathology ; Male ; Syphilis

Authors suggest new radiologic lateral view of upper airway which can simultaneously visualize whole length of upper airway for the preanesthetic evaluation. 1) The proper use of special wedge filter and removal of shoulder shadow from the tracheal ahadow were the two essentials for the imagification of the airway. 2) This view gives pretty images of upper respiratory tract ineluding epiglottis, vocal cord and tracheal passage. 3) The potential usefulness of the whole lengt lateral view of upper airway is thought to be promising in many fields. For example, measurement of length of variaus airway structure ia poseible by use of this view. In conclusion, this view is a noninvasive and inexpensive radiologic method as a approach to detect abnormalities of the larynx and trachea both before and after intubation.
Epiglottis ; Intubation ; Larynx ; Respiratory System* ; Shoulder ; Trachea ; Vocal Cords

OBJECTIVE: To evaluate the accuracy of the swallowing kinematic analysis. METHODS: To evaluate the accuracy at various velocities of movement, we developed an instrumental model of linear and rotational movement, representing the physiologic movement of the hyoid and epiglottis, respectively. A still image of 8 objects was also used for measuring the length of the objects as a basic screening, and 18 movie files of the instrumental model, taken from videofluoroscopy with different velocities. The images and movie files were digitized and analyzed by an experienced examiner, who was blinded to the study. RESULTS: The Pearson correlation coefficients between the measured and instrumental reference values were over 0.99 (p<0.001) for all of the analyses. Bland-Altman plots showed narrow ranges of the 95% confidence interval of agreement between the measured and reference values as follows: 0.14 to 0.94 mm for distances in a still image, -0.14 to 1.09 mm/s for linear velocities, and -1.02 to 3.81 degree/s for angular velocities. CONCLUSION: Our findings demonstrate that the distance and velocity measurements obtained by swallowing kinematic analysis are highly valid in a wide range of movement velocity.
Biomechanics ; Deglutition ; Epiglottis ; Mass Screening ; Reference Values ; Reproducibility of Results