Foreign Bodies ; Glottis ; Humans

Foreign Bodies ; diagnosis ; Glottis ; Humans ; Infant

Hiccups are an involuntarily powerful spasm of the diaphragm, followed by a sudden inspiration with a closure of the glottis. Hiccups that are caused by gastric distention, spicy foods and neural dysfunction can resolve themselves without any treatment. Some hiccups are associated with certain diseases or they occur postsurgically, and life-restricting intractable hiccups should be treated. The cause of hiccups should be quickly determined so as to administer the proper treatment. Hiccups often remit spontaneously within a short period of time, but they may also occur without remission for a prolonged period in some cases. We report here on a 36-year-old man who suffered with intractable hiccups for 5 years. We administered a single oral dose of baclofen, and then the hiccups disappeared. We conclude that a single dose of baclofen is a good treatment for intractable hiccups.
Adult ; Baclofen ; Diaphragm ; Glottis ; Hiccup ; Humans ; Spasm

PURPOSE: The purpose of this study is to compare the effectiveness of the GlideRite with the conventional-malleable-stylet (CMS) in endotracheal intubation (ETI) using the Macintosh-laryngoscope. METHODS: This study is a randomized crossover simulation study. Participants performed ETI using both the GlideRite and the CMS in the normal airway and in a tongue edema (simulated difficult airway resulting in lower percentage of glottis opening [POGO]) model. RESULTS: In both the normal and the tongue edema models, all 36 participants performed ETI successfully using the two stylets on the first attempt. In the normal airway model, there was no difference in time required for ETI (T(ETI)) or ease of handling between the two stylets. In the tongue edema model, the T(ETI) increased as POGO score decreased with the CMS (POGO score showing negative correlation with T(ETI) for the CMS, Spearman's rho=-0.518, p=0.001) but not for the GlideRite (rho=-0.208, p=0.224). The T(ETI) was shorter with the GlideRite than the CMS, but without statistical significance (15.1 vs. 18.8 seconds, p=0.385). Ease of handling was superior with the GlideRite compared to the CMS (p=0.006). CONCLUSION: Performance of the GlideRite and the CMS was not different in the normal airway model. However, in the simulated difficult airway model with a low POGO score, the GlideRite performed better than the CMS for direct laryngoscopic intubation.
Edema ; Glottis ; Intubation ; Intubation, Intratracheal* ; Tongue

Glottis ; physiopathology ; Humans ; Vocal Cords ; physiopathology ; Voice Training

Glottis ; pathology ; Humans ; Laryngeal Neoplasms ; surgery ; Minimally Invasive Surgical Procedures

B-Lymphocytes ; Glottis ; Humans ; Lymphoma, B-Cell, Marginal Zone ; diagnosis

Child, Preschool ; Foreign Bodies ; Glottis ; Hoarseness ; etiology ; Humans ; Male

PURPOSE: The most important function of the larynx is airway protection which is provided through a polysynaptic reflex closure triggered by the receptors in the glottic and supraglottic mucosa, evoking the reflex contraction of the laryngeal muscles especially by strong adduction of vocal cords. Based on the hypotheses that central facilitation is essential for this bilateral adductor reflex and that its disturbance can result in weakened laryngeal closure, we designed this study to elucidate the effect of central facilitation on this protective reflex. MATERIALS AND METHODS: Seven adult, 20 kg mongrel dogs underwent evoked response laryngeal electromyography under 0.5 to 1.0 MAC (minimum alveolar concentration) isoflurane anesthesia. The internal branch of the superior laryngeal nerve was stimulated through bipolar platinum-iridium electrodes, and recording electrodes were positioned in the ipsilateral and contralateral thyroarytenoid muscles. RESULTS: Ipsilateral reflex closure was consistantly recorded regardless of anesthetic levels. However, contralateral reflex responses disappeared as anesthetic levels were deepened. Additionally, late responses (R2) were detected in one animal at lower level of anesthesia. CONCLUSIONS: Deepened level of anesthesia affects central facilitation and results in the loss of the crossed adductor reflex, predisposing to a weakened glottic closure response. Precise understanding of this effect may possibly provide a way to prevent aspiration in unconscious patients.
Anesthesia/methods ; Animals ; Dogs ; Glottis/*physiology ; Laryngeal Nerves/physiology ; *Reflex

Intubating patients with a huge, fixed supraglottic mass causing an obstruction of the glottis is difficult to most anesthesiologists. We attempted awake fiberoptic orotracheal intubation assisted by Glidescope(R) Videolaryngoscope (GVL) following topical anesthesia with 4% lidocaine spray and remifentanil infusion. The glottis could not be identified by the GVL view. However, by entering toward the right side of the mass with bronchoscope, the glottis was found. Due to stiffness of the mass, we were unable to further enter the area using the bronchoscope. Alternatively, we attempted to expose the glottis by GVL blade and then successfully intubated the patient by manually pressing the cricoids cartilage. GVL is nonetheless an excellent instrument in airway management compared to fiberoptic bronchoscope for patients with a huge and fixed supraglottic mass.
Airway Management ; Anesthesia ; Bronchoscopes ; Cartilage ; Glottis ; Humans ; Intubation ; Lidocaine ; Piperidines