Assuntos
Humanos , Criança , Sons Respiratórios , Laringoestenose , Coleta de Dados , Constrição Patológica , Intubação IntratraquealAssuntos
Laringoestenose , Sons Respiratórios , Criança , Constrição Patológica , Coleta de Dados , Humanos , Intubação IntratraquealRESUMO
PURPOSE: To assess the use of preoperative, dynamic ultrasound to predict ulnar nerve instability following in situ decompression for cubital tunnel syndrome. METHODS: Prior to undergoing in situ decompression, 43 consecutive patients underwent dynamic ultrasound to assess the stability of the ulnar nerve during elbow flexion. The dynamic ultrasound findings were compared with the intraoperative assessment of nerve stability following in situ decompression. RESULTS: The preoperative dynamic ultrasound agreed with intraoperative findings in 38 of 43 patients (88%). Physical examination of ulnar nerve stability agreed with the intraoperative findings in 5 of 43 patients (12%). For the 5 of 43 cases in which the dynamic ultrasound did not correlate with the degree of ulnar nerve stability after in situ decompression, dynamic ultrasound overestimated the degree of ulnar nerve stability in 4 cases. CONCLUSIONS: Preoperative dynamic ultrasound can be used to accurately predict the degree of ulnar nerve instability following in situ decompression. TYPE OF STUDY/LEVEL OF EVIDENCE: Diagnostic II.
Assuntos
Síndrome do Túnel Ulnar/cirurgia , Descompressão Cirúrgica , Nervo Ulnar/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Período Intraoperatório , Masculino , Pessoa de Meia-Idade , Cuidados Pré-Operatórios , UltrassonografiaRESUMO
INTRODUCTION: It is essential for clinicians to understand issues relevant to the airway management of infants and to be cognizant of the fact that infants with congenital laryngeal anomalies are at particular risk for an unstable airway. OBJECTIVES: To familiarize clinicians with issues relevant to the airway management of infants and to present a succinct description of the diagnosis and management of an array of congenital laryngeal anomalies. METHODS: Revision article, in which the main aspects concerning airway management of infants will be analyzed. CONCLUSIONS: It is critical for clinicians to understand issues relevant to the airway management of infants.
Assuntos
Doenças da Laringe/congênito , Laringe/anormalidades , Cistos/congênito , Hemangioma/congênito , Humanos , Neoplasias Laríngeas/congênito , Laringomalácia/congênito , Laringoestenose/congênito , Paralisia das Pregas Vocais/congênitoRESUMO
Introduction: It is essential for clinicians to understand issues relevant to the airway management of infants and to be cognizant of the fact that infants with congenital laryngeal anomalies are at particular risk for an unstable airway. Objectives: To familiarize clinicians with issues relevant to the airway management of infants and to present a succinct description of the diagnosis and management of an array of congenital laryngeal anomalies. Methods: Revision article, in which the main aspects concerning airway management of infants will be analyzed. Conclusions: It is critical for clinicians to understand issues relevant to the airway management of infants. .
Introdução: As anomalias congênitas da laringe estão em risco de uma via aérea instável, sendo essencial que o clínico tenha uma boa compreensão dos problemas relevantes para o manuseio das vias aéreas de bebês. Objetivos: Familiarizar os clínicos com os problemas relevantes para o manuseio das vias aéreas de bebês e apresentar uma descrição sucinta do diagnóstico e tratamento de uma série de anomalias congênitas da laringe. Método: Artigo de revisão, no qual serão tratados os principais aspectos relacionados ao manuseio das vias aéreas de bebês. Conclusões: É essencial que o clínico tenha um bom conhecimento dos problemas relevantes ao manuseio das vias aéreas de bebês. .
Assuntos
Humanos , Doenças da Laringe/congênito , Laringe/anormalidades , Paralisia das Pregas Vocais/congênito , Laringoestenose/congênito , Neoplasias Laríngeas/congênito , Cistos/congênito , Laringomalácia/congênito , Hemangioma/congênitoRESUMO
Tracheal stenosis caused by complete tracheal rings has previously not been associated with Down syndrome. We identified 7 children with Down syndrome and complete tracheal rings. We found the clinical presentation and airway anatomy to be variable, advocating a heightened level of suspicion when evaluating a child with Down syndrome.
Assuntos
Síndrome de Down/complicações , Traqueia/anormalidades , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Traqueia/cirurgia , Estenose Traqueal/etiologia , Estenose Traqueal/cirurgiaRESUMO
Severe subglottic stenosis in children is best managed by laryngotracheal reconstruction or cricotracheal resection (CTR). We describe clinical outcomes with CTR and end-to-end anastomosis in pediatric patients with severe subglottic stenosis in a tertiary-care pediatric teaching hospital in Mexico City. We prospectively followed up all consecutive patients younger than 18 years of age with a Myer-Cotton grade 3 or 4 subglottic stenosis who underwent CTR between May 1, 2000, and March 31, 2003. The frequency of each clinical outcome was calculated. Twenty-two patients (16 boys [72.7%] and 6 girls [27.3%]) were included. The mean age at operation was 4.6 years (range, 11 months to 16 years). Eighteen patients (81.8%) required primary CTR, and 4 (18.2%) required extended CTR. Seventeen (77.3%) had grade 3 stenosis, and 5 (22.7%) had grade 4 stenosis. Six (27.3%) had associated clinical conditions, and 3 (13.6%) had associated vocal cord mobility defects. All were tracheostomy-dependent at presentation, and none had undergone previous airway surgery. Ten (45.5%) underwent one-stage surgery, and 12 (54.5%) had a concomitant temporary tracheotomy. No intraoperative complications occurred. Seventeen patients (77.3%) developed postoperative granulation tissue requiring endoscopic resection. The mean follow-up was 1.2 years (range, 2 months to 2.8 years). No deaths occurred. Fifteen children (88.2%) with grade 3 stenosis and 5 (100%) with grade 4 stenosis were decannulated, for an overall decannulation rate of 90.9%. Partial cricoid resection with end-to-end anastomosis has been a feasible procedure with reproducible successful results among our patients. We conclude that CTR performed as a primary procedure is an effective treatment for the management of severe subglottic stenosis in children.