Exercise-induced asthma is defined as bronchospasm within the distal airways initiated by exercise. Whether the larynx responds to produce an exacerbation or alleviation of symptoms during an attack has never been evaluated. Thirty subjects were tested, including 15 normals and 15 with exercise-induced asthma. Laryngeal response to exercise was determined by measuring the area of the glottic aperture before, during, and after exercise. The glottis was visualized with a flexible laryngoscope and video images were recorded during monitoring of respirations. Asthma was induced in subjects by having them exercise on an ergometer for 10 minutes while breathing dry air at 10 degrees C. Measurements were subsequently made from recorded images and relative glottic areas were compared between groups. Our data quantify the normal physiologic response of the larynx to exercise and demonstrate a substantial laryngeal contribution to asthma induced by exercise.
Objective 1) Measure the effectiveness of the Monarch implant in correcting nasal valve dysfunction. 2) Determine the longevity of effectiveness. Methods This study consists of a prospective, cumulative, three-year experience with the Monarch adjustable nasal implant for correcting nasal valve dysfunction in a total of 46 patients. Implantation success was determined by the use of acoustic rhinomanometry and a subjective NOSE-type quality of life scale. Data was subjected to the student-t test. Results In the series of 46 patients spanning 36 months there is a mean 150% improvement in the internal nasal valve areas at 3 years as measured by acoustic rhinomanometry (p<.0001). Using a NOSE-type questionnaire, patients also noted significant improvements in daytime (p<.0004) and nighttime (p<.0002) nasal airways, a decrease in apnea (p<.01) and snoring (p<.05), and a decrease in the propensity for daytime oral breathing (p<.0002). Conclusions The Monarch Implant provides a simple, consistent, adjustable and apparently long-term correction of the nasal airway in patients suffering from nasal valvular dysfunction.
A 14-year-old girl developed progressive hoarseness and breathing difficulty due to a mass in the subglottic larynx. A biopsy specimen obtained at direct laryngoscopy snowed localized aggregates of amyloid. The lesion was excised completely with a carbon dioxide laser. This is the second case of laryngeal amyloidosis in a child reported in the English-language literature.
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