Technique for improved safety in the endoscopic management of subglottic stenosis

Hulstein, Stephanie L.; Hoffman, Henry T.

doi:10.1016/j.amjoto.2015.10.009

Cited by 3 publications

(2 citation statements)

References 9 publications

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“…These include barotrauma, mucosal damage, laryngospasm, hypoxemia, cervicomediastinal emphysema, pneumothorax, esophageal injury, and death. [5][6][7] Of the various techniques, the percutaneous trans-tracheal approach appeared to have a higher rate of complication. 6 At our center, we reasoned that the adoption of a standardized MJV protocol that limits peak jet pressures would provide satisfactory respiratory support and operating conditions, and minimize the risk associated with jet ventilation.…”

Section: Introductionmentioning

confidence: 99%

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Low Pressure Low Frequency Jet Ventilation: Techniques, Safety and Complications

Myint¹,

Teng

Butler

et al. 2022

Ann Otol Rhinol Laryngol

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Objective: Manual jet ventilation is a specialized oxygenation and ventilation technique that is not available in all facilities due to lack of technical familiarity and fear of complications. The objective is to review our center’s 15 year experience with low pressure low frequency jet ventilation (LPLFJV). Methods: Retrospective review of procedures utilizing LPLFJV from 2005 to 2019 were performed collecting patient demographic, surgery type and complications. Fisher exact test, Chi square, and t-test were used to determine statistical significance. Results: Four hundred fifty-seven patients underwent a total of 891 microlaryngeal surgeries—279 cases for voice disorders, 179 for lesions, and 433 for airway stenosis. The peak jet pressure for all cases did not exceed 20 psi and average peak pressure for the last 100 procedures in this case series was 14.9 ± 4.6 psi. The average lowest oxygen saturation for all cases was 95% ± 0.6%. Brief intubation was required in 154 cases (17%). Surgical duration was significantly longer for cases requiring intubation P < .001. The need for intubation was not associated with smoking or cardiopulmonary disease, but was strongly associated with body mass index (BMI). Intubation rates were 7% for normal weight (BMI < 25, N = 216), 13% for overweight (BMI 25-30, N = 282), 24% for obese (BMI 30-40, N = 342), and 37% for morbidly obese (BMI > 40, N = 52) patients. Three patients developed respiratory distress in the recovery unit and 2 patients required intubation. Conclusion: LPLFJV assisted by intermittent endotracheal intubation is an exceedingly safe and effective intraoperative oxygenation and ventilationmodality for a broad variety of laryngeal procedure.

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Section: Introductionmentioning

confidence: 99%

“…These include barotrauma, mucosal damage, laryngospasm, hypoxemia, cervicomediastinal emphysema, pneumothorax, esophageal injury, and death. 5 -7 Of the various techniques, the percutaneous trans-tracheal approach appeared to have a higher rate of complication. 6…”

Section: Introductionmentioning

confidence: 99%

Low Pressure Low Frequency Jet Ventilation: Techniques, Safety and Complications

Myint¹,

Teng

Butler

et al. 2022

Ann Otol Rhinol Laryngol

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Anesthesia considerations during management of airway stenosis: A systematic review

Mangahas

Talugula

Husain

2023

American Journal of Otolaryngology

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Outcomes of balloon dilation for paediatric laryngeal stenosis

Cantarella

Gaffuri

Torretta

et al. 2020

Acta Otorhinolaryngol Ital

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SUMMARY Objective Balloon dilation (BD) is a minimally invasive endoscopic treatment for paediatric laryngeal stenosis (LS) with reduced morbidity compared to open surgery. We retrospectively describe our experience in a cohort of children with chronic LS. Methods Fourteen children (median age: 28.5; range: 2-81 months) with chronic LS (multilevel in 8) were treated with tubeless total intravenous anaesthesia under spontaneous ventilation. Results Grade III LS was preoperatively detected in 12 children; the remaining 2 had grade IV stenosis. Six had prior tracheotomy, and one received it during the first intervention. Dilation laryngoplasty was the primary treatment in 11 children and was used as an adjuvant treatment in 3 after open reconstructive surgery. The median number of dilations was 2 (range: 1-6). There were no postoperative complications. At the end of the follow-up (median: 20.5; range: 2-46 months), detectable laryngeal lumen widening and/or respiratory improvement occurred in 12 children. Two of 7 patients with tracheostomy were decannulated. Conclusions Balloon laryngoplasty is a valuable therapeutic option to improve laryngeal patency in children with chronic multilevel LS, both as a primary and secondary adjuvant treatment after reconstructive surgery.

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Technique for improved safety in the endoscopic management of subglottic stenosis

Cited by 3 publications

References 9 publications

Low Pressure Low Frequency Jet Ventilation: Techniques, Safety and Complications

Low Pressure Low Frequency Jet Ventilation: Techniques, Safety and Complications

Anesthesia considerations during management of airway stenosis: A systematic review

Outcomes of balloon dilation for paediatric laryngeal stenosis

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