Valvular glottic obstruction following extubation

Chatterji, Sumit; Gupta, Neera; Mishra, Trishla

doi:10.1111/j.1365-2044.1984.tb07235.x

Cited by 19 publications

(8 citation statements)

References 3 publications

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“…Spontaneous reduction of the dislocated arytenoid cartilage has been reported 14,23,24 and was observed in four patients in this series. Spontaneous reduction can be preceded by coughing or vomiting.…”

Section: Discussionmentioning

confidence: 77%

See 1 more Smart Citation

Arytenoid Cartilage Dislocation: A 20-year Experience

Rubin¹,

Hawkshaw²,

Moyer³

et al. 2005

Journal of Voice

116

143

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Section: Discussionmentioning

confidence: 77%

“…The usefulness of CT imaging 13,14,16,21,26,28 and laryngeal EMG 16,26 to otolaryngologists has been Journal of Voice, Vol. 19, No.…”

Section: Discussionmentioning

confidence: 99%

Arytenoid Cartilage Dislocation: A 20-year Experience

Rubin¹,

Hawkshaw²,

Moyer³

et al. 2005

Journal of Voice

116

143

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“…Cardiovascular complications include tachycardia, hypotensive and hypertensive episodes [7][8][9][10], which may be significant in patients with pre-existing ischaemic heart disease [11,12], pre-eclampsia [13] and in those undergoing neurological procedures [14]. Respiratory complications include local trauma, coughing, desaturation, breath-holding, masseter-spasm, laryngospasm, airway obstruction and aspiration [7,[15][16][17][18]]. …”

mentioning

confidence: 99%

Airway management before, during and after extubation: a survey of practice in the United Kingdom and Ireland

Rassam¹,

Sandby-Thomas²,

Vaughan³

et al. 2005

Anaesthesia

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SummaryComplications at extubation remain an important risk factor in anaesthesia. A postal survey was conducted on extubation practice amongst consultant anaesthetists in the United Kingdom and Ireland. The use of short acting drugs encourages anaesthetists to extubate the trachea at lighter levels of anaesthesia. The results show that oxygen (100%) is not routinely administered either before extubation or en route to the recovery area. A trend towards a head up or sitting position at extubation is emerging. However, further research into the use of these positions is required. Airway related complications at extubation are relatively frequent but are usually dealt with by simple basic measures. The role of drugs such as propofol in decreasing the incidence of these complications needs further evaluation. Some of these results give concern for patient safety and for training. The importance of teaching and adherence to continued oxygenation until complete recovery is strongly emphasised. Nerve stimulators should be used continually as standard monitoring throughout the anaesthetic period when muscle-relaxing drugs are part of the anaesthetic technique. It has been shown that there are more adverse incidents associated with extubation than intubation and these are occurring not only during extubation itself, but also during the time spent in the recovery room [1][2][3][4][5]. The increased incidence of complications has been correlated with the pre-operative physical status, depth of anaesthesia at extubation, increasing age and gender with a male preponderance [2,6]. These complications remain consistent regardless of the type of operation [1].The problems associated with extubation may be broadly categorised into cardiovascular and respiratory complications. Cardiovascular complications include tachycardia, hypotensive and hypertensive episodes [7][8][9][10], which may be significant in patients with pre-existing ischaemic heart disease [11,12], pre-eclampsia [13] and in those undergoing neurological procedures [14]. Respiratory complications include local trauma, coughing, desaturation, breath-holding, masseter-spasm, laryngospasm, airway obstruction and aspiration [7,[15][16][17][18]].An on-line journal search revealed a lack of recent investigations or statistical data in these areas. This survey was performed with this in mind. The main aims of the survey were twofold. The first was to ascertain extubation practices with regard to the type of surgery, timing, position and techniques. The second was to estimate the incidence of problems associated with extubation and how these were treated. MethodsA postal survey was conducted in May 2004. A total of 845 Consultant Anaesthetists were randomly selected from the membership database of the Association of Anaesthetists of Great Britain and Ireland (AAGBI). These anaesthetists were sent the questionnaire, which they were asked to complete and return anonymously in the stamped, addressed envelope provided. The questionnaire (Fig. 1) was a structured document with...

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“…11,21 Posterior displacement has been attributed to a posterolateral force applied to the arytenoid from the convex curvature of the distal third of the endotracheal tube as it is inserted. 3 The stretching of the aryepiglottic fold that occurs upon elevation of the supraglottis with insertion of the direct laryngoscope has been proposed as a maneuver that may compromise the stability of the joint and predispose it to subluxation."…”

Section: Hoffman Et Al Arytenoid Subluxationmentioning

confidence: 99%

Arytenoid Subluxation: Diagnosis and Treatment

Hoffman

Brunberg²,

Winter³

et al. 1991

Ann Otol Rhinol Laryngol

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Both arytenoid subluxation and recurrent laryngeal nerve paralysis (RLNP) may result from injury to the larynx, and they may be difficult to distinguish clinically. A patient with arytenoid subluxation who was initially believed to have RLNP was treated with medialization laryngoplasty 1 year after the injury. Preoperative magnetic resonance imaging and computed tomography effectively demonstrated the cricoarytenoid subluxation, which was confirmed by intraoperative electromyography (EMG) showing normal electrical activity in the thyroarytenoid muscle. Photographs from preoperative fiberoptic laryngoscopy are presented to identify the appearance of arytenoid subluxation. Computed tomographic findings and photographs from laryngoscopy of two patients with RLNP documented by intraoperative EMG evaluation are presented to help distinguish the clinical appearance of this disorder from arytenoid subluxation. An integrated approach to the diagnosis and treatment of arytenoid subluxation is presented.

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Valvular glottic obstruction following extubation

Abstract: A case of glottic valvular obstruction following extubation is reported. The cause was bilateral dislocation of arytenoidr due to coughing on following a further bout of coughing.

Cited by 19 publications

References 3 publications

Arytenoid Cartilage Dislocation: A 20-year Experience

Arytenoid Cartilage Dislocation: A 20-year Experience

Airway management before, during and after extubation: a survey of practice in the United Kingdom and Ireland

Arytenoid Subluxation: Diagnosis and Treatment

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