Biomedical subjects

Yvonne Fischer

Publications and source records attributed to Yvonne Fischer.

5 recordsLinked to original sources

PubMed2006

Influence of passive humidification on respiratory heat loss in tracheotomized patients.

BACKGROUND: The aim of this study was to evaluate changes in total respiratory heat loss during use of a heat and moisture exchanger (HME) in tracheotomized patients. METHODS: Tracheal humidity and temperature were measured before the application and during use of the HME (plastic foam impregnated with CaCl2), and total respiratory heat loss was calculated. RESULTS: No significant difference was found between the convective heat exchange before and after use of the HME for a 10-minute period. When the HME was placed on the tracheal opening, the evaporative heat exchange and the total respiratory heat loss decreased significantly. CONCLUSIONS: The results indicate that passive airway humidification is effective in tracheotomized patients even after a 10-minute period. However, the positive effect on the energy balance of the tracheal mucosa after prolonged use of the HME remains to be proven.

Body Temperature↗

PubMed2005

[Identification and evaluation of obstructive sleep apnea in children before adenotonsillectomy using evaluative surveys].

Sleep-disordered breathing (SDB) caused by enlarged tonsils and adnoids is common in early childhood. SDB without alterations in alveolar ventilation or sleep architecture is called primary snoring and affects up to 3-12 % of young children. In contrast, SDB with associated apneas or hypopneas affects between 0.7-3 % and is called obstructive sleep apnea syndrome (OSAS). OSAS and primary snoring should be distinguished with polysomnography (PSG). Despite the large number of patients undergoing tonsillectomy and adenoidectomy, the ability to assess patients-based preoperative diagnosis and surgical outcomes polysomnographically is limited. As a consequence it remains difficult which children will or will not benefit from surgical intervention. In the context of OSAS diagnosis, a discriminative survey is desired, one that cold classify differences before surgery as small, moderate or large. A promising office based surrogate measure are disease-specific quality-of-life surveys. Change within patients can be measured using an evaluative survey, administered before and after an intervention.

Adenoidectomy↗

PubMed2005

[Tonsillotomy].

BACKGROUND: In contrast to tonsillectomy, only intracapsular parts of palatine tonsil are resected in tonsillotomy. This procedure has been revived for treatment of tonsillar hypertrophy causing obstructive sleep apnoea. Tonsillar hypertrophy is the most relevant cause for obstructive sleep apnoea in children often associated with malnutrition due to problems with swallowing. In these patients tonsillotomy is performed, because it is less painful, the children recover more quickly and the results on snoring, difficulty breathing and apnoea are equal in comparison to conventional tonsillectomy. In patients elder than 8 years or suffering from chronic or recurrent tonsillitis, tonsillectomy is the preferable surgical modality, because scarring and persistent inflammation in tonsillar remnants may be urge revision surgery. CONCLUSION: Tonsillotomy is a good alternative for tonsillectomy in children with symptomatic hypertrophy of the palatine tonsils.

Adenoids↗

PubMed2003

Multilevel temperature-controlled radiofrequency therapy of soft palate, base of tongue, and tonsils in adults with obstructive sleep apnea.

OBJECTIVES/HYPOTHESIS: The concept of two-level pharyngeal collapse in patients with obstructive sleep apnea is too simplified. Aggressive multilevel surgeries addressing several airway segments, including skeletal surgery, demonstrate improved success rates. STUDY DESIGN: The study aimed to evaluate the safety and efficacy of multilevel radiofrequency application to soft palate, tonsils, and base of tongue in 16 white patients (mean age, 56.9 +/- 11.1 y; mean body mass index, 27.3 +/- 2.6 kg/m2) with obstructive sleep apnea. There was one dropout. Therapeutic effects after one treatment session were assessed 20.6 +/- 12.6 weeks postoperatively. Treatment outcome measurements were based on Epworth Sleepiness Scale, Likert scales, and polysomnography. METHODS: Every patient received 16 treatment sites with a total dose of 9750 J radiofrequency energy into soft palate, base of tongue, and tonsils. Success was defined as respiratory disturbance index equal to or less than 20 or at least 50% improvement if baseline respiratory disturbance index was less than 20. Statistical analysis was determined with the Spearman rank test. RESULTS: Mean score on Epworth Sleepiness Scale decreased from 11.1 to 8.2 (P =.0001). Of the patients, 53.3% reported improvement of their daytime sleepiness. Snoring was assessed with 10-point Lickert scale, and score decreased from 7.5 to 4.9 (P =.08). Mean respiratory disturbance index decreased from 32.6 +/- 17.4 to 22.0 +/- 15.0 (P =.003). By our definition of success, 5 of 15 patients (33%) have been treated successfully surgically and 4 of 15 (27%) had remarkable improvement after one treatment session; 1 patient (6.6%) demonstrated deterioration. There were two adverse effects, one superficial ulceration of the soft palate and one unilateral tonsillar abscess formation, with an overall complication rate of 13.3% for our patients and 0.41% for all treatment sites (n = 240). CONCLUSION: Moderate to severe obstructive sleep apnea usually requires multilevel pharyngeal surgery. Radiofrequency offers the potential of altering the upper airway on different sites.

Adult↗

PubMedDate not supplied

Radiofrequency-induced thermotherapy on nasal polyps: preliminary results.

BACKGROUND: The aim of this study was to determine the effects of radiofrequency-induced thermotherapy (RFITT) in patients with nasal polyps. METHODS: A retrospective analysis was performed of prospectively collected data from 17 consecutive patients (11 men and 6 women; mean age, 51.7 +/- 16.9 years) treated with RFITT from 2002 to 2003. The postoperative outcome was assessed using active anterior rhinomanometry, "sniffin' stick" test, and endoscopic nasal examination preoperatively and 4 weeks postoperatively. Subjective complaints were assessed with Likert scales. RESULTS: Transnasal airflow increased by 40.3% 4 weeks postoperatively (p = 0.029). Endoscopic appearance of nasal polyps indicated a nonsignificant reduction of 37.1%. Subjective complaints such as impaired nasal ventilation (p = 0.014), nasal discharge (p = 0.0007), postnasal drip (p = 0.0002), and hyposmia (p = 0.048) improved significantly 4 weeks after surgery. CONCLUSION: RFITT is well tolerated as a day case procedure under local anesthesia and might be a procedure for treating recurrence of NP after sinus surgery. It remains unclear at this point whether RFITT for nasal polyps results in a permanent reduction.

Adult↗