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PubMed1990

[Video fluoroscopy of the swallowing act following partial supraglottic laryngectomy].

Videofluoroscopy of swallowing was performed in 21 patients who had undergone partial horizontal laryngectomy. Food residues were present in most of these patients. Residues of liquid contrast were observed in 85.7% of the patients and residues of consistent contrast in 61.5% of the patients. In most cases, food remnants were to be found in the glossolaryngeal recess. The mechanisms of compensation, additional swallowing, and expiration after swallowing are an important factor in clearing the throat of any residual food. Impaired clearing of food residues results in aspiration. Aspiration of liquid contrast was observed in 76.2% of the patients and aspiration of consistent contrast in 19.1% of the patients (p less than 0.001). Aspiration after swallowing was observed in most of the patients.

Aged↗
PubMedDate not supplied

Comparison of extraction devices for the removal of supraglottic foreign bodies.

OBJECTIVE: By using a porcine model, the efficacy of various extraction devices for airway foreign body removal was examined. METHODS: The upper airways of euthanized swine were occluded with a rubber ball, glass marble, or grape. A Magill forceps, a spongestick forceps, and a nasal trumpet attached to suction were used by test subjects for foreign body removal. Extraction success and time were recorded for each removal attempt. Satisfaction scores were recorded for each foreign body and device combination. RESULTS: Seven paramedics, seven residents, and seven attending physicians participated. A total of 189 attempts were analyzed. Success rates for foreign body extraction with Magill and spongestick forceps were similar, with both devices superior to nasal trumpet (98% and 97% vs. 83%, respectively, p < 0.001). For successful ball removal attempts, the mean extraction time with spongestick forceps was less than those for both Magill forceps and nasal trumpet: 12.4 (95% confidence interval [CI], 10-14.7) versus 23.4 (95% CI, 16.3-30.3) and 21.2 (95% CI, 14.2-28.3) seconds, respectively. For marble removal, the mean extraction time with spongestick forceps also was less than Magill forceps and nasal trumpet: 10.8 (95% CI, 8.7-12.8) versus 18.4 (95% CI, 12.8 to 23.8) and 16.7 (95% CI, 12.6-20.8) seconds, respectively. For grape removal, the mean extraction times with both spongestick and Magill forceps were less than that of nasal trumpet: 11.8 (95% CI, 7.1 to 16.4) and 8.1 (95% CI, 6.8-9.4) versus 15.6 (95% CI 10-21.2) seconds, respectively. Subjects preferred the spongestick forceps for removal of the glass and rubber ball to the Magill forceps and nasal trumpet. CONCLUSION: In this porcine model, the SF appeared to be the most efficient and preferred device for extracting the type of airway foreign body that is associated with fatal asphyxiation.

Airway Obstruction↗