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At least 955 records · Page 53Linked to original sources
PubMed1983

Predictive factors of cricoid ring size in adults in relation to acquired subglottic stenosis.

Subglottic stenosis secondary to endotracheal intubation is a distinct clinical entity. Prolonged intubation is an important causative factor, but even short-term endotracheal intubation with too large a tube can damage the cricoid sufficient to cause delayed subglottic stenosis. After studying cricoid size and other factors in 130 adult laryngectomy and autopsy specimens, the following conclusions were reached: (1) The subglottic cricoid is the smallest, fixed cross section in the upper airway. (2) Even if height is comparable, women have smaller cricoid diameters than men. (3) Height is the best predictor of cricoid size. (4) Weight and race are not accurate predictors. (5) Third finger length and cricoid size correlate well, particularly in men. (6) Thus height and third finger length can be used to choose the proper endotracheal tube for adults.

Adult↗
PubMed1990

[Cricothyreotomy using the Quicktrach coniotomy instrument set].

Percutaneous cricothyroidotomy may be a lifesaving procedure for airway obstruction, which cannot be relieved by endotracheal intubation and can be performed with specially designed instruments. A new device, the "Quicktrach", was evaluated by an anatomical preparation, flow and resistance measurements, and puncture of the cricothyroid membrane in 55 corpses. The size of the parts of the instrument (needle, plastic cannula, depth gauge) in relation to the size of the larynx is adequate, thus there is little likelihood of perforation of the posterior wall of the larynx. Resistance of the plastic cannula is sufficiently low to allow for adequate ventilation. The duration of time until the cannula is positioned properly in the trachea is significantly shorter, when an incision prior to the puncture is done (83 +/- 88 seconds without incision versus 35 +/- 41 seconds with incision; mean +/- SD). The "Quicktrach" is easy to apply even by inexperienced persons. The incidence of damage to the larynx (lesions including fractures of the thyroid, cricoid and 1. tracheal cartilage in 18%; soft tissue injury in 9%) is relatively high, however considering the live saving character of the procedure these numbers appear to be acceptable. Technical problems which occur with the use of the device are discussed and suggestions for improvement are made.

Airway Obstruction↗
PubMed1982

An assessment of grafts in the posterior cricoid lamina.

Subglottic stenosis is a recognized complication of prolonged intubation. To date, there is no uniformly successful operative procedure for severe subglottic stenosis, fulfilling the criteria of decannulation and a serviceable voice. The surgical ideals for such a procedure should include the use of autogenous grafting material, avoidance of internal stenting, and limited manipulation of the mucosa. This study was intended to assess the fate of isolated hyoid and thyroid alar grafts interposed in the posterior cricoid lamina. Additionally, anterior/posterior splits with and without anterior grafting were evaluated. Seventeen dogs were used in the determinate animal model. Vocal cord mobility was evaluated by direct laryngoscopy prior to sacrifice. Graphic gross anatomical specimens depict the effects of anterior/posterior splitting on the cricoid cartilage. Clinical correlations are suggested.

Animals↗
PubMed1993

[2 children with stridor and a thymus in the posterior mediastinum].

Two infants are described with an inspiratory and expiratory stridor with apnea. X-ray examination showed a mass in the posterior mediastinum. For this reason both infants underwent a diagnostic thoracotomy because detailed study didn't resolve the problem. An aberrant localized thymus was found in both infants. In both infants, however, the complaints persisted after the operation. Both infants needed a second operation to relieve the stridor, which appeared to be due to (primary and secondary) tracheomalacia. This article describes shortly the embryology of the abnormally located thymus. The possibilities to diagnose a posterior mediastinal mass without thoracotomy are also described. Using magnetic resonance imaging (MRI), the posterior located thymus can be diagnosed noninvasively in most cases. The aberrantly positioned thymus should be included in the differential diagnosis of a posterior mediastinal mass, otherwise invasive methods are needed to come to the good diagnosis.

Apnea↗
PubMed1987

The anterior cricoid split in puppies.

The acute and long-term effects of the anterior cricoid split on the subglottis of puppies intubated from 7 to 14 days are documented. The anterior cricoid split acutely increased the intralumenal cricoid surface area in puppies with intubation-induced airway injury. An intense inflammatory response with mucosal ulceration and granulation tissue is elicited by 14 days of intubation by using the canine model of induced subglottic stenosis developed by Supance et al. [19]. When animals intubated for 14 days underwent an anterior cricoid split on day 7, the airway appears essentially normal by day 14. The split cricoid cartilage maintained a 'U' configuration following the procedure. The region of deficient cartilage anteriorly is bridged by fibrous tissue with normal epithelium lining the lumenal surface. Splitting the cricoid cartilage anteriorly increased the intralumenal area and no long term complications resulted from the procedure. The mechanisms by which the anterior cricoid split expands the airway intralumenal area while maintaining airway support have been reviewed.

Animals↗
PubMed1986

The cricoid yoke--a device for providing consistent and reproducible cricoid pressure.

An instrument is described which, when used during the accelerated induction technique, ensures that consistent and adequate cricoid pressure can be applied. Mothers undergoing general anaesthesia for elective Caesarean section were studied in order to illustrate the clinical application of the instrument. The consequences to intubating conditions of applying adequate cricoid pressure, and an assessment of the instrument's control over the incidence of regurgitation during operation were investigated.

Adult↗