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At least 973 records · Page 54Linked to original sources
PubMed1981

Cervical esophageal dysphagia: indications for and results of cricopharyngeal myotomy.

Twenty patients with cervical esophageal dysphagia were treated by cricopharyngeal myotomy. Of these 20 patients, ten had pharyngoesophageal diverticula, four had a hypertensive upper esophageal sphincter (UES), four had bulbar palsy, and two has miscellaneous forms of cricopharyngeal dysfunction. Preoperative esophageal manometric examination revealed mean UES pressures of 37.2 mmHg +/- 4.8 SEM in patients with diverticula-markedly lower (p = 0.01) than in normal patients (55.9 mmHg +/- 5.0 SEM). In patients with hypertensive UES the mean pressure was 166.2 mmHg +/- 13.4, significantly higher (p less than 0.001) than normal. Incoordination of the deglutitive response of the UES characterised by premature relaxation and contraction was present in all patients with diverticula and in one other patient. Another patient exhibited incomplete sphincteric relaxation (achalasia). A 4-5 cm myotomy of the cricopharyngeus muscle and adjacent esophageal muscle was performed in all patients. On the patients with diverticula two also had diverticulectomy. No patient with bulbar palsy was benefited. All other patients were relieved of dysphagia by the operation, with the exception of one patient with a diverticulum. A subsequent diverticulectomy was required in this patient. Postoperative manometric examination revealed an average decrease in UES pressure of 63% and an average decreased in length of the high pressure zone of 1.4 cm.

Adult↗
PubMed1988

Cricoid pressure and the pressor response to tracheal intubation.

Forty healthy adults who underwent rapid sequence induction of anaesthesia were allocated randomly to receive either cricoid pressure or its stimulation. The anticipated increase in systolic arterial pressure and heart rate after laryngoscopy and tracheal intubation were not altered significantly by the application of cricoid pressure.

Adult↗
PubMed1984

Chronic chondritis of the arytenoid cartilages in a pony mare.

The upper respiratory tract of a pony mare with marked exercise intolerance and respiratory stridor was examined with a flexible fibreoptoscope. Both arytenoids were adducted and distorted. A diagnosis of bilateral chondritis of the arytenoids was made and confirmed at autopsy after surgery to enlarge the rima glottidis was unsuccessful. Other space occupying lesions of the rima glottidis are discussed and theories on the aetiology are postulated.

Animals↗
PubMed1984

Endoscopic laser arytenoidectomy for the treatment of bilateral vocal cord paralysis.

Most patients with bilateral vocal cord paralysis have a fairly satisfactory voice, but their airway is usually compromised. The management of such patients presents a challenge to the otolaryngologist-head and neck surgeon. Numerous surgical procedures have been developed in an attempt to improve the patients's airway insufficiency without leaving him with a breathy, weak voice. Arytenoidectomy is currently the most reliable method of treating patients with bilateral vocal cord paralysis. Although both endoscopic and external approaches have been described for performing an arytenoidectomy, the endoscopic technique is more desirable since it requires no incision and theoretically allows for the immediate assessment of airway size. The addition of the CO2 laser to the surgical armamentarium offers certain refinements to the technique of endoscopic arytenoidectomy. Eleven patients with bilateral vocal cord paralysis of the larynx have been treated by endoscopic laser arytenoidectomy by the authors utilizing a technique developed by the two senior authors and subsequently taught to over 200 participants of the CO2 laser workshops sponsored by the Department of Otolaryngology-Head and Neck Surgery at Northwestern University Medical School; 10 of the 11 patients have been successfully decannulated. The technique and problems of this operation will be discussed.

Aged↗
PubMed1989

[The aging alterations of the arytenoid cartilage].

The aging processes of the arytaenoid cartilage were described. We inspected 58 arytaenoid cartilage at the age of 0 to 91 years. The arytaenoid cartilage consists mainly of hyaline cartilage, whereas the apex, colliculus and the vocal processus consist of elastic cartilage. The cartilage of larynx exhibits changes concerning the cells and the intercellular substance. Chondrocytes show fatty degeneration, the cell density decreased. During the age intercellular substance shows the following changes: albuminoid degeneration, partly loss of intercellular substance with exhibition of well visible collagen fibers, calcification and ossification. Intercellular substance shows basophilic reaction up to the 4th decennium, later the reaction becomes more and more eosinophilic.

Adolescent↗
PubMed1987

[Therapy of ankylosis of the cricoarytenoid joint following intubation].

The immobility of the vocal cord following endotracheal intubation is often misinterpreted as a paralysis. Possibilities are pointed out to differentiate between vocal cord paralysis and ankylosis of the cricoarytenoid joint. Furthermore it is shown another simple therapeutic procedure to mobilize the fixed joint.

Adolescent↗
PubMed1985

[Vocal cord paralysis with stridor caused by interarytenoid fibrosis--a complication of intensive care].

Translaryngeal long-term intubation in intensive-care patients was followed in three cases by immobilisation of the vocal cords and severe stridor, caused by a fibrotic scar between the processus vocales and the posterior commissure. Different surgical approaches are described. Endoscopic incision of the scars is recommended. Most important is a bolting technique for several consecutive days.

Adult↗
PubMed1984

Experience with elective coniotomy.

One hundred and five coniotomies have been carried out, as an alternative to tracheotomy on patients in the ICU, Danderyd Hospital. The procedure is easy to perform, relatively riskfree and is attractive in terms of resources required. However a rather high frequency of voice-changes were found.

Adolescent↗
PubMed1993

Laryngeal carcinoma: sclerotic appearance of the cricoid and arytenoid cartilage--CT-pathologic correlation.

PURPOSE: To assess the significance of sclerotic-appearing cricoid and arytenoid cartilage with computed tomography (CT) in patients with laryngeal carcinoma. MATERIALS AND METHODS: CT scans obtained in 75 patients with laryngeal carcinoma were prospectively studied; laryngeal CT studies obtained in 50 patients without laryngeal carcinoma were retrospectively reviewed. RESULTS: Twenty-four of the 75 patients (32%) with laryngeal carcinoma had sclerotic cartilage. Evaluation of pathologic specimens obtained in 12 of these 24 patients showed 11 cases of sclerotic arytenoid cartilage and two cases of sclerotic cricoid cartilage. Tumor infiltration was demonstrated in six of these cases but not in the seven others. In 11 of the 12 cases with pathologic proof, however, tumor was adjacent to the perichondrium. In the 12 cases without pathologic proof, the proportion was similar. The positive predictive value of this sign for cartilaginous invasion was 46%. CONCLUSION: Although it is not a reliable sign of cartilaginous invasion, sclerotic-appearing cricoid and arytenoid cartilage in patients with laryngeal carcinoma is predictive of the tumor to this cartilage.

Adult↗
PubMed1990

Extraluminal arytenoid reconstruction: laryngeal framework surgery applied to a pediatric problem.

Laryngeal framework surgery has proved to be an important alternative in the treatment of vocal cord paralysis in adults. We have modified one of these operations in order to manage debilitating aspiration in a 14-year-old boy. His laryngeal incompetence resulted from a severe neurologic injury and laryngeal scarring from a unilateral arytenoidectomy and multiple Teflon injections. To help him, we studied a series of pediatric larynges and devised an operation that succeeded in rebuilding the bulk of his excised arytenoid cartilage and markedly reducing aspiration.

Adolescent↗