The pediatric airway and respiratory function differ from those in adults. Optimum management requires consideration of these differences, but the application of adult principles is usually sufficient to buy time in an emergency until specialist pediatric help is available. Simple airway opening techniques such as head tilt and jaw thrust are usually sufficient to open the child's airway, but t...

and is a commonly reported problem with other supraglottic intubating devices. The tip of the TotaltrackTM blade is protected by a silicone cover to minimize epiglottic or oropharyngeal injury. The TotaltrackTM does require a minimum inter-incisor distance of at least two cm and the device may be more difficult to insert in the presence of enlarged breasts. In all our study patients, a full vie...

1. Departamento de Radiología, Hospital Universitario Ramón y Cajal, Madrid, España. 2. Departamento de Cirugía Torácica, Hospital Universitario Ramón y Cajal, Madrid, España. A 68-year-old woman with myasthenia gravis underwent a CT scan of the chest, which revealed a 4-cm solid mass in the anterior mediastinum, consistent with a thymoma (Figure 1). A type II tracheal bronchus, arising 3 cm ab...

Perioperative airway problems frequently result in significant morbidity and mortality in children. Therefore, proficiency in airway management is one of the most important key elements in the safe conduct of paediatric anaesthesia. This review includes important anatomical and physiological aspects of the paediatric airway, challenges encountered, and their management with commonly available r...

This report describes an unusual case of severe obstructive sleep apnea and alveolar hypoventilation leading to hypersomnolence and cor pulmonale, which were corrected by tracheostomy. Four years later, after a 22.5-kg weight gain, nocturnal apneas of similar frequency, duration, and depth of desaturation reappeared but were totally central in origin. The central apneas were eliminated with hom...

OBJECTIVE To assess the utility of the pectoralis major muscle flap (PMMF) in patients undergoing salvage total laryngectomy. DESIGN Retrospective cohort analysis. SETTING Tertiary care cancer center. PATIENTS The study included 461 patients who underwent laryngectomy. Eighty of them underwent salvage surgery with primary pharyngeal closure. INTERVENTIONS Of the 80 patients, 69 (86%) un...

A 63-yr-old man (height, 173 cm) with a remote history of bronchiectasis and a double lung transplant was emergently intubated during a recent bout of bronchitis. An air leak was noted with positive-pressure ventilation through an 8.0-mm cuffed endotracheal tube until the cuff contained 12 ml air, with a cuff pressure of 22 cm H2O. This computed tomographic image shows the following: (A) the en...

BACKGROUND Radiation therapy-related dysphagia is worsened by xerostomia. The submandibular glands (SMG) produce saliva rich in lubricating mucins, and sparing the SMG has been shown to reduce xerostomia. The goal of this study was to determine whether SMG sparing IMRT is associated with reduced post-treatment PEG dependence in locally advanced oropharynx cancer patients. METHODS Patients tre...

OBJECTIVES Chest tube insertion seems to be one important factor leading to intercostal nerve impairment. The purpose of this prospective study was to objectively evaluate intercostal nerve damage using current perception threshold testing in association with chest tube insertion. METHODS Sixteen patients were enrolled in this study. Intercostal nerve function was assessed with a series of 20...