BACKGROUND Fibrobronchoscopy is a common adjunct tool that requires anesthesia and is widely used in the diagnosis and treatment of various respiratory diseases.However,current anesthesia methods,such as spray,nebuliz...BACKGROUND Fibrobronchoscopy is a common adjunct tool that requires anesthesia and is widely used in the diagnosis and treatment of various respiratory diseases.However,current anesthesia methods,such as spray,nebulized inhalation,and cricothyroid membrane puncture,have their own advantages and disadvantages.Recently,studies have shown that bronchoscopic direct-view glottis anesthesia is a simple and inexpensive method that shortens the examination time and provides excellent anesthetic results.AIM To evaluate the effectiveness of bronchoscopic direct vision glottis anesthesia for bronchoscopy.METHODS The study included 100 patients who underwent bronchoscopy during thoracic surgery.A random number table method was used to divide the patients into control and observation groups(50 patients each).The control and observation groups were anesthetized using the nebulized inhalation and bronchoscopic direct vision glottis method,respectively.Hemodynamic indices[systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),and oxygen saturation(SpO_(2))before(T1),5 min after anesthesia(T2),and at the end of the operation(T3)]serum stress hormone indices[norepinephrine(NE),epinephrine(E),adrenocorticotropic hormone(ACTH),and cortisol(Cor)before and after treatment]were compared between the 2 groups.Adverse effects were also RESULTS At T2 and T3,SBP,DBP,and HR were lower in the observation group than the control group,whereas SpO_(2) was higher than the control group[(119.05±8.01)mmHg vs(127.05±7.83)mmHg,(119.35±6.66)mmHg vs(128.39±6.56)mmHg,(84.68±6.04)mmHg vs(92.42±5.57)mmHg,(84.53±4.97)mmHg compared to(92.57±6.02)mmHg,(74.25±5.18)beats/min compared to(88.32±5.72)beats/min,(74.38±5.31)beats/min compared to(88.42±5.69)beats/min,(97.36±2.21)%vs(94.35±2.16)%,(97.42±2.36)%vs(94.38±2.69%],with statistically significant differences(all P<0.05).After treatment,NE,E,ACTH,and Cor were significantly higher in both groups than before treatment,but were lower in the observation group than in the control group[(68.25±8.87)ng/mL vs(93.35±14.00)ng/mL,(53.59±5.89)ng/mL vs(82.32±10.70)ng/mL,(14.32±1.58)pg/mL vs(20.35±3.05)pg/mL,(227.35±25.01)nmol/L vs(322.28±45.12)nmol/L],with statistically significant differences(all P<0.05).The incidence of adverse reactions was higher in the control group than in the observation group[12.00%(12/50)vs 6.00%(3/50)](P<0.05).CONCLUSION The use of bronchoscopic direct vision glottis anesthesia method for bronchoscopy patients is beneficial for stabilizing hemodynamic indices during bronchoscopy and reducing the level of patient stress,with good safety and practicality.展开更多
In this paper, we propose a restricted, adaptive threshold approach for the segmentation of images of the glottis acquired from high speed video-endoscopy (HSV). The approach involves first, identifying a region of in...In this paper, we propose a restricted, adaptive threshold approach for the segmentation of images of the glottis acquired from high speed video-endoscopy (HSV). The approach involves first, identifying a region of interest (ROI) that encloses the vocal-fold motion extent for each image frame as estimated by the different image sequences. This procedure is then followed by threshold segmentation restricted within the identified ROI for each image frame of the original image sequences, or referred to as sub-image sequences. The threshold value is adapted for each sub-image frame and determined by respective minimum gray-scale value that typically corresponds to a spatial location within the glottis. The proposed approach is practical and highly efficient for segmenting a vast amount of image frames since simple threshold method is adapted. Results obtained from the segmentation of representative clinical image sequences are presented to verify the proposed method.展开更多
BACKGROUND Myxomas are benign tumors of mesenchymal origin that rarely occur in the larynx.CASE SUMMARY We report a case of a laryngeal myxoma that presented as a right vocal cord mass in a 54-year-old man.CONCLUSION ...BACKGROUND Myxomas are benign tumors of mesenchymal origin that rarely occur in the larynx.CASE SUMMARY We report a case of a laryngeal myxoma that presented as a right vocal cord mass in a 54-year-old man.CONCLUSION Laryngeal myxoma is a rare benign tumor in the larynx.It is difficult to distinguish glottis myxoma from vocal cord polyps on laryngoscopy.We recommend that otolaryngologists acquire a better understanding of this disease.If a laryngeal myxoma is suspected,dynamic laryngoscopy,acoustic voice analysis,and pathological biopsy should be performed.展开更多
Foreign body in glottis especially in infants is rare. Retrieval of foreign body is a rather simple procedure but sharing of the airway with the anaesthetist and impeding complication makes it more challenging and dan...Foreign body in glottis especially in infants is rare. Retrieval of foreign body is a rather simple procedure but sharing of the airway with the anaesthetist and impeding complication makes it more challenging and dangerous. Making a diagnosis of foreign body is most challenging in delayed cases. Complete history and detailed physical examination along with high index of suspicion, in cases of persistent cough, fever, nonresolving respiratory infection, are needed to rule out airway especially laryngeal foreign body. This series of 4 cases is being reported because of the rarity of the glottis foreign body in infants.展开更多
BACKGROUND In anesthesia practice,orotracheal intubation remains the primary concern of the anesthesiologist.The introduction of video laryngoscopy(VL)has increased the success rate of orotracheal intubation;however,c...BACKGROUND In anesthesia practice,orotracheal intubation remains the primary concern of the anesthesiologist.The introduction of video laryngoscopy(VL)has increased the success rate of orotracheal intubation;however,conflicting results have been reported regarding the usefulness of the current technique with VL in clinical practice.AIM To describe a modification to improve intubation with VL,followed by evaluation of the practice in vivo.METHODS First,a mannequin trial was conducted with operators having different experience and background.Then,a retrospective analysis was performed for an>1-year period with patients who underwent general anesthesia with orotracheal intubation.The endotracheal tube used had been pre-formed with two curves.Stepwise intubation had been performed with direct eye vision,followed by screen assistance and rotation of the tube as needed to direct it toward the glottis.In the mannequin trial,the outcome measures were quantification of torque(force with angular acceleration during levering),need for external maneuvers,and time to intubate.In the clinical experience,orotracheal intubation used VL(pre-formed tube)or direct laryngoscopy(DL)at the anesthetist’s discretion and throat discomfort was reported by the patient.RESULTS In the mannequin trials using VL,there was less torque with the pre-formed tube than with a regular tube(8%and 65%,respectively).The first-pass rate was higher with the pre-formed tube(95%)than with a regular tube(81%).However,the time to intubate was longer with the pre-formed tube than with a regular tube(22 s and 12 s,respectively).In clinical practice,562 patients underwent surgery under general anesthesia with orotracheal intubation using either VL(n=244)or DL(n=318)at the discretion of the attending anesthetist.VL was specifically planned in 62 of the patients,due to anticipated difficulty.Second attempts by readjustment of the curve of the tube were significantly fewer with VL than with DL(10%vs 18%).Throat discomfort was reported by fewer patients who underwent VL than those who underwent DL(6%vs 24%).CONCLUSION Pre-formed endotracheal tube with stepwise insertion produces less torque,fewer external maneuvers and higher first-pass success rate during VL intubation.Further,prospective studies are warranted.展开更多
OBJECTIVE: To study the pathologic features of occult lymphatic metastasis in supraglottic carcinoma. METHODS: Serial sections of 153 neck dissection specimens in 100 patients with supraglottic carcinoma were evaluate...OBJECTIVE: To study the pathologic features of occult lymphatic metastasis in supraglottic carcinoma. METHODS: Serial sections of 153 neck dissection specimens in 100 patients with supraglottic carcinoma were evaluated under the microscope. RESULTS: In 100 patients, 38 had occult metastatic lymph nodes. 51 metastatic lymph nodes were found in pathology, and their sizes ranged from 0.5 cm to 2.6 cm (average 1.1 cm). The distribution of 51 lymph nodes was 1 in level I (2%), 37 in level II (73%), 12 in level III (24%), and 1 in level IV (2%). Among the 51 nodes, 21 (41%) were early stage, 18 (35%) were growth stage, 7 (14%) were tull stage, and 5 (10%) were extracapsular stage. The differentiation degree and appearance of supraglottic carcinoma was not directly related with occult metastasis. CONCLUSION: The occult metastatic rate of supraglottic carcinoma is high, and selective neck dissection may be necessary.展开更多
基金Hebei Science and Technology Program,No.162777232(to Xing SS).
文摘BACKGROUND Fibrobronchoscopy is a common adjunct tool that requires anesthesia and is widely used in the diagnosis and treatment of various respiratory diseases.However,current anesthesia methods,such as spray,nebulized inhalation,and cricothyroid membrane puncture,have their own advantages and disadvantages.Recently,studies have shown that bronchoscopic direct-view glottis anesthesia is a simple and inexpensive method that shortens the examination time and provides excellent anesthetic results.AIM To evaluate the effectiveness of bronchoscopic direct vision glottis anesthesia for bronchoscopy.METHODS The study included 100 patients who underwent bronchoscopy during thoracic surgery.A random number table method was used to divide the patients into control and observation groups(50 patients each).The control and observation groups were anesthetized using the nebulized inhalation and bronchoscopic direct vision glottis method,respectively.Hemodynamic indices[systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),and oxygen saturation(SpO_(2))before(T1),5 min after anesthesia(T2),and at the end of the operation(T3)]serum stress hormone indices[norepinephrine(NE),epinephrine(E),adrenocorticotropic hormone(ACTH),and cortisol(Cor)before and after treatment]were compared between the 2 groups.Adverse effects were also RESULTS At T2 and T3,SBP,DBP,and HR were lower in the observation group than the control group,whereas SpO_(2) was higher than the control group[(119.05±8.01)mmHg vs(127.05±7.83)mmHg,(119.35±6.66)mmHg vs(128.39±6.56)mmHg,(84.68±6.04)mmHg vs(92.42±5.57)mmHg,(84.53±4.97)mmHg compared to(92.57±6.02)mmHg,(74.25±5.18)beats/min compared to(88.32±5.72)beats/min,(74.38±5.31)beats/min compared to(88.42±5.69)beats/min,(97.36±2.21)%vs(94.35±2.16)%,(97.42±2.36)%vs(94.38±2.69%],with statistically significant differences(all P<0.05).After treatment,NE,E,ACTH,and Cor were significantly higher in both groups than before treatment,but were lower in the observation group than in the control group[(68.25±8.87)ng/mL vs(93.35±14.00)ng/mL,(53.59±5.89)ng/mL vs(82.32±10.70)ng/mL,(14.32±1.58)pg/mL vs(20.35±3.05)pg/mL,(227.35±25.01)nmol/L vs(322.28±45.12)nmol/L],with statistically significant differences(all P<0.05).The incidence of adverse reactions was higher in the control group than in the observation group[12.00%(12/50)vs 6.00%(3/50)](P<0.05).CONCLUSION The use of bronchoscopic direct vision glottis anesthesia method for bronchoscopy patients is beneficial for stabilizing hemodynamic indices during bronchoscopy and reducing the level of patient stress,with good safety and practicality.
文摘In this paper, we propose a restricted, adaptive threshold approach for the segmentation of images of the glottis acquired from high speed video-endoscopy (HSV). The approach involves first, identifying a region of interest (ROI) that encloses the vocal-fold motion extent for each image frame as estimated by the different image sequences. This procedure is then followed by threshold segmentation restricted within the identified ROI for each image frame of the original image sequences, or referred to as sub-image sequences. The threshold value is adapted for each sub-image frame and determined by respective minimum gray-scale value that typically corresponds to a spatial location within the glottis. The proposed approach is practical and highly efficient for segmenting a vast amount of image frames since simple threshold method is adapted. Results obtained from the segmentation of representative clinical image sequences are presented to verify the proposed method.
文摘BACKGROUND Myxomas are benign tumors of mesenchymal origin that rarely occur in the larynx.CASE SUMMARY We report a case of a laryngeal myxoma that presented as a right vocal cord mass in a 54-year-old man.CONCLUSION Laryngeal myxoma is a rare benign tumor in the larynx.It is difficult to distinguish glottis myxoma from vocal cord polyps on laryngoscopy.We recommend that otolaryngologists acquire a better understanding of this disease.If a laryngeal myxoma is suspected,dynamic laryngoscopy,acoustic voice analysis,and pathological biopsy should be performed.
文摘Foreign body in glottis especially in infants is rare. Retrieval of foreign body is a rather simple procedure but sharing of the airway with the anaesthetist and impeding complication makes it more challenging and dangerous. Making a diagnosis of foreign body is most challenging in delayed cases. Complete history and detailed physical examination along with high index of suspicion, in cases of persistent cough, fever, nonresolving respiratory infection, are needed to rule out airway especially laryngeal foreign body. This series of 4 cases is being reported because of the rarity of the glottis foreign body in infants.
基金the Ethics and Research Committee of University Hospital Sharjah,No.UHS-HERC-014-30072019.
文摘BACKGROUND In anesthesia practice,orotracheal intubation remains the primary concern of the anesthesiologist.The introduction of video laryngoscopy(VL)has increased the success rate of orotracheal intubation;however,conflicting results have been reported regarding the usefulness of the current technique with VL in clinical practice.AIM To describe a modification to improve intubation with VL,followed by evaluation of the practice in vivo.METHODS First,a mannequin trial was conducted with operators having different experience and background.Then,a retrospective analysis was performed for an>1-year period with patients who underwent general anesthesia with orotracheal intubation.The endotracheal tube used had been pre-formed with two curves.Stepwise intubation had been performed with direct eye vision,followed by screen assistance and rotation of the tube as needed to direct it toward the glottis.In the mannequin trial,the outcome measures were quantification of torque(force with angular acceleration during levering),need for external maneuvers,and time to intubate.In the clinical experience,orotracheal intubation used VL(pre-formed tube)or direct laryngoscopy(DL)at the anesthetist’s discretion and throat discomfort was reported by the patient.RESULTS In the mannequin trials using VL,there was less torque with the pre-formed tube than with a regular tube(8%and 65%,respectively).The first-pass rate was higher with the pre-formed tube(95%)than with a regular tube(81%).However,the time to intubate was longer with the pre-formed tube than with a regular tube(22 s and 12 s,respectively).In clinical practice,562 patients underwent surgery under general anesthesia with orotracheal intubation using either VL(n=244)or DL(n=318)at the discretion of the attending anesthetist.VL was specifically planned in 62 of the patients,due to anticipated difficulty.Second attempts by readjustment of the curve of the tube were significantly fewer with VL than with DL(10%vs 18%).Throat discomfort was reported by fewer patients who underwent VL than those who underwent DL(6%vs 24%).CONCLUSION Pre-formed endotracheal tube with stepwise insertion produces less torque,fewer external maneuvers and higher first-pass success rate during VL intubation.Further,prospective studies are warranted.
基金theNationalNaturalScienceFoundationofChina (No 3870 82 6 )
文摘OBJECTIVE: To study the pathologic features of occult lymphatic metastasis in supraglottic carcinoma. METHODS: Serial sections of 153 neck dissection specimens in 100 patients with supraglottic carcinoma were evaluated under the microscope. RESULTS: In 100 patients, 38 had occult metastatic lymph nodes. 51 metastatic lymph nodes were found in pathology, and their sizes ranged from 0.5 cm to 2.6 cm (average 1.1 cm). The distribution of 51 lymph nodes was 1 in level I (2%), 37 in level II (73%), 12 in level III (24%), and 1 in level IV (2%). Among the 51 nodes, 21 (41%) were early stage, 18 (35%) were growth stage, 7 (14%) were tull stage, and 5 (10%) were extracapsular stage. The differentiation degree and appearance of supraglottic carcinoma was not directly related with occult metastasis. CONCLUSION: The occult metastatic rate of supraglottic carcinoma is high, and selective neck dissection may be necessary.
