Use of McGrath^(■) MAC Video Laryngoscope for Nasotracheal Intubation in Patients for Whom Intubation Was Expected to Be Difficult Due to the Limited Mouth Opening

McGrath? MAC video laryngoscope (McG) has been used for orotracheal intubation in both normal patients and patients for whom intubation was expected to be difficult, and has been reported to provide improved visibility of the glottis during tracheal intubation. There are some reports that normal nasotracheal intubation is easier with McG than with macintosh laryngoscope (ML). The usefulness of McG for nasotracheal intubation is beginning to be recognised. We experienced three cases using McG in patients for whom intubation was expected to be difficult due to the limited mouth opening and using McG for those patients enabled smooth nasotracheal intubation. McG provides good visual field during nasotracheal intubation, and is less invasive to the patient.

Effect of Mouth Opening Training Stick Combined with Oral Massage on Mouth Opening Difficulty in Head and Neck Cancer Patients after Treatment

Objective: To study the application effect of mouth-opening training sticks combined with oral massage on patients with mouth-opening difficulty after treatment for head and neck cancer. Methods: Using convenient sampling, 60 patients with mouth-opening difficulty after treatment for head and neck cancer admitted to the Oncology Department from February 2022 to October 2023 were selected for a 2-week exercise and nursing program. The patients were divided into a control group (February 1, 2022 to November 30, 2022) and an observation group (December 1, 2022 to October 31, 2023), with 30 patients in each group. The control group underwent routine mouth-opening functional exercises combined with cork for oral support training, while the observation group underwent routine mouth-opening functional exercises combined with oral massage and mouth-opening training sticks for oral support training. The mouth-opening degree, mouth-opening difficulty level, comfort level, compliance, and quality of life were observed in both groups. Results: Before the intervention, there were no statistically significant differences in mouth-opening degree and mouth-opening difficulty level between the two groups (P > 0.05). After the intervention, the mouth-opening degree, mouth-opening difficulty level, oral comfort level, compliance, and QLICP-HN scores in the observation group were all better than those in the control group, with statistically significant differences (P < 0.05). Conclusion: The combination of mouth-opening training sticks and oral massage with mouth-opening functional exercises can effectively improve the degree of mouth-opening difficulty, enhance oral comfort, increase compliance with mouth-opening exercises, and improve quality of life.

Visual communication in social play of a hierarchical carnivore species:the case of wild spotted hyenas

Communication relies on signals that can be produced via different sensory modalities to modify receivers’behavior.During social interactions,the possibility to perceive subtle visual cues enhances the use of facial expressions to exchange information.One of the most appropriate fields to explore the specific design features of visual signals is play fighting.Here,we explored the production and potential role of Relaxed Open Mouth(ROM)and Head Bobbing(HB)in regulating play fighting of wild spotted hyenas Crocuta crocuta,a highly hierarchical carnivore species.In accordance with the assumptions of the signal optimization theory,wild hyenas produced ROM and HB almost exclusively when the sender was in direct visual contact with the receiver thus suggesting that senders were attentive to the playmates’face.Contrary to HB,the sequential analysis revealed that ROM often anticipated offensive patterns such as play biting thus supporting the hypothesis that ROM,but not HB,is a metacomunicative signal.Moreover,when the offensive patterns were biased toward one of the 2 players,the session was punctuated by a higher number of ROMs.Our findings support the general hypothesis that these 2 visual signals can play different roles in the management of play fighting in this carnivore species.The complementary use of ROM and HB would suggest that spotted hyenas are highly competent and fast in processing facial displays of different nature to correctly“read others’intentions”and respond with appropriate motor actions to avoid misunderstanding during one of the most multifaceted and risky social interaction.