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Query: UMLS:C0262471 (ENT)
 5,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The laryngeal mask (LM) is a new concept developed by Brain. Easily inserted, the LM allows appropriate ventilation without the disadvantages of either the facial mask or the endotracheal intubation with its own complications. The limits of its use concern all the cases of reduction of thoracopulmonary compliance and full stomach. The LM offers no protection against regurgitation and aspiration. Airway obstruction may occur following laryngospasm (light anaesthesia) or down folding of the epiglottis. Trauma to the uvula and the posterior pharyngeal wall have been reported. The LM may be useful in all cases of surgery in which intubation is not absolutely required. Moreover, the LM is widely used for ENT and ophthalmic surgeries, in paediatric and adult procedures. Many cases of foreseeable or unforeseeable difficult intubation have been resolved by the insertion of a LM, allowing secondary intubation through the mask. Further investigations are required in order to evaluate the real limits and indications for its extended use.
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PMID:[The laryngeal mask]. 162 30

Experiences with propofol in pediatric anesthesia are limited. We undertook a study to evaluate the quality of induction and recovery from anesthesia with propofol compared to thiopental/halothane. Twenty children received 3 mg.kg-1.min-1 of propofol as a loading dose followed by a maintenance dose of 0.1 mg.kg-1.min-1 (+/- 10%). Twenty children received 5-7 mg/kg of thiopental, and maintenance was provided with halothane (0.5%-1.5%). The interval between the end of the administration of propofol or thiopental/halothane and extubation, as well to discharge to the ward, was significantly shorter with propofol (4.4 versus 13.5 min and 7.22 versus 30.4 min, respectively). Spontaneous movements and pain on injection were seen significantly more frequently with propofol, whereas laryngospasm and hiccup were only observed with thiopental. During the first 6 h after the surgical procedure, analgesics were needed significantly more often in the thiopental group. Nausea and vomiting also were observed more frequently in the thiopental group. In conclusion, propofol used as a single anesthetic is a satisfactory technique for ENT surgery of short duration in children.
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PMID:Comparison of propofol and thiopental/halothane for short-duration ENT surgical procedures in children. 222 11

The ENT doctor is often confronted with pathological changes or functional disturbances of the larynx of uncertain aetiology. With regard to differential diagnosis various drugs should always be taken into consideration that have been prescribed by other specialists. This is pertinent particularly in three groups of pathological changes: Paralysis of the recurrent nerve, dyskinesia and laryngospasm. Exsiccation of the mucous lining, loss of kinaesthesia, development of local oedema and hyperplasia. Voice changes due to androgenic and anabolic steroids. The causative drugs and their mode of action are discussed.
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PMID:[Side effects of drugs on the larynx]. 378 26

Gastroesophageal reflux disease (GERD) is the most common esophageal disease. It typically presents with heartburn and regurgitation, but it may also cause atypical symptoms, either alone or in combination. About 20 to 60 percent of patients with GERD have ENT symptoms without any heartburn. The most common ENT symptom is a globus sensation, yet there are many possible clinical signs such as laryngitis, pharyngitis, sinusitis, laryngospasm, laryngeal edema and granuloma that may mislead the initial work-up. In this work the pathophysiology, symptomatology, diagnostic measurements and therapeutic options of GERD are discussed. It is suggested that GERD has to be included into differential diagnostic approaches especially when routine treatment of these ENT diseases failes.
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PMID:[Reflux-associated diseases of the otorhinolaryngology tract]. 1155 31

It was our goal to compare the Proseal-laryngeal mask airway (PLMA) with the classical laryngeal mask airway (LMA) in a german multicenter trial. Handling of the instruments and application criteria were to be tested. 7 anaesthesia departments were able to take part in this study. 280 patients could be investigated after approval of the ethics committee of the medical faculty of the university of Goettingen. 145 patients received the PLMA and 135 the LMA. The surgical interventions were small to moderate procedures with a duration of at least 20 minutes in the sections general surgery, trauma/orthopedic surgery, urology, vascular surgery, gynecology, ENT-surgery and ophthalmology. There was equivalence of the two instruments PLMA and LMA concerning duration and ease of insertion, endoscopic position check, observations on emergence, potential for injury and some postoperative complaints. This equivalence could be confirmed statistically. Laryngospasm was observed in three, Bronchospasm in two patients with the PLMA, in no one with the LMA. In one case of laryngospasm and another of bronchospasm a mechanism of supraglottic laryngeal stenosis has been involved which may occur in rare instances with the PLMA. This mechanism is due to the double cuff of the PLMA with the instruments proximity to the laryngeal inlet. The seal pressure in both groups differs significantly (p = 0.001). The mean value for the seal pressure was 29,3 +/- 0,21 mbar for the PLMA and 20,9 +/- 0,21 mbar for the LMA. In the PLMA the gastric tube could be positioned with the first attempt in 118 patients, with the second attempt in 17 cases. In 10 patients the gastric tube could not be placed. Contrary to the LMA the tip of the PLMA cuff may be bent in some cases with loss of airway safety and positioning of the gastric tube. The symptoms sore throat and painful swallowing on the first postoperative day were more frequent with LMA application. These differences could be confirmed statistically (sore throat p = 0.01, painful swallowing p = 0.04). They may be explained by the more rigid LMA compared to the PLMA and by the fact that the LMA in this study was older than the PLMA, loosing plasticizer. The drainage tube within the PLMA offers safety from aspiration in patients with no primary aspiration risk, additional reassurance for a correct position and a better stability of the airway. Our data may support a wider indication range for the PLMA compared with the LMA. The PLMA may be applied in laparoscopies and lower abdominal surgical interventions. Careful clinical observation will show, if the minimal invasiveness of the PLMA offers an advantage for these patients. The PLMA should not be applied in patients with increased aspiration risk.
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PMID:[A comparison of the Proseal laryngeal mask to the standard laryngeal mask on anesthesized, non-relaxed patients]. 1246 85

An important number of patients are referred to the ENT specialist because of extraoesophageal manifestations of gastroesophageal reflux. The most alarming symptom is a paroxysmal dyspnea secondary to a laryngospasm. The patients report a laryngeal choking sensation associated to an aphonia. We report three cases of laryngospasm secondary to acid gastric reflux. The diagnosis was made with the clinical history, a laryngeal examination and a 24-hour pH-monitoring enabled us to demonstrate a clear temporal relation between the reflux episodes and the choking episodes. In conclusion, the pharyngo-laryngeal reflux is a possible cause of laryngospasm. In our three patients, a high dose antiacid treatment was efficient to bring a lasting relief of the symptoms.
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PMID:[Gastroesophageal reflux: a possible cause of paroxysmal laryngeal dyspnea]. 1861 Jul 25