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Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
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Trachea01:22

Trachea

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The trachea, commonly known as the windpipe, is a vital part of the human respiratory system. It serves as a passageway for air to travel between the larynx and the bronchi, allowing oxygen to reach the lungs. Let's explore its anatomical features, dimensions, layers of the tracheal wall, associated muscles, and the functions of its parts.
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Posterior Glottic Insufficiency in Children.

Reema Padia1, Marshall E Smith1

  • 11 Division of Otolaryngology-Head and Neck Surgery, University of Utah School of Medicine, UT, USA.

The Annals of Otology, Rhinology, and Laryngology
|January 12, 2017
PubMed
Summary
This summary is machine-generated.

Posterior glottic insufficiency (PGI) causes breathy voices due to arytenoid erosion. Endoscopic posterior cricoid reduction laryngoplasty (EPCRL) offers significant voice improvement for pediatric patients with PGI.

Keywords:
glottic insufficiencylaryngoplastyneonatal dysphoniapediatric dysphonia

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Area of Science:

  • Otolaryngology
  • Pediatric Voice Disorders
  • Laryngeal Surgery

Background:

  • Posterior glottic insufficiency (PGI) presents as dysphonia due to inadequate arytenoid approximation.
  • Medial arytenoid erosion leads to a posterior glottal gap, causing breathy, weak voices.
  • PGI is challenging to diagnose and treat, particularly with traditional vocal fold injection laryngoplasty.

Purpose of the Study:

  • To review the presentation, evaluation, and treatment of pediatric patients diagnosed with PGI.
  • To assess the effectiveness of different treatment modalities for PGI in children.

Main Methods:

  • A retrospective chart review of pediatric patients diagnosed with PGI between 2013 and 2015.
  • Evaluation included laryngoscopy, microlaryngoscopy, and patient/parent-based voice impairment ratings.
  • Treatment responses to injection laryngoplasty and endoscopic posterior cricoid reduction laryngoplasty (EPCRL) were analyzed.

Main Results:

  • Seven pediatric patients with PGI were identified, all showing medial arytenoid erosion.
  • Injection laryngoplasty provided suboptimal voice improvement in these patients.
  • Three patients underwent EPCRL, achieving significant voice improvement across perceptual, laryngoscopic, and patient-based assessments.

Conclusions:

  • Key diagnostic indicators for PGI include posterior glottal gap on laryngoscopy and poor response to injection laryngoplasty.
  • Endoscopic posterior cricoid reduction laryngoplasty (EPCRL) is an effective surgical treatment for dysphonia caused by PGI.
  • EPCRL offers a viable solution for pediatric patients with PGI when other methods fail.