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Airway management is essential in emergency and surgical medicine, ensuring ventilation and oxygenation in patients who cannot maintain their own airway. Clinicians use a range of techniques and devices to secure the airway, depending on the patient’s condition and the clinical context. Key methods include endotracheal intubation, rapid sequence intubation (RSI), supraglottic airway devices, and advanced visualization aids. In cases where these approaches fail, surgical airway...
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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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Can Upper Airway Surgeries Improve Lower Airway Function ? A Prospective Study.

K A Arifa1, V G Nayana1, K M Irfan2

  • 1Dept of Otorhinolaryngology, Yenepoya Medical College, Derelakkatte, Mangalore, Karnataka India.

Indian Journal of Otolaryngology and Head and Neck Surgery : Official Publication of the Association of Otolaryngologists of India
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Summary

Nasal obstruction from deviated septum or enlarged turbinates can impair lung function and exercise tolerance. Upper airway surgeries like septoplasty and turbinoplasty significantly improved spirometry results and some 6-minute walking test parameters.

Keywords:
Airway resistanceExercise toleranceNasal obstructionNasal septumSpirometry

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Area of Science:

  • Otolaryngology
  • Pulmonology
  • Respiratory Medicine

Background:

  • Nasal obstruction, commonly caused by deviated nasal septum and turbinate hypertrophy, increases airway resistance.
  • Reduced nasal airflow can negatively impact lung volumes, pulmonary function, and exercise tolerance.

Purpose of the Study:

  • To investigate the effect of upper airway surgeries (septoplasty, turbinoplasty) on lower airway functions.
  • To assess changes in spirometry and 6-minute walking test (6mWt) parameters post-surgery.

Main Methods:

  • Prospective study involving 88 subjects undergoing septoplasty and/or turbinoplasty.
  • Spirometry (FVC, FEV1, FEV1/FVC, PEFR) and 6mWt (SBP, DBP, HR, SpO2) were measured preoperatively and one month postoperatively.

Main Results:

  • Significant improvements were observed in all four spirometry parameters (FVC, FEV1, FEV1/FVC, PEFR) post-surgery.
  • The 6-minute walking test showed significant improvements in systolic blood pressure (SBP) and oxygen saturation (SpO2), but not in diastolic blood pressure (DBP) or heart rate (HR).
  • Improvement in parameters was independent of patient age and symptom duration.

Conclusions:

  • Upper airway surgeries like septoplasty and turbinoplasty can positively impact lower airway functions.
  • Nasal airway narrowing conditions can compromise pulmonary function and exercise capacity.