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Anesth Prog 2020 Jun;67(2):90-97

Program Director of Dental Anesthesiology, Division of Oral and Maxillofacial Surgery and Dental Anesthesiology, The Ohio State University, Columbus, Ohio.

Epiglottitis is most commonly caused by bacterial infection resulting in inflammation and edema of the epiglottis and neighboring supraglottic structures. Acute infection was once found predominantly in children ages 2 to 6 years old, but with the introduction of the Haemophilus influenzae B (HiB) vaccine the incidence of cases in adults is increasing. Typical clinical presentation of epiglottitis includes fever and sore throat. Read More

Respir Investig 2020 Jul 3. Epub 2020 Jul 3.

Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.

Background: Before advance care planning, it is essential to understand the differences in preferences for medical care of terminal-phase pneumonia in elderly patients among the patients, their families, and their doctors. This study aimed to clarify these differences and investigate the actual care provided to elderly patients with pneumonia in nursing hospitals.

Methods: Multicenter questionnaire surveys of 179 patients admitted to nursing homes and long-term care beds in hospitals of three healthcare corporations, their families, and their physicians were conducted between January and August 2018. Read More

Eur Ann Otorhinolaryngol Head Neck Dis 2020 Jun 28. Epub 2020 Jun 28.

Elément Militaire de Réanimation du Service de Santé des Armées EMRSSA, Mulhouse, France; Service d'Anesthésie-Réanimation, Hôpital d'Instruction des Armées Percy, Clamart, France; École du Val-de-Grâce, Paris, France.

Objectives: The main objective was to demonstrate the feasibility of percutaneous tracheostomy performed under difficult conditions by military ENT physicians during their deployment in the military intensive care field hospital of the French Military Medical Service in Mulhouse to confront the exceptional COVID-19 pandemic. The secondary objective was to assess reliability and safety for patient and caregivers, with a risk of iatrogenic viral contamination.

Material And Methods: A single-center retrospective study was conducted between March 25 and April 25, 2020, in 47 COVID-19 patients requiring prolonged mechanical ventilation. Read More

J Cardiothorac Surg 2020 Jul 6;15(1):164. Epub 2020 Jul 6.

Department of Radiology, King Hussein Cancer Center, Amman, Jordan.

Background: Ventricular rupture is rarely described in the literature outside the context of myocardial infarction, infection or neoplasm. It is associated with a high mortality rate due to late presentation and delayed surgical intervention, which involves sutureless or sutured techniques. Comprehensive literature review failed to identify any case of intra-operative right ventricular heart rupture followed by myocardial repair and a complete recovery after a prolonged intensive care unit (ICU) stay. Read More

Ann Otol Rhinol Laryngol 2020 Jul 4:3489420938817. Epub 2020 Jul 4.

Department of Otolaryngology-Head and Neck Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.

Objective(s): Negative pressure pulmonary edema (NPPE) is a rare perioperative complication with a potentially fatal outcome. The aim of this study was to perform a systematic review of NPPE in adult otolaryngology procedures with the goal of identifying risk factors, clinical presentation, diagnosis, management and outcomes.

Methods: Systematic review performed using PubMed, Scopus, Web of Science, and Cochrane databases. Read More

Eur Ann Otorhinolaryngol Head Neck Dis 2020 Jun 10. Epub 2020 Jun 10.

Centre universitaire d'enseignement par simulation, CUESim, hôpital virtuel de Lorraine HVL, université de Lorraine, Nancy, France; Département d'ORL et chirurgie cervico-faciale, CHRU de Nancy, université de Lorraine, 54511, Vandœuvre-Lès-Nancy, Nancy, France. Electronic address:

Tracheostomy in COVID-19-related severe acute respiratory syndrome is at high risk of viral dissemination. The percutaneous dilatation technique could reduce this risk, being performed at the bedside and minimising airway opening. In the COVID-19 context, however, with precarious respiratory status, it requires specific preparation. Read More

Phys Med Rehabil Clin N Am 2020 Aug 6;31(3):397-413. Epub 2020 May 6.

Department of PM&R, Icahn School of Medicine at Mount Sinai, 3 East 101th Street, New York, NY 10029, USA.

Intubated ventilator-dependent patients with high-level spinal cord injury can be managed without tracheostomy tubes provided that they have sufficient cognition to cooperate and that any required surgical procedures are completed and they are medically stable. Intubation for a month or more than extubation to continuous noninvasive ventilatory support (NVS) can be safer long term than resort to tracheotomy. Noninvasive ventilation (NIV) is not conventionally being used for ventilatory support. Read More

Phys Med Rehabil Clin N Am 2020 Aug 24;31(3):379-395. Epub 2020 Apr 24.

Department of PM&R, Icahn School of Medicine at Mount Sinai, 3 East 101st Street, New York, NY 10029, USA.

Respiratory complications often result from acute spinal cord injury. Ventilatory assistance/support is often required 12 hours to 6 days after admission and is typically delivered via translaryngeal tubes. When not weanable from ventilatory support, tracheostomy tubes are placed. Read More

J Laryngol Otol 2020 Jun 18:1-9. Epub 2020 Jun 18.

ENT Department, Leicester Royal Infirmary, UK.

J Laryngol Otol 2020 Jun 17;134(6):553-557. Epub 2020 Jun 17.

Department of Otolaryngology, Freeman Hospital, Newcastle upon Tyne, UK.

Background: ENT presentations are prevalent in clinical practice but feature little in undergraduate curricula. Consequently, most medical graduates are not confident managing common ENT conditions. In 2014, the first evidence-based ENT undergraduate curriculum was published to guide medical schools. Read More

Dysphagia 2020 Jul 4. Epub 2020 Jul 4.

School of Audiology and Speech Sciences, University of British Columbia, 2177 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.

Critically ill patients who require a tracheostomy often have dysphagia. Widespread practice guidelines have yet to be developed regarding the acute assessment and management of dysphagia in patients with tracheostomy. In order for clinicians to base their practice on the best available evidence, they must first assess the applicable literature and determine its quality. Read More

Auris Nasus Larynx 2020 Jul 1. Epub 2020 Jul 1.

Senior Clinical Lecturer in Anaesthesia, Lancaster Medical School, Faculty of Health and Medicine, Lancaster University Lancaster, UK.

J Cardiothorac Vasc Anesth 2020 Jun 12. Epub 2020 Jun 12.

Department of Anesthesia and Intensive Care, Royal Papworth Hospital, Cambridge, UK.

J Neurosurg 2020 Jul 3:1-11. Epub 2020 Jul 3.

2Department of Neurosurgery, Stanford University, Palo Alto, California.

Objective: Traumatic brain injury (TBI) is a major cause of mortality and morbidity in Uganda and other low- and middle-income countries (LMICs). Due to the difficulty of long-term in-person follow-up, there is a paucity of literature on longitudinal outcomes of TBI in LMICs. Using a scalable phone-centered survey, this study attempted to investigate factors associated with both mortality and quality of life in Ugandan patients with TBI. Read More

Ann Thorac Surg 2020 Jun 30. Epub 2020 Jun 30.

Department of Thoracic and Cardiovascular Surgery, University of Virginia, PO Box 800678, Charlottesville, Virginia, 22908.

Background: The long-term implications of tracheostomy in cardiac surgical patients are largely unknown. We sought to investigate outcomes including decannulation and long-term mortality in a population of post-cardiac surgery patients.

Methods: All patients undergoing cardiac surgery at a single institution between 1997-2016 were evaluated for postoperative tracheostomy placement, time to decannulation and mortality. Read More

Am J Transplant 2020 Jul 3. Epub 2020 Jul 3.

Division of Thoracic surgery, Medical University of Vienna, Austria.

Severe chest wall deformities are considered an absolute contraindication for lung transplantation. The significantly impaired chest compliance associated with pectus excavatum is thought to result in a high risk of postoperative respiratory complications and significant morbidity and mortality. We herein report our pooled institutional experience consisting of three patients who underwent bilateral lung transplantation and simultaneous correction of a pectus excavatum. Read More

J Dent Anesth Pain Med 2020 Jun 24;20(3):155-160. Epub 2020 Jun 24.

Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Korea.

Submental or submandibular intubation has been reported to cause fewer complications than tracheostomy. However, the risk of infection is always inherent because oral wounds are exposed to microbial flora and bacteria in the oral cavity. A novel technique of submandibular intubation was devised to reduce infection and injury to the soft tissues. Read More

J Thorac Cardiovasc Surg 2020 May 6. Epub 2020 May 6.

Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Mass. Electronic address:

Objective: Aortic uncrossing is an effective procedure for relieving the external airway compression from a circumflex aortic arch by transferring the aortic arch to the same side as the descending aorta. However, patients frequently have residual tracheobronchomalacia (TBM), which may result in persistent postoperative symptoms. We review a series of patients who underwent an aortic uncrossing and concomitant tracheobronchopexy to correct the airway compression and residual TBM. Read More

Brain Inj 2020 Jul 2:1-6. Epub 2020 Jul 2.

Section of Neurocritical Care and Emergency Neurology, Program in Trauma, Department of Neurology, University of Maryland School of Medicine , Baltimore, MD, USA.

Objective: To assess variables associated with decannulation in patients with traumatic brain injury (TBI).

Participants: 79 patients with TBI requiring tracheostomy and ICU admission from January 1 to December 31, 2014.

Design: Retrospective analysis. Read More

Ann Thorac Surg 2020 Jun 29. Epub 2020 Jun 29.

Department of Cardiac Surgery, Boston Children's Hospital and Harvard Medical School, Boston, MA. Electronic address:

Background: Tracheobronchomalacia and airway obstruction from severely dilated pulmonary arteries in Tetralogy of Fallot with absent pulmonary valve (TOF-APV) has been associated with high rates of respiratory failure and mortality (15-25%). It is not known whether aggressive pulmonary artery and/or direct airway intervention during early definitive cardiac repair improves outcomes.

Methods: Retrospective observational study of all patients undergoing surgical repair for TOF-APV at our center between 2006-2018. Read More

Oral Oncol 2020 07 13;106:104796. Epub 2020 May 13.

Department of Otolaryngology Head and Neck Surgery, S. Orsola-Malpighi University Hospital, Via Massarenti 9, 40138 Bologna, Italy.

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2020 Jun;55(6):576-579

Department of Otorhinolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China; Institute of Otorhinolaryngology Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China.

To discuss the the effects, indications and protective measures of tracheotomy for severe cases of coronavirus disease 2019 (COVID-19) patients. A retrospectively analysis was conducted to explore the clinical data of COVID-19 patients who received tracheotomy in February to March 2020, and descriptive statistics were used to analyze the indication of tracheotomy, particularity of intraoperative treatment and protective measures. A total of 4 cases were included in this article. Read More

Tanaffos 2019 Apr;18(4):285-293

Department of ENT, Tehran University of Medical Sciences, Tehran, Iran.

Background: Tracheostomy is common among intensive care unit (ICU) patients. Reconsideration of tracheostomy indications in patients can be effective in modifying and reducing irrevocable patient complaints. The present study aimed to analyze the prevalence of tracheostomy indications and to estimate the prevalence of tracheostomy in Iran. Read More

Ann Am Thorac Soc 2020 Jul;17(7):809-810

Department of Pediatrics-Pulmonary Medicine, University of Colorado School of Medicine, Aurora, Colorado.

Ear Nose Throat J 2020 Jul 1:145561320937627. Epub 2020 Jul 1.

Department of Otolaryngology, Head and Neck Surgery, Charing Cross Hospital, Imperial College Healthcare, London, United Kingdom.

Introduction: Human papilloma virus (HPV)-positive oropharyngeal cancer carries a good prognosis when managed with primary chemoradiotherapy. However, the dramatically increasing rate of this disease means more patients are now developing recurrence, with surgery remaining the mainstay of treatment. Despite this, there is no agreed technique for excision of recurrent oropharyngeal cancer. Read More

In Vivo 2020 Jul-Aug;34(4):1749-1758

Institute of New Frontier Research Team, Hallym University, Hallym Clinical and Translation Science Institute, Chuncheon, Republic of Korea

Background/aim: A three-dimensional (3D) printed tracheostomy tube has potential application for patients who require a specialized tube. The aim of this study was to evaluate the characteristics of various 3D printing materials and determine their use in producing 3D-printed tracheostomy tube.

Materials And Methods: Mechanical, chemical, and microbiological in vivo changes in the scaffolds were analyzed using a hamster cheek pouch (HCP) model. Read More

J Laryngol Otol 2020 Jul 1:1-4. Epub 2020 Jul 1.

Department of Otolaryngology - Head and Neck Surgery, Loma Linda University School of Medicine, California, USA.

Background: Ex utero intrapartum treatment ('EXIT' procedure) is a well described method for maintaining maternal-fetal circulation in the setting of airway obstruction from compressive neck masses. When ex utero intrapartum treatment to airway is not feasible, ex utero intrapartum treatment to extracorporeal membrane oxygenation ('ECMO') has been described in fetal cardiopulmonary abnormalities.

Objective: This paper presents the case of a massively compressive midline neck teratoma managed with ex utero intrapartum treatment to extracorporeal membrane oxygenation, allowing for neonatal survival, with controlled airway management and subsequent resection. Read More

Compr Child Adolesc Nurs 2020 Jun 30:1-11. Epub 2020 Jun 30.

Children's Nursing Research Unit, Institute in the Park, Alder Hey Children's NHS Foundation Trust , Liverpool, Merseyside, UK.

Caring for a child with a tracheostomy can be challenging for parents and learning to safely manage their child's airway can be frightening due to their child's breathing issues, complex diagnosis and the difficult decisions they have to make. The aim of this longitudinal narrative study was to tell the stories of parents whose child had a new tracheostomy. Twenty three narrative interviews were conducted with twelve parents from nine families at three time points over a 12 month period. Read More

J Craniofac Surg 2020 Jun 19. Epub 2020 Jun 19.

Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine.

In patients with Pierre Robin sequence (PRS), understanding the mechanism of airway obstruction and the potential for concurrent airway lesions is important for determining appropriate intervention. When concomitant airway anomalies are present with PRS, mandibular distraction osteogenesis alone is often contraindicated and unsuccessful at alleviating the obstruction, mandating the need for tracheostomy. Herein, the authors present the second-reported case of PRS with concomitant complete tracheal rings and highlight the importance collaborative surgical efforts to avoid tracheostomy. Read More

Otolaryngol Head Neck Surg 2020 Jun 30:194599820940652. Epub 2020 Jun 30.

Otolaryngol Head Neck Surg 2020 Jun 30:194599820935454. Epub 2020 Jun 30.

Department of Otolaryngology, University of Vermont Medical Center, Burlington, Vermont, USA.

We aim to demonstrate the feasibility of in-office transcervical ultrasound (TCUS)-guided fine-needle aspiration (FNA) of base of tongue (BOT) tumors in a single-institution. Retrospective chart review was performed and 3 patients met criteria, with BOT tumors ≥3 cm . Two patients had no cervical adenopathy, while FNA of a cervical lymph node was inconclusive in patient 3. Read More

Otolaryngol Head Neck Surg 2020 Jun 30:194599820940655. Epub 2020 Jun 30.

North Shore University Hospital, Northwell Health, Manhasset, New York, USA.

Thirty-eight tracheostomies were performed on patients with respiratory failure secondary to SARS-CoV-2 infection over the month of April at North Shore University Hospital and Lenox Hill Hospital (members of Northwell Health System in Long Island and New York City). Follow-up by May 14 revealed that 21 (55.2%) had been weaned from ventilators and 7 (18. Read More

Otolaryngol Head Neck Surg 2020 Jun 30:194599820940654. Epub 2020 Jun 30.

Am J Otolaryngol 2020 Jun 20;41(6):102613. Epub 2020 Jun 20.

National & Kapodistrian University of Athens, School of Medicine, 2nd Otolaryngology Department, "Attikon" University Hospital, Athens, Greece.

Purpose: Cervical Necrotizing fasciitis (CNF) has been reported as an unusual rapidly progressive, life-threatening, inflammatory disease that is known to affect predominately immunocompromised patients. Few case reports have been sporadically published involving immunocompetent adults. This is the first study presents a series of immunocompetent CNF patients. Read More

Laryngoscope Investig Otolaryngol 2020 Jun 7;5(3):473-476. Epub 2020 May 7.

Department of Health Communication Sciences, College of Health and Rehabilitation Sciences Princess Nourah bint Abdulrahman University Riyadh Saudi Arabia.

Background: Airway and swallowing evaluation is a crucial step before weaning the patient from a tracheostomy tube. Different evaluation procedures can be used successfully in many patients, but sometimes, this can be difficult or impossible for patients who have laryngeal edema as the existence of edema tends to block the view of true vocal folds. Thus, a new approach using retrograde fiberoptic endoscopy evaluation of swallowing (FEES) has been suggested to help visualize the vocal folds clearly. Read More

Iran J Otorhinolaryngol 2020 May;32(110):187-191

Department of Otolaryngology, "Attikon" University Hospital, Athens, Greece. Rimini 1, Chaidari, Athens 124 62, Greece.

Introduction: Acute epiglottitis or supraglottitis is a rapidly progressing upper respiratory tract infection that can often threaten the airway patency. Epiglottic abscess that expands to the paraglottic (PGS) or preepiglottic (PES) space and acute airway obstruction constitute rare complications, exclusively presented in adults.

Case Report: We report two cases. Read More

Iran J Otorhinolaryngol 2020 May;32(110):139-145

Department of Paediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Introduction: Evidence for factors determining paediatric tracheostomy decannulation vary extensively; therefore, this prospective observational study aimed to investigate these factors.

Materials And Methods: In total, 67 consecutive paediatric patients (<12 years old) who referred to the Department of Otolaryngology, (Postgraduate Institute Medical Education and Research),(Chandigarh), India, for decannulation were included and evaluated for contributing factors in this study. Parental counselling was performed, and informed consents were obtained from them. Read More

J Surg Case Rep 2020 Jun 19;2020(6):rjaa194. Epub 2020 Jun 19.

Clinic of Otorhinolaryngology and Maxillofacial Surgery, Clinical Center of Montenegro, Podgorica, Montenegro.

Some of coronavirus disease 2019 (COVID-19) patients with prolonged ventilation may require tracheostomy, which is an aerosol-generating procedure and poses a significant risk of viral transmission. We report our experience of the management of a patient with COVID-19 who underwent surgical tracheostomy and describe several essential infection control principles. In our patient, on the 14th day after intubation, an open tracheostomy was carried out because of the prolonged tracheal intubation and unsuccessful extubation attempts. Read More

Oral Oncol 2020 Jun 17;109:104861. Epub 2020 Jun 17.

Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address:

Background: A subset of patients with COVID-19 require intensive respiratory care and tracheostomy. Several guidelines on tracheostomy procedures and care of tracheostomized patients have been introduced. In addition to these guidelines, further details of the procedure and perioperative care would be helpful. Read More

Singapore Med J 2020 Jun 26. Epub 2020 Jun 26.

Department of Otolaryngology, Head and Neck Surgery, Tan Tock Seng Hospital, Singapore.

Front Pediatr 2020 10;8:261. Epub 2020 Jun 10.

Department of Pulmonology, Mother and Child Health Care Institute, Belgrade, Serbia.

Home mechanical ventilation (HMV) is a method of treatment in children with sleep-disordered breathing (SDB) and alveolar hypoventilation regardless of primary disease. The goal of the study was to describe the changes in the HMV program in Serbia during the last two decades. Cross-sectional retrospective study included data from the national HMV database from 2001 until 2019. Read More

J Burn Care Res 2020 Jun 25. Epub 2020 Jun 25.

Department of Surgery, University of Cincinnati.

Introduction: The Boston Criteria and the Abbreviated Burn Severity Index are two widely accepted models for predicting mortality in burn patients. We aimed to elucidate whether these models are able to predict risk of mortality in patients who sustain burns while smoking on home oxygen given their clinical fragility.

Methods: We conducted a retrospective chart review of 48 patients admitted to our burn center from November 2013 to September 2017 who sustained a burn while smoking on home oxygen. Read More

Ann Otol Rhinol Laryngol 2020 Jun 25:3489420935500. Epub 2020 Jun 25.

Unit of Otorhinolayngology-Head and Neck Surgery, ASST Spedali Civili di Brescia, Department of Medical and Surgical Specialties, Radiologic Sciences, and Public Health; University of Brescia, Brescia, Italy.

Objective: To date, no cases have been reported on the effects of COVID-19 in laryngectomees.

Case Presentation: We herein presented two clinical cases of laryngectomized patients affected by COVID-19, detailing their clinical course and complications.

Discussion: In our experience, permanent tracheostomy did not significantly affect the choice of treatment. Read More

Neurosurg Rev 2020 Jun 25. Epub 2020 Jun 25.

Department of Critical Care Medicine, Beijing Tiantan Hospital, Capital Medical University, South 4th Ring West Road 119, Fengtai District, Beijing, 100070, People's Republic of China.

We evaluated the association between the timing of tracheostomy and clinical outcomes in patients with infratentorial lesions. We performed a retrospective observational cohort study in a neurosurgical intensive care unit (ICU) at a tertiary academic medical center from January 2014 to December 2018. Consecutive adult patients admitted to the ICU who underwent resection of infratentorial lesions as well as tracheostomy were included for analysis. Read More

Perfusion 2020 Jun 25:267659120932034. Epub 2020 Jun 25.

Fiona Stanley Hospital, Murdoch, WA, Australia.

Pediatr Pulmonol 2020 Jun 24. Epub 2020 Jun 24.

Department of Medicine, University of Toronto, Toronto, Canada.

Background: Children using home mechanical ventilation (HMV) live at home with better quality of life, despite financial burden for their family. Previous studies of healthcare utilization and costs have not considered public and private expenditures, including family caregiver time. Our objective was to examine public and private healthcare utilization and costs for children using HMV, and variables associated with highest costs. Read More

Rev Col Bras Cir 2020 Jun 3;47:e20202549. Epub 2020 Jun 3.

University of Insubria, University Hospital of Varese, ASST, Department of General Surgery - Sette Laghi - Lombardia - Itália.

Currently doctors and health professionals are facing a challenging pandemic caused by a new strain called 2019 Novel Coronavirus (COVID-19). Human infection with COVID-19 does not yet have the clinical spectrum fully described, and the pattern of lethality, mortality, infectivity and transmissibility is not known with precision. There is no specific vaccine or medication available. Read More

Rev Col Bras Cir 2020 19;47:e20202574. Epub 2020 Jun 19.

- Medical School of USP, Discipline of General Surgery and Trauma - São Paulo - SP - Brazil.

The COVID-19 Pandemic has resulted in a high number of hospital admissions and some of those patients need ventilatory support in intensive care units. The viral pneumonia secondary to Sars-cov-2 infection may lead to acute respiratory distress syndrome (ARDS) and longer mechanical ventilation needs, resulting in a higher demand for tracheostomies. Due to the high aerosolization potential of such procedure, and the associated risks of staff and envoirenment contamination, it is necesseray to develop a specific standardization of the of the whole process involving tracheostomies. Read More

Eur Arch Otorhinolaryngol 2020 Jun 23. Epub 2020 Jun 23.

Otolaryngology-Head and Neck Surgery Department, Grenoble Alpes University Hospital, BP 217, 38043, Grenoble Cedex 09, France.

Purpose: To describe the technique and outcomes of percutaneous tracheostomy under laryngosuspension.

Methods: A consecutive series of patients who underwent percutaneous tracheostomy under laryngosuspension were reviewed for outcomes. The procedure is performed under general anesthesia and laryngosuspension. Read More