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Ann Allergy Asthma Immunol 2020 Jun 26. Epub 2020 Jun 26.

Department of Internal Medicine Division of Allergy & Immunology University of Texas Southwestern Medical Center 5323 Harry Hines Blvd Dallas, TX, 75390-8859. Electronic address:

J Clin Monit Comput 2020 Jun 15. Epub 2020 Jun 15.

Phoniatrics at Otorhinolaryngology Department, Faculty of Medicine, Zagazig University, Alsharkia, Egypt.

Prediction of vocal cord dysfunction is essential after anterior cervical spine surgeries. This study aimed to detect the validity of transcutaneous laryngeal ultrasonography by both anterior and novel lateral approaches for prediction of vocal cord edema and paralysis after anterior cervical spine surgeries. A prospective cohort study conducted on 90 patients scheduled for anterior cervical spine surgeries underwent consecutive pre and postoperative vocal cord examination for edema and paralysis by both anterior and lateral approaches laryngeal ultrasonography. Read More

Ann Otol Rhinol Laryngol 2020 Jun 12:3489420931894. Epub 2020 Jun 12.

The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Objectives: To explore long-term patient reported outcome (PRO) measures of pediatric paradoxical vocal cord motion (PVCM) including ease of diagnosis, management, symptom duration and effect on quality of life.

Methods: All children >8 years of age diagnosed with PVCM at a tertiary pediatric hospital between 2006 and 2017 were invited to complete a survey addressing study objectives.

Results: 21/47 eligible participants could be contacted and 18/21 (86%) participated. Read More

Cureus 2020 Apr 16;12(4):e7702. Epub 2020 Apr 16.

Pulmonary and Critical Care, East Tennessee State University, Johnson City, USA.

Idiopathic tracheal stenosis (ITS) is a rare condition, and diagnosis of exclusion should be suspected in patients with exercise intolerance, wheezing, and dyspnea on exertion with a flow-volume loop suggestive of fixed airway obstruction. We report a case of a 32-year-old asthmatic woman with an existing diagnosis of vocal cord dysfunction and previous normal CT scan of the neck. She continued to have fixed upper airway obstruction on repeated flow-volume loops with persistent wheezing and cough along with occasional stridor and hoarseness of voice despite appropriate management of her asthma. Read More

J Voice 2020 May 7. Epub 2020 May 7.

Department of Otorhinolaryngology-Head and Neck Surgery, College of Medicine, Pusan National University and Medical Research Institute, Pusan National University Hospital, Busan, South Korea. Electronic address:

Background: The thyroidectomy-related voice questionnaire (TVQ) is an efficient screening tool for detecting postoperative vocal dysfunction. The aim of this study was to confirm the significance of the preoperative TVQ score in thyroid surgery.

Methods: We examined 180 women who underwent total thyroidectomy with central lymph node dissection from March 2014 to May 2016. Read More

Respir Med 2020 Jul 25;168:105990. Epub 2020 Apr 25.

Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, Newcastle, NSW, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Newcastle, NSW, Australia.

Background And Aim: Vocal Cord Dysfunction (VCD) and chronic cough (CC) are challenging conditions which lead to significant quality of life impairment. The underlying mechanisms are poorly understood, but laryngeal dysfunction may be common to both conditions. The aim of this study was to determine the characteristics of cough in VCD and whether patients with cough have coexisting VCD. Read More

Endocrinol Diabetes Metab 2020 Apr 26;3(2):e00115. Epub 2020 Feb 26.

University Hospital for Visceral Surgery Medical Campus University of Oldenburg Pius-Hospital Oldenburg Germany.

Objective: Quality of life (QoL) has so far seldom been taken into account by default in decision-making for surgical indication in thyroid surgery. Therefore, we compared pre- and postoperative QoL of patients using the EuroQoL-5D (EQ-5D) questionnaire. The influence of certain socio-economic factors on QoL as a second end-point was considered. Read More

Medicine (Baltimore) 2020 Apr;99(16):e19745

Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.

Rationale: Multiple system atrophy (MSA) is a rare neurodegenerative disease characterized by Parkinsonism and autonomic dysfunction or cerebellar ataxia. MSA can be accompanied by stridor caused by laryngeal stenosis secondary to vocal cord dysfunction.

Patient Concern: A 60-year-old woman with MSA, complaining of difficulty in breathing during sleep. Read More

Expert Rev Respir Med 2020 Apr 27:1-9. Epub 2020 Apr 27.

Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University School of Medicine, Detroit, MI, USA.

: Gastroesophageal reflux disease (GERD) is a widespread condition with a significant impact on the quality of life and healthcare resources. In addition to its gastrointestinal problems, GERD has been linked to a variety of respiratory diseases either as a direct cause, or as a risk factor to the inability to control or worsening of the disease.: We performed a literature search in the PubMed database for articles addressing GERD and pulmonary diseases. Read More

Auris Nasus Larynx 2020 Apr 6. Epub 2020 Apr 6.

Department of Paediatrics Otolaryngology Head & Neck Surgery, Perth Children's Hospital, Roberts Road, Nedlands 6009, Australia; Murdoch ENT, Wexford Medical Centre, St John of God Hospital (Murdoch), Suite 17-18, Level 1, 3 Barry Marshall Parade, Murdoch 6150, Australia; School of Surgery, University of Western Australia, Stirling Highway, Crawley 6009, Australia; St John of God Hospital (Murdoch), Wexford Medical Center, Suite 17-18, Level 1, 3 Barry Marshall Parade, Murdoch 6150, Australia. Electronic address:

Objectives: Unilateral vocal fold palsy (UVFP) is the commonest neurological laryngeal disorder. Much of the research have focused on its implication on voice, with limited data on its impact on swallowing. The aim of this paper is to examine the current evidence on the pathophysiology, impact and management of UVFP and swallowing. Read More

J Allergy Clin Immunol Pract 2020 Jul - Aug;8(7):2256-2262. Epub 2020 Mar 12.

Allergy, Asthma & Clinical Immunology, The Alfred Hospital, Melbourne, VIC, Australia; School of Public Health & Preventive Medicine, Monash University, Melbourne, VIC, Australia.

Background: Many patients with difficult asthma also have coexisting vocal cord dysfunction (VCD), evident by paradoxical vocal fold motion (PVFM) on laryngoscopy.

Objective: Among patients with difficult asthma, we sought to identify clinical features associated with laryngoscopy-diagnosed PVFM.

Methods: Consecutive patients with "difficult asthma" referred by respiratory specialists underwent systematic assessment in this observational study. Read More

J Laryngol Otol 2020 Mar 4;134(3):263-269. Epub 2020 Mar 4.

Department of Otolaryngology Head and Neck Surgery, Rambam Healthcare Campus, The Technion, Institude of Thechnology, Haifa, Israel.

Background: Vocal fold injection augmentation is a recognised treatment modality for glottic insufficiency. Causes of glottal closure insufficiency include vocal fold paralysis, paresis, atrophy, sulcus vocalis, scarring and vocal fold deficiency after laryngeal surgery. A variety of materials exist for injection augmentation. Read More

Minerva Anestesiol 2020 May 30;86(5):577-579. Epub 2020 Jan 30.

Department of Otorhinolaryngology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Saudi J Anaesth 2020 Jan-Mar;14(1):112-114. Epub 2020 Jan 6.

Department of Anesthesiology and Pain Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea.

Parkinson's disease (PD) is a neurodegenerative disorder that affects the extrapyramidal system, and respiratory dysfunction has also been noted in patients with PD. However, acute upper airway obstruction due to bilateral vocal cord paralysis is a very rare finding in PD. Here, we describe a rare life-threatening respiratory failure caused by bilateral vocal cord paralysis in an elderly woman with PD during emergence from general anesthesia. Read More

J Allergy Clin Immunol 2020 Apr 12;145(4):1165-1173. Epub 2020 Jan 12.

National Heart & Lung Institute, Imperial College London & Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom. Electronic address:

Background: Laryngeal or vocal cord dysfunction has long been regarded as a mimic of asthma; however, recent evidence indicates that it may be a significant comorbid condition in patients with asthma.

Objective: We aimed to systematically estimate the prevalence of comorbid laryngeal dysfunction (LD) in adults with asthma and characterize its clinical impact on asthma.

Methods: Electronic databases were searched for relevant studies published until June 2019. Read More

Case Rep Anesthesiol 2019 12;2019:2309598. Epub 2019 Dec 12.

Anesthesiology/Pain Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.

Spinocerebellar ataxia 3 (SCA3), also known as Machado-Joseph disease (MJD) is an autosomal dominant, progressive neurodegenerative disorder. Patients present with cerebellar ataxia, dystonia, rigidity, and neuropathy that worsen with time. On a molecular level, it occurs due to a CAG trinucleotide repeat expansion in the gene. Read More

BMC Surg 2020 Jan 8;20(1). Epub 2020 Jan 8.

Department of Otolaryngology-Head and Neck Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan.

Background: Head and neck surgeries can perturb normal structures of neck muscles and nerve innervations, which are supposed to function in harmony to allow complicated process like swallowing. It is still likely that cricopharyngal dysfunction emerges years after the head and neck surgeries.

Case Presentation: We report a case with history of left unilateral vocal cord immobility and development of dysphagia and aspiration 2 years after radical thyroidectomy with neck lymph nodes dissection and medialization thyroplasty. Read More

Paediatr Anaesth 2020 03 20;30(3):347-352. Epub 2020 Jan 20.

Department of Pediatric Surgery, Montreal Children's Hospital, McGill University, Montreal, QC, Canada.

Background: Point-of-care ultrasonography of the airway is becoming a first-line noninvasive adjunct assessment tool of the pediatric airway. It is defined as a focused and goal-directed portable ultrasonography brought to the patient and performed and interpreted on the spot by the provider. Successful use requires a thorough understanding of airway anatomy and ultrasound experience. Read More

Folia Phoniatr Logop 2020 Jan 2:1-11. Epub 2020 Jan 2.

NW Center for Voice & Swallowing, Department of Otolaryngology-Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA,

Objective: Associations between dysphonia and paradoxical vocal fold motion (PVFM) have been previously reported in adults, but it is unclear whether similar associations exist for adolescents. The goals of this study were to identify the prevalence and severity of voice disorders in adolescent patients with PVFM, identify differences between those with and without clinician-identified dysphonia, and investigate what factors were associated with voice handicap in this population.

Methods: A retrospective review of eligible adolescent patients diagnosed with PVFM over a 1-year period at a single institution was undertaken. Read More

Nagoya J Med Sci 2019 Nov;81(4):687-691

Department of Internal Medicine, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu, Japan.

Cricoid cartilage fracture is generally caused by significant neck trauma and causes continuous dyspnea, neck pain, or hoarseness developing immediately after the traumatic episode. A 69-year-old woman without any history of trauma was admitted to our hospital with intermittent dyspnea. Six months before admission she had started to complain of dyspnea occurring several times a month without warning, improving spontaneously within a few hours without treatment. Read More

World J Clin Cases 2019 Dec;7(23):3957-3963

Department of Otolaryngology Head and Neck Surgery, Zhongda Hospital Southeast University, Nanjing 210000, Jiangsu Province, China.

Background: Treatment of fistulas arising from the third branchial cleft includes endoscopic cauterization or open cervical fistulectomy. Both approaches are associated with recurrence rates of 14%-18%, and possibly greater rates when the fistula has been treated operatively beforehand. Treatment of fistulas arising from the third branchial cleft is associated with an inordinate recurrence rate. Read More

Yonsei Med J 2019 Dec;60(12):1181-1186

Department of Rehabilitation Medicine, Pusan National University School of Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.

Purpose: To examine correlations among rating scales and findings suggestive of tracheal aspiration and pharyngeal residue between fiberoptic endoscopic evaluation of swallowing (FEES) and videofluoroscopic swallowing study (VFSS) in dysphagia patients.

Materials And Methods: We studied patients referred to our hospital for dysphagia assessment. Three raters judged the residue severity and laryngeal penetration or tracheal aspiration of FEES and VFSS. Read More

Insights Imaging 2019 Nov 18;10(1):108. Epub 2019 Nov 18.

Mayo Clinic, Jacksonville, FL, 32224, USA.

The differential diagnosis for hoarseness is extensive and includes a multitude of etiologies that span a large geographic area from the brainstem to the mediastinum. Therefore, localizing a causative lesion can be extremely difficult for clinicians and radiologists alike. In this review, we will first discuss the normal anatomy of the larynx and its innervation via the vagus and recurrent laryngeal nerves. Read More

Int J Pediatr Otorhinolaryngol 2020 Feb 2;129:109765. Epub 2019 Nov 2.

Department of Surgical Sciences, Otorhinolaryngology and Head & Neck Surgery, Uppsala University, Akademiska Sjukhuset, 751 85, Uppsala, Sweden.

Objectives: To compare glottic and supraglottic movements in healthy adolescents and adolescents experiencing dyspnoea during strenuous exercise.

Methods: Using the continuous laryngoscopy exercise (CLE)-test laryngeal movements during exercise were analysed in healthy controls (n = 28) and compared to subjects with exercise induced bronchoconstriction (EIB) (n = 10), exercise induced laryngeal obstruction (EILO) (n = 10) and subjects experiencing exercise-induced dyspnoea without having any of these diagnoses (n = 31). Images from the video recordings were assessed regarding glottic angle, glottic area and supraglottic area using the software measuring tool EILOMEA. Read More

Minerva Anestesiol 2020 May 28;86(5):518-526. Epub 2019 Oct 28.

Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Ain Shams University, Cairo, Egypt.

Background: Early detection of post-thyroidectomy vocal cord dysfunction is crucial. This study compared GlideScope® with Macintosh direct laryngoscope (MDL) regarding the accuracy of assessment of post-thyroidectomy vocal cord dysfunction.

Methods: One hundred and twenty patients scheduled for elective thyroidectomy, aged 18 - 50 years, of either sex were enrolled in the study. Read More

World Neurosurg 2020 Feb 31;134:76-78. Epub 2019 Oct 31.

Department of Neurology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA.

Background: Vagal nerve stimulation is a generally safe adjunctive treatment for medically refractory epilepsy. Nevertheless, reports of vocal cord dysfunction during stimulation can be found in the literature. When vagal nerve stimulation-induced vocal cord dysfunction is compounded with contralateral dysfunction, such as that which can occur after anterior cervical diskectomy and fusion, serious pulmonary complications can occur. Read More

Arch Dis Child Educ Pract Ed 2019 Oct 25. Epub 2019 Oct 25.

IRCCS Materno Infantile Burlo Garofolo, Trieste, Italy.

A 12-year-old girl was referred with a 7-month history of episodes of dyspnoea, stridor and a sense of chest constriction during physical exercise. These were self-limiting and never occurred at night. Physical examination was normal. Read More

Laryngorhinootologie 2019 Dec 16;98(12):877-878. Epub 2019 Oct 16.

Department of Otorhinolaryngology, Head and Neck Surgery, University-Hospital Bonn, Germany.

J Laparoendosc Adv Surg Tech A 2020 Jan 15;30(1):76-80. Epub 2019 Oct 15.

School of Medicine, University of Split, Split, Croatia.

The aim of this study was to compare the perioperative and postoperative respiratory complications between laryngeal mask (LM) airway and tracheal intubation (TI) in children undergoing percutaneous internal ring suturing (PIRS) for inguinal hernia. From October 2015 to February 2019, 135 pediatric patients (97 males and 38 females) with median age of 4 years, who underwent PIRS for inguinal hernia, were included in study. Patients were divided in two groups. Read More

AANA J 2019 Apr;87(2):145-151

is on faculty in the nurse anesthesia program at Western Carolina University, Asheville, North Carolina.

Laryngospasm is an exaggeration of a protective reflex that prevents aspiration of foreign objects into the lower airway (eg, during swallowing). This results in complete or partial closure of the glottis, and impedance or total obstruction of airflow to the trachea and lungs. Often, the resulting hypoxia will by itself break a laryngospasm; however, if the spasm continues without relief, it can lead to pulmonary edema, cardiac dysrhythmias, cardiac arrest, and ultimately death. Read More

Neurology 2019 10;93(14):630-639

From the IRCCS (P.C., G.C.-B., G.G., F.P., L.V.), Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy; Dipartimento di Scienze Biomediche e Neuromotorie (P.C., G.C.-B., G.G., P.M., F.P.), Università di Bologna, Bologna, Italy; Department of Neurology (E.E.B., P.A.L.), Mayo Clinic, Rochester, MN; Multidisciplinary Sleep Unit (A.I.), Neurology Service, Hospital Clinic de Barcelona, IDIBAPS CIBERNED, Barcelona, Spain; UCL Queen Square Institute of Neurology (N.Q.), Queen Square, London; Parkinson's Disease and Movement Disorders Unit (E.T.), Neurology Service, Hospital Clinic de Barcelona; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) (E.T.), University of Barcelona (UB), and Centre for Networked Biomedical Research on Neurodegenerative Diseases (CIBERNED), Barcelona, Spain; Department of Neurology (G.K.W.), Innsbruck Medical University, Innsbruck, Austria; Department of Neuroscience (G.A.), Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, Genoa, Italy; The Multiple System Atrophy Coalition, Inc. (P.B.), Charlotte, NC; Neurophysiopathology Unit (E.A.), IRCCS "C. Mondino" Foundation, Pavia, Italy; Department of Clinical Neurophysiology (I.G.), CHU de Bordeaux, Bordeaux, France; Université de Bordeaux (I.G.), Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, Bordeaux, France; CNRS (I.G.), Institut de Neurosciences Cognitives et Intégratives d'Aquitaine, Bordeaux, France; Department of Neurology (T.O.), Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Minami Uonuma, Niigata, Japan; Parkinson's Disease and Movement Disorders Unit (C.P., N.G.P.), IRCCS "C. Mondino" Foundation, Pavia; Dipartimento di Medicina Specialistica (C.V.), Diagnostica e Sperimentale (DIMES), University of Bologna, Bologna, Italy; Dipartimento di Scienze biomediche e chirurgico specialistiche (C.V.), University of Ferrara, Ferrara, Italy; Department of Neurosciences (A.A.), University of Padua, Padua, Italy; Department of Clinical and Motor Neuroscience (A.P.B.), UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London; Spinal Unit (J.B.), Montecatone Rehabilitation Institute, Imola, Italy; Department of Neurology (H.K.), New York University School of Medicine, New York, NY; Department of Medicine (M.T.P.), Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy; "Luigi Sacco" Department of Biomedical and Clinical Sciences (N.P., A.S.), University of Milan, Milan, Italy; Service de Neurologie (F.T., W.G.M.), CRMR Atrophie Multisystématisée, CHU Bordeaux, Bordeaux, France; Univ. de Bordeaux (F.T., W.G.M.), Institut des Maladies Neurodégénératives, Bordeaux, France; and Department Medicine (W.G.M.), University of Otago, Christchurch, and New Zealand Brain Research Institute, Christchurch, New Zealand.

Multiple system atrophy (MSA) is a neurodegenerative disorder characterized by a combination of autonomic failure, cerebellar ataxia, and parkinsonism. Laryngeal stridor is an additional feature for MSA diagnosis, showing a high diagnostic positive predictive value, and its early occurrence might contribute to shorten survival. A consensus definition of stridor in MSA is lacking, and disagreement persists about its diagnosis, prognosis, and treatment. Read More

Immunol Allergy Clin North Am 2019 11 31;39(4):547-560. Epub 2019 Aug 31.

Section of Allergy, Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. Electronic address:

Vocal cord dysfunction (VCD) is an upper airway disorder characterized by exaggerated and transient glottic constriction causing respiratory and laryngeal symptoms. Although the origin of VCD symptoms is in the upper airway, it is frequently misdiagnosed as asthma resulting in significant morbidity. VCD can coexist with asthma or mimic allergic conditions affecting the upper airway. Read More

J Voice 2019 Sep 16. Epub 2019 Sep 16.

Department of Otolaryngology, New York Medical College, School of Medicine, Valhalla, New York.

Objectives: Paradoxical vocal fold motion disorder (PVFMD), or induced laryngeal obstruction (ILO), is a clinical phenomenon characterized by inappropriate adduction of the true vocal folds during inspiration. The resultant episodes of acute respiratory distress marked by exercise-induced cough, inspiratory stridor, throat tightness, and shortness of breath are often misattributed to asthma despite normal pulmonary function testing results. Although the pathogenesis of the disease remains unclear, the etiology is likely multifactorial with an inflammatory, neurological, and psychiatric basis. Read More

Hua Xi Kou Qiang Yi Xue Za Zhi 2019 Aug;37(4):450-452

State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Anesthesia, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China.

Negative pressure pulmonary edema is a rare complication of general anesthesia. This paper presents a case of acute negative pressure pulmonary edema that occurred during general anesthesia resuscitation. The patient is a young male that underwent bimaxillary surgery under general anesthesia. Read More

Laryngoscope 2020 Jun 11;130(6):1508-1513. Epub 2019 Sep 11.

Department of Otolaryngology-Head & Neck Surgery, Chicago Institute for Voice Care, University of Illinois at Chicago, Chicago, Illinois.

Objectives: Vocal cord dysfunction (VCD) has been used by clinicians, primarily pulmonologists, to describe a variety of conditions in which the regulation and coordination of vocal fold movements are part of the explanation of cough or difficulty breathing, mainly paradoxical vocal fold motion disorder (PVFM). Prior studies show an intersection of mental health issues, primarily anxiety, and PVFM. We began incorporating mental health screening tools using the Life Events Checklist-5 (LEC-5) and the Posttraumatic Stress Disorder (PTSD) Checklist for Civilians (PCL-C) to assess symptomatology that may be related to traumatic life events. Read More

Laryngoscope 2020 Jun 9;130(6):E400-E406. Epub 2019 Sep 9.

Cleveland Clinic, Head and Neck Institute, Cleveland, Ohio, U.S.A.

Objective: To identify different presentations, referral patterns, comorbidities, and laryngoscopy findings in children and young adults with exercise-induced laryngeal obstruction (EILO).

Methods: We performed a retrospective chart review of 112 patients, age <26 years, with EILO between 2013 and 2016.

Results: Of the 112 patients who met criteria, 91 were female and 21 were male. Read More

Curr Allergy Asthma Rep 2019 09 4;19(9):43. Epub 2019 Sep 4.

Division of Allergy/Immunology, Naval Medical Center Portsmouth, 620 John Paul Jones Circle, Portsmouth, VA, 23708, USA.

Purpose Of Review: Reports of respiratory symptoms, including asthma and hyper-reactive airway disease, have been more numerous in the media and medical literature since active duty service members (SM) began to support campaigns in South West Asia (SWA). Numerous environmental exposures have been reported and this review assesses the available evidence surrounding exposures, confounding conditions, and attempts to develop screening mechanisms.

Recent Findings: While particulate matter exposures and particularly exposure to burn pits have garnered much attention, a 2010 Armed Forces Health Surveillance Center report and 2011 Institute of Medicine publication did not identify a link between exposure to particulate matter with SM respiratory disease. Read More

Eur Arch Otorhinolaryngol 2019 Nov 4;276(11):3159-3164. Epub 2019 Sep 4.

Department of Otolaryngology-Head and Neck Surgery, Kyorin University School of Medicine, 6-20-2, Shinkawa, Mitaka, Tokyo, 181-8611, Japan.

Purpose: Ultra-high-resolution computed tomography (UHRCT) is an emerging imaging technology that is able to achieve simultaneous 160 slices with super-thin 0.25 mm thickness. The purpose of this study was to assess the feasibility of UHRCT to visualize laryngeal structure and kinetics. Read More

Clin Sports Med 2019 Oct;38(4):563-575

Department of Orthopaedics, The University of Pittsburgh, 3200 South Water Street, Pittsburgh, PA 15203, USA.

Respiratory symptoms and infections are common among athletes. Viral upper respiratory infection symptoms may precede dyspneic symptoms seen in asthmatics or worsen symptoms of exercise-induced bronchoconstriction Knowing how to instruct an athlete on use of inhalers and having an asthma action plan are critical in management of these athletes. Other life-threatening conditions that may be seen are pneumothorax and laryngeal/pharyngeal perforation. Read More

Medicine (Baltimore) 2019 Aug;98(35):e17012

Department of Anaesthesiology, Liaocheng People's Hospital, Liaocheng, Shandong, China.

Background: Percutaneous tracheostomy, almost associated with cough reflex and hemodynamic fluctuations, is a common procedure for traumatic brain injury (TBI) patients, especially those in neurosurgery intensive care units (NICUs). However, there are currently a lack of effective preventive measures to reduce the risk of secondary brain injury. The aim of this study was to compare the effect of dexmedetomidine (DEX) vs sufentanil during percutaneous tracheostomy in TBI patients. Read More

Asian J Anesthesiol 2019 06;57(2):61-61

Department of Anesthesiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan

J Voice 2019 Aug 12. Epub 2019 Aug 12.

Department of Communication Sciences and Disorders, University of Delaware, Newark, Delaware.

Purpose: The primary purpose of the current study was to determine the usefulness of Buteyko breathing technique (BBT) in reducing dyspnea in patients with one form of Paradoxical Vocal Fold Motion (PVFM), exertion-induced PVFM (EI-PVFM), concomitant with hyperventilation. The secondary purpose was to determine whether BBT had an effect on physiological markers of hyperventilation, as speculated by BBT theory: respiratory tidal minute volume (RTMV), end-tidal carbon dioxide (ETCO), and resting heart rate (HR).

Methods: Using a within-subjects, repeated measures group design, 12 participants with EI-PVFM and hyperventilation underwent 12 weeks of BBT, following an initial no-treatment control condition. Read More

Int J Pediatr Otorhinolaryngol 2019 Oct 18;125:199-200. Epub 2019 Jul 18.

Northwestern University Feinberg School of Medicine, Department of Otolaryngology - Head and Neck Surgery, 675 N St Clair Ct Suite 15-200, Chicago, IL, 60611, USA; Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Otolaryngology - Head and Neck Surgery, 225 E. Chicago Ave., Chicago, IL, 60611, USA. Electronic address:

We present a unique case of intermittent paradoxical vocal fold motion (PVFM) as the presenting symptom of a rare underlying neuromuscular disorder in a neonate. Paramyotonia congenita (PC) is an autosomal dominant condition that typically presents in infancy with myotonic episodes affecting the skeletal muscles. Our patient developed intermittent episodes of stridor quickly progressing to apnea shortly after birth that were marked by PVFM on laryngoscopy, ultimately leading to the diagnosis of a previously unrecognized mutation in SCN4A, the gene responsible for PC. Read More

Ann Surg 2019 Jul 25. Epub 2019 Jul 25.

Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.

Objective: We compared the surgical outcomes of minimally invasive esophagectomy (MIE) and open esophagectomy (OE) for esophageal cancer.

Summary Background Data: MIE has become a widespread procedure. However, the definitive advantages of MIE over OE at a nationwide level have not been established. Read More

Brain Dev 2019 Nov 25;41(10):888-893. Epub 2019 Jul 25.

Department of Pediatrics, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan.

In partial monosomy of the distal part of chromosome 16q, abnormal facial features, intellectual disability (ID), and feeding dysfunction are often reported. However, seizures are not typical and the majority of them were seizure-free. Here we present the case of a 16q22. Read More

JAAPA 2019 Aug;32(8):28-30

At the time this article was written, Wei Chao Chang practiced in the Department of Surgery at MedStar Good Samaritan Hospital in Baltimore, Md. He now practices in the Department of Surgery at Greater Baltimore Medical Center. The author has disclosed no potential conflicts of interest, financial or otherwise.

Negative-pressure pulmonary edema (NPPE) is acute-onset bilateral pulmonary interstitial edema. This condition can be caused by significant negative intrathoracic pressure generated by large inspiratory effort against acute upper airway obstruction. Postoperative NPPE is rare but potentially life-threatening if not recognized and treated promptly. Read More

Pediatr Cardiol 2019 Aug 24;40(6):1296-1303. Epub 2019 Jul 24.

Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, 45229, USA.

Dysphagia and vocal cord dysfunction are frequent complications after congenital heart surgery. Both are risk factors for aspiration, which can lead to pneumonia, progressive lung disease, and respiratory arrest. A protocol was implemented to promote early detection of aspiration in a high-risk cohort of patients. Read More

Pediatr Crit Care Med 2019 09;20(9):817-825

Division of Pediatric Critical Care, Pediatrics Department, University of Utah, School of Medicine, Salt Lake City, UT.

Objectives: Surgery of the aortic arch poses risk of recurrent laryngeal nerve injury due to the anatomic proximity and can manifest as vocal cord dysfunction after surgery. We assessed risk factors for vocal cord dysfunction and calculated surgical procedure associated rates in young infants after congenital heart surgery.

Design: Cross section analysis. Read More

Ann Otol Rhinol Laryngol 2019 Nov 19;128(11):1019-1022. Epub 2019 Jun 19.

Department of Otolaryngology, University of Tennessee Health Science Center College of Medicine, Memphis, Tennessee, USA.

Objectives: To evaluate our experience with a significant number of brain malignancy-related vocal fold paralysis patients and their response to vocal cord-related therapies.

Background: Vocal fold paralysis is a potentially devastating complication of various types of pediatric diseases and surgeries that can lead to significant vocal and swallowing difficulties. While there is significant data in the literature on outcomes of children treated for vocal fold paralysis following cardiac or thyroid surgery, there is a scarcity of such information on children following the treatment of neurologic malignancy. Read More