Impending carotid blowout stabilization using an LT-D tube

Adequate stabilization of a patient presenting with a carotid blowout is one of the most challenging issues an on-call ENT surgeon can be confronted with. Reducing the bleeding and securing the airway are essential before more definitive management. We present the case of a 72-year-old patient with head and neck cancer who arrived at the emergency room with a carotid blowout and who was successfully stabilized using a King LT-D ventilation tube

The Montgomery Thyroplasty Implant System: A 360° Assessment

This thesis provides a 360° assessment of one thyroplasty implant called the Montgomery Thyroplasty Implant System (MTIS).The author made an effort to use alternative and innovative research techniques. The originality lies in the choice of the Pareto technique as literature review, in the technique of the e-mail survey as to the use of voice indicators by practitioner, in a proof-of-concept study of an innovative (perhaps even disruptive) endoscopic measuring technique, and finally in the development of a new concept, the α -ratio with the use of virtual CT scan reconstruction to study the interactions between thyroid cartilage morphology and post-operative voice results.Thesis results can be summarized as follows:Most commonly used Voice Outcome Indicators (VOIs) to determine the effectiveness of surgical Unilateral Vocal Fold Palsy (UVFP) treatment are: Maximum Phonation Time and Voice Handicap Index. Mean Airflow is a VOI deserving further investigations.MTIS is a simple technique, offering permanent results with the possibility of treating posterior glottal gaps in most UVFP configurations.MTIS provides excellent results for male individuals. Female patients have a lower benefit after MTIS. The depth of the implant, as well as cartilage fenestration location, are factors influencing this gender discrepancySoluvos b.v. BESS Group Inc. XION-Medical GmbHLUMC / Geneeskund

Union of the European Phoniatricians' position statement on the exit strategy of phoniatric and laryngological services : staying safe and getting back to normal after the peak of coronavirus disease 2019 (issued on 25th May 2020)

Background The following position statement from the Union of the European Phoniatricians, updated on 25th May 2020 (superseding the previous statement issued on 21st April 2020), contains a series of recommendations for phoniatricians and ENT surgeons who provide and/or run voice, swallowing, speech and language, or paediatric audiology services. Objectives This material specifically aims to inform clinical practices in countries where clinics and operating theatres are reopening for elective work. It endeavours to present a current European view in relation to common procedures, many of which fall under the aegis of aerosol generating procedures. Conclusion As evidence continues to build, some of the recommended practices will undoubtedly evolve, but it is hoped that the updated position statement will offer clinicians precepts on safe clinical practice.Peer reviewe

Application of Simple Smart Logic for Waterflooding Reservoir Management

A simple smart logic for controlling inflow control valves (ICV) in waterflooding reservoir management is implemented and analyzed, with the final objective of improving the long term financial return of a petroleum reservoir. Such a control is based in a reactive simple logic that responds to the watercut measured in the ICV. Basically, when the watercut increases, the ICV is set to close proportionally. For comparison purposes, four strategies are presented: base case scenario with conventional control, the best completion configuration found by trial-and-error, the reactive control, and a deterministic optimal control based on Nonlinear Gradient Method with adjoint-gradient formulation is shown for comparison purposes. Finally, all four strategies are tested again in different reservoir realizations in order to mimic the geological uncertainties. Two different synthetic reservoir models were studied. First, a simple cube with a five-spot well configuration, in which the permeability field has a horizontal pattern defined by lognormal distributions. The second model is a benchmark proposed by the Dutch university, TU delft, with 101 channelized permeability fields representing river patterns. For the first model, no significant relative gain is found neither in the variable control nor in the optimal control. Manly because of the high homogeneity of the reservoir models. Therefore, no intelligent completion is recommended. On the other hand, for the second and more complex case, the results indicate an expressive relative gain in the use of simple reactive logic. Besides, this type of control achieves results nearly as good as the optimal control. The test in different realizations, however, shows that reservoir characterization is still a key part of any attempt to improve production. Although the variable reactive control is semi-independent, with action being taken based on measurements, some parameters need a priori model to be tuned

Head-and-neck paragangliomas are associated with sleep-related complaints, especially in the presence of carotid body tumors

Item does not contain fulltextOBJECTIVES: The carotid body functions as a chemoreceptor. We hypothesized that head-and-neck paragangliomas (HNP) may disturb the function of these peripheral chemoreceptors and play a role in sleep-disordered breathing. DESIGN: This is a case-control study. SETTING: This study was conducted in a tertiary referral center. PARTICIPANTS AND MAIN OUTCOME MEASURES: We assessed fatigue, sleep, and exercise capacity in 74 HNP patients using three questionnaires (Epworth Sleepiness Scale, St. George Respiratory Questionnaire, and a standard clinical sleep assessment questionnaire). Outcomes were compared to those of age- and sex-matched controls. RESULTS AND CONCLUSIONS: Activity, disturbance of psychosocial function, and total score were worse compared to controls (15.4 +/- 18.5 vs. 7.2 +/- 9.9, P = 0.007; 5.3 +/- 10.5 vs. 1.2 +/- 2.6, P = 0.008; and 10.4 +/- 12.9 vs. 5.0 +/- 4.8, P = 0.006, respectively). Patients reported more daytime fatigue, concentration difficulties, and depression (51% vs. 24%, P = 0.006; 31% vs. 10%, P = 0.010; and 19% vs. 2%, P = 0.012). Waking up was reported to be less refreshing in HNP patients (53% vs. 73%, P = 0.038). Dysphonia was a predictor of symptoms, activity, disturbance of psychosocial function, and total scores. Remarkably, the presence of a carotid body tumor was an independent predictor of increased daytime sleepiness (beta = 0.287, P = 0.029). In conclusion, patients with HNP have remarkable sleep-related complaints. Especially the presence of carotid body tumors appears to be associated with increased daytime somnolence.1 juni 201

Accuracy of Thyroid Cartilage Fenestration During Montgomery Medialization Thyroplasty

Accuracy of thyroid cartilage fenestration during Montgomery thyroplasty (MTIS) is considered a key success factor. The primary aim of the study was to retrospectively evaluate the accuracy of fenestration. Furthermore, recent publications indicate a possible discrepancy in MTIS voice outcomes related to gender. The secondary aim of the study was to investigate whether the fenestration accuracy could explain this discrepancy

The larynx ruler to measure height and profile of vocal folds : a proof of concept

Glottic leakage during phonation is a direct consequence of unilateral vocal fold (VF) paralysis. This air leakage can be in the horizontal plane and in the vertical plane. Presently, there is no easily applicable medical device allowing non-invasive, office-based measurement of the relative vertical position of the VFs. The larynx ruler (LR) is a laser-based measuring device that could meet the previously stated need, using a flexible endoscope. This study represents a proof of concept regarding the use of the LR in assessing VF relative positions in the vertical plane