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Article
Management of Thyroid Isthmus During Tracheostomy

Authors: Adil Hadi Salih Al-Azzawi --- Wissam Kadhum Abdel Amer --- Ahmed Kareem Shiaan Al-Baidhani
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 2 Pages: 388 -391
Publisher: Babylon University جامعة بابل

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Abstract

A tracheotomy is a surgical procedure which consists of making an incision on the anterior aspect of the neck and opening a direct airway through an incision in the trachea (windpipe). As with any surgery, there are some risks associated with tracheotomies. Early Complications that may arise during the tracheostomy procedure or soon thereafter include bleeding, pneumothorax, and subcutaneous emphysema.The aim of this study was to evaluate the use of cautery knife instead of artery forceps in management of thyroid isthmus during tracheostomy with regard to time of operation, post-operative bleeding, and surgical emphysema.This study was a cross-sectional research performed on 60 ICU patients in need of tracheostomy through a period started from January 2009 to January 2012. The patients were divided into two groups each formed of 30 patients, one group(group A) dealt with by traditional tracheostomy through clamping of the thyroid by artery forceps and transfixion to expose tracheal rings, and second group (group B) had a new method of management through cautery knife. Time of both procedures and early complications were registered in questionnaires and the data were analyzed for both groups.A tracheostomy was performed in 60 morbidly ICU patients. The two groups had no significant difference in age, sex, and vital signs. Average duration of the procedure was 10-20 minutes in group A patients using the traditional procedure and 5-10 minutes in the second group (group B) using a cautery knife. Three patients out of thirty in group A got post-operative bleeding, while no patient in group B got bleeding. There was a significant difference between the two groups regarding time of procedure and post-operative bleeding, otherwise there was no significant differences between the two groups regarding occurrence of surgical emphysema. The use of cautery knife for thyroid isthmus management during tracheostomy minimize operation time and reduce occurrence of postoperative complication especially bleeding.

Keywords

Tracheostomt --- cautery knife --- ENT


Article
Foreign Body Inhalation in Pediatric Age Group

Authors: Wissam Kadhum Abdel Amer --- Adil Hadi Salih Al-Azzawi --- Ahmed Kareem Shiaan Al-Baidhani
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 2 Pages: 392 -397
Publisher: Babylon University جامعة بابل

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Abstract

Bronchoscopic removal of foreign body inhalation is treatment of choice. Development of anesthesia and endoscopic techniques supported by finer ,purposeful instruments and better understanding of the problems made the management easier, safer and surer and mortality claimed to be 1-2% compare to 50% before advent of endoscopy until 1800 foreign body inhalation removed by bronchotomy.over period of 2 years 2012-2014, 230 patient below 5 years received at our department to do bronchoscopy ,190 have definite history of foreign body inhalation proved by bronchoscopy , 40 cases suspected inhalation with persistence of chest infection.The most frequent affected group by foreign body inhalation 5 monthes-2 yearsmale to female ratio 1.8-1 most patient have definite history of foreign body inhalation . Recurrent chest infection with negative history foreign body inhalation needs bronchoscopy . Radiology should be done prior procedure .Bronchoscopy is procedure of choice for foreign body inhalation when a suspected, sometimes it's lifesaving.


Article
Lidocaine Spray to Prevent Laryngospasm in Air Ways Surgeries

Authors: Adil Hadi Salihy --- Wissam Kadhum Abdel Amer --- Malath Azeez Al-Saadi
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2016 Volume: 13 Issue: 3 Pages: 728 -730
Publisher: Babylon University جامعة بابل

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Abstract

Laryngospasm is life threatening event that complicate airway surgeries requiring especial attention to prevent. To evaluate the advantage of pre intubation lidocaine spray to the laryngeal mucosa to prevent extubation laryngospasm.80 patients of both sexes below 9 years old admitted for adenoidectomy or rigid bronchoscope foreign body removal included in this study. All patients were from risk groups to develop laryngospasm.At induction stage, before intubation and bronchoscope introduction 10%lidocain sprayed to the laryngeal mucosa . The incidence of laryngospasmis noticed after removal of endotracheal tube and bronchoscope.All patients included in this study for both types of surgical procedures not develop any type of laryngospasm whether partial or complete after extubation Lidocaine spray can prevent laryngospasm in risk patients.

Keywords

Lidocaine --- spray --- laryngospasm --- foreign body

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