Development Of Airway Obstruction Research Articles

Prevalence, stability, and clinical significance of an isolated low FEV1 spirometry pattern in children.

In adults, an isolated low FEV1 pattern (an FEV1 below the lower limit of normal with a preserved FVC and FEV1/FVC) has been associated with the risk of developing airway obstruction. Our objective was to examine the prevalence, stability, and clinical significance of an isolated low FEV1 pattern in the pediatric population. We conducted a retrospective study of spirometries from children ages 6-21 years and categorized tests into spirometry patterns according to published guidelines and recent literature. In a subgroup of tests with an isolated low FEV1 pattern, we evaluated spirometry technique. We also examined the association of having a test with an isolated low FEV1 pattern with clinical markers of disease severity in a subgroup of children with cystic fibrosis (CF). The isolated low FEV1 pattern was uncommon across the 29,979 tests included (n = 645 [2%]). In the 263 children with an isolated low FEV1 pattern who had a follow-up test performed, the most frequent spirometry pattern at last test was normal (n = 123 [47%]). A primary diagnosis of CF was associated with increased odds of having at least one test with an isolated low FEV1 pattern (OR = 8.37, 95%CI = 4.70-15.96, p < .001). The spirometry quality in a subgroup of tests with an isolated low FEV1 pattern (n = 50) was satisfactory. In the subgroup of children with CF (n = 102), those who had a test with an isolated low FEV1 pattern had higher odds of using oral antibiotics in the last 12 months than those who had a normal pattern (OR = 3.50, 95%CI = 1.15-10.63, p = .03). The isolated low FEV1 pattern can occur repeatedly over time, usually transitions to a normal pattern, is not due to a poor spirometry technique, and could be clinically relevant in children with chronic lung diseases.

Posterior Atlantoaxial Fusion With C1-2 Pedicle Screw Fixation for Atlantoaxial Dislocation in Pediatric Patients With Mucopolysaccharidosis IVA (Morquio a Syndrome): A Case Series

To investigate the efficacy and safety of posterior atlantoaxial fusion (AAF) with C1-2 pedicle screw fixation for atlantoaxial dislocation (AAD) in pediatric patients with mucopolysaccharidosis IVA (MPS IVA). This study included 21 pediatric patients with MPS IVA who underwent posterior AAF with C1-2 pedicle screw fixation. Anatomical parameters of the C1 and C2 pedicle were measured on preoperative computed tomography (CT). The American Spinal Injury Association (ASIA) scale was used to evaluate the neurological status. The fusion and accuracy of pedicle screw was assessed on postoperative CT. Demographic, radiation dose, bone density, surgical, and clinical data were recorded. Patients reviewed included 21 patients younger than 16years with an average age of 7.4±4.2years and an average of 20.9±7.7months follow-up. Fixation of 83 C1 and C2 pedicle screws was performed successfully and 96.3% of them were identified as being safe. One patient developed postoperative transient disturbance of consciousness and one developed fetal airway obstruction and died about 1month after the surgery. Out of the remaining20 patients, fusion was achieved, symptoms were improved, and no other serious surgical complications were observed at the latest follow-up. Posterior AAF with C1-2 pedicle screw fixation is effective and safe for AAD in pediatric patients with MPS IVA. However, the procedure is technically demanding and should be performed by experienced surgeons with strict multidisciplinary consultations.

Associative factors for tracheostomy in patients presenting with stridor or upper airway obstruction.

This study aimed to identify associative factors for tracheostomy in patients presenting with airway obstruction. Data from a tertiary hospital were reviewed to identify patients who presented with airway obstruction between 2009 and 2020. Patient demographics, causative pathology and treatments were analysed. The study identified 297 admitted patients. Of these, 66 underwent a tracheostomy and formed the 'tracheostomy' group and 231 formed the 'other intervention' group. The tracheostomy group had a higher mean age (p = 0.003), and higher percentages of males (p = 0.031) and smokers or ex-smokers (p = 0.020), compared to the other intervention group. The tracheostomy group also had a higher number of patients with a malignancy (p < 0.001) compared to the other intervention group. Being older, male, a previous or current smoker, or developing airway obstruction due to a malignancy were found to be the main associative factors for requiring a tracheostomy.

An Increase in Plasma Adipsin Levels Is Associated With Higher Cumulative Dust Exposure and Airway Obstruction in Foundry Workers.

The aim of the study was to assess whether plasma adipokine levels (adipsin, adiponectin, leptin, and resistin) are associated with pulmonary function in foundry workers. We examined 65 dust-exposed foundry workers and 40 nonexposed controls and analyzed their lung function and plasma adipokine levels at baseline and after approximately 7 years of follow-up. A higher increase in plasma adipsin was associated with the development of airway obstruction in exposed subjects during follow-up after adjusting for body mass index changes during the follow-up period. Furthermore, the increase in adipsin levels was positively associated with cumulative dust exposure even after adjusting for smoking and body mass index changes during follow-up ( P = 0.015). The results suggest that plasma adipsin is involved in the pathogenesis of subclinical airway inflammation and the development of chronic obstruction and is induced by occupational dust exposure.

Obstructive Sleep Apnea Effects on Pulmonary and Respiratory Muscle Function of Obese Children and Adolescents: A Preliminary Study.

OBJECTIVEObstructive sleep apnea causes a marked decrease in lung volume and increases lung elasticity in obese adults. However, pulmonary and respiratory muscle function of obese children with obstructive sleep apnea who are more prone to develop airway obstruction than adults is less understood. This study aimed to determine the effects of obstructive sleep apnea on pulmonary and respiratory muscle function in obese children and adolescents compared to those without obstructive sleep apnea.MATERIAL AND METHODSThis cross-sectional study enrolled 12 obese children and adolescents with a known polysomnographic diagnosis of obstructive sleep apnea and 12 controls that were matched for age, gender, and body mass index. Pulmonary function, maximal inspiratory pressure, maximum voluntary ventilation, and anthropometric variables were measured.RESULTSObese children and adolescents with obstructive sleep apnea exhibited significantly lower maximal mid-expiratory flow and displayed a forced expiratory flow at 50% and 75% of vital capacity (all P< .05) compared to the control group. However, there were no changes in other pulmonary function variables (all P > .05). Their maximal inspiratory pressure and maximum voluntary ventilation were lower than those of the controls, but this was not statistically significant (all P> .05).CONCLUSIONObstructive sleep apnea did not change pulmonary and respiratory muscle function in obese children and adolescents. The special assessment should be warranted to identify a reduction in maximal mid-expiratory flow and forced expiratory flow at 50% and 75% of vital capacity observed in this population.

Negative Pressure Pulmonary Edema

Negative pressure pulmonary edema is a well-known clinical condition mostly affecting young healthy adults and at times pediatric patients. It occurs mostly acutely in patients who have experienced airway obstruction. Most common pathophysiology is the development of a negative intrathoracic pressure which results in increased preload and subsequently increase pulmonary hydrostatic pressures. The pulmonary edema develops once the airway obstruction is relieved and the forces opposing the transudation of fluid into the interstitial tissues are removed. Management includes a high index of suspicion in patients who have developed airway obstruction, early recognition, relief of obstruction, and maintenance of airway along with oxygen therapy. BIPAP or CPAP may be needed in patients who do not responds to these measures. Invasive mechanical ventilation with high FiO2 is reserved for refractory hypoxia.

Inducible expression quantitative trait locus analysis of the MUC5AC gene in asthma in urban populations of children

Mucus plugging can worsen asthma control, lead to reduced lung function and fatal exacerbations. MUC5AC is the secretory mucin implicated in mucus plugging, and MUC5AC gene expression has been associated with development of airway obstruction and asthma exacerbations in urban children with asthma. However, the genetic determinants of MUC5AC expression are not established. This study sought to assess single-nucleotide polymorphisms (SNPs) that influence MUC5AC expression and relate to pulmonary functions in childhood asthma. This study used RNA-sequencing data from upper airway samples and performed cis-expression quantitative trait loci (eQTL) and allele-specific expression analyses in 2 cohorts of predominantly Black and Hispanic urban children, a high asthma-risk birth cohort, and an exacerbation-prone asthma cohort. Inducible MUC5AC eQTLs were further investigated during incipient asthma exacerbations. Significant eQTLs SNPs were tested for associations with lung function measurements and their functional consequences were investigated in DNA regulatory databases. Two independent groups of SNPs in the MUC5AC gene that were significantly associated with MUC5AC expression were identified. Moreover, these SNPs showed stronger eQTL associations with MUC5AC expression during asthma exacerbations, which is consistent with inducible expression. SNPs in 1 group also showed significant association with decreased pulmonary functions. These SNPs included multiple EGR1 transcription factor binding sites, suggesting a mechanism of effect. These findings demonstrate the applicability of organ-specific RNA-sequencing data to determine genetic factors contributing to a key disease pathway. Specifically, they suggest important genetic variations that may underlie propensity to mucus plugging in asthma and could be important in targeted asthma phenotyping and disease management strategies.

Life-threatening airway obstruction caused by angioedema in a morbidly obese postoperative patient: a case report

BackgroundWe report a case of a morbidly obese patient who developed life-threatening airway obstruction due to angioedema.Case presentationA 50-year-old Japanese morbidly obese female was treated with enalapril for 10 years, with no history of angioedema. After 3 h of completion of breast cancer resection under general anesthesia with tracheal intubation, she developed airway obstruction and respiratory arrest. Her oral cavity was occupied with a swollen tongue. It was extremely difficult to determine the airway anatomical orientation although tracheal intubation was attempted using a videolaryngoscope. At this time, she probably started gasping respiration, which generated a faint bubble and revealed a possible airway. Her airway was established using a tracheal tube without confirming the glottis or the vocal cord.ConclusionsAngioedema induced by angiotensin-converting enzyme (ACE) inhibitors is rare; however, once it occurs, it can be potentially life threatening, especially for patients with possible difficult airway. Considering the risk–benefit ratio, we must be careful in administering ACE inhibitor therapy in morbidly obese patients.

P3508A novel mouse model of sleep-disordered breathing is associated with contractile dysfunction and CaMKII overexpression

Abstract Background Patients with sleep-disordered breathing (SDB) develop arrhythmias and contractile dysfunction, but the mechanisms are poorly understood, possibly due to the lack of mouse models that mimic airway obstruction in spontaneously sleeping mice. Interestingly, New Zealand obese mice have been shown to develop airway obstruction with inspiratory flow limitation resulting in apneas, but these mice also develop diabetes. Purpose We developed a novel mouse model of increased airway obstruction in spontaneously sleeping lean mice and investigated the impact on sleep-related apneas and contractile function. Methods and results Male C57BL6 mice at 8–12 weeks of age were subjected to polytetrafluoroethylene (PTFE) injection (100 μl) into the tongue. This resulted in an increased tongue volume and reduced pharyngeal luminal diameter. Conscious mice behave normal and there was no difference in body weight between PTFE injected mice and untreated littermates (control). Whole body plethysmography was used to monitor spontaneous breathing for 8h in a quiet environment. Interestingly, compared to control, mice with PTFE injection showed a significantly increased frequency of apneas (lasting &gt;1s, fig. A, * indicated P&lt;0.05, t-test). Echocardiographic analysis revealed that ejection fraction was significantly reduced in PTFE-treated mice 8 weeks after surgery (vs. control, fig. B). In accordance, the developed force of isolated papillary muscles from hearts of PTFE mice was significantly reduced compared to control (fig. C). Ca/calmodulin-dependent protein kinase II (CaMKII) has been implicated in the development of heart failure. Intriguingly, compared to control, CaMKII expression was significantly increased in ventricular heart homogenates of PTFE-treated mice (fig. D). Moreover, the magnitude of CaMKII overexpression correlated significantly with the frequency of apneas (fig. E). Papillary muscle post-pause contractions can be used as measure of diastolic sarcoplasmic reticulum (SR) Ca leak, which is known to be enhanced by CaMKII. Compared to control, post-pause contraction amplitude was significantly smaller in PTFE-treated mice, indicating an increased SR Ca leak (fig. F). Figure 1 Conclusion PTFE injection in mice results in an increased frequency of spontaneous apneas. PTFE-treated mice develop mild contractile dysfunction, which is accompanied by CaMKII overexpression. This novel mouse model offers great opportunities for investigation of sleep-related breathing disorders. Acknowledgement/Funding This study was supported by the Medical Faculty of the University of Regensburg (ReForM programme).

Lung Microbiome Is Influenced by the Environment and Asthmatic Status in an Equine Model of Asthma.

There is evidence that the lung microbiome differs between patients with asthma and healthy humans, but the effect of environmental conditions and medication is unknown and difficult to study. Equine asthma is a naturally occurring chronic airway disease characterized by reversible airway inflammation and bronchoconstriction upon exposure to inhaled antigens. In the present study, we evaluated the effect that environmental conditions and disease status have on pulmonary, nasal, and oral microbiomes. Six asthmatic and six healthy horses were studied while at pasture ("low antigen exposure"), as well as when being housed indoors and fed good-quality hay ("moderate exposure") and poor-quality hay ("high exposure"). At each time point, lung function was recorded; BAL, oral, and nasal rinses were collected; and 16S rRNA gene sequencing was performed. Asthmatic horses developed airway obstruction and inflammation under moderate and high antigen exposure conditions, whereas nonasthmatic horses showed mild inflammation under high antigen exposure, without bronchoconstriction. Lung, oral, and nasal communities clustered by environmental condition, but only lung communities were different between healthy and asthmatic horses. The association between asthma and lung microbiome was strongest in horses under moderate antigen exposure. Pulmonary, oral, and nasal microbiomes are influenced by environmental conditions, but only the pulmonary microbiome differs between horses with and without asthma. This difference, seen mainly when airway inflammation was present in horses with asthma but not in control animals, suggests that the altered lung microbiome in asthma might not be inherent but coincident with inflammation.

Fatal outcome of late-onset angiotensin-converting enzyme inhibitor induced angioedema

Rationale:Angiotensin-converting enzyme (ACE) inhibitors are one of the most used medication among patients with arterial hypertension. In most cases, ACE inhibitors caused side effects are mild; however, from 0.1% to 0.7% of patients can develop life threatening adverse effect, angioedema. Unlike histamine mediated, ACE inhibitor-related angioedema can develop at any time during the treatment course.Patient concerns:An 89-year-old woman with a medical history for arterial hypertension, ischemic heart disease, heart failure, chronic atrial fibrillation developed ACE inhibitor-induced angioedema after 5 years of daily ramipril administration.Diagnoses:Arterial hypertension, ischemic heart disease, heart failure, chronic atrial fibrillation and late onset ACE inhibitor-induced angioedema.Interventions:The ACE inhibitor was used for arterial hypertension on a daily basis for the past 5 years. Patient developed airway obstruction requiring intubation. Standard therapy with epinephrine, methylprednisolone and clemastine was administered. Treatment was ineffective, considering that angioedema persisted.Outcomes:Angioedema resolved after 13 days from the discontinuation of ramipril. Death due to cardiopulmonary insufficiency occurred 24 days after the admission to intensive care unit, despite full clinical resolution of ACE inhibitor-induced angioedema.Lessons:Our case highlight the importance of educating clinicians about ACE inhibitor-induced angioedema, as potentially fatal adverse drug reaction. Considering the fact, that no laboratory or confirmatory test exist to diagnose ACE inhibitor-induced angioedema, clinicians’ knowledge is the key element in recognition of ACE inhibitor-related angioedema.

Does Obstructive Sleep Apnea (OSA) Increase the Risk of Post-Operative Respiratory Complications after Bariatric Surgery?

Background: OSA affects up to quarter of general population. It is associated with morbid obesity with a higher morbidity and mortality rates. STOP Bang questionnaire is a validated method for OSA screening. OSA patients are at high risk of developing airway obstruction, cardiac events, congestive heart failure, stroke and desaturation post operatively. The aim of this study is to evaluate adverse respiratory events in patients undergoing bariatric surgery in relation to risk of OSA using Stop Bang questionnaire. Methods: This prospective double cohort study was conducted in Tanta University Hospital from Marchto August 2017. During the preoperative assessment, STOP-BANG questionnaire was performed. After extubation, patients were transferred to PACU unit. Respiratory complications were assessed thereafter. Based on STOP-BANG score, patients were divided into two groups, high risk of OSA with STOP-BANG > 3 (Group I) and low risk of OSA with STOP-BANG Results: 104 patients were included in this study. Group I had more comorbidities in the form of CAD (15% versus 2%, P 0.001). Higher number of respiratory complications was noted in high-risk group (31 patients, 59%) compared to (24 patients, 46%) in group II yet, it was not significant. Conclusion: Obese patients with STOP-BANG score > 3 undergoing bariatric surgery are associated with hypertension, dyslipidemia, CAD, and renal insufficiency. High-risk OSA obese patients are at higher risk of developing respiratory compilations like inability to breathe deeply and hypoxia in postoperatively.

Topicalisation of airway for awake fibre-optic intubation: Walking on thin ice.

Topicalisation of the airway by various techniques has routinely been recommended for awake fibre-optic bronchoscopy in cases of difficult airway. However, topicalisation by itself can cause airway obstruction by decreasing the tone of the laryngeal muscles and causing a dynamic air inflow obstruction. Two cases of difficult airway are illustrated where anaesthetising upper airway with nebulisation with 4% lignocaine (Xylocaine™) or 2% lignocaine (Xylocaine™) jelly resulted in stridor and upper airway obstruction. This is the first reported case of airway obstruction after lignocaine (Xylocaine™) jelly. We would like to highlight that topicalisation of airway, once thought as a relatively safe technique, can cause airway collapse if not detected and anticipated at the earliest. Pre-operative spirometry and airway ultrasonography can be useful in detecting the patients at risk of developing airway obstruction. Using a nasopharyngeal airway during topicalisation can serve as a valuable device in preventing total airway obstruction in susceptible patients.

IDENTIFICATION AND ASSESSMENT OF THE CHRONIC OBSTRUCTIVE PULMONARY DISEASE RISK FACTORS IN FIRST DIAGNOSED PATIENTS

According to the World Health Organization (WHO), today about 210 million people are suffering from chronic obstructive pulmonary disease (COPD) worldwide. The main risk factor of COPD is smoking, registered in 80-90 % of cases. Smokers have the highest mortality from COPD, they develop airway obstruction and dyspnea more quickly. The objective of this study is to establish the prevalence of smoking as a major risk factor among employees of an organized group, and to assess gender and age structure. The study was conducted in several phases. In the first phase, we interviewed the population using the original questionnaire, created on the basis of GOLD questionnaire (2012, 2015) and Order of the MOH of Ukraine No. 555 of 27 June 2013. We questioned 525 people over 35, who had not had the history of any chronic respiratory disease. In the next phase, individuals who scored 18 or more points, were subjected to a spirography with bronchodilatation test using salbutamol 400 µg and a passed a survey using a modified medical research council dyspnea scale (mMRC) and COPD assessment test (CAT). A degree of nicotine dependence was assessed using a Fagerstrom test, and an interest to quit smoking – according to smoking evaluation form. The study involved 136 patients aged 38 to 77 years. In the group of individuals, who regularly passed medical examinations, undiagnosed COPD was detected in 14,9 % of subjects. Among respondents who were first diagnosed COPD, 53 (67.1%) individuals were smokers, including 7 (8,9 %) former smokers. When compared the prevalence of smoking in individuals diagnosed COPD to those without COPD, we found significantly more smokers attributed to the first group. Smoker patients with first diagnosed COPD had a high degree of nicotine dependence (74 %). Among smokers with newly diagnosed COPD, 58,7 % of patients presented significant and moderate desire to quit smoking. World practice shows that treatment of patients suffering from nicotine dependence in combination with other measures may be very effective in reducing the prevalence of smoking, which in turn will lead to reduction in the number of patients with chronic lung disease.

Deep neck infections: A single-center analysis of 63 cases.

Background and PurposeWith the use of antibiotic therapy, the incidence of deep neck infections has decreased in recent decades. The aim of this investigation was to review the clinical course and the management of deep neck infections in our department, compare them to the experiences of the common literature and identify predisposing factors for lethal complications.Material and MethodsIn this single-center analysis, 63 patients with deep neck infections were treated surgically. The following clinical data were analyzed and compared: age, gender, laboratory data, spatial manifestation, therapeutic modalities, comorbidities, length of hospitalization and complications.ResultsThere was a predominance of male patients (58.7%) and a mean age of 57.9 years. The most common symptoms at diagnosis were sore throat (96.8%) and neck swelling (92.0%). Cardio/pulmonary diseases and diabetes mellitus were the most common comorbidities. There was a significantly longer hospital stay for patients with diabetes mellitus. The most common manifestation was a parapharyngeal abscess in 24 patients (38.1%), followed by peri-/retrotonsillar infections in 19 patients (30.2%). In 29 patients, a multiple space infection was observed, with a significantly longer duration of hospitalization and a higher rate of complications. The main life-threatening complication was the development of airway obstruction in 20 patients (31.7%), who all received a tracheostomy. The duration of hospitalization for patients with complications was significantly longer.ConclusionsClose attention must be paid to the management of patients with deep neck infections, especially patients with diabetes mellitus and cardio/pulmonary diseases or patients with multiple space infections. Key words:Deep neck infections, comorbidities, surgical treatment, tracheostomy, diabetes mellitus.

Acute unilateral post-operative submandibular sialadenitis following posterior cranial fossa surgery.

Extreme degree of rotation and flexion of the head during posterior fossa surgeries can lead to acute post-operative submandibular sialadenitis that can cause respiratory compromise. Identification of this problem is vital to prevent deterioration in the early post-operative period. This condition responds well to conservative management provided airway obstruction is taken care of. We discuss a case of a 63-year-old female, with a left side vestibular schwannoma who developed airway obstruction in post-operative period due to swelling of right submandibular gland. Various possible mechanisms leading to this condition and related literature are briefy reviewed.

Introducing COPD Research and Practice

Chronic obstructive pulmonary disease (COPD) is now the fourth leading cause of death globally, and the World Health Organization (WHO) has predicted that it will become the third most common cause of death in the world by 2030 [1]. In developed countries, current information estimates a prevalence of 8 % to 10 % among adults 40 years of age and older, whereas in developing countries, prevalence varies significantly among countries and is difficult to quote [2]. It is estimated that more than 210 million people have the disease worldwide [3]. Concerning a large number of subjects, COPD generates important health and social costs. However, although COPD is one of the most common chronic diseases and has a high health and social impact, it is still poorly recognized among the general public and also clinicians. Consequently, there is a major and urgent need to better understand this complex disease. Since I started to get interested in this disease, more than 40 years ago, major progress has been made in the identification, pathogenesis, assessment and treatment of COPD. Nonetheless, many important questions remain unanswered. Peter J. Barnes [4] has properly and authoritatively emphasized that we still do not understand why only a minority of smokers develop airway obstruction, nor the complex interplay between different risk factors in addition to smoking and biomass smoke exposure. Moreover, we do not realize how the underlying inflammatory process is linked to pathophysiology and disease progression and the reason why inflammation and disease progression persist even after smoking cessation. COPD is a heterogeneous disease and can be classified into different “phenotypes” [5]. For many years, clinicians have noted two very different subgroups of patients in COPD, those with chronic bronchitis and those with emphysema [6]. Recently, the Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints (ECLIPSE) study has helped improve the characterization of other subsets of patients, including the

Pierre Robin sequence in association with tracheo-oesophageal fistula: a heterogenous birth defect

Pierre Robin Sequence (PRS) is not a genetic syndrome. It consists of multiple defects that occur as a result of a single structural anomaly. A full term male baby with micrognathia, retrognathia, glossoptosis and cleft palate was brought at second day of life for respiratory difficulty and unswallowed saliva. After clinical examination and abdomen radiograph, it was found that he had trachea-esophageal fistula. The fistula was ligated and esophageal anastomosis was done. Gavage feeding was commenced from fifth post-operative day with no problems. Karyotyping came out to be normal for him. On day 40 of life he arrived with failure to thrive and noisy breathing. Infants with Pierre Robin sequence develop airway obstruction soon after birth. Persistence of upper airway obstruction, is associated with serious consequences. This can be avoided by clinical evaluation and polysomnography.

The use of a Fogarty Catheter in a Case of an Endobronchial Blood Clot in a Laryngectomy Patient

ABSTRACT Introduction Endobronchial blood clot causing airway obstruction is a rare but potentially life-threatening condition and can occur in a variety of clinical settings. Case report A male laryngectomy, with a background of bronchogenic carcinoma was treated conservatively for tracheitis following an episode of upper respiratory tract infection. However, he later developed airway obstruction secondary to endobronchial bleeding with endobronchial clot formation. Conventional methods of suctioning and rigid bronchoscopy with forceps failed to remove the hematoma. A Fogarty embolec tomy catheter was used to remove the hematoma, relieving the airway obstruction. Discussion The Fogarty embolectomy catheter has been widely used in various vascular operations for removal of arterial and venous emboli over the last years. However, its application in nonvascular cases is not widely published. Conclusion We report a case of tracheitis, complicated by an endobronchial clot in a laryngectomy patient, and demonstrated the use of Fogarty embolectomy catheter in such case when conventional methods fail. How to cite this article Wong B. The use of a Fogarty Catheter in a Case of an Endobronchial Blood Clot in a Laryn gectomy Patient. Int J Head Neck Surg 2015;6(3):118120.

Bronchoscopic management of malignant airway obstruction.

Approximately one-third of patients with lung cancer will develop airway obstruction and many cancers lead to airway obstruction through meta stases. The treatment of malignant airway obstruction is often a multimodality approach and is usually performed for palliation of symptoms in advanced lung cancer. Removal of airway obstruction is associated with improvement in symptoms, quality of life, and lung function. Patient selection should exclude patients with short life expectancy, limited symptoms, and an inability to visualize beyond the obstruction. This review outlines both the immediate and delayed bronchoscopic effect options for the removal of airway obstruction and preservation of airway patency with endobronchial stenting.