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Objective: To describe and evaluate the surgical outcomes of multilayered closure of persistent tracheocutaneous fistulae (TCF) in patients with challenged wound healing. Methods: A retrospective chart review of all patients who underwent closure of TCF by the senior author between October 2011 and December 2021 was performed. Age, body mass index (BMI), time between decannulation and TCF repair, medical comorbidities, procedure duration, length of hospitalization, and postoperative complications were recorded. The primary outcomes were closure of the fistula, postoperative subcutaneous emphysema, pneumomediastinum, pneumothorax, wound infection, or breakdown. Outcomes of patients with and without challenged wound healing were compared. Results: Thirty-five patients who underwent TCF repair during the study period were identified. The mean age and BMI were 62.9 years and 28.43 respectively. Twenty-six (74%) patients met criteria for challenged wound healing at the time of the TCF repair. There was 1 (3.84%) minor complication in the challenged wound healing group and none (0%) in the control group (P = 1.00). No patients experienced wound breakdown or air leak noted on exam or chest radiography. Conclusion: Multilayered closure of persistent tracheocutaneous fistulae is a simple technique which is safe and effective even in patients with challenged wound healing. [ABSTRACT FROM AUTHOR]

Background/Objective: Traditional jet ventilation requires the use of a catheter that is inserted either through an endotracheal tube or laryngoscope. Specially designed laryngoscopes with a built-in luer lock adapter to which the high-pressure tubing may be attached exist but are not always available. We present our experience with an adapter which allows connection of the high-pressure tubing to the suction side port of suitable laryngoscopes that is easily assembled using readily available materials in the operating room. Method: We designed a jet ventilator adapter using a high-pressure jet ventilation tubing assembly and a 3-way stopcock extension set which we have used for the past 13 years. A retrospective case series of all adult patients who underwent direct laryngoscopy and/or bronchoscopy using this jet ventilation adapter between January 2017 and August 2021 was performed. Result: A total of 100 consecutive patients underwent laryngoscopy and bronchoscopy using jet ventilation between January 2017 and August 2021 was identified. The mean age was 56.3 years, and the mean BMI was 31.2. The most common diagnoses were idiopathic subglottic/tracheal stenosis (46.4%), acquired tracheal stenosis (34.1%), and acquired subglottic stenosis (14.8%). The median duration of the surgical procedure was 53 minutes with an interquartile range of 23. The CO2 laser was used in all cases. There was no disconnection of the adapter, episodes of postoperative respiratory compromise, or extraluminal air on chest radiography for any of our cases. Oxygen saturations remained above 90% intraoperatively for all cases. Conclusion: Our simple jet ventilator adapter connects the jet ventilator to the suction side port of suitable laryngoscopes and eliminates the need for a jet ventilation catheter or specialized laryngoscope at a minimal cost. [ABSTRACT FROM AUTHOR]

The article focuses on the study to analyze the duration of use, presentation, and management related to the angiotensin converting enzyme (ACE) inhibitor focused on angioedema patients. It mentions that ACE inhibitors are used in the management of patients with hypertension, congestive heart failure and myocardial infarction.

Objective: This study aimed to present a case of a successful re-implantation of an amputated auricle following a human bite using the Baudet technique. Methods: Case report and review of the literature. Results: The patient had a very satisfactory postoperative result in terms of appearance and function of the reattached auricle. Cartilage loss was minimal. Conclusion: Reattachment of an amputated auricle as a composite graft following a traumatic human bite is feasible. The Baudet technique is a simple alternative that avoids the complexity of microsurgical anastomosis while improving upon the high failure rate associated with simple reattachment. [ABSTRACT FROM AUTHOR]

Objectives: We present a series of patients who underwent excision of subepithelial lesions using a laryngeal microdebrider. Methods: A retrospective review was carried out of all patients who between June 2005 and April 2009 underwent microlaryngoscopy and excision of vocal fold lesions by the senior author using a microdebrider. The patients' demographics, past medical history, preoperative and postoperative videostroboscopy findings, and surgical pathology findings were reviewed. Results: Eight patients were identified. All were female and had a mean age of 44 years (range, 21 to 54 years). Four patients had a unilateral pseudocyst, 2 patients had bilateral pseudocysts, 1 patient had bilateral Reinke's edema, and 1 patient had unilateral Reinke's edema. Through an incision made just lateral to the lesion on the superior surface, a small microdebrider blade was inserted and run at 800 to 1,000 revolutions per minute in oscillation mode with low wall suction until the lesion was completely excised, and the overlying epithelium was left intact. Postoperative videostroboscopic examination of the larynx revealed an absence of lesions and near-complete glottal closure in all patients. Seven of the 8 patients reported an improvement in voice. Conclusions: Microdebrider excision of subepithelial vocal fold lesions is feasible. The patients with Reinke's edema had slightly more residual edema, a decreased epithelial wave, and less improvement in voice as compared to the patients with pseudocysts. Meticulous technique, low oscillation speeds, and low wall suction are necessary to avoid injury to the overlying epithelium. [ABSTRACT FROM AUTHOR]

Objectives: Thyroglossal duct cysts with intralaryngeal extension are rare. We present only the 10th reported case in the literature. Methods: The clinical presentation, diagnosis, and treatment of the patient are reviewed and summarized. The uniqueness of the case, as well as the diagnostic and treatment pitfalls of this subgroup of patients, is presented. Results: Our patient, at 76 years of age, is the only woman and the oldest person reported to have had a thyroglossal duct cyst with intralaryngeal extension. Conclusions: Intralaryngeal extension should be considered when there is hoarseness, dysphagia, or dyspnea associated with a thyroglossal duct cyst. Office laryngoscopy and computed tomography make the diagnosis. Care must be taken with airway management and intraoperative dissection for good outcomes. [ABSTRACT FROM AUTHOR]