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Copyright of Nouveau Praticien Vétérinaire - Équine is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Nouveau Praticien Vétérinaire Canine & Féline is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Relapsing polychondritis is a systemic auto-immune disease that mainly affects cartilage structures, progressing through inflammatory flare-ups between phases of remission and ultimately leading to deformation of the cartilages involved. In addition to characteristic damage of auricular or nasal cartilage, tracheobronchial and cardiac involvement are particularly severe, and can seriously alter the prognosis. Tracheobronchial lesions are assessed by means of a multimodal approach, including dynamic thoracic imaging, measurement of pulmonary function (with recent emphasis on pulse oscillometry), and mapping of tracheal lesions through flexible bronchoscopy. Diagnosis can be difficult in the absence of specific diagnostic tools, especially as there may exist a large number of differential diagnoses, particularly as regards inflammatory diseases. The prognosis has improved, due largely to upgraded interventional bronchoscopy techniques and the development of immunosuppressant drugs and targeted therapies, offering patients a number of treatment options., (Copyright © 2024 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Introduction. Rapid development of perinatal medicine has led to an increase in the number of fetal surgical interventions performed intrauterine, on the trachea and principal bronchi. Therefore, topographic and anatomical peculiarities of the trachea and its morphometric parameters in the human fetuses of different ages cause interest of morphologists and surgeons. The objective of the study was to determine the skeleto-topic nature and the morphometric indices of the thoracic part of the trachea in the human fetuses aged 4-6 months. Materials and methods. Anatomical study of typical and variant anatomy of the thoracic part of the trachea involved 37 specimens of human fetuses, of 81.0-230.0 mm of crown-rump length, by means of macro-microscopic preparation and morphometry. Results. In the examined 4-6-month-old human fetuses, trachea within the superior mediastinum is predominantly placed in the median sagittal plane (25 cases, 67.6%), or is slightly replaced to the right (9 observations, 24.3%) or to the left (3 cases, 8.1%) from the median sagittal plane. In the fetuses aged 4-6 months the bifurcation of the trachea into the principal bronchi, is usually skeleton-topically determined at the level of the body of the II thoracic vertebra, and the pulmonary trunk bifurcates into the pulmonary arteries at the level of the body of the III thoracic vertebra. An intensive increase in the length and external diameter of the trachea within the superior mediastinum is noted in the fetuses aged 4 and 6 months. During the 4th-6th month of intrauterine development, these morphometric indices of the thoracic part of the trachea are 1.6 times higher.

Tracheostomy cannula care is of paramount importance in the daily management of tracheotomized patients. While some complications are commonplace, specific events can occur, often according to type of cannula. We herein report the case of a 71-year-old patient; following a lengthy stay in the intensive care unit, she had received a Safe T-Tube cannula designed to provide support in a stenotic trachea. At home, while suctioning her tracheal secretions, she suddenly experienced respiratory distress requiring a rapid intervention. On arrival, no seeable cannula was found, either in the tracheostomy or in the patient's immediate surroundings. Following her transfer to intensive care, a new cannula was inserted into the tracheostomy opening, enabling mechanical ventilation to begin and achieving rapid relief of dyspnea and improvement of the patient's overall condition. Bronchial fibroscopy was then performed, during which the Safe T-Tube cannula was found folded on itself in a supra-carinal intra-tracheal position. It was extracted and replaced by a cannula of the same model, which was sewn to the skin. Although rare and usually limited to flexible cannulas, this complication is potentially fatal. Generally speaking, when cannula obstruction is suspected, bronchial endoscopy in an intensive care setting is a vital necessity. It is not only the cornerstone of the diagnosis, but also of paramount importance in treatment taking into full account the mechanism of obstruction., (Copyright © 2024 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

A 39-year-old man presented with a productive cough, a history of chronic dyspnea and recurrent lower respiratory tract infections. Physical examination and laboratory tests were unremarkable. A chest X-ray (A) showed an enlarged tracheal diameter (white arrows), with multiple cysts in the lower lobes (red arrows). A computed tomography scan of the chest (B) showed the dilatation of both the trachea and the two main bronchi (white arrows) with multiple diverticulae (blue arrows). It also revealed bilateral cystic bronchiectasis involving both lower lung zones (red arrows). A possibility of Mounier-Kuhn syndrome (MKS) was considered. MKS is a rare condition characterized by recurrent lower respiratory tract infections and tracheobronchial dilation that is due to atrophy of the muscular and elastic tissues in the trachea and main bronchial wall. The patient underwent bronchoscopy which demonstrated tracheal dilation with diverticulae and enlargement of both main bronchi confirming the diagnosis of MKS.

Congenital malformations due to anomalous position and development of primitive branchial arches account for 1% of congenital cardiovascular anomalies. We report the rare case of a 22-month old infant born full term by vaginal birth with intermittent dyspnea associated with cough. Cervicothoracic angioscanner allowed to detect right aortic arch as well as left pretracheoesophageal subclavian artery pinching the esophagus and the trachea approximately 15mm above the carina and causing a stenosis of the trachea of approximately 70% with a height of 16mm. This complex malformation is a rare type of aortic arch anomaly with an unusual variant of the left subclavian artery path. It poses a diagnostic and therapeutic problem in our environment due to difficulty associated with access to scanner and surgery. [ABSTRACT FROM AUTHOR]

Primary malignant tracheal tumors are not common and adenoid cystic carcinoma (ACC) of trachea is very rare. The diagnosis is often delayed due to the atypical symptoms. We report an extremely rare case of ACC of proximal trachea, in a 55-year-old female who presented with a 12 month history of progressive dyspnea. Laryngoscopy and computed tomography revealed a broad-based polypoidal mass arising from posterior wall of the proximal trachea. Biopsy confirmed the diagnosis of ACC. The patient underwent a complete surgical resection and post operative radiotherapy. Six months follow-up of the patient did not reveal local recurrence or distant metastases. The literature of tracheal ACC is reviewed.

Copyright of Phytothérapie is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Adenoid cystic carcinoma (ACC) of the trachea is rare, it represents 1% of all respiratory tract cancers. It's generally considered as a slow- growing, with pronlonged clinical course. Most patients present with dyspnea, and the symptoms often mimic those of asthma or chronic bronchitis Surgical resection is the mainstay of treatment often combined to radiotherapy because of close surgical margins. When surgery isn't possible, most tumors respond to radiotherapy alone wich often results in long periods of remission We report two cases of primary ACC of trachea: a 49 year old male presented a distal unresectable tracheal ACC treated with chemo-radiotherapy who developed a recurrence and died 7 years after the diagnosis. And a 50 years old female with a proximal tracheal tumor treated by surgical resection and end- to- end anastomosis followed by adjuvant radiotherapy. At 10 months follow-up, our patient shows no evidence of disease with negative histological findings.

Résumé: La bonne connaissance des caractéristiques normales prénatale de la coupe des trois vaisseaux et de la trachée permet non seulement de dépister, mais également d’identifier des anomalies telles que des variantes de la normale et des malformations qui intéressent les gros vaisseaux (tronc de l’artère pulmonaire et ses branches, l’aorte et la veine cave supérieure) et différents éléments vasculaires du médiastin antéro-supérieur. Ces anomalies peuvent être isolées ou associées à d’autres anomalies de l’architecture cardiaque. [ABSTRACT FROM AUTHOR]

Résumé: Les cardiopathies congénitales (CG) sont majoritairement issues d’une population à bas risque. Leur dépistage doit reposer sur des méthodes reproductibles et faciles d’utilisation. L’analyse échocardiographique prénatale repose essentiellement sur l’analyse des quatre cavités cardiaques et des gros vaisseaux. L’étude des voies d’admission généralisée dans les années 1980 s’effectue sur une coupe axiale alors que celle des gros vaisseaux est de diffusion plus récente et, s’effectue via plusieurs coupes et reste difficile. Nous passons en revue les caractéristiques, en situation normale, de la coupe des trois vaisseaux et de la trachée qui permet via une coupe axiale du thorax fœtal d’analyser simultanément le tronc de l’artère pulmonaire et ses branches, la convergence du canal artériel et de la crosse aortique, la veine cave supérieure, et la trachée. Par ailleurs, l’utilisation du mode Doppler couleur optimise les informations obtenues par cette coupe. [ABSTRACT FROM AUTHOR]

Résumé: L’intubation et la ventilation au masque impossible est une situation dramatique avec des conséquences parfois graves. Nous rapportons le cas d’une patiente de 43ans, suivie pour un goitre, qui était programmée pour une thyroïdectomie totale sous anesthésie générale. L’évaluation préopératoire ne notait pas de signes de compression ou de déviation trachéale, de même il n’y avait pas de critères prédictifs d’intubation ou de ventilation au masque difficile. L’induction de l’anesthésie était standard. La ventilation au masque était efficace autorisant une curarisation. La laryngoscopie standard montrait un score de Cormack et Lehane grade IV. Plusieurs tentatives d’intubation étaient faites conduisant à une situation d’intubation et de ventilation au masque impossible avec une désaturation profonde. Une trachéotomie était faite en urgence. La patiente était opérée, six mois après, avec une intubation sous fibroscopie. À travers ce cas, les auteurs attirent l’attention sur la difficulté de réalisation en urgence d’une trachéotomie en présence d’un goitre et insistent sur la nécessité d’intégration des différents modes d’apprentissage et de maintien des compétences pour la gestion des voies aériennes supérieures. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To evaluate the risk of over-inflation of endotracheal tube cuffs (ETC) when used with nitrous oxide (N2O); to assess the rate of under and over-inflation of ETC when they are inflated without a manometer; to survey anesthesiologists about how they prevent these risks. Methods: Nine types of endotracheal tube were studied on bench using various N2O concentrations; airway pressure levels and two sizes of trachea. Then, the rate and magnitude of over and under inflation pressure of ETC was assessed in our clinical practice. Finally, a national survey assessed how anesthesiologists prevented misuse of endotracheal tube with N2O. Results: Pressure in ETC rose sharply using N2O, up to more than 40cmH2O in six over nine tube types. Only two tube types (Mallinckrodt™ Hi-Lo Brandt® and Lanz®) were immune regarding N2O. Pratice study showed that ETC over inflation (>30cmH2O) and under inflation (<20cmH2O) was observed in 50 and 31 % of patients, respectively when cuff was inflated without a manometer. In France, a minority of anesthesiologists inflated ETC with a manometer (41 %) because in 61 % of theatres only manometers were available. Conclusion: There are risks induced by the use of N2O with tracheal tubes. This study provides data to sensitize users to these risks. [Copyright &y& Elsevier]

Abstract: The first hand and face allografts opened a new era in medicine history: a time when allotransplantation and reconstructive surgery coupled their principles. Their success and their development made composite tissue allotransplantation (CTA) a clinical reality for our speciality. Although still recent and limited, experience from this new surgical practice will widen with feedback from the first clinical cases and with experience gained from more clinical cases, more anatomical areas, more type of allografts, more surgical techniques, more immunosuppressive regimens. Tongue, trachea, abdominal wall, uterus, penis allotransplantations have been performed, contemporarily. Whatever the future and the benefits for the selected patients might have been, reports from these — un- and misknown — cases contribute to a better knowledge of CTA, its therapeutic potential, its limits, its challenges. [Copyright &y& Elsevier]

Abstract: Lung cancer is lymphophile and may involve lymph nodes (LN) belonging to lung lymph drainage. LN metastases are figured within stations numbered 1 to 14. These stations are located along lymph vessels. The lymph vessels and the LN are forming together anatomical chains. Lymph vessels are valved and pulsatile and travel to the cervical venous confluence where they pour the lung lymph into the blood circulation. They may be totally or partly nodeless along their travel, anastomose with each other around the trachea, and connect with the thoracic duct within the mediastinum. Within the anatomical LN chains, LN are variable in number and in size from one individual to another. They may be absent from one or several stations of the international mapping. Stations are located along the anatomical chains: pulmonary ligament (9), tracheal bifurcation(8 and 7), right paratracheal (4R, 2R and 1), preaortic (5 and 6), left paratracheal (4L, 2L and 1). Station 3 is located on 2 differents chains (phrenic and right esophagotracheal). Station 10 are located at the beginning of the mediastinal lymph nodes chains. Each chain connects with the blood circulation, anastomoses with he neighbouring chains and behave as an own entity whatever the number of its LN. International station mapping misknowns this anatomy and occults the true pronostic value of lung lymph drainage. [Copyright &y& Elsevier]

Abstract: Adenoid cystic carcinomas in the trachea are rare, but represent around 40% of all tracheal tumours. Other intrathoracic localisations include the carena or proximal airways. Adenoid cystic carcinoma''s growth rate is slow so that it is frequently diagnosed at an advanced stage. Pathological identification may be difficult. Treatment in limited tumours is based upon surgical resection often combined to radiotherapy because of close surgical margins. Radiotherapy dose may vary between 45 and 65 Gy according to margins status. Five-year survival rates of 65–80% have been reported after surgery or surgery and postoperative radiotherapy. Among inoperable patients treated with exclusive radiotherapy for tracheal tumours (including adenoid cystic but also squamous cell carcinomas of poorer prognosis), the recommended delivered dose should be over 60 Gy. Five-year survival rate in these very heterogeneous series may vary between 12 and 27%. Local or metastatic recurrences may occur very lately. They are considered chemo-resistant and targeted therapies may prove to be effective in the future. [Copyright &y& Elsevier]

Copyright of EMC-Radiologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of EMC-Oto-rhino-laryngologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of EMC-Pneumologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of EMC-Oto-rhino-laryngologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective. – Define the pressure–volume relationship of the cuff of paediatric cuffed tracheal tubes.Study design. – Experimental study.Material and methods. – The cuff pressure was measured after incremental 0.1 ml filling volumes for 6 sizes (3.0 to 5.5 mm of internal diameter) of paediatric high volume–low pressure cuffed–tracheal tubes. The pressure–volume relationship of the cuff was assessed with and without resistance to the filling. Results were expressed with medium ± SD.Result. – Each increment increased the cuff pressure, without resistance, of 7.3 ± 1.7 mmHg for sizes 3.0, 3.5 and 4.0, 4.8 ± 1.6 mmHg for size 4.5, and 2.3 ± 0.9 mmHg for sizes 5 and 5.5. The resistance decreased the filling volume of the cuff for each size of tracheal tubes.Conclusion. – The margin of safety provided by cuff of smallest cuffed tracheal tubes is too small. Then, the smallest sizes (3.0 to 4.5) should not be called low pressure–high volume cuff. [Copyright &y& Elsevier]

Objective: Assessment of the learning curve of a new device for blind orotracheal intubation: Intubating laryngeal mask.Study design: Prospective clinical study.Methods: Ten persons practicing anaesthesia (specialist, fellow, nurse) underwent videotape learning and manikin training required with the device. Each person had to carry out a tracheal intubation in ten consecutive patients undergoing scheduled surgery. No patient presented history or clinical sign of difficult airway management. Results were expressed as mean ± SD. Main percentages were provided with their 95 % confidence interval; the percentage comparison were performed using Chi 2 test. The significance level for overall analysis was p < 0.05.Results: One hundred patients were included. The overall success rate of tracheal intubation with the intubating laryngeal mask was 88 %. An easy learning curve was obtained according to the low failure rate that was observed. No failure was noticed after eight procedures. Significant diminution of the delay for tube insertion was observed during the practice (3 ± 1.30 min for the first procedure and 1.16 ± 0.60 min for the tenth procedure). Circumstances of the oral intubation were improved with muscle relaxation. Finally, all failure with the intubating laryngeal mask were followed by successful intubation using direct laryngoscopy.Conclusion: The intubating laryngeal mask is a new device for blind orotracheal intubation with an easy learning curve in patients without difficulty in airway management, even for non-selected operators. [Copyright &y& Elsevier]

We report a case of two consecutive episodes of difficult intubation in a patient with an endotracheal Dumon’s prosthesis inserted two years before. Despite several preanaesthetic visits and ENT examination, the absence of recollection by the patient and the lack of information in her previous medical records led to the impossibility to introduce a normal tube into her trachea during two consecutive anaesthetic procedures. This case points out the limits of preanaesthetic visits. It allows to remind special measures that must be taken in patients having tracheal prosthesis and scheduled for anaesthesia and surgery. [Copyright &y& Elsevier]

Introduction: Tracheal tumors are rare, they are most often malignant and can manifest themselves by a non-specific respiratory symptomatology with progressively increasing dyspnea orienting in the first place towards a COPD or even an asthma. Among them, tracheal lipoma is exceptional. Its management is based on removal by rigid bronchoscopy., Observation: We report the case of a 73-year-old male patient who presented with non-specific dyspnea that progressively worsened over several months. The EFR showed a flattening of the flow-volume curves, the CT scan showed an anterolateral oval tracheal tumor with fatty density, the bronchial endoscopy showed a tumor lesion with stenosis of about 90% of the airway. Management consisted of a rigid bronchoscopy to delete obtruction with biopsies. Anatomopathology concluded to a tracheal lipoma., Conclusion: Progressively worsening dyspnea, especially if there are signs of inspiratory dyspnea, required a systematic bronchial endoscopy to avoid the possibility of a tracheal tumor., (Copyright © 2021 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

Inhalation of foreign bodies is not often observed in young adults, and may go unnoticed. A 37-year-old patient, with no significant medical history, was admitted for right basal pleuro-pneumopathy. Endoscopic examination revealed the presence of a brittle yellowish formation. It was a bone fragment, accidentally inhaled by the patient. It is necessary to look for an inhaled foreign body in cases of serious infection unusually observed in an immuno-competent patient., (Copyright © 2021 SPLF. Published by Elsevier Masson SAS. All rights reserved.)

The purpose of this article is to review the main airway devices available to the emergency physician in a prehospital setting. Since the risk of difficult intubation is increased under pre-hospital conditions; the emergency physician should be aware of alternatives to direct tracheal intubation such as supraglottic devices, video laryngoscopes and cricothyroidotomy. These different techniques and devices must be integrated into a strategy for the management of the upper airway. We propose a prehospital airways algorithm adapted from the Latin Airway Foundation (FLAVA)., Competing Interests: Les auteurs n’ont déclaré aucun conflit d’intérêts en relation avec cet article.