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Abstract Introduction Temporomandibular joint disorders (TMD) present with a multitude of symptoms that can range from headaches to shoulder pain. Patients frequently present with pain in the ear, dizziness, and vertigo. It is noted that some patients who report TMDs also have a history of sleep disturbances, which is noted in cone beam computed tomography (CBCT) as a reduction in the oropharyngeal airway volume. Objective To evaluate the airway volume in pre- and posttreatment of TMD with the use of neuromuscular orthotics made with ultra-low frequency transcutaneous electrical nerve stimulation (ULF-TENS). Methods A total of 15 patients were evaluated for TMDs using the related criteria. Those included were treated with ULF-TENS with evaluation of the airway volume both pre- and posttreatment using CBCT and the Dolphin 3D volume analysis software. Results While the symptoms were shown to be significantly reduced in patients who were treated with this particular modality, the airway volume varied in those who reported a reduction after a period of 3 months and those that reported after a period of 6 months. Conclusion Posttreatment evaluation of the airway should be done after a period of 6 months for a more objective evaluation. A multidisciplinary evaluation of the patient is required in such cases.
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BACKGROUND: In patients undergoing transoral atlantoaxial reduction and internal fixation, anterior atlantoaxial plate placement, soft tissue swelling and other factors may affect oropharyngeal space. Up to now no anatomical factors regarding dysphagia or dyspnea after anterior approach for atlantoaxial dislocation have been reported. OBJECTIVE: To observe the spatial changes of oropharyngeal airway after atlantoaxial dislocation and internal fixation with transoral atlantoaxial reduction screw-rod system and analyze the related influencing factors. METHODS: Sixty-six patients with atlantoaxial dislocation undergoing transoral atlantoaxial reduction screw-rod system surgery were retrospectively included from January 2012 to December 2016 in the General Hospital of Southern Theater Command. There were 38 males and 28 females aged from 11 to 71 years. All patients signed the informed consent. This study was approved by the Hospital Ethics Committee. The narrowest oropharyngeal airway space, thickness of soft tissue before C2 vertebra, anterior atlantodental interval, O-C2 angle, and C2-C6 angle were measured in the neutral position before and after surgery. Changes of postoperative data and their effects on the narrowest airway distance in oropharynx were analyzed. RESULTS AND CONCLUSION: (1) The narrowest airway distance in oropharynx, anterior atlantodental interval and C2-C6 angle were significantly decreased after surgery compared with that before surgery (P <0.001). Thickness of soft tissue before C2 vertebra and O-C2 angle increased significantly after surgery compared with that before surgery (P < 0.001). (2) In the multiple regression analysis, the change in the anterior atlantodental interval (0=7.070) and thickness of soft tissue before C2 vertebra 03=0.387) were significant variables related to the change in the narrowest airway distance in oropharynx. On the contrary, there was no significant correlation with the O-C2 angle. (3) It is indicated that reduction of atlantoaxial dislocation and the thickness of soft tissue before C2 vertebrae have negative effect on the oropharyngeal airway space. Therefore, reduction of atlantoaxial dislocation during transoral reduction screw-rod surgery may cause postoperative dysphagia despite maintenance of the O-C2 angle.
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Objective To explore the effect of oropharyngeal airway on the fixation of oral trachea cannula in restless patients. Methods Toally 82 restless patents with oral trachea cannulation hospitalized in the two sections of ICU during January 2014 and August 2015 were involved in the study: those in the first section were assigned into the control group and those in the second into the experiment group. The former was treated with ordinary dental pad and the latter with oropharyngeal airway. The groups were compared in terms of effectiveness in fixation of the cannula and damage to oral mucosa. Result The rates of cannula displacement, oral mucosa damage in the experiment group were significantly smaller than those in the control group (P<0.05). Conclusion Oropharyngeal airway used in restless patients is effective in the fixation of oral trachea cannula and decrease the rate of oral mucosa damage and improve the comfort degree.
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BACKGROUND: COPA (cuffed oropharyngeal airway) is a convenient device for airway management in patients undergoing general anesthesia for elective surgery in supine position. It causes less pharyngeal trauma than LMA (Laryngeal mask airway). The purpose of this study was to compare the effect of COPA with and without muscle relaxant. METHODS: Forty patients with ASA physical status I and II for elective surgery were randomly assigned to two groups. Anaesthesia was induced with propofol (2 mg/kg) and vecuronium (1.5 mg/kg) and was administered intravenously in Group I but not in Group II. Mask ventilation was done for 5 min with O2 5 L/min. COPA was placed and heart rate, and systolic, mean, diastolic blood pressure and peak inspiratory pressure were measured at 1 min interval for 5 min. Anaesthesia was maintained with propofol 150 microgram/kg/min, fentanyl 1 microgram/kg/hr, O2 2 L/min and N2O 2 L/min. RESULTS: There were no significant differences between Group I and Group II in heart rate, systolic, mean and diastolic blood pressure. PIP (Peak inspiratory pressure) was increased and hiccups occurred significantly (p < 0.05) in Group II. Complete airway obstruction occurred in one patient of Group I and severe coughing, body movements and gagging occurred during induction and insertion in Group II. CONCLUSIONS: With the use of appropriate muscle relaxant, we can use COPA without increased inspiratory pressure or significant complication.