ABSTRACT
Despite continuing advances in the surgical and nutritional management of esophageal perforation, morbidity and mortality remain significant. Described within is the successful management of two such cases by the physiologic exclusion of the esophagus. By this, we mean distal decompression and proximal diversion and decompression through a gastrostomy and cervical esophagostomy. This provides the greatest chance for protection of the esophageal suture line repair.
Subject(s)
Esophageal Perforation/surgery , Aged , Esophagostomy , Female , Gastrostomy , Humans , Middle AgedABSTRACT
Because the larynx is situated anatomically in an area which is difficult to measure and visualize, theoretical, in vitro, and in vivo models are used in laryngeal research. Vocal fold vibration was studied in anesthetized dogs, while electrically stimulating independently the superior and recurrent laryngeal nerves under conditions of constant airflow. Photoglottographic (PGG), electroglottographic (EGG), and subglottic pressure signals were obtained while stroboscopically photographing the larynx. Specific points along PGG, EGG, and subglottic pressure waveforms were correlated with laryngeal events which occurred during vibration. The canine larynx, in an experimentally produced phonatory mode, vibrates in a two mass (upper and lower margin) system and appears comparable to modal human voice production. The recorded glottographic waveforms from experimentally produced phonation in the canine are similar to signals recorded from humans. However, observed differences can be related to anatomic differences.