|VIEW THE MOBILE VERSION of www.homemedicine.ca|| Informational|
Medical ArticlesAcute Diarrhea
Take B D current. Place N. P., long cord, upon the lumbar ver...
Stage I Entering The Right Pyriform Sinus
The operator standing (as in Fig. 66), inserts the esophagos...
Technic Of Specular Esophagoscopy
Recumbent patient. Boyce position. The larynx is to be expos...
_Nux Vomica_ should be used once in about four hours, for twe...
See Hives; "Outstrikes;" Saltrome, etc. ...
under a well conducted course of hydriatic treatment is, in g...
This frequent and severe trouble results most usually from chi...
How To Conquer Consumption
Different Forms of Tuberculosis. The terrible disease tubercu...
Clothes should be Loose and Comfortable. Man is the only anim...
The abdomen is formed of a series of rings containing the bowe...
Where this arises from a more or less putrid wound, what is ai...
There is a vast variety of ailments associated with what is ca...
Bronchoscopic And Esophagoscopic Grasping Forceps
are of the tubular type, that is, a stylet carrying the jaws...
Symptomatology And Treatment Of Chronic Valvular Lesions
Before discussing the treatment of broken compensation in gen...
Nursing Sore Mouth
Sore mouth of nursing women, as the name of the disease indic...
The Relation Of The Internal Parts To The External Surface Of The Body
An exact acquaintance with the normal character of the extern...
Stokes Adams Disease Heart Block
Stokes-Adams disease, or the Stokes-Adams syndrome, is a name...
Rubbing Sheet Substitute For The Half-bath
It cannot be difficult to procure a wash-tub. Should you be s...
During rheumatism the peripheral blood vessels are generally ...
See Baths for Head. ...
Decannulation After Cure Of Laryngeal Stenosis
Category: DECANNULATION AFTER CURE OF LARYNGEAL STENOSIS
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
In order to train the patient to breathe again through the larynx it
is necessary to occlude the cannula. This is best done by inserting a
rubber cork in the inner cannula. At first it may be necessary to make
a slot in the cork so as to permit some air to enter through the tube
to supplement the insufficient supply obtainable through the
insufficiently patulous glottis, new corks with smaller grooves being
substituted as laryngeal breathing becomes easier. Corking the cannula
is an excellent orthopedic treatment in certain cases where muscle
atrophy and partial inflammatory fixation of the cricoarytenoid joints
are etiological factors in the stenosis. The added pull of the
posterior cricoarytenoid muscles during the slight effort at
inspiration restores their tone and increases the mobility of all the
attached structures. By no other method can panic and spasmodic
stenosis be so efficiently cured.
[FIG. 111.--Illustration of corks used to occlude the cannula in
training patients to breathe through the mouth again, before
decannulation. The corks allow air leakage, the amount of which is
regulated by the use of different shapes. A smaller and still smaller
air leak is permitted until finally an ungrooved cork is tolerated. A
central hole is sometimes used instead of a slot. A, one-third cork;
B, half cork; C, three-quarter cork; D, whole cork.]
Following the subsidence of an acute laryngeal stenosis, it is my rule
to decannulate after the patient has been able to breathe through the
larynx with the cannula tightly corked for 3 days and nights. This
rule does not apply to chronic laryngeal stenosis, for while the lumen
under ordinary conditions might be ample, a slight degree of
inflammation might render it dangerously small. In these cases, many
weeks are sometimes required to determine when decannulation is safe.
A test period of a few months is advisable in most cases of chronic
laryngeal stenosis. Recurrent contractions after closure of the wound
are best treated by endoscopic bouginage. The corks are best made of
pure rubber cord, cut and ground to shape, and grooved, if desired, on
a small emery wheel (Fig. 112). The ordinary rubber corks and those
made of cork-bark should not be used because of their friability, and
the possible aspiration of a fragment into the bronchus, where rubber
particles form very irritant foreign bodies.
[FIG. 112.--This illustration shows the method of making safe corks
for tracheotomic cannulae by grinding pure rubber cord to shape on an
emery wheel. After grinding the taper, if a partial cork is desired, a
groove is ground on the angle of the wheel. If a half-cork is desired
half of the cork is ground away on the side of the wheel. Reliable
corks made in this way are now obtainable from Messers Charles J.
Pilling and Son.]
Previous: Treatment Of Cicatricial Stenosis