One of the most notorious charlatans of the eighteenth centur...
The Healing Influence Of Music Continued
Dr. Herbert Lilly, in a monograph on musical therapeutics, ...
Punctures Case Iii
A female servant punctured the end of the finger by a pin; th...
Treatment Of Other Eruptive Fevers
The treatment as prescribed for scarlatina in this pamphlet, ...
Lues Of The Tracheobronchial Tree
Compared to laryngeal involvement, syphilis of the tracheobr...
Early Symptoms Of Irritating Foreign Body Such As A Peanut Kernel In The Bronchus
1. Initial laryngeal spasm is almost invariably present wit...
Technic Of Specular Esophagoscopy
Recumbent patient. Boyce position. The larynx is to be expos...
Bruises Case Xviii
Mrs. C. aged 40, was detained on a journey by a bruised wound...
Part of a raw turnip is grated down to a pulp. As much of this...
_Nux Vomica_ should be used once in about four hours, for twe...
How To Sew Easily
IT is a common saying that we should let our heads sa...
After a fall from a height, where there is no apparent outward...
Before Perspiration Comes On There Is A Little More Excitement For
a few minutes (41), which must not induce the friends of the pa...
The spinal cord is continuous with the back part of the brain....
The Anti-gastric Method
consisting in the free use of emetics or purgatives, has been...
Compression Stenosis Of The Trachea
Decannulation in these cases can only follow the removal of ...
Punctures Case Iv
The present case is somewhat more severe than those which hav...
Acute Dilatation Of The Stomach
This condition is not well understood, nor is its frequence k...
Where biliousness prevails, without any symptom of real liver ...
Teething Of Children
Affections arising from teething of children, are often of a ...
Category: CHRONIC STENOSIS OF THE LARYNX AND TRACHEA
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Bilateral abductor laryngeal paralysis causes severe
stenosis, and usually tracheotomy is urgently required. In cadaveric
paralysis both cords are in a position midway between abduction and
adduction, and their margins are crescentic, so that sufficient airway
remains. Efforts to produce the cadaveric position of the cords by
division or excision of a portion of the recurrent laryngeal nerves,
have been failures. The operation of ventriculocordectomy consists
in removing a vocal cord and the portion or all of the ventricular
floor by means of a punch forceps introduced through the direct
laryngoscope. Usually it is better to remove only the portion of the
floor anterior to the vocal process of the arytenoid. In some cases
monolateral ventriculocordectomy is sufficient; in most cases,
however, operation on both sides is needed. An interval of two months
between operations is advisable to avoid adhesions. In almost all
cases, ventriculocordectomy will result in a sufficient increase in
the glottic chink for normal respiration. The ultimate vocal results
are good. Evisceration of the larynx, either by the endoscopic or
thyrotomic method, usually yields excellent results when no lesion
other than paralysis exists. Only too often, however, the condition is
complicated by the results of a faultily high tracheotomy. A rough,
inflexible voice is ultimately obtained after this operation,
especially if the arytenoid cartilage is unharmed. In recent bilateral
recurrent paralysis, it may be worthy of trial to suture the recurrent
to the pneumogastric. Operations on the larynx for paralytic stenosis
should not be undertaken earlier than twelve months from the inception
of the condition, this time being allowed for possible nerve
regeneration, the patient being made safe and comfortable, meanwhile,
by a low tracheotomy.
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