Medical ArticlesNervous Fears
TO argue with nervous anxiety, either in ourselves or...
Small Pox - Variola
This disease begins with pain in the head and back, chilly se...
Scarlatina Simplex Or Simple Scarlet-fever
In the _mildest form_ of the disease, called _scarlatina simp...
Breathing In Going Uphill
See Breath, and Nerve. British Cholera is to a certain ext...
Theory Of Man
Let the question now be raised--What is man? The answer will ...
On The Treatment By Eschar And Poultice
In many cases in which it is impossible to adopt either the m...
The Curative Influence Of The Imagination
At the present day the remarkable benefit which often resul...
Scarlet-fever Or Scarlatina
is an eruptive fever, produced by a peculiar contagious poiso...
Conclusion: Help Yourselves If Your Physicians Will Not Help You!
And I am none of your water-enthusiasts, who pretend to cure ...
Do Not Hurry
HOW can any one do anything well while in a constant ...
Length Of Pack
Usually it is time for the patient to come out from his pack,...
Scarlatina Sine Exanthemate
There are also mild cases of scarlet-fever, when little or no...
Lues Of The Tracheobronchial Tree
Compared to laryngeal involvement, syphilis of the tracheobr...
The Religion Of It
THE religion of it is the whole of it. "All religion ...
Heart Disease In Children And During Pregnancy
A common characteristic in a large proportion of middle-age...
Diet For A Long, Long Life
Some people not only want to be healthy, but they want to liv...
Brain Inflammation Of
This arises often from over-schooling of young boys and girls....
Freshness Of Fruits And Vegetables
Most people do not realize the crucial importance of freshnes...
Length Of Bath
Although the temperature, in sthenic cases, should be a littl...
See Veins, Swollen, etc. ...
Removal Of Foreign Bodies From The Larynx
Category: MECHANICAL PROBLEMS OF BRONCHOSCOPIC FOREIGN BODY EXTRACTION
Source: A Manual Of Peroral Endoscopy And Laryngeal Surgery
Symptoms and Diagnosis.--The history of a sudden choking attack
followed by impairment of voice, wheezing, and more or less dyspnea
can be usually elicited. Laryngeal diphtheria is the condition most
frequently thought of when these symptoms are present, and antitoxin
is rightly given while waiting for a positive diagnosis. Extreme
dyspnea may render tracheotomy urgently demanded before any attempts
at diagnosis are made. Further consideration of the symptomatology and
diagnosis of laryngeal foreign body will be found on pages 128, 133
Preliminary Examination.--In the adult, mirror examination of the
larynx should be done, the patient being placed in the recumbent
position. Whenever time permits roentgenograms, lateral and
anteroposterior, should be made, the lateral one as low in the neck as
possible. One might think this an unnecessary procedure because of the
visibility of the larynx in the mirror; but a child's larynx cannot
usually be indirectly examined, and even in the adult a pin may be so
situated that neither head nor point is visible, only a portion of the
shaft being seen. The roentgenogram will give accurate information as
to the position, and will thus allow a planning of the best method for
removal of the foreign body. A bone in the larynx usually is visible
in a good roentgenogram. Accurate diagnosis in children is made by
direct laryngoscopy without anesthesia, but direct laryngoscopy should
not be done until one is prepared to remove a foreign body if found,
to follow it into the bronchus and remove it if it should be dislodged
and aspirated, and to do tracheotomy if sudden respiratory arrest
 Technic of Removal of Foreign Bodies from the Larynx.--The
patient is to be placed in the author's position, shown in Fig. 53. No
general anesthesia should be given, and the application of local
anesthesia is usually unnecessary and further, is liable to dislodge
and push down the foreign body.* Because of the risk of loss downward
it is best to seize the foreign body as soon as seen; then to
determine how best to disimpact it. The fundamental principles are
that a pointed object must either have its point protected by the
forceps grasp or be brought out point trailing, and that a flat object
must be so rotated that its plane corresponds to the sagittal plane of
the glottic chink. The laryngeal grasping forceps (Fig. 53) will be
found the most useful, although the alligator rotation forceps (Fig.
31) may occasionally be required.
* In adolescents or adults a few drops of a 4 per cent solution of
cocain applied to the laryngopharynx with an atomizer or a dropper
will afford the minimum risk of dislodgement; but the author's
personal preference is for no anesthesia, general or local.
Next: Mechanical Problems Of Bronchoscopic Foreign Body Extraction*
Previous: Complications And After-effects Of Bronchoscopy