The passage of endotracheal tubes, both PVC and Flexometallic were studied in three phases with regard to passage of ETT from nasopharynx to oropharynx, from oropharynx to
laryngeal inlet and from
laryngeal inlet to trachea.
One was a hotdog at the
laryngeal inlet, and the patient died from respiratory arrest despite initiation of the Heimlich maneuver and cardiopulmonary resuscitation (CPR).
The right prevertebral extent of the disease was causing compression of right
laryngeal inlet from behind.
He consulted an ENT surgeon where a fibre optic laryngoscopy showed a pedunculated mass occupying the
laryngeal inlet and extending up to base of tongue (Figure 1).
The masks help in providing excellent ventilation without going through the normal visualization and intubation process of the
laryngeal inlet. The masks in endotracheal tube shaped on the proximal end, which connects to an elliptical mask over the distal end.
Laryngeal FBs can be separated into two categories: large, conforming items that obstruct the
laryngeal inlet causing immediate respiratory distress, and sharp, thin, aerodynamic FBs causing partial obstruction.
Indirect laryngoscopy and video endoscopy performed with a rigid endoscope indicated that the epiglottis was slightly lowered to the
laryngeal inlet. During examination and request for repeated phonation of the vowel "e", the epiglottis descended even more and blocked the view of the larynx.
Laryngoscopy identified bulging of the posterior pharyngeal wall that partially occluded the
laryngeal inlet. A lateral neck x-ray revealed that the prevertebral space was widened, and computed tomography detected fluid in the retropharyngeal and parapharyngeal spaces.
When a foreign body reaches the
laryngeal inlet it triggers a cough reflex just by touching the laryngeal mucosa.
F Full when the whole of the
laryngeal inlet is visible.
Direct laryngoscopy revealed an extensive oedematous supraglottis with severe necrosis involving the
laryngeal inlet, base of the tongue and right tonsillar bed.
The Intubaid fits within most endotracheal tubes and laryngeal masks to provide video-assisted visualization of the
laryngeal inlet. Along with the Intubaid, EZC offers the LaryngaSee[TM],a laryngeal mask that enables visualization during laryngoscopy.