1/31. Reversible cardio-pulmonary changes due to adeno-tonsilar hypertrophy.Adeno-tonsillar hypertrophy, with signs of upper airway obstruction is a common presentation in ENT clinics. Recently it is identified as a major cause of sleep apnea syndrome. Several isolated case reports of pulmonary hypertension and corpulmonale appeared in the literature. The authors report two such children aged less than 2 years with cardio-pulmonary changes occurring secondary to chronic adeno-tonsillar hypertrophy that were successfully treated with the surgical removal.- - - - - - - - - - ranking = 1keywords = airway obstruction, airway, obstruction (Clic here for more details about this article) |
2/31. Pickwickian syndrome, 20 years later.The Pickwickian syndrome stimulated new pathophysiological concepts in regard to control of ventilation. With the advent of sleep laboratories, the peculiar sleep apnea occurring in some of these patients has been explained on the basis of intermittent upper airway obstruction. Two patients with different manifestations of the Pickwickian syndrome are presented. The suggestion is made that these two subsyndromes should have unique designations. The Auchincloss syndrome is manifested by right heart failure and respiratory acidosis in obese patients who are alert and have no major abnormality of breathing pattern. The fundamental cause of this abnormality is the increased work of breathing caused by the obesity. The cost of breathing is so high that the ventilatory regulation is compromised and respiratory acidosis results. The Gastaut syndrome is characterized principally by hypersomnia and sleep apnea. The fundamental defect is upper airway obstruction during sleep, resulting in increased work of breathing, which together with the increased work caused by obesity leads to respiratory acidosis and right ventricular failure. Hypersomnia, rather than heart failure or respiratory acidosis, is the major manifestation of this syndrome, and is the result of sleep loss.- - - - - - - - - - ranking = 2keywords = airway obstruction, airway, obstruction (Clic here for more details about this article) |
3/31. Hurler's syndrome with cor pulmonale secondary to obstructive sleep apnoea treated by continuous positive airway pressure.A 6-year-old boy with Hurler's syndrome presented with right heart failure and pulmonary hypertension secondary to severe obstructive sleep apnoea. Both his sleep apnoea and cor pulmonale were effectively controlled with continuous positive airway pressure therapy.- - - - - - - - - - ranking = 0.21050542262576keywords = airway (Clic here for more details about this article) |
4/31. Successful pulmonary thromboendarterectomy for chronic thromboembolic pulmonary hypertension associated with anticardiolipin antibodies: report of a case.Chronic pulmonary thromboembolism with pulmonary hypertension is a rare but most unique syndrome in the broad spectrum of pulmonary embolism. This report describes a successful pulmonary thromboendarterectomy performed for a totally occluded right pulmonary artery on a 43 year old man who presented with positive cardiolipin antibodies. The surgery was performed through a median sternotomy with cardiopulmonary bypass and intermittent periods of deep hypothermic circulatory arrest. We are convinced that this method allows for complete removal of the thrombotic obstruction and should be the procedure of choice for patients with very proximal obstruction of a pulmonary artery.- - - - - - - - - - ranking = 0.049818120515934keywords = obstruction (Clic here for more details about this article) |
5/31. Upper and lower airway compromise in the Apert syndrome.Both upper and lower airway compromise may be responsible for early death in some patients with the Apert syndrome. We report on two and review six cases with complete or partial cartilage sleeve abnormalities of the trachea. Possible mechanisms include tracheal stenosis and/or lack of tracheal distensibility which may result in respiratory inefficiency, inability to clear secretions, and/or increased liability to surface injury from tracheal suctioning. Upper airway compromise, consisting of obstructive sleep apnea and cor pulmonale, may result from reduced nasopharyngeal and oropharyngeal dimensions in the Apert craniofacial configuration.- - - - - - - - - - ranking = 0.25260650715091keywords = airway (Clic here for more details about this article) |
6/31. Respiratory obstruction and cor pulmonale in the Hallermann-Streiff syndrome.The risk of respiratory death in the Hallermann-Streiff syndrome is not insignificant, particularly in the neonatal period and in infancy. Upper airway obstruction may result from small nares and glossoptosis secondary to micrognathia, which sometimes lead to cor pulmonale. I report on a patient with such problems.- - - - - - - - - - ranking = 1.0996362410319keywords = airway obstruction, airway, obstruction (Clic here for more details about this article) |
7/31. A case of chronic mountain sickness diagnosed by routine pulmonary function tests.In summary, this is a patient who presented with respiratory acidosis and cor pulmonale. The major diagnostic challenge was in differentiating primary cardiopulmonary disease from a central abnormality of ventilatory drive. The arterial blood gases showed a normal A-a gradient suggesting hypoventilation as the etiology of his hypoxemia. Pulmonary function testing showed air trapping, but a relatively normal FEV1/FVC and airways resistance. The literature suggests that most altitude natives have depressed hypoxemic and hypercapnic drives with a distinct subset demonstrating a profoundly depressed drive to ventilation. This latter group has been labeled as having chronic mountain sickness or Monge's disease. As one might expect, ventilatory control during sleep is also abnormal in these patients with CMS. Our patient indeed showed typical frequent severe desaturations with hypopnea. The diagnosis of CMS in our patient was made with routine arterial blood gases and standard pulmonary function tests. Additional tests of ventilatory responsiveness to oxygen and carbon dioxide could have been performed, but are not necessary to make the diagnosis.- - - - - - - - - - ranking = 0.042101084525151keywords = airway (Clic here for more details about this article) |
8/31. Adenotonsillar hypertrophy and cor pulmonale: clinical and echocardiographic correlation.It is well recognized that upper airways obstruction by adenotonsillar hypertrophy can lead to cor pulmonale, but delays in diagnosis still occur, leading to an appreciable morbidity and even occasional mortality. In the case presented, echocardiographic recognition of right ventricular enlargement and abnormal pulmonary valve motion served to complement and confirm the clinical diagnosis. Following surgical relief of the airways obstruction, the echocardiographic examination usefully documented the regression in right ventricular size and the return to normality of pulmonary valve motion.- - - - - - - - - - ranking = 0.13402028956624keywords = airway, obstruction (Clic here for more details about this article) |
9/31. Rapid development of cor pulmonale following acute tonsillitis in adults.We describe two adult patients in whom acute tonsillitis resulted in the rapid development of cor pulmonale in the absence of clinically evident upper airway obstruction or diffuse obstructive airway disease. Both patients had developed symptoms of sleep apnea and all-night polysomnography confirmed the presence of severe obstructive sleep apnea. These cases emphasize the potentially severe cardiovascular consequences of acute tonsillar hypertrophy in the obese adult patient.- - - - - - - - - - ranking = 1.0421010845252keywords = airway obstruction, airway, obstruction (Clic here for more details about this article) |
10/31. Adenotonsillar hypertrophy and cor pulmonale.Pulmonary hypertension is a known complication of chronic upper airway obstruction resulting from adenotonsillar hypertrophy. Surgical removal of the hypertrophic tissue usually leads to rapid improvement. Although anaesthetic management is potentially hazardous, little has been written on this aspect. Six paediatric patients (all male) are reported here, and a suitable anaesthetic technique is described.- - - - - - - - - - ranking = 1keywords = airway obstruction, airway, obstruction (Clic here for more details about this article) |
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