phenylephrine-hydrochloride and Hemorrhage

Rottura dell’arteria carotide interna durante la chirurgia nasale endoscopica: nostra esperienza e review della letteratura.. La rottura iatrogena dell’arteria carotide interna è una complicanza catastrofica, sebbene non frequente, della chirurgia endoscopica nasale. In questo lavoro presentiamo la nostra esperienza nella gestione di questa emergenza. Un uomo di 52 anni è stato sottoposto ad intervento di chiusura di fistola rinoliquorale, e durante l’intervento si è verificata una copiosa emorragia durante l’apertura, mediante pinza sfenoidale di Hajek, della parete anteriore del seno sfenoidale. L’immediato tamponamento del seno sfenoidale ha controllato l’emorragia. Mediante l’esecuzione di un’angiografia urgente, è stato individuato un punto di rottura della carotide interna sinistra a livello del segmento paraclivale. Quindi inizialmente è stato posizionato uno stent, ma si è trombizzato; successivamente è stata utilizzata una spirale endovascolare. Il paziente è andato incontro ad ischemia cerebrale con emiparesi post-procedura, che si è risolta del tutto nel giro di 6 settimane. Il tamponamento nasale seguito da un’angiografia in urgenza e il posizionamento di uno stent endovascolare possono rappresentare il trattamento definitivo meno invasivo. Se lo stent non dovesse avere successo, l’occlusione mediante balloon endovascolare o l’embolizzazione mediante spirale dovrebbero essere i trattamenti di scelta quando la rivascolarizzazione dai distretti controlaterali è garantita. Il successo del trattamento si basa soprattutto sull’immediatezza della gestione da parte di un team multidisciplinare.. Iatrogenic internal carotid artery injury is a catastrophic but uncommon complication of endonasal sinus surgery. We present our experience in managing this emergency situation. A 52-year-old man underwent revision endoscopic repair of recurrent cerebrospinal fluid leak that was complicated with profuse haemorrhage during removal of the anterior wall of sphenoid sinus using a Hajek sphenoid punch forceps. Immediate packing of the sphenoid sinus controlled the haemorrhage. Urgent angiography revealed injury at the paraclival segment of the left internal carotid artery. An endovascular stent was initially placed but thrombosed; it was subsequently converted to coil embolisation. The patient had watershed cerebral infarct with hemiparesis post procedure but made full recovery within 6 weeks. Immediate nasal packing followed by urgent angiography and endovascular stent placement is the least invasive definitive treatment. If stenting is unsuccessful, endovascular balloon occlusion or coil embolisation is the next preferred treatment, if there is adequate cross-cerebral circulation. The success of treatment relies on its immediate management by a multidisciplinary team.

Topics: Aneurysm, False; Angiography; Blood Pressure; Carotid Artery Injuries; Carotid Artery, Internal; Cone-Beam Computed Tomography; Endoscopy; Endovascular Procedures; Extravasation of Diagnostic and Therapeutic Materials; Hemorrhage; Humans; Male; Middle Aged; Middle Cerebral Artery; Nose; Sphenoid Sinus; Stents; Thrombosis

The nasal cavity has a robust vascular supply, and bleeding is a primary obstacle to the minimally invasive skull base technique. Venous bleeding, including the cavernous sinus, can be managed with various techniques using hemostatic materials and pressure. A thorough understanding of the skull base vascular anatomy is vital for avoiding injury to major arteries and having confidence to control venous bleeding to optimize the endoscopic view and tumor resection.

Topics: Cavernous Sinus; Embolization, Therapeutic; Endoscopy; Hemorrhage; Hemostasis; Humans; Nasal Cavity; Neurosurgical Procedures; Nose; Paranasal Sinuses; Skull Base; Skull Base Neoplasms

Serious complications of cosmetic rhinoplasty are extremely rare. However, awareness of their existence is essential so that the surgeon can minimize the potential hazards of the procedure. This demands a careful preoperative examination, a meticulous intraoperative technique, and a careful postoperative monitoring of the patient. The complications of rhinoplasty have been classified into infectious, traumatic, hemorrhagic, systemic, and miscellaneous groups. The pertinent literature is reviewed, as well as cases of inclusion cyst formation, disturbance of eye closure, local activation of systemic disease, and fatalities from intracranial injury with brain laceration and pneumocephalus.

Topics: Adolescent; Adult; Aged; Anesthesia; Arteriovenous Fistula; Bacterial Infections; Endocarditis; Female; Gastrointestinal Hemorrhage; Hemorrhage; Humans; Intraoperative Care; Male; Middle Aged; Nose; Pneumocephalus; Postoperative Care; Radiography; Rhinoplasty

Review of published cases of pregnancies in which coumarin derivatives or heparin were administered demonstrates that use of either class of anticoagulant carries substantial risks. Of 418 reported pregnancies in which coumarin derivatives were used, one-sixth resulted in abnormal liveborn infants, one-sixth in abortion or stillbirth and, at most, two-thirds in apparently normal infants. In addition to the expected hemorrhagic complications, fetal effects of coumarin derivative administration include a specific embryopathy and central nervous system abnormalities. All available cases (including unpublished ones) of warfarin embryopathy and central nervous system abnormalities following gestational exposure to coumarin derivatives are reviewed, various complications are tabulated, critical periods of teratogenesis are discussed and possible mechanisms proposed. The use of heparin during gestation does not result in a significantly better outcome of pregnancy. In 135 published cases, the infants in one-eighth were stillborn, in one-fifth premature (a third of whom died) and, again at most, in two-thirds apparently normal. Because of the substantial risks of both clases of anticoagulants, and the inherent risks of pregnancy complicated by the indications for anticoagulation, prevention of pregnancy is usually indicated. If pregnancy occurs, a relatively normal outcome can be anticipated in about two-thirds of the pregnancies regardless of the anticoagulant used. Heparin does not appear to be a clearly superior alternative to coumarin derivatives.

Topics: Abnormalities, Drug-Induced; Adult; Central Nervous System; Chondrodysplasia Punctata; Coumarins; Female; Fetal Death; Fetal Diseases; Gestational Age; Hemorrhage; Heparin; Humans; Infant, Newborn; Male; Nose; Pregnancy; Pregnancy Complications, Cardiovascular; Risk; Syndrome

Topics: Cerebrospinal Fluid Rhinorrhea; Cranial Nerve Injuries; Diplopia; Ethmoid Bone; Ethmoid Sinus; Fixation, Ocular; Fractures, Bone; Hemorrhage; Humans; Lacrimal Apparatus; Maxillofacial Injuries; Nose; Oculomotor Muscles; Oculomotor Nerve Injuries; Orbit; Radiography; Tendon Injuries; Vision Disorders; Visual Acuity

Epistaxis, or nasal bleeding, is a common complication after nasotracheal intubation (NTI). Because such bleeding is likely related to trauma during intubation, use of fiberoptic visualization and guidance rather than direct laryngoscopy may affect the incidence and severity of epistaxis. We compared the incidence of epistaxis after NTI using a fiberoptic versus a direct laryngoscopy approach.. Seventy patients who were able to breathe easily through unobstructed nostrils and required NTI as part of their anesthetic management were recruited. Exclusion criteria included unequal nasal airflow, nostril obstruction, previous nasal trauma or surgery, and coagulation abnormalities as determined by history. Patients were randomly assigned to undergo NTI with thermosoftened Mallinckrodt nasal Ring-Adair-Elwyn (RAE) tubes via either traditional direct laryngoscopy using a Macintosh blade or fiberoptic nasal intubation. All patients first underwent anesthetic induction and were randomized to blind or fiberoptic groups. Patients in the blind insertion/direct laryngoscopy group were then intubated via a randomly selected nostril. Patients in the fiberoptic group underwent an asleep nasal fiberoptic examination to determine the most patent nostril, followed by tube insertion under fiberoptic guidance. Ten minutes after NTI, the incidence and severity of epistaxis were evaluated and graded by the surgeon, who was blinded to the intubation method.. Initial nasal fiberoptic endoscopy identified asymptomatic nasal pathology in 51% of patients: inferior turbinate hypertrophy (28.6%) and deviation of the nasal septum in (22.8%). The incidence of epistaxis was higher in the blind insertion/direct laryngoscopy group (88%) than in the fiberoptic group (51%; relative risk, 0.55; 95% confidence interval, 0.38-0.79; P = .0011). The severity of bleeding was also greater in the blind tube insertion/direct laryngoscopy cohort (Wilcoxon Mann-Whitney odds, 3.5; 95% confidence interval, 1.8-11.1).. Fiberoptic nostril selection and guidance during NTI reduced the incidence and severity of epistaxis when compared with NTI performed via blind insertion and direct laryngoscopy.

Topics: Adult; Anesthesiology; Anesthetics; Elective Surgical Procedures; Epistaxis; Female; Fiber Optic Technology; Hemorrhage; Humans; Incidence; Intubation, Intratracheal; Laryngoscopes; Laryngoscopy; Male; Middle Aged; Nasal Cavity; Nose; Respiration; Young Adult

Several techniques have been suggested to reduce the trauma of nasotracheal intubation, although no comparative studies exist. The authors evaluated red-rubber catheters as a guide to nasotracheal intubation.. Children presenting for elective surgery were randomized to undergo red-rubber catheter-guided nasotracheal intubation or to have the nasotracheal tube alone inserted. After general anesthesia and paralysis with vecuronium, the nares were prepared with topical vasoconstrictor. The nasotracheal tube was softened with warm water. In the catheter-guided group, the nasotracheal tube tip was fitted to the trailing end of the red-rubber catheter, and the two were advanced together. The red-rubber catheter was retrieved from the nasopharynx, disconnected, and removed. In the other group, the nasotracheal tube was advanced blindly into the nasopharynx. In both groups, intubation was then completed during direct laryngoscopy using Magill forceps. A blinded observer swabbed the pharynx and rated the severity of bleeding based on reference photographs.. Age, weight, snoring history, and difficulty of intubation were not different between groups. Obvious bleeding was lower using the red-rubber catheter technique (10 vs. 29%, P = 0.013), which took longer to perform (74 vs. 56 s, P = 0.02).. Although the incidence of bleeding in both groups was similar, severity of bleeding was reduced in the catheter-guided group during nasotracheal intubation. Use of a red-rubber catheter may reduce the trauma associated with nasotracheal intubation.

Topics: Child; Child, Preschool; Female; Hemorrhage; Humans; Intubation, Intratracheal; Male; Nose

An uncuffed nasotracheal tube for use in minor maxillofacial surgery has been developed using polyurethane. The suitability of this tube as an alternative to the existing soft red rubber and harder polyvinyl chloride materials has been assessed at four centres during anaesthesia for routine oral surgery. The tube was found to be satisfactory.

Topics: Anesthesia, General; Equipment Design; Esophagus; Female; Hemorrhage; Humans; Intubation, Intratracheal; Male; Mouth; Nose; Polyurethanes

A prospective study to compare 3 different types of nasal pack after septoplasty with or without a supplementary turbinectomy has been performed with respect to discomfort and complications caused by the packing and the short-term results evaluated 3 months after operation. Fingerstall packings gave less problems than either Merocel or hydrocortisone-terramycine gauze packs with ventilation tubes. They were easier to remove and were associated with less persistent secretion in the post-operative period. No definite advantage from the patient's point of view has been demonstrated by the use of tubes and nasal packing. An analysis of the nasal patency 3 months post-operatively by peak-flow index and acoustic rhinometry revealed no differences between groups.

Topics: Adolescent; Adult; Bandages; Female; Fever; Formaldehyde; Hematoma; Hemorrhage; Hemostatics; Humans; Hydrocortisone; Intubation; Male; Middle Aged; Nasal Septum; Nose; Oxytetracycline; Petrolatum; Polyvinyl Alcohol; Pressure; Prospective Studies; Pulmonary Ventilation; Surgical Sponges; Turbinates; Wound Healing

Topic adrenaline with cocaine has been used commonly for intranasal vasoconstriction to facilitate surgery and to control haemorrhage. Pharmacologically the drug combination is known to be a potentially dangerous interaction. This investigation studied whether either drug could be used separately rather than in combination, to achieve the same purposes. One hundred cases were randomized into four groups using 1:1000 Adrenaline, 5% Cocaine, 10% Cocaine and 5% Cocaine/1:1000 Adrenaline as the topical vasoconstriction regimes. The results showed that the vasoconstrictor effect was not significantly different within the four groups; topical 1:1000 Adrenaline resulted in more haemorrhage compared to the other three regimes; comparing the other three regimes the blood loss was not significantly different. The conclusion is that the Adrenaline/Cocaine mixture has no advantage and its potentially dangerous interaction makes it unnecessary and unjustified. Topical 5% Cocaine is recommended because it achieves the aims with the least side-effects.

Topics: Administration, Topical; Adult; Cocaine; Drug Combinations; Epinephrine; Female; Hemorrhage; Humans; Male; Middle Aged; Nose; Postoperative Complications

Topics: Adult; Aerosols; Atrophy; Beclomethasone; Chronic Disease; Clinical Trials as Topic; Common Cold; Hemorrhage; Humans; Infections; Nasal Polyps; Nose; Rhinitis; Rhinitis, Allergic, Seasonal

Topics: Biopsy; Carotid Artery Injuries; Carotid Artery, External; Hemorrhage; Hemostatic Techniques; Humans; Nose; Ophthalmic Artery; Protective Devices; Sports Equipment; Swimming

Topics: Adult; Antitubercular Agents; Biopsy, Needle; Diagnosis, Differential; Disease Progression; Follow-Up Studies; Hemorrhage; Humans; Immunohistochemistry; India; Lupus Vulgaris; Male; Mycobacterium tuberculosis; Nose; Skin Diseases, Papulosquamous; Treatment Outcome

To analyze the effective treatment of deep neck infection in children.. Thirty-three cases of deep neck infection treated from September 2005 to May 2015 were retrospectively reviewed. To observe the effect of antibiotics and surgical drainage.. All cases were cured, including one case who was complicated with carotid artery rupture and was timely cured by vascular interventional therapy, and the cure rate was 100%.. Combined application of broad-spectrum antibiotics and effective surgical drainage are key to treat deep neck infection in children. The emergence of repeated small amount of bleeding in the nose and throat in children is an indicator for big neck vessel rupture and interventional vascular therapy may be considered.

Topics: Anti-Bacterial Agents; Carotid Artery Diseases; Child; Drainage; Hemorrhage; Humans; Neck; Nose; Pharynx; Retrospective Studies; Treatment Outcome

Rhinophyma is a subtype of rosacea which develops at the advanced stage of rosacea and is characterized by an excessive enlargement of the sebaceous glands. Its etiology is not well-defined beyond the following usual suspects: vitamin deficiencies, stress, hormonal factors and the Demodex folliculorum mite. Carcinoma may develop in rhinophyma patients. The first surgical process for rhinophyma was applied by Daniel Sennert in 1629. The ideal surgical method for treatment of rhinophyma is still unclear and controversial. Massive bleeding makes a controlled excision of the mass impossible, which contributes to the recurrence of rhinophyma. In this case, we combined trichloroacetic acid (TCA 45%) with dermabrasion, a treatment which hasn't been reported previously. Our method was suggested by the Mohs micrographic surgery technique, which employs serial excisions.

Topics: Aged, 80 and over; Anesthesia, Local; Caustics; Dermabrasion; Hemorrhage; Humans; Male; Mohs Surgery; Nose; Rhinophyma; Secondary Prevention; Skin Transplantation; Trichloroacetic Acid

Topics: Hematopoietic Stem Cell Transplantation; Hemorrhage; Humans; Leukemia, Myeloid, Acute; Male; Nose

Two dogs were presented with dermal arteritis of the nasal philtrum associated with repeated episodes of bleeding. Described treatment for this condition consists of long-term, usually life-long medication with various combinations of immune suppressant and anti-inflammatory medication. This paper describes a novel surgical approach to the condition that induced long-term remission in both cases.

Topics: Animals; Arteritis; Dog Diseases; Dogs; Female; Hemorrhage; Male; Nose; Plastic Surgery Procedures; Skin Diseases, Vascular; Skin Ulcer; Treatment Outcome

The differentiation of SIDS from accidental or inflicted suffocation may be impossible without corroborating findings from the death scene or autopsy or in the absence of a confession from a perpetrator. Pulmonary intra-alveolar hemorrhage (PH) has been proposed as a potential clue to suffocation, but none of the previous studies on this topic have limited SIDS cases to those who were in a safe sleep environment, in which all were found supine and alone on a firm surface with their heads uncovered. Our aims are to: (1) compare PH in SIDS cases found in a safe sleep environment to a control group comprised of infants whose deaths were attributed to accidental or inflicted suffocation and (2) assess the effect of age, CPR, and postmortem interval (PMI), with regard to the severity of PH in this subset of safe-sleeping SIDS cases. We conducted a retrospective study of all postneonatal cases accessioned by the Office of the Medical Examiner in San Diego County, California who died of SIDS or suffocation between 1999 and 2004. A total of 74 cases of sudden infant death caused by SIDS (34 cases as defined above, comprising 8% of the total SIDS cases), accidental suffocation (37), and inflicted suffocation (3) from the San Diego SIDS/SUDC Research Project database were compared using a semiquantitative measure of pulmonary intra-alveolar hemorrhage. The most severe (grade 3 or 4) PH occurred in 35% of deaths attributed to suffocation, but in only 9% of the SIDS cases. Age, duration of CPR attempts and PMI had no effect on the severity of PH in SIDS. Our results indicate that the severity of PH cannot be used independently to differentiate SIDS from suffocation deaths. Each case must be evaluated on its own merits after thorough review of the medical history, circumstances of death, and postmortem findings.

Topics: Asphyxia; Case-Control Studies; Female; Forensic Pathology; Hemorrhage; Humans; Hydrogen-Ion Concentration; Infant; Infant, Newborn; Infanticide; Lung Diseases; Male; Nose; Pulmonary Alveoli; Retrospective Studies; Safety; Severity of Illness Index; Sleep; Sudden Infant Death

Topics: Adult; Body Piercing; Female; Foreign Bodies; Hemorrhage; Humans; Infections; Intubation, Intratracheal; Nose; Respiratory System; Tongue

To determine the effects of an external nasal dilator strip on cytologic characteristics of bronchoalveolar lavage (BAL) fluid in racing Thoroughbreds.. Clinical trial.. 23 Thoroughbred racehorses in active training.. Each horse raced on 2 occasions: once while wearing an external nasal dilator strip and once while not. Bronchoalveolar lavage was performed 12 to 18 hours after each race, and BAL fluid was analyzed for RBC and leukocyte counts and hemosiderin content.. Mean +/- SEM count of RBCs in BAL fluid when horses raced without the nasal dilator strip (84.6 +/- 275 cells/microL) was not significantly different from count when they raced with it (41.7 +/- 12.2 cells/microL). Horses were grouped as having mild or severe bleeding on the basis of RBC count in BAL fluid after horses raced without the nasal dilator strip. Mean count when horses with severe bleeding raced without the nasal dilator strip (271.0 +/- 63.7 cells/microL) was significantly higher than mean count when these horses raced with the strip (93.8 +/- 376 cells/microL). Mean count of lymphocytes in BAL fluid was significantly lower after horses raced with the external nasal dilator strip.. Results suggest that use of an external nasal dilator strip in Thoroughbred racehorses may decrease pulmonary bleeding, particularly in horses with severe exercise-induced pulmonary hemorrhage.

Topics: Animals; Bronchoalveolar Lavage Fluid; Dilatation; Erythrocyte Count; Female; Hemorrhage; Hemosiderin; Horse Diseases; Horses; Leukocyte Count; Male; Nasal Cavity; Nose; Physical Conditioning, Animal; Pulmonary Ventilation

The purpose of this investigation was to study the effects of an equine nasal strip (NS), furosemide (Fur), and a combination of both (NS + Fur) on exercise-induced pulmonary hemorrhage (EIPH) at speeds corresponding to near-maximal effort. Five Thoroughbreds (526 +/- 25 kg) were run on a flat treadmill from 7 to 14 m/s in 1 m x s(-1) x min(-)1 increments every 2 wk (treatment order randomized) under control (Con), Fur (1 mg/kg iv 4 h prior), NS, or NS + Fur conditions. During each run, pulmonary arterial (Ppa) and esophageal (Pes) pressures were measured. Severity of EIPH was quantified via bronchoalveolar lavage (BAL) 30 min postrun. Furosemide (Fur and NS + Fur trials) reduced peak Ppa approximately 7 mmHg compared with Con (P < 0.05) whereas NS had no effect (P > 0.05). Maximal Pes swings were not different among groups (P > 0.05). NS significantly diminished EIPH compared with the Con trial [Con, 55.0 +/- 36.2; NS, 30.8 +/- 21.8 x 10(6) red blood cells (RBC)/ml BAL fluid; P < 0.05]. Fur reduced EIPH to a greater extent than NS (5.2 +/- 3.0 x 10(6) RBC/ml BAL; P < 0.05 vs. Con and NS) with no additional benefit from NS + Fur (8.5 +/- 4.2 x 10(6) RBC/ml BAL; P > 0.05 vs. Fur, P < 0.05 vs. Con and NS). In conclusion, although both modalities (NS and Fur) were successful in mitigating EIPH, neither abolished EIPH fully as evaluated via BAL. Fur was more effective than NS in constraining the severity of EIPH. The simultaneous use of both interventions appears to offer no further gain with respect to reducing EIPH.

Topics: Animals; Blood Pressure; Body Weight; Bronchoalveolar Lavage Fluid; Diuretics; Esophagus; Furosemide; Hemorrhage; Horse Diseases; Horses; Male; Nose; Physical Exertion; Pulmonary Circulation

This study examines the incidence of serious complications in nasal surgery and discusses the diagnosis and management of these complications. The authors review 259 consecutive cases performed between January 1, 1983, and August 31, 1988. One-hundred and ninety-five patients had septorhinoplasties, 29 had septoplasties, and 35 had rhinoplasties. Thirteen of these cases involved serious complications as follows: hemorrhage (5), perforation (4), infections (3), and pneumocephalus (1). All the patients with these serious complications had associated septal and/or turbinate surgery. The diagnosis and management of these complications will be discussed. In this small series of nasal surgery patients, the incidence of serious complications was 5.0 percent, with no fatalities reported. The higher incidence of serious complications occurred when associated septal and/or turbinate surgery was required. Awareness of these complications is essential because of the increasing number of patients presenting to plastic surgeons for nasal surgery in whom associated septal and/or turbinate surgery is necessary.

Topics: Adolescent; Adult; Female; Hemorrhage; Humans; Intraoperative Complications; Male; Middle Aged; Nasal Septum; Nose; Pneumocephalus; Postoperative Complications; Radiography; Sinusitis; Surgical Wound Infection

Topics: Adenoids; Adolescent; Adult; Aged; Child; Female; Hemorrhage; Humans; Intubation, Intratracheal; Male; Middle Aged; Nose

My experience with 250 intranasal laser surgical procedures performed with the carbon dioxide laser and the surgical microscope are described. Procedures include excision and vaporization of polyps, turbinates, tumors, telangiectasias, synechiae, nasal stenoses, intranasal cysts, papillomas, and septal spurs. Avoidance of technical problems is emphasized in this article since intranasal laser surgery is, in some respects, difficult to perform. Included are practical suggestions about patient positioning, use of protective devices, and patient selection.

Topics: Granuloma; Hemangioma; Hemorrhage; Humans; Laser Therapy; Lasers; Methods; Microscopy; Nasal Polyps; Nasopharyngeal Neoplasms; Nose; Nose Diseases; Papilloma; Postoperative Complications; Turbinates; Volatilization

Topics: Dacryocystitis; Female; Hemorrhage; Humans; Intraoperative Complications; Lacrimal Apparatus; Male; Nose

Following a consequent outline of his communication, the author subsequently describes his experiences, the possibilities of managing and personal techniques available in case of operative problems or postoperative complications such as bleeding, haematoma, dermal necrosis or scar formation or infection. The nasal physiology and its relation to the operative treatment, and the importance of a thoroughly preoperative evaluation of certain tissue characteristics are discussed. Postoperative skeletal alterations, such as insufficient or excessive removal of humps, cartilages and soft tissues as well as their surgical management are pointed out. Remarks about nasal tip correction conclude the presentation of the subject.

Topics: Adolescent; Adult; Dermatitis, Contact; Female; Hemorrhage; Humans; Male; Necrosis; Nose; Nose Diseases; Osteomyelitis; Postoperative Complications; Rhinoplasty; Surgical Wound Infection; Tissue Adhesives

Topics: Antineoplastic Agents; Bacterial Infections; Ear, Middle; Hemorrhage; Humans; Larynx; Mouth; Mucous Membrane; Neoplasms; Nose; Paralysis; Pharynx; Skin; Virus Diseases

The complications observed in twelve patients undergoing guided blind nasotracheal intubation are presented. The commonest was minor bleeding, followed by difficulty in hooking the cannula out of the nostril. These complications are minor enough to justify the more frequent use of the technique in patients with intubation problems.

Topics: Adolescent; Adult; Child; Female; Hemorrhage; Humans; Intubation, Intratracheal; Male; Nose

Topics: Animals; Cell Movement; Cleft Palate; Face; Hemorrhage; Humans; Neural Crest; Nose; Palate; Skull; Vitamin A

Topics: Hemorrhage; Hemostatic Techniques; Humans; Maxilla; Nose; Nose Diseases

Obstruction of the upper and lower airways is common in horses. In the upper airway, paresis of abductor muscles of the nares and larynx allows inspiratory collapse of soft tissues, which is accentuated by factors increasing upper airway resistance and by high inspiratory flow rates. Intrapulmonary airway obstruction occurs due to accumulation of secretions, release of chemical mediators in response to a variety of stimuli, and parasympathetic stimulation of airways. Obstruction of large airways increases the work of breathing, whereas obstruction of small airways may cause no measurable increase in resistance but does cause uneven distribution of ventilation and hypoxemia, especially during exercise. Poor collateral ventilation accentuates gas exchange problems in the horse with airway obstruction and may be a factor causing intrapulmonary hemorrhage during racing.

Topics: Airway Obstruction; Airway Resistance; Animals; Bronchi; Hemorrhage; Horse Diseases; Horses; Humans; Larynx; Lung; Lung Diseases; Nose; Physical Exertion; Respiration; Respiratory Tract Infections

Topics: Adenoidectomy; Adult; Anesthesia, General; Child; Ear; Hemorrhage; Humans; Nose; Pharynx; Positive-Pressure Respiration; Preanesthetic Medication; Tonsillectomy; Turbinates; Tympanic Membrane

Topics: Adult; Female; Hemorrhage; Humans; Nose; Telangiectasia, Hereditary Hemorrhagic

Topics: Carcinoma, Squamous Cell; Cobalt Radioisotopes; Female; Follow-Up Studies; Hemorrhage; Humans; Infections; Lacrimal Duct Obstruction; Lymphatic Metastasis; Male; Middle Aged; Neck Dissection; Neoplasm Recurrence, Local; Nose; Nose Neoplasms; Osteoradionecrosis; Radiation Injuries; Radiotherapy; Radiotherapy, High-Energy; Radium

Topics: Catheterization; Dacryocystitis; Dacryocystorhinostomy; Eye Neoplasms; Fistula; Hemorrhage; Humans; Lacrimal Apparatus; Nasal Mucosa; Nasal Polyps; Nose; Postoperative Complications; Skull Fractures; Suture Techniques

Topics: Ear; Esthetics; Facial Injuries; Hemorrhage; Humans; Inflammation; Interprofessional Relations; Nose; Otolaryngology; Paranasal Sinuses; Patient Care Team; Radiography; Respiration; Skull Fractures

Topics: Animals; Artiodactyla; Hemagglutination Inhibition Tests; Hemorrhage; Immunodiffusion; Nose; Paramyxoviridae Infections; Pasteurella; Pasteurella Infections; Respirovirus; Sepsis; Vaccination

Topics: Hemorrhage; Humans; Intubation, Intratracheal; Methods; Nose; Posture

Topics: Adolescent; Adult; Aged; Airway Obstruction; Anesthesia, Intravenous; Carcinoma, Squamous Cell; Cough; Epistaxis; Female; Fracture Fixation, Internal; Fractures, Bone; Hemorrhage; Humans; Ketamine; Male; Mandibular Neoplasms; Nose; Orthopedic Fixation Devices; Pharynx; Reflex; Surgery, Oral

Topics: Adjuvants, Anesthesia; Adult; Aged; Anesthesia, Local; Blood Pressure; Cognition; Diazepam; Female; Hemorrhage; Humans; Male; Maxillary Sinus; Memory; Middle Aged; Nasal Polyps; Nose; Turbinates

Topics: Aging; Anesthesia, General; Anesthesia, Local; Arteriosclerosis; Bronchitis; Cataract Extraction; Diabetes Complications; Diabetes Mellitus; Drug Interactions; Eye Diseases; Eye Injuries; Glaucoma; Hemorrhage; Humans; Hypertension; Hypoglycemic Agents; Intraocular Pressure; Intubation; Lacrimal Apparatus; Middle Aged; Monoamine Oxidase Inhibitors; Nose; Ophthalmologic Surgical Procedures; Preanesthetic Medication

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Chronic Disease; Dacryocystitis; Female; Hemorrhage; Humans; Lacrimal Apparatus; Male; Methods; Middle Aged; Nasal Mucosa; Nose; Postoperative Care; Postoperative Complications; Preoperative Care; Suture Techniques; Tendons

Topics: Abortion, Spontaneous; Bacteriuria; Birth Weight; Boston; Cervix Uteri; Ethnicity; Female; Fetal Death; Genitalia, Female; Gestational Age; Hemorrhage; Humans; Infant, Newborn; Mycoplasma; Mycoplasma Infections; Nose; Obstetric Labor, Premature; Pharynx; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Infectious; Prospective Studies; Socioeconomic Factors

Topics: Adolescent; Adult; Aged; Analgesia; Anesthesia, General; Anesthesia, Local; Arteries; Blood Pressure; Catheterization; Child; Cocaine; Cough; Epinephrine; Female; Hemorrhage; Humans; Hypoxia; Intubation, Intratracheal; Larynx; Lidocaine; Male; Methods; Middle Aged; Nasopharynx; Nose; Oxygen; Oxygen Inhalation Therapy; Posture; Preanesthetic Medication

Topics: Adolescent; Adult; Aged; Anesthesia, General; Benperidol; Drainage; Fentanyl; Halothane; Hemorrhage; Humans; Middle Aged; Nasopharyngeal Diseases; Nose; Posture

Topics: Blood Coagulation Disorders; Blood Coagulation Tests; Blood Platelet Disorders; Blood Transfusion; Capillaries; Epistaxis; Hemophilia A; Hemophilia B; Hemorrhage; Hemostasis; Hemostatics; Humans; Nose; Otolaryngology; Pharynx; Surgical Procedures, Operative; Tonsillectomy

Topics: Cartilage; Cervical Vertebrae; Cornea; Dermatology; Ear, External; Embolism; Embolism, Air; Head; Hemorrhage; Humans; Lymphedema; Neck; Neck Dissection; Nose; Otitis Media; Paralysis; Parotid Gland; Postoperative Complications; Respiratory Insufficiency; Salivary Gland Fistula; Spinal Injuries; Surgical Procedures, Operative; Thoracic Duct; Tooth

Topics: Disease; Hemophilia A; Hemorrhage; Humans; Nose; Respiration Disorders; Respiratory System; Respiratory Tract Diseases

Topics: Epistaxis; Estrogens; Estrogens, Conjugated (USP); Hemorrhage; Hemostatics; Humans; Neck; Nose; Tonsillectomy

Topics: Hemorrhage; Hemostasis; Humans; Neoplasms; Nose; Nose Neoplasms; Paranasal Sinus Neoplasms; Paranasal Sinuses

Topics: Hemorrhage; Hemostasis; Nasal Surgical Procedures; Nose

Topics: Epistaxis; Hemorrhage; Humans; Medical Records; Nose

Topics: Biomedical Research; Hemorrhage; Humans; Nasal Surgical Procedures; Nose; Thromboplastin; Tonsillectomy

Topics: Adrenochrome; Epistaxis; Hemorrhage; Neck; Nose; Pharynx; Sodium Salicylate; Staining and Labeling

Topics: Epistaxis; Hemorrhage; Hospitals; Humans; Nose; Pharynx

Topics: Epistaxis; Hemorrhage; Humans; Nasopharynx; Nose

Topics: Adenoids; Epistaxis; Estrogens; Hemorrhage; Hemostatics; Humans; Nasopharynx; Nose; Palatine Tonsil

Topics: Adrenochrome; Epistaxis; Hemorrhage; Humans; North Carolina; Nose; Pharynx; Salicylates

Topics: Adenoids; Adrenochrome; Epistaxis; Hemorrhage; Neck; Nose; Palatine Tonsil; Pharynx; Staining and Labeling

Topics: Epistaxis; Hemorrhage; Humans; Nasopharynx; Neck; Nose; Pharynx

Topics: Disease Management; Epistaxis; Hemorrhage; Neck; Nose; Pharynx; Staining and Labeling

Topics: Hemorrhage; Humans; Nasal Surgical Procedures; Nose

Topics: Ear; Epistaxis; Hemorrhage; Humans; Neck; Nose; Pharynx

Topics: Ear; Hemorrhage; Humans; Nose; Pharynx

Topics: Hemorrhage; Humans; Nasal Septum; Nose

Topics: Hemorrhage; Humans; Nasal Septum; Nose; Polyps; Sepsis

Topics: Bandages; Cellulose; Cellulose, Oxidized; Hemorrhage; Nose

Topics: Hemorrhage; Humans; Influenza, Human; Nose

Topics: Animals; Coleoptera; Hemorrhage; Humans; Nose; Rhinitis, Atrophic

Topics: Hemorrhage; Humans; Nose

Topics: Cardiovascular System; Epistaxis; Hemorrhage; Nose

Topics: Disease; Hemorrhage; Humans; Mastoiditis; Nose; Temporal Bone

Topics: Epistaxis; Hemorrhage; Nose

Topics: Conjunctiva; Conjunctival Diseases; Disabled Persons; Eye Hemorrhage; Hemorrhage; Humans; Nose; Nystagmus, Pathologic; Vision, Ocular

Topics: Animals; Epistaxis; Hemorrhage; Nose; Porifera

Topics: Carotid Artery, External; Diathermy; Epistaxis; Hemorrhage; Humans; Ligation; Nose; Orbit

Topics: Hemorrhage; Humans; Nose

Topics: Ethmoid Sinus; Hemorrhage; Humans; Nose

Topics: Epistaxis; Hemorrhage; Nose

Topics: Antifibrinolytic Agents; Ascorbic Acid; Epistaxis; Hemorrhage; Hemostatics; Humans; Nose; Prothrombin; Vitamin K; Vitamins

Topics: Hemorrhage; Humans; Liver Diseases; Nose; Pharynx

Topics: Cellulose, Oxidized; Hemorrhage; Humans; Nose; Pharynx

Topics: Hemorrhage; Humans; Nose

Topics: Epistaxis; Fistula; Hemorrhage; Humans; Nose; Paranasal Sinuses

Topics: Carotid Arteries; Carotid Artery, External; Epistaxis; Hemorrhage; Humans; Ligation; Nose

Topics: Epistaxis; Hemorrhage; Nose

Topics: Hemorrhage; Humans; Nose

Topics: Epistaxis; Hemorrhage; Humans; Nose

Topics: Hemorrhage; Humans; Nose

Topics: Epistaxis; Hemorrhage; Nose

Topics: Hemorrhage; Humans; Nose; Rheumatic Fever

Topics: Epistaxis; Hemorrhage; Humans; Nose

Topics: Hemorrhage; Nose; Recurrence

Topics: Hemorrhage; Humans; Nose

Topics: Disease Susceptibility; Hemorrhage; Hemorrhagic Disorders; Humans; Nose

Topics: Hemorrhage; Humans; Nose

Topics: Hemorrhage; Humans; Nose

Topics: Hemorrhage; Humans; Neck; Nose; Pharynx; Respiratory System

Topics: Epistaxis; Fistula; Hemorrhage; Humans; Nose; Paranasal Sinuses

Topics: Epistaxis; Female; Hemorrhage; Humans; Nose; Pregnancy; Pregnancy Complications

Topics: Arteries; Epistaxis; Hemorrhage; Humans; Nose

Topics: Bandages; Cellulose; Cellulose, Oxidized; Epistaxis; Hemorrhage; Hemostasis; Humans; Nose

Topics: Epistaxis; Hemorrhage; Nose

Topics: Epistaxis; Hemorrhage; Humans; Nose

Topics: Disease; Epistaxis; Ethmoid Bone; Ethmoid Sinus; Hemorrhage; Humans; Nose; Paranasal Sinus Diseases

Topics: Arteries; Epistaxis; Hemorrhage; Humans; Ligation; Nose; Ophthalmic Artery