title: Two cases in which the effectiveness of "laryngospasm notch" pressure against laryngospasm was confirmed by imaging examinations.
abstract: We report two cases in which development of laryngospasm and release of the spasm immediately after applying pressure in the "laryngospasm notch" was confirmed by ultrasonographic and fiberoptic examinations. A bronchoscopy was planned under propofol sedation using a laryngeal mask airway for a 61-year-old man after subtotal esophagotomy. When a bronchoscope was advanced into the trachea, the vocal cords suddenly closed. Immediately after pressure with the fingertips was applied to the "laryngospasm notch," the vocal cords opened, which was observed through the bronchoscope in real time. A 22-year-old woman presented for emergency caesarean section under general anesthesia. After the completion of the procedures, the patient was not yet following commands but her breathing was steady. Thus, extubation was performed; however, she began to display signs of respiratory stridor. An ultrasonographic examination revealed that the vocal cords were noted to close, which suggested that she was developing laryngospasm. With this diagnosis, pressure at the "laryngospasm notch" was applied. Immediately after this maneuver, the vocal cords opened. We reconfirmed that applying pressure in the "laryngospasm notch" was effective to release laryngospasm. Imaging studies, especially ultrasonographic examination, were useful for making the decision to apply pressure in the "laryngospasm notch."
authors.affiliation: Division of Intensive Care, Nara Medical University, Kashihara, Japan.
authors.forename: Takeaki
authors.initials: T
authors.lastname: Shinjo
authors.forename: Satoki
authors.initials: S
authors.lastname: Inoue
authors.forename: Junji
authors.initials: J
authors.lastname: Egawa
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kawaguchi
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Furuya
mesh_terms: D000328:Adult; D001999:Bronchoscopy / Q000379:methods; D005260:Female; D006801:Humans; D007826:Laryngismus / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D014463:Ultrasonography; D055815:Young Adult