title: Complications with utilization of positive-pressure devices in a young man with duchenne muscular dystrophy.
abstract: Because of the progressive muscle weakness they experience, patients with Duchenne muscular dystrophy frequently utilize positive-pressure devices to maintain adequate bronchial hygiene and ventilation. This case illustrates the course of a 19-y-old male who presented with a perforated right tympanic membrane (TM) following the use of these devices. Perforation of the TM while utilizing positive-pressure devices is a rarely reported event. A challenging aspect in this case was balancing the reduction of pressures and maintaining adequate ventilation while at the same time allowing the TM to heal.
authors.affiliation: Respiratory Care Services, Arkansas Children's Hospital, Little Rock, Arkansas.
authors.forename: Scott L
authors.initials: SL
authors.lastname: Gee
authors.affiliation: Respiratory Care Services, Arkansas Children's Hospital, Little Rock, Arkansas. lowegr@archildrens.org.
authors.forename: Gary R
authors.initials: GR
authors.lastname: Lowe
authors.affiliation: Pulmonary Medicine Section, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
authors.forename: Robert H
authors.initials: RH
authors.lastname: Warren
mesh_terms: D000293:Adolescent; D006801:Humans; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000628:therapy*; D063087:Noninvasive Ventilation / Q000009:adverse effects*; D011175:Positive-Pressure Respiration / Q000009:adverse effects*; D012648:Self Care; D018058:Tympanic Membrane Perforation / Q000209:etiology*
keywords: insufflator-exsufflator; myringorupture; noninvasive ventilation; perforated tympanic membrane; positive-pressure ventilation