title: Anterior-commissure laryngoscope extraction of esophageal coins in children using an apnea technique.
abstract: This is a case series with chart review of 59 consecutive pediatric patients with a diagnosis of cervical esophageal coin who underwent anterior-commissure laryngoscope (ACLA) extraction during apnea. The purpose of this study was (1) to evaluate the efficacy and safety of coin extraction and (2) to analyze foreign body features and intraoperative physiological parameters (apnea time, O2 saturation and end-tidal CO2 (ETCO2) of apnea, minimum O2 during procedure, and heart rate). The technique was completed in 94.9% of the sample. The mean of the length of apnea was 57.7 ± 25.2 seconds. The median minimum O2 saturation was 99.5% (minimum = 93, maximum = 100), and the median of the ETCO2 at the end of the procedure was 35.7 ± 4.8 mm Hg. Heart rates remained at baseline values during the procedure (P < .001). This technique represents an efficient and secure modality for treatment. If successful, the patient can be safely discharged after clearance from anesthesia and a swallowing trial.
authors: Department of Otolaryngology Head and Neck Surgery, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico, USA luisamtarrats@gmail.com.
authors: Luis A
authors: LA
authors: Tarrats
authors: Department of Anesthesiology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico, USA.
authors: Marinell
authors: M
authors: Rivera-Rodríguez
authors: Research Design, Biostatistics, and Clinical Research Ethics, Puerto Rico Clinical and Translational Research Consortium, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico, USA.
authors: Lorena
authors: L
authors: González
authors: Department of Surgery, Saint Luke's Episcopal Hospital, Ponce School of Medicine, Ponce, Puerto Rico, USA.
authors: Susana
authors: S
authors: Vargas-Pinto
authors: Department of Otolaryngology Head and Neck Surgery, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico, USA.
authors: Miguel
authors: M
authors: Garratón
authors: Department of Anesthesiology, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico, USA.
authors: Elisa
authors: E
authors: Quintero
authors: Department of Otolaryngology Head and Neck Surgery, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico, USA.
authors: Antonio
authors: A
authors: Riera-March
mesh_terms: D001049:Apnea; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004947:Esophagus / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D009717:Numismatics; D011647:Puerto Rico; D012189:Retrospective Studies; D018570:Risk Assessment; D016896:Treatment Outcome
keywords: apnea; esophageal coins