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3 results

  • Anomalous innominate artery complicating tracheal surgical procedures

  • J J E Sargunaraj, R R Paul, S S Mathews, R R A Albert
  • Journal:
    The Journal of Laryngology & Otology / Volume 135 / Issue 2 / February 2021
    Published online by Cambridge University Press:
    25 January 2021, pp. 185-188
    Print publication:
    February 2021
  • Objective

    To highlight the importance of imaging in reducing an accidental injury to the anomalous brachiocephalic trunk and its branches during tracheal surgery.

    Case report

    This paper reports two cases of accidental injury to the great vessels in the neck during tracheal surgery. The first incident occurred during a repeat tracheostomy, when the right common carotid artery was injured. On reviewing the computed tomography images, the bifurcation of the brachiocephalic artery was seen to the left of the midline, and the right common carotid artery was adherent just below the tracheostomy site. The second incident happened during surgery for tracheal stenosis, when there was an inadvertent injury to the main brachiocephalic trunk, which was adherent to the trachea in the lower neck region.

    Conclusion

    For airway surgeons, radiological assessment of vascular structures in relation to the trachea prior to surgery is as important as the endoluminal airway assessment for the best outcome.

  • 11 - Wheelchair design and seating technology

  • from Section A2 - Therapeutic technology
  • Edited by Michael Selzer, University of Pennsylvania, Stephanie Clarke, Université de Lausanne, Switzerland, Leonardo Cohen, National Institute of Mental Health, Bethesda, Maryland, Pamela Duncan, University of Florida, Fred Gage, Salk Institute for Biological Studies, San Diego
  • Book:
    Textbook of Neural Repair and Rehabilitation
    Published online:
    04 August 2010
    Print publication:
    16 February 2006, pp 147-164

  • Summary

    Wheelchair and seating biomechanics research includes studies to prevent secondary conditions due to wheelchair and seating use, and to reduce the incidence of accidental injuries. Upper extremity models have been created in order to determine motion as well as net joint forces and moments. It has been shown that wheelchair pushrim forces are related to nerve conduction studies (NCS) variables. A pushrim activated power assisted wheelchair (PAPAW) uses motors and batteries to augment the power applied by the users to one or both pushrims during propulsion or braking. Powered wheelchairs can be grouped into several classes or categories. A convenient grouping by intended use is primarily indoor, both indoor/outdoor, and active indoor/outdoor. In response to the needs of clinicians with specialized knowledge of and experience with assistive technology (AT), the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) developed a credentialing program in AT.

  • Vehicle crashworthiness and the older motorist

  • ANDREW MORRIS, RUTH WELSH, RICHARD FRAMPTON, JUDE CHARLTON, BRIAN FILDES
  • Journal:
    Ageing & Society / Volume 23 / Issue 4 / July 2003
    Published online by Cambridge University Press:
    25 June 2003, pp. 395-409
    Print publication:
    July 2003

  • This study examines the relationship between age and the injury outcomes for belted drivers in road vehicle crashes in the United Kingdom. The sample of 1,541 drivers was divided into three age groups: 889 drivers were aged 17–39 years (young drivers); 515 were 40–64 years (middle-aged), and 137 aged 65–84 years (older drivers). Both frontal and side impact crashes in which the vehicles sustained sufficient damage to be towed away from the scene are considered. In-depth information obtained from examinations of the crashed vehicles was combined with clinical data obtained from hospitals to throw light on the mechanisms that led to the injuries. Results show that in crashes of approximately equal severity, older drivers were significantly more likely than middle-aged and young drivers to be fatally injured in both frontal (p<0.001) and side (p<0.05) impact crashes. The results also show that older drivers sustained more injuries to the chest (p<0.0001) and that this body region is particularly problematic. The main sources of the chest injuries were found to be the seat belt in frontal crashes and the door in side impact crashes. As the number of older car users will increase rapidly in most OECD countries in the coming decades, the results suggest that vehicle re-designs are required, including in-vehicle crashworthiness systems, to take into account older people's relatively low tolerance of crash impacts.