Greg Burg

46 timestamped statements across 2 collections — auto-found in recorded discussions, each timestamp jumps to the exact moment.

Aerodigestive / ENT · guest expert

Featured diaries

▶ Ep 24 · 2:37
I would theorize that patients that have significant tracheal bronchoalacia or upper airway obstruction from things like tonsils and adenoids, they sometimes have to generate greater forces with their respiratory mechanics, and that pushes. More air across the glottis and can increase the risk of aspiration
quote · Aerodigestive / ENT
▶ Ep 3 · 2:37
I would theorize that patients that have significant tracheal bronchoalacia or upper airway obstruction from things like tonsils and adenoids, they sometimes have to generate greater forces with their respiratory mechanics, and that pushes. More air across the glottis and can increase the risk of aspiration
quote · Laryngeal Cleft
▶ Ep 24 · 0:41
This is a 5 year old trach dependent patient who had encephalopathy, wants to get her trach out, does OK with capping, and it's mainly fed PO has a G tube in place though, and they came to us to look at getting decannulated.
quote · Aerodigestive / ENT
▶ Ep 3 · 0:41
This is a 5 year old trach dependent patient who had encephalopathy, wants to get her trach out, does OK with capping, and it's mainly fed PO has a G tube in place though, and they came to us to look at getting decannulated.
quote · Laryngeal Cleft

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Aerodigestive / ENT 23 entries

QUAD #25: Medical Management of Minor Laryngeal Clefts with Dr. Greg Burg

▶ Ep 24 · 0:41
quote This is a 5 year old trach dependent patient who had encephalopathy, wants to get her trach out, does OK with capping, and it's mainly fed PO has a G tube in place though, and they came to us to look at getting decannulated. ↗
▶ Ep 24 · 1:02
quote This patient has. Secretions in the lower airway and there's a diffuse mucopurulent bronchitis looking at the MLMB portion and we'll come back and check for a cleft here. ↗
▶ Ep 24 · 1:34
clinical The case patient had a very inflammatory pattern on bronchoalveolar lavage but did not have lipid-laden macrophages despite being orally fed. ↗
▶ Ep 24 · 1:34
quote This child had a very inflammatory pattern on the bronchoalveolar lavage, did not have any lipolaid macrophages despite being orally fed, so that was interesting. ↗
▶ Ep 24 · 1:52
quote So in terms of what we do with these clefts, I think a lot of it has to do with how bad is the chow, and that a lot of that comes down to the degree of aspiration. ↗
▶ Ep 24 · 1:52
clinical Management of laryngeal clefts depends heavily on the degree of aspiration. ↗
▶ Ep 24 · 2:34
clinical Patients with significant tracheobronchomalacia or upper airway obstruction from tonsils and adenoids may generate greater respiratory forces that push more air across the glottis and can increase aspiration risk. ↗
▶ Ep 24 · 2:37
quote I would theorize that patients that have significant tracheal bronchoalacia or upper airway obstruction from things like tonsils and adenoids, they sometimes have to generate greater forces with their respiratory mechanics, and that pushes. More air across the glottis and can increase the risk of aspiration ↗
▶ Ep 24 · 2:50
clinical BAL analysis examines inflammatory cell types, culture results, and macrophage contents. ↗
▶ Ep 24 · 3:05
clinical Parental report of choking and coughing with water intake raises suspicion for a minor cleft. ↗
▶ Ep 24 · 3:07
quote A Kid comes to clinic and the parents say every time they have a cup of water they choke and cough. You're already suspecting that there may be a minor cleft. ↗
▶ Ep 24 · 3:27
clinical A child with a deepened interarytenoid notch plus evidence of aspiration on BAL or other assessments plus bronchiectasis on imaging warrants consideration for surgical repair. ↗
▶ Ep 24 · 3:42
clinical For patients with an interarytenoid notch and genetic components with concern for central swallowing control, brain MRI may be checked to assess neurologic and functional comorbidities. ↗
▶ Ep 24 · 4:04
clinical Safe swallowing techniques include thickening, pacing, and volume modification. ↗
▶ Ep 24 · 4:20
quote So you can aspirate from 3 different locations, things that start in your upper airway, things you put in your upper airway, and things that come up from your GI system ↗
▶ Ep 24 · 4:20
clinical Aspiration can occur from three locations: things that start in the upper airway, things put in the upper airway, and things that come up from the GI system. ↗
▶ Ep 24 · 4:29
clinical Medical management addresses excessive drooling and esophageal or GI motility issues that increase vomiting and reflux aspiration risk. ↗
▶ Ep 24 · 4:49
opinion Pulmonary therapies are mostly considered reactive band-aids. ↗
▶ Ep 24 · 4:54
clinical Inhaled steroids may be tried to reduce inflammation. ↗
▶ Ep 24 · 5:06
clinical Albuterol may be used for bronchodilation if there is a reactive airway component to aspiration pneumonitis. ↗
▶ Ep 24 · 5:19
clinical Airway clearance augmentation is needed for neurodevelopmentally limited or musculoskeletally limited patients who lack effective cough or airway clearance ability. ↗
▶ Ep 24 · 5:41
clinical Health maintenance for aspiration-risk patients includes vaccination against respiratory illnesses and reducing environmental hazards including smoke exposure. ↗
▶ Ep 24 · 5:54
clinical For non-operative monitoring, pulmonologists track clinical symptoms, hospitalization frequency, response to interventions, and may repeat bronchoscopy and swallow assessments to guide further management. ↗
Laryngeal Cleft 23 entries

QUAD #25: Medical Management of Minor Laryngeal Clefts with Dr. Greg Burg

▶ Ep 3 · 0:41
quote This is a 5 year old trach dependent patient who had encephalopathy, wants to get her trach out, does OK with capping, and it's mainly fed PO has a G tube in place though, and they came to us to look at getting decannulated. ↗
▶ Ep 3 · 1:02
quote This patient has. Secretions in the lower airway and there's a diffuse mucopurulent bronchitis looking at the MLMB portion and we'll come back and check for a cleft here. ↗
▶ Ep 3 · 1:34
clinical The case patient had a very inflammatory pattern on bronchoalveolar lavage but did not have lipid-laden macrophages despite being orally fed. ↗
▶ Ep 3 · 1:34
quote This child had a very inflammatory pattern on the bronchoalveolar lavage, did not have any lipolaid macrophages despite being orally fed, so that was interesting. ↗
▶ Ep 3 · 1:52
quote So in terms of what we do with these clefts, I think a lot of it has to do with how bad is the chow, and that a lot of that comes down to the degree of aspiration. ↗
▶ Ep 3 · 1:52
clinical Management of laryngeal clefts depends heavily on the degree of aspiration. ↗
▶ Ep 3 · 2:34
clinical Patients with significant tracheobronchomalacia or upper airway obstruction from tonsils and adenoids may generate greater respiratory forces that push more air across the glottis and can increase aspiration risk. ↗
▶ Ep 3 · 2:37
quote I would theorize that patients that have significant tracheal bronchoalacia or upper airway obstruction from things like tonsils and adenoids, they sometimes have to generate greater forces with their respiratory mechanics, and that pushes. More air across the glottis and can increase the risk of aspiration ↗
▶ Ep 3 · 2:50
clinical BAL analysis examines inflammatory cell types, culture results, and macrophage contents. ↗
▶ Ep 3 · 3:05
clinical Parental report of choking and coughing with water intake raises suspicion for a minor cleft. ↗
▶ Ep 3 · 3:07
quote A Kid comes to clinic and the parents say every time they have a cup of water they choke and cough. You're already suspecting that there may be a minor cleft. ↗
▶ Ep 3 · 3:27
clinical A child with a deepened interarytenoid notch plus evidence of aspiration on BAL or other assessments plus bronchiectasis on imaging warrants consideration for surgical repair. ↗
▶ Ep 3 · 3:42
clinical For patients with an interarytenoid notch and genetic components with concern for central swallowing control, brain MRI may be checked to assess neurologic and functional comorbidities. ↗
▶ Ep 3 · 4:04
clinical Safe swallowing techniques include thickening, pacing, and volume modification. ↗
▶ Ep 3 · 4:20
quote So you can aspirate from 3 different locations, things that start in your upper airway, things you put in your upper airway, and things that come up from your GI system ↗
▶ Ep 3 · 4:20
clinical Aspiration can occur from three locations: things that start in the upper airway, things put in the upper airway, and things that come up from the GI system. ↗
▶ Ep 3 · 4:29
clinical Medical management addresses excessive drooling and esophageal or GI motility issues that increase vomiting and reflux aspiration risk. ↗
▶ Ep 3 · 4:49
opinion Pulmonary therapies are mostly considered reactive band-aids. ↗
▶ Ep 3 · 4:54
clinical Inhaled steroids may be tried to reduce inflammation. ↗
▶ Ep 3 · 5:06
clinical Albuterol may be used for bronchodilation if there is a reactive airway component to aspiration pneumonitis. ↗
▶ Ep 3 · 5:19
clinical Airway clearance augmentation is needed for neurodevelopmentally limited or musculoskeletally limited patients who lack effective cough or airway clearance ability. ↗
▶ Ep 3 · 5:41
clinical Health maintenance for aspiration-risk patients includes vaccination against respiratory illnesses and reducing environmental hazards including smoke exposure. ↗
▶ Ep 3 · 5:54
clinical For non-operative monitoring, pulmonologists track clinical symptoms, hospitalization frequency, response to interventions, and may repeat bronchoscopy and swallow assessments to guide further management. ↗