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Silent aspiration

Janaina Gonçalves da Silva Leite, Maria Luzete Costa Cavalcante, Francisco Vagnaldo Fechine-Jamacaru, Margarida Maria de Lima Pompeu, José Alberto Dias Leite, Dulce Maria Nascimento Coelho, Marcos Rabelo de Freitas
Sensory receptors are distributed throughout the oral cavity, pharynx, and larynx. Laryngeal sensitivity is crucial for maintaining safe swallowing, thus avoiding silent aspiration. Morphologic description of different receptor types present in larynx vary because of the study of many different species, from mouse to humans. The most commonly sensory structures described in laryngeal mucosa are free nerve endings, taste buds, muscle spindles, glomerular and corpuscular receptors. This study aimed at describing the morphology and the distribution of nerve endings in premature newborn glottic region...
October 2016: International Journal of Pediatric Otorhinolaryngology
C A Hockey, A A J van Zundert, J D Paratz
Correct inflation pressures of the tracheal cuff are recommended to ensure adequate ventilation and prevent aspiration and adverse events. However there are conflicting views on which measurement to employ. The aim of this review was to examine whether adjustment of cuff pressure guided by objective measurement, compared with subjective measurement or observation of the pressure value alone, was able to prevent patient-related adverse effects and maintain accurate cuff pressures. A search of PubMed, Web of Science, Embase, CINAHL and ScienceDirect was conducted using keywords 'cuff pressure' and 'measure*' and related synonyms...
September 2016: Anaesthesia and Intensive Care
Hiroyuki Maeda, Zeyi Deng, Taro Ikegami, Sen Matayoshi, Shinya Agena, Asanori Kiyuna, Yukashi Yamashita, Takayuki Uehara, Akira Ganaha, Mikio Suzuki
Branchiogenic carcinoma (BC) usually appears as a mass lesion with a predominant cystic component. Since lymph node metastasis from oropharyngeal carcinoma (OPC) has a cystic appearance, it is occasionally difficult to distinguish between BC and nodal metastases from clinically silent OPC. Factors associated with the malignant transformation process in BC remain obscure. The present study reports the case of a 56-year-old man with a right cystic cervical mass that was diagnosed as squamous cell carcinoma based on examination by fine-needle aspiration biopsy...
September 2016: Oncology Letters
Farhang Babamahmoodi, Lotfollah Davoodi, Roya Sheikholeslami, Fatemeh Ahangarkani
Empyema necessitans (EN) is a kind of empyema that diffuses to extrapleural space and can involve chest pain. Tuberculosis (TB) is the most common cause of EN. This disease can be found in both immunocompromised and immunocompetent individuals but is usually seen in the immunocompromised individuals. Because of long duration and ambiguous symptoms of the disease, diagnosis can be hard. The disease can be treated both medically and surgically. Missing the disease can lead to undesirable effects on patient's condition and health care setting...
2016: Case Reports in Infectious Diseases
Ahmed Fathi Abdallah, Tarek El-Desoky, Khalid Fathi, Wagdy Fawzi Elkashef, Ahmed Zaki
Background. There is no gold standard test for diagnosis of gastroesophageal reflux disease (GERD) associated infantile wheezing. Objectives. To evaluate the value of bronchoalveolar lavage (BAL) pepsin assay in diagnosis of GERD in wheezy infants. Methods. Fifty-two wheezy infants were evaluated for GERD using esophageal combined impedance-pH (MII-pH) monitoring, esophagogastroduodenoscopy with esophageal biopsies, and BAL pepsin. Tracheobronchial aspirates from 10 healthy infants planned for surgery without history of respiratory problems were examined for pepsin...
2016: Canadian Respiratory Journal: Journal of the Canadian Thoracic Society
Sarah Bishop, Warren Michael Reed
Combination chemoradiation is the gold standard of management for locally advanced squamous cell carcinomas of the head and neck. One of the most significant advantages of this approach to treatment is organ preservation which may not be possible with radical surgery. Unfortunately, few treatments are without side-effects and the toxicity associated with combined modality treatment causes meaningful morbidity. Patients with head and neck cancer (HNC) may have difficulties meeting their nutritional requirements as a consequence of tumour location or size or because of the acute toxicity associated with treatment...
December 2015: Journal of Medical Radiation Sciences
Arwen Jackson, Jennifer Maybee, Maura K Moran, Kristine Wolter-Warmerdam, Francis Hickey
Aspiration is an often unrecognized comorbidity in children with Down syndrome with serious medical consequences. This retrospective chart review of swallow study reports characterizes oral and pharyngeal phase dysphagia and diet modifications on videofluoroscopic swallow studies (VFSS) in a large cohort of children with Down syndrome. A total of 158 pediatric patients (male = 95; female = 63; mean age 2.10 years, SD 3.17 years) received an initial VFSS at a pediatric teaching hospital as part of their medical care...
October 2016: Dysphagia
Marisa Gasparin, Cláudia Schweiger, Denise Manica, Antônio Carlos Maciel, Gabriel Kuhl, Deborah Salle Levy, Paulo José Cauduro Marostica
OBJECTIVE: To investigate the accuracy of clinical evaluation of swallowing in a sample of children with laryngomalacia or glossoptosis and describe the prevalence of dysphagia in each of these diseases, as well as characterize the swallow response to speech and language therapy interventions. STUDY DESIGN: Children aged 1 month to 11 years receiving care at the Department of Otolaryngology, Hospital de Clínicas de Porto Alegre, Brazil, were evaluated in a cross-sectional design...
May 26, 2016: Pediatric Pulmonology
Prasad John Thottam, Matthew Georg, David Chi, Deepak K Mehta
OBJECTIVES/HYPOTHESIS: To examine the effect of and predict the success of type 1 laryngeal cleft (LC-1) augmentation through swallowing evaluations. STUDY DESIGN: Retrospective chart analysis. METHODS: Sixty-eight patients with LC-1s underwent interarytenoid injection laryngoplasty (IL) and were examined. The median age at IL was 9 months. Swallowing evaluations were performed pre- and postoperatively using fiberoptic endoscopic examination of swallowing or modified barium swallow...
May 12, 2016: Laryngoscope
Samantha Holmes
PURPOSE OF REVIEW: The article reviews recent literature supporting the use of cough reflex testing (CRT), and outlines a service evaluation of CRT conducted with postsurgical head and neck cancer patients. There is a growing evidence base to support the use of CRT in dysphagia management to establish laryngeal sensation and screen for silent aspiration; however, there is a lack of evidence relating to using CRT within the head and neck population. RECENT FINDINGS: Over a 3-month period, inpatients on an ear, nose and throat/maxillofacial ward underwent CRT as part of their clinical swallow evaluation...
June 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
Daniel P Mistrot, Vincent A Gemma, Ronald A Gagliano, Ashraf Omar, Tanmay S Panchabhai
A 54-year-old man who had undergone bilateral sequential lung transplant for idiopathic pulmonary fibrosis was admitted to the hospital for further evaluation of an abnormal abdominal CT scan. Three months previously a gastrojejunostomy tube had been placed after he was found to have evidence of silent aspiration with oral intake. At a recent clinic visit, he denied abdominal pain or problems with the feeding tube. He described frequent diarrhea since placement of the feeding tube.
May 2016: Chest
Satoru Ebihara, Hideki Sekiya, Midori Miyagi, Takae Ebihara, Tatsuma Okazaki
Despite the development and wide distribution of guidelines for pneumonia, death from pneumonia is increasing due to population aging. Conventionally, aspiration pneumonia was mainly thought to be one of the infectious diseases. However, we have proven that chronic repeated aspiration of a small amount of sterile material can cause the usual type of aspiration pneumonia in mouse lung. Moreover, chronic repeated aspiration of small amounts induced chronic inflammation in both frail elderly people and mouse lung...
March 2016: Journal of Thoracic Disease
Eusebi Chiner, Mónica Llombart, Joan Valls, Esther Pastor, José N Sancho-Chust, Ada Luz Andreu, Manuel Sánchez-de-la-Torre, Ferran Barbé
BACKGROUND: We hypothesized that obstructive sleep apnea (OSA) can predispose individuals to lower airway infections and community-acquired pneumonia (CAP) due to upper airway microaspiration. This study evaluated the association between OSA and CAP. METHODS: We performed a case-control study that included 82 patients with CAP and 41 patients with other infections (control group). The controls were matched according to age, sex and body mass index (BMI). A respiratory polygraph (RP) was performed upon admission for patients in both groups...
2016: PloS One
Tina Pakala, Marco Molina, George Y Wu
Cystic echinococcosis (CE) is a widely endemic helminthic disease caused by infection with metacestodes (larval stage) of the Echinococcus granulosus tapeworm. E. granulosus are common parasites in certain parts of the world, and are present on every continent with the exception of Antarctica. As a result, a large number of people are affected by CE. The increased emigration of populations from endemic areas where prevalence rates are as high as 5-10% and the relatively quiescent clinical course of CE pose challenges for accurate and timely diagnoses...
March 28, 2016: Journal of Clinical and Translational Hepatology
Ryuji Hori, Masaaki Isaka, Kazuhiko Oonishi, Toru Yabe, Yoshitaka Oku
BACKGROUND AND OBJECTIVE: The purpose of this study was to test the hypothesis that the risk of silent aspiration is increased in non-invasive positive pressure ventilation. METHODS: We analysed the coordination between respiration and swallowing, in 12 young volunteers and 10 elder volunteers, by simultaneously monitoring respiratory flow, laryngeal movement and swallowing sound in three different conditions: control, continuous positive airway pressure (CPAP), and bi-level positive airway pressure (BiPAP)...
August 2016: Respirology: Official Journal of the Asian Pacific Society of Respirology
Molly Kallesen, Alex Psirides, Maggie-Lee Huckabee
PURPOSE: Orotracheal intubation is known to impair cough reflex, but the validity of cough reflex testing (CRT) as a screening tool for silent aspiration in this population is unknown. MATERIAL AND METHODS: One hundred and six participants in a tertiary-level intensive care unit (ICU) underwent CRT and videoendoscopic evaluation of swallowing (VES) within 24 hours of extubation. Cough reflex threshold was established for each participant using nebulized citric acid...
June 2016: Journal of Critical Care
Yasushi Hoshikawa, Naoko Tanda, Yasushi Matsuda, Hiroshi Katsumata, Hirotsugu Notsuda, Tatsuaki Watanabe, Hiromichi Niikawa, Masafumi Noda, Akira Sakurada, Takashi Kondo, Yoshinori Okada
Pneumonia in elderly people is mainly caused by silent aspiration due to an age-related impairment of cough and swallowing reflexes. Because most of the patients with lung cancer are elderly people, we hypothesized that the age-related impairment of these protective reflexes might exist or occur in patients undergoing lung surgery, and cause postoperative pneumonia. We revealed that many elderly patients showed depressed swallowing reflex even before surgery and transient attenuation of cough reflex after surgery, and that postoperative pneumonia occurred only in the patients whose cough and/or swallowing reflex was abnormal postoperatively...
January 2016: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Rainer Wirth, Rainer Dziewas, Anne Marie Beck, Pere Clavé, Shaheen Hamdy, Hans Juergen Heppner, Susan Langmore, Andreas Herbert Leischker, Rosemary Martino, Petra Pluschinski, Alexander Rösler, Reza Shaker, Tobias Warnecke, Cornel Christian Sieber, Dorothee Volkert
Oropharyngeal dysphagia (OD) is a highly prevalent and growing condition in the older population. Although OD may cause very severe complications, it is often not detected, explored, and treated. Older patients are frequently unaware of their swallowing dysfunction which is one of the reasons why the consequences of OD, ie, aspiration, dehydration, and malnutrition, are regularly not attributed to dysphagia. Older patients are particularly vulnerable to dysphagia because multiple age-related changes increase the risk of dysphagia...
2016: Clinical Interventions in Aging
Julie E Strychowsky, Pamela Dodrill, Ethan Moritz, Jennifer Perez, Reza Rahbar
BACKGROUND: The Modified Barium Swallow (MBS) is the most widely utilized instrumental assessment of swallowing disorders in children; however, the exact role in the evaluation of laryngeal clefts remains controversial. METHODS: This study was an IRB-approved retrospective review on patients diagnosed with laryngeal cleft from 2002 to 2014. The objective was to describe the range of swallowing dysfunction that may be present in patients with laryngeal clefts both pre- and post-intervention (conservative management versus surgery)...
March 2016: International Journal of Pediatric Otorhinolaryngology
Ulrika Lindblom, Per Nilsson, Ola Gärskog, Elisabeth Kjellen, Göran Laurell, Peter Wahlberg, Björn Zackrisson, Eva Levring Jäghagen
Conclusion Neck dissection after radiotherapy increased the risk of aspiration as a late effect in a sub-sample of patients treated for head and neck cancer in the ARTSCAN study. Patients treated with accelerated fractionation (AF) developed aspiration, with or without coughing, more frequently than patients treated with conventional fractionation (CF). Objectives A long-term follow-up study was conducted to determine the frequency of aspiration as a late effect in patients with head and neck cancer treated with AF or CF...
2016: Acta Oto-laryngologica
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