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Andreas Gravvanis, Despoina Kakagia, Nick Katsikeris, Dimosthenis Tsoutsos
BACKGROUND: This report aims to first present Integra as an adjunct to complex mandibular reconstruction for intraoral lining resurfacing, and to review the literature on the use of dermal matrices for mucosal resurfacing of the floor of the mouth. CLINICAL REPORT: A 62-year-old female patient with previous ablation surgery for squamous cell carcinoma of the floor of the mouth, presented with extrusion of the mandibular plate through the chin skin and serious tongue tethering...
October 2016: Journal of Craniofacial Surgery
Thomas Godet, Russell Chabanne, Julien Marin, Sophie Kauffmann, Emmanuel Futier, Bruno Pereira, Jean-Michel Constantin
BACKGROUND: The decision to extubate brain-injured patients with residual impaired consciousness holds a high degree of uncertainty of success. The authors developed a pragmatic clinical score predictive of extubation failure in brain-injured patients. METHODS: One hundred and forty brain-injured patients were prospectively included after the first spontaneous breathing trial success. Assessment of multiparametric hemodynamic, respiratory, and neurologic functions was performed just before extubation...
October 3, 2016: Anesthesiology
Cláudia Maria de Felício, Franciele Voltarelli da Silva Dias, Gislaine Aparecida Folha, Leila Azevedo de Almeida, Jaqueline Freitas de Souza, Wilma Terezinha Anselmo-Lima, Luciana Vitaliano Voi Trawitzki, Fabiana Cardoso Pereira Valera
OBJECTIVES: The purposes of this study were (1) to identify possible differences in muscular and orofacial functions between children with obstructive sleep apnea (OSA) and with primary snoring (PS); (2) to examine the standardized difference between normal values of myofunctional scores and those of subjects with OSA or PS; and (3) to identify the features associated with OSA. METHODS: Participants were 39 children (mean age 8 ± 1.2 years) of which, 27 had a diagnosis of OSA and 12 had PS...
November 2016: International Journal of Pediatric Otorhinolaryngology
Arno Olthoff, Arun A Joseph, Matthias Weidenmüller, Blake Riley, Jens Frahm
The reduction in intraoral pressure during swallowing has previously been linked to bolus transport, although no such relation has yet been proven. The purpose of this work was to evaluate the time course of intraoral pressure during swallowing using simultaneous real-time magnetic resonance imaging (MRI) and dynamic pressure recordings. Real-time MRI based on highly undersampled radial fast low-angle shot (FLASH) and regularized nonlinear inverse reconstruction was performed at 3 T using a standard head coil and a mid-sagittal section covering the entire oral cavity...
September 30, 2016: NMR in Biomedicine
Shethal Bearelly, Steven W Cheung
Importance: Sensory function in the oral cavity and oropharynx is integral to effective deglutition and speech production. The main hurdle to evaluation of tactile consequences of upper aerodigestive tract diseases and treatments is access to a reliable clinical tool. We propose a rapid and reliable procedure to determine tactile thresholds using buckling monofilaments to advance care. Objective: To develop novel sensory testing monofilaments and map tactile thresholds of oral cavity and oropharyngeal structures...
September 29, 2016: JAMA Otolaryngology—Head & Neck Surgery
Georg Kägi, Natascha Leisi, Marian Galovic, Marlise Müller-Baumberger, Werner Krammer, Bruno Weder
BACKGROUND: Up to 50% of ischaemic stroke patients show initial dysphagia, which may persist for months. Guidelines recommend switching nasogastric (NG) to percutaneous endoscopic gastrostomy (PEG) tube feeding at the second week after the stroke if impaired deglutition is expected for another 4 weeks. Precise prognostic criteria are lacking. We hypothesised that the Parramatta Hospitals' Assessment of Dysphagia (PAHD) performed 8 to 10 days after the stroke predicts impaired deglutition for another 4 weeks...
2016: Swiss Medical Weekly
Roberta Weber Werle, Eduardo Matias Dos Santos Steidl, Renata Mancopes
Purpose: To identify the main factors associated with oropharyngeal dysphagia following cardiac surgery through a systematic review of the literature. Methods: A bibliographic search was conducted in the PubMed and ScienceDirect databases using the following keywords: "cardiac surgery", "deglutition disorders", and "dysphagia". Selection criteria: Articles published in Portuguese, English, or Spanish addressing oropharyngeal dysphagia following cardiac surgery were selected with no time limitation...
September 26, 2016: CoDAS
J Pauchot, D Feuvrier, I Pluvy, F Floret, O Mauvais
INTRODUCTION: Reconstruction of the soft palate after oncologic resection remains a surgical challenge. Speech and swallowing problems are the consequences of velopharyngeal incompetence following soft palate resection. Free tissue transfer like radial forearm flaps can be used in larger defects for complex reconstruction. The conformation of the flap in order to be closer to the shape of the soft palate improves the functional outcome. In the same way, we describe an original "double-arched" flap design...
September 21, 2016: Annales de Chirurgie Plastique et Esthétique
K Hoetzenecker, T Schweiger, W Klepetko
Idiopathic subglottic stenosis is a disease characterized by slow, progressive scarring and constriction of the subglottic airway. It almost always occurs in females between the 3rd and 5th decade of life. Symptoms are frequently misinterpreted as asthma and patients are referred for endoscopic evaluation only when asthma medications fail to alleviate their symptoms. Treatment options can be divided into endoscopic and open surgical techniques. Microlaryngoscopic scar reduction by laser followed by balloon dilation usually delivers good short-term results...
September 2016: Zentralblatt Für Chirurgie
Gosuke Takiguchi, Tetsu Nakamura, Yasunori Otowa, Ayako Tomono, Shingo Kanaji, Taro Oshikiri, Satoshi Suzuki, Tsukasa Ishida, Yoshihiro Kakeji
Liposarcoma of the esophagus is very rare. We experienced a huge (27.5 × 11.6 cm) liposarcoma of the esophagus. A 73-year-old man presented with severe dyspnea requiring emergency tracheal intubation. Computed tomography and esophagogastroduodenoscopy showed a large submucosal tumor arising from the esophageal entrance and extending intraluminally to the lower esophagus. We successfully performed endoscopic submucosal dissection (ESD) and esophagotomy to remove the tumor, which preserved swallowing and phonation...
December 2016: Surgical Case Reports
Chang Jiang Li, Lei Cheng, Haitao Wu, Lei Tao, Liang Zhou
Ideal speech restoration remains a difficult challenge for patients undergoing laryngectomy so far. Our aim was to explore the feasibility of neoglottic reconstruction with sternohyoid muscles on upper-tracheal orifice after total laryngectomy which can obtain relatively ideal voice rehabilitation. Fifteen male patients are laryngectomized, of whom eight with standard total laryngectomy and seven underwent nonstandard total laryngectomy with epiglottis conserved. After laryngectomy, the upper margin of the anterior hypopharyngeal mucosa (postcricoid mucosa) was stitched to the posterior margin of upper-tracheal orifice and a triangle-shaped neoglottis on upper-tracheal orifice was reconstructed using bilateral sternohyoid muscles near the hyoid bone which were sutured to the posterior wall and bilateral of upper-tracheal orifice...
August 24, 2016: European Archives of Oto-rhino-laryngology
Nurul Hafizah Mohd Nor, Zurairah Berahim, Azlina Ahmad, Thirumulu Ponnuraj Kannan
Oral mucosa is a mucous membrane lining the oral cavity. Its main function is to protect the deeper structures against the external factors; thermal, chemical, mechanical and biological stimuli. Apart from that, it also plays a significant role during mastication, deglutition and speech. Some oral diseases or injuries to oral mucosa lead to impairment of the oral functions and aesthetics which eventually result in permanent defect of oral mucosa. In order to overcome this defect, different approaches for the development of reconstructed oral mucosa models have been employed including skin/autologous grafts, guided tissue replacement, vestibuloplasty etc...
August 17, 2016: Current Stem Cell Research & Therapy
Adam Basiago, Devin K Binder
Over the course of the development of deep brain stimulation (DBS) into a well-established therapy for Parkinson's disease, essential tremor, and dystonia, its utility as a potential treatment for autonomic dysfunction has emerged. Dysfunction of autonomic processes is common in neurological diseases. Depending on the specific target in the brain, DBS has been shown to raise or lower blood pressure, normalize the baroreflex, to alter the caliber of bronchioles, and eliminate hyperhidrosis, all through modulation of the sympathetic nervous system...
August 16, 2016: Brain Sciences
Alex J A McLellan, Matthew G D Bates, Shane D F Young, Paul B Sparks
Deglutition-induced atrial tachycardia is a rare arrhythmia with a poor response to medical therapy. Electrophysiological study is challenging due to the dependence of induction on swallowing. We present a novel approach to management of deglutition-induced atrial tachycardia arising from right superior pulmonary vein. Use of minimal conscious sedation and repeated swallow challenge inductions, together with contact force-guided mapping were key determinants of success. We review published cases, discussing potential mechanisms including oesophageal distension and neural reflexes...
November 2016: Heart, Lung & Circulation
Achille Tarsitano, Salvatore Battaglia, Leonardo Ciocca, Roberto Scotti, Riccardo Cipriani, Claudio Marchetti
The maxilla provides support to the overlying structures and contributes significantly to the overall facial appearance and to critical functions such as mastication, speech, and deglutition. Many different techniques have been used over the years to achieve this reconstructive goal. Modern computer-assisted surgery affords new methods for planning resections, as well as optimising reconstructive outcomes and functional rehabilitation. The aim of this study was to describe our experience with, and technique for, the functional, structural, and aesthetic reconstruction of maxillary bone defects using a computer-assisted design (CAD)/computer-assisted manufacturing (CAM)-printed titanium mesh to provide structural support for free flap reconstruction...
September 2016: Journal of Cranio-maxillo-facial Surgery
Makbule Heval Şahan, Görkem Eskiizmir, Pınar Ateş
Lip cancers can severely affect a person in terms of function, esthetics, and psychological trauma. After surgical resection, lip defects require special rehabilitation. This clinical report describes a neck prosthesis of a male patient diagnosed with lower lip squamous cell carcinoma with perineural involvement. The neck prosthesis was connected to the mandibular complete denture with cobalt samarium magnets. Both prostheses improved the patient's mastication, deglutition, and esthetics.
August 12, 2016: Journal of Prosthodontics: Official Journal of the American College of Prosthodontists
Chin-Man Wang, Hsueh-Yu Li, Li- Ang Lee, Wann-Yun Shieh, Shih-Wei Lin
The objectives of this study are to investigate swallowing and its coordination with respiration in patients with obstructive sleep apnea (OSA). This is a prospective cohort study conducted in a tertiary referred Medical Center. A non-invasive method of assessing swallowing was used to detect the oropharyngeal swallowing parameters and the coordination with respiration during swallowing. The system used to assess swallowing detected: (1) movement of the larynx using a force-sensing resistor; (2) submental muscle activity using surface electromyography; and (3) coordination with respiration by measuring nasal airflow...
August 12, 2016: Dysphagia
Taeheon Lee, Jung Ho Park, Chongil Sohn, Kyung Jae Yoon, Yong-Taek Lee, Jung Hwan Park, Il Seok Jung
Background/Aims: We attempted to examine the relationship between abnormal findings on high-resolution manometry (HRM) and videofluoroscopic swallowing study (VFSS) of the pharynx and upper esophageal sphincter (UES) and to identify the risk factors for aspiration. Methods: We performed VFSS and HRM on the same day in 36 ischemic stroke patients (mean age, 67.5 years) with dysphagia. Pressure (basal, median intra bolus, nadir), relaxation time interval of the UES, and mesopharyngeal and hypopharyngeal contractility (as a contractile integral) were examined using HRM...
August 10, 2016: Journal of Neurogastroenterology and Motility
Gabriel Ferreira Nicoloso, Iuri Silveira dos Santos, Jorge Abel Flores, Bruno Lopes da Silveira, Marta Dutra Machado Oliveira
Ankyloglossia entails short lingual frenum, impairing satisfactory tongue movement and leading to problems related to deglutition, feeding and diction. This clinical report uses laser technology, rather than traditional surgical procedure with scalpel, to perform a lingual frenulotomy on a 9-year old child diagnosed with ankyloglossia, aiming to investigate more conservative and less traumatic dental procedures. Due to the many advantages of the laser device, such as bloodless surgical field, absence of sutures, minimal swelling and post-surgical pain, the high intensity diode laser is a viable alternative technique in soft tissue surgeries...
2016: Journal of Clinical Pediatric Dentistry
Hagit Shoffel-Havakuk, Sharon Cahanovitc, Meital Adi, Oded Cohen, Yaara Haimovich, Yonatan Lahav, Doron Halperin
The aim of this study is to define the relationship between anatomical and pathological cervical structures and the impaction of ingested foreign bodies (FBs). The effects of such structures on deglutition have been previously discussed, however their contribution to FB impaction has not yet been examined. This was a retrospective case-control study of 171 patients who underwent computed tomography (CT) scans over the period 2008-2014: 57 patients with an esophageal or hypopharyngeal FB; the other 114 comprised the control group, selected using the 'neighbor control' method...
July 27, 2016: Dysphagia
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