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Modified Barium Swallow

Kristine E Day, Nicholas J Smith, Brian D Kulbersh
OBJECTIVE: Diagnosis and treatment of type 1 laryngeal clefts remains a challenge. The purpose of this study is to determine if early surgical intervention in type I laryngeal clefts improves outcomes. METHODS: A retrospective case series was conducted at an academic tertiary care children's hospital. 18 children undergoing early (≤3 months from diagnosis) surgical intervention for type I laryngeal cleft repair between August of 2012 and December 2014. Data was compiled through a manual chart review...
November 2016: International Journal of Pediatric Otorhinolaryngology
Jill M Merrow
The instinctual drive to gain nourishment can become complicated by structural differences, physiologic instability and environmental influences. Infants with craniofacial anomalies may experience significant feeding and swallowing difficulties related to the type and severity of the anomalies present as well as social-emotional interactions with caregivers. Typical outcome measures and feeding goals are discussed. Details regarding clinical and instrumental evaluation, including fiberoptic endoscopic evaluation of swallowing and modified barium swallow study, as well as management techniques are reported...
November 2016: Facial Plastic Surgery Clinics of North America
Memorie M Gosa, Pamela Dodrill
BACKGROUND: Unlike adult populations, who primarily depend on liquids for hydration alone, infants rely on liquids to provide them with hydration and nutrition. Speech-language pathologists working within pediatric medical settings often identify dysphagia in patients and subsequently recommend thickened liquids to reduce aspiration risk. Caregivers frequently report difficulty attempting to prepare infant formula to the prescribed thickness. MATERIALS AND METHODS: This study was designed to determine (1) the relationship between consistencies in modified barium swallow studies and thickened infant formulas and (2) the effects of time and temperature on the resulting thickness of infant formula...
August 31, 2016: Nutrition in Clinical Practice
Katherine A Hutcheson, Martha P Barrow, Denise A Barringer, Jodi K Knott, Heather Y Lin, Randal S Weber, Clifton D Fuller, Stephen Y Lai, Clare P Alvarez, Janhavi Raut, Cathy L Lazarus, Annette May, Joanne Patterson, Justin W G Roe, Heather M Starmer, Jan S Lewin
BACKGROUND: The National Cancer Institute's Common Terminology Criteria for Adverse Events (CTCAE) is the universal framework for toxicity reporting in oncology trials. The objective of this study was to develop a CTCAE-compatible modified barium swallow (MBS) grade for the purpose of grading pharyngeal dysphagia as a toxicity endpoint in cooperative-group organ-preservation trials for head and neck cancer (HNC). It was hypothesized that a 5-point, CTCAE-compatible MBS grade (Dynamic Imaging Grade of Swallowing Toxicity [DIGEST]) based on the interaction of pharyngeal residue and laryngeal penetration/aspiration ratings would be feasible and psychometrically sound...
August 26, 2016: Cancer
Loni C Arrese, Ricardo Carrau, Emily K Plowman
The Eating Assessment Tool-10 (EAT-10) represents a validated, easy to administer patient report dysphagia severity scale. Although its ability to detect swallowing impairment has been investigated in other patient populations, the utility of this instrument in individuals with head and neck cancer (HNC) has not been studied. The aim of the current investigation was to determine the relationship between patient ratings of swallowing impairment (EAT-10) and objective clinical ratings of swallow physiology in individuals with HNC...
August 18, 2016: Dysphagia
Janina Wilmskoetter, Teri Lynn Herbert, Heather S Bonilha
Gastrostomy feeding tubes are commonly placed in patients with dysphagia after stroke. The subsequent removal of the tube is a primary goal during rehabilitation. The purpose of our review was to identify predictors and factors associated with gastrostomy tube removal in patients with dysphagia after stroke. We conducted a literature review following the PRISMA statement and included the search databases PubMed, Scopus, Web of Science, and CINAHL. Articles were included in the final analysis per predefined inclusion and exclusion criteria...
August 9, 2016: Nutrition in Clinical Practice
Kathleen M Tibbetts, Derek Wu, Jeffrey V Hsu, William B Burton, Michel Nassar, Melin Tan
OBJECTIVE: Unilateral vocal fold immobility (UVFI) results in deficits in phonatory, respiratory, and swallow function of the pediatric patient. Little is known about long-term functional swallow outcomes. METHODS: Medical records of children diagnosed with UVFI between 2005 and 2014 at a tertiary children's hospital were retrospectively reviewed. Etiology, laryngoscopy findings, and swallow status at diagnosis and follow-up were recorded. Swallow outcomes were compared by etiology using Fisher's exact test...
September 2016: International Journal of Pediatric Otorhinolaryngology
Giovanni Bibbo, Debbie Balman, Rebecca Linke
INTRODUCTION: Diagnostic reference levels (DRL) of procedures involving ionising radiation are important tools for optimising radiation doses delivered to patients and to identify cases where the levels of dose are unusually high. This is particularly important for paediatric patients undergoing fluoroscopic examinations as these examinations can be associated with a high radiation dose. In this study, a large amount of paediatric fluoroscopic data has been analysed to: establish local DRL, identify the most significant factors determining radiation dose to patients, and modify fluoroscopic techniques to optimise the examination protocols...
August 2016: Journal of Medical Imaging and Radiation Oncology
Leanne K Jackson, Sheila H Ridner, Jie Deng, Carmin Bartow, Kyle Mannion, Ken Niermann, Jill Gilbert, Mary S Dietrich, Anthony J Cmelak, Barbara A Murphy
BACKGROUND: Tumor/treatment-related internal lymphedema (IL) and/or external lymphedema (EL) are associated with functional deficits and increased symptom burden in head and neck cancer patients (HNCP). Previously, we noted association between EL/IL and patient-reported dysphagia using the Vanderbilt Head and Neck Symptom Survey (VHNSS) version 1.0. OBJECTIVE: To determine the relationship between IL/EL and subjective and objective measures of swallowing function...
September 2016: Journal of Palliative Medicine
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
Katherine A Kendall, Julia Ellerston, Amanda Heller, Daniel R Houtz, Chong Zhang, Angela P Presson
Quantitative, reliable measures of swallowing physiology can be made from an modified barium swallowing study. These quantitative measures have not been previously employed to study large dysphagic patient populations. The present retrospective study of 139 consecutive patients with dysphagia seen in a university tertiary voice and swallowing clinic sought to use objective measures of swallowing physiology to (1) quantify the most prevalent deficits seen in the patient population, (2) identify commonly associated diagnoses and describe the most prevalent swallowing deficits, and (3) determine any correlation between objective deficits and Eating Assessment Tool (EAT-10) scores and body mass index...
August 2016: Dysphagia
Jessica M Pisegna, Susan E Langmore
The aim of this study was to compare selected parameters of two swallow evaluations: fiberoptic endoscopic evaluation of swallowing (FEES) and the modified barium swallow (MBS) study. This was a cross-sectional, descriptive study. Fifty-five clinicians were asked to watch video recordings of swallow evaluations of 2 patients that were done using fluoroscopy and endoscopy simultaneously. In a randomized order, clinicians viewed 4 edited videos from simultaneous evaluations: the FEES and MBS videos of patient 1 and 2 each taking one swallow of 5 mL applesauce...
June 2016: Dysphagia
Andrés Sánchez-Pernaute, Pablo Talavera, Elia Pérez-Aguirre, Inmaculada Domínguez-Serrano, Miguel Ángel Rubio, Antonio Torres
BACKGROUND: Observational studies based on quality-of-life and endoscopy relate sleeve gastrectomy (SG) to gastroesophageal reflux disease (GERD), while some functional studies have demonstrated a decrease in esophageal exposure to gastric acid after SG. Currently, it is recommended to treat hiatal hernia along with the SG. However, as the sleeve gastrectomy involves the resection of the fundus, it is not possible to add a traditional fundoplication to the closure of the hiatus. METHODS: Based on the classic works of Hill et al...
April 2016: Obesity Surgery
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
Tyler Crosby, Jeff Phillips, Alberto Carbo, Kelley Babcock, Cherie-Ann Nathan
Conclusion Measurement of the posterior airway space (PAS) using modified barium swallow (MBS) appears to correlate well with CT imaging. This data suggests MBS may be a low-cost alternative imaging modality to assess obstructive sleep apnea patients. Objectives Obstructive sleep apnea research has focused on imaging modalities that supplement polysomnography in evaluation of potential sites of airway obstruction. While several techniques have been used to assess the PAS, many incur significant costs and risks to the patient...
June 2016: Acta Oto-laryngologica
Go Miyano, Hiromu Miyake, Mariko Koyama, Keiichi Morita, Masakatsu Kaneshiro, Hiroshi Nouso, Masaya Yamoto, Koji Fukumoto, Naoto Urushihara
This study presents a modified surgical approach to laparoscopic myotomy for achalasia using stepped dilation with a Rigiflex balloon and contrast medium under image guidance. A 10-year-old boy with persistent dysphagia and vomiting had ingested only liquids for 3 months, losing >10 kg in body weight. Barium swallow and esophageal manometry diagnosed esophageal achalasia with mild esophageal dilatation. After failed pneumatic dilatation, laparoscopic Heller myotomy with Dor fundoplication was performed...
May 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Daniel R Duncan, Janine Amirault, Nikki Johnston, Paul Mitchell, Kara Larson, Rachel L Rosen
OBJECTIVES: Gastroesophageal reflux is common but remains a controversial disease to diagnose and treat and little is known about the role of reflux testing in predicting clinical outcomes, particularly in children at risk for extraesophageal reflux complications. The aim of this study was to determine if rates of hospitalization were affected by reflux burden even after adjusting for aspiration risk. METHODS: We prospectively recruited, between 2009 and 2014, a cohort of pediatric patients with suspected extraesophageal reflux disease who were referred for reflux testing and underwent both multichannel intraluminal impedance with pH (pH-MII) and modified barium swallow studies...
August 2016: Journal of Pediatric Gastroenterology and Nutrition
Udo Hoffmann, Scott R Akers, Richard K J Brown, Kristopher W Cummings, Ricardo C Cury, S Bruce Greenberg, Vincent B Ho, Joe Y Hsu, James K Min, Kalpesh K Panchal, Arthur E Stillman, Pamela K Woodard, Jill E Jacobs
Primary imaging options in patients at low risk for coronary artery disease (CAD) who present with undifferentiated chest pain and without signs of ischemia are functional testing with exercise or pharmacologic stress-based electrocardiography, echocardiography, or myocardial perfusion imaging to exclude myocardial ischemia after rule-out of myocardial infarction and early cardiac CT because of its high negative predictive value to exclude CAD. Although possible, is not conclusive whether triple-rule-out CT (CAD, pulmonary embolism, and aortic dissection) might improve the efficiency of patient management...
December 2015: Journal of the American College of Radiology: JACR
Julia K Ellerston, Amanda C Heller, Daniel R Houtz, Katherine A Kendall
OBJECTIVE: Dysphagia and associated aspiration pneumonia are commonly reported sequelae of Parkinson's disease (PD). Previous studies of swallowing in patients with PD have described prolonged pharyngeal transit time, delayed onset of pharyngeal transit, cricopharyngeal (CP) achalasia, reduced pharyngeal constriction, and slowed hyolaryngeal elevation. These studies were completed using inconsistent evaluation methodology, reliance on qualitative analysis, and a lack of a large control group, resulting in concerns regarding diagnostic precision...
May 2016: Annals of Otology, Rhinology, and Laryngology
Bhishamjit S Chera, Robert J Amdur, Joel Tepper, Bahjat Qaqish, Rebecca Green, Shannon L Aumer, Neil Hayes, Jared Weiss, Juneko Grilley-Olson, Adam Zanation, Trevor Hackman, William Funkhouser, Nathan Sheets, Mark Weissler, William Mendenhall
PURPOSE: To perform a prospective, multi-institutional, phase 2 study of a substantial decrease in concurrent chemoradiation therapy (CRT) intensity as primary treatment for favorable-risk, human papillomavirus-associated oropharyngeal squamous cell carcinoma. METHODS AND MATERIALS: The major inclusion criteria were: (1) T0 to T3, N0 to N2c, M0; (2) human papillomavirus or p16 positive; and (3) minimal/remote smoking history. Treatment was limited to 60 Gy intensity modulated radiation therapy with concurrent weekly intravenous cisplatinum (30 mg/m(2))...
December 1, 2015: International Journal of Radiation Oncology, Biology, Physics
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