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Pharyngeal dysphagia

Sang Hee Ha, Min-Soo Kim, Jiwoo Suh, Jong Seok Lee
PURPOSE: The self-pressurized air-Q® (air-Q SP) intubating laryngeal airway is a relatively new supraglottic airway (SGA) device. The intracuff pressure of air-Q dynamically equilibrates with the airway pressure and adjusts to the patient's pharyngeal and periglottic anatomy, potentially providing improved airway fit and seal. The aim of this prospective randomized study was to compare the clinical performance of air-Q to the LMA® Classic™ SGA. METHODS: Adult patients requiring general anesthesia for elective surgery were prospectively enrolled and randomly assigned to either air-Q SP or the LMA Classic SGA...
February 6, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Jitsuro Yano, Yoichiro Aoyagi, Takahiro Ono, Kazuhiro Hori, Wakami Yamaguchi, Shigehiro Fujiwara, Isami Kumakura
The effects of bolus volume and flow time on the sequential coordination of tongue pressure (TP) and pharyngeal pressure (PP), which are important in the biomechanics of swallowing, are unclear. In this study, we measured TP and PP simultaneously in 10 healthy adults at multiple points during dry swallowing and the swallowing of 5 ml and 15 ml of liquids with different viscosities, and investigated changes in the timing of the onset, peak, and offset of these pressures. TP was measured using a sensor sheet system with five measuring points on the hard palate, and PP was measured using a manometry catheter with four measuring points...
March 6, 2018: Physiology & Behavior
A R Watkins, E J Parente
BACKGROUND: Guttural pouch mycosis (GPM) is a cause of nasal discharge, dysphagia, and fatal haemorrhage in the horse. OBJECTIVES: To report the complications and success of salpingopharyngeal fistulation in horses with GPM. We hypothesised that creating a direct static opening into the guttural pouch from the pharynx would cause a regression of fungal plaques due to a change in the guttural pouch environment and that this treatment would result in resolution of infection prior to secondary complications...
March 7, 2018: Equine Veterinary Journal
Hyojun Kim, Ho Jun Lee, Jin-Woo Park
Background: The objective of this study was to investigate the clinical course and final outcome in patients afflicted with severe dysphagia following a diagnosis of lateral medullary syndrome (LMS). Methods: The patients with severe dysphagia after LMS admitted to a rehabilitation unit were included and their respective clinical data were prospectively collected. The criteria of 'severe dysphagia' was defined as the condition that showed decreased pharyngeal constriction with no esophageal passage in a videofluoroscopic swallowing study (VFSS) and initially required enteral tube feeding...
2018: Therapeutic Advances in Neurological Disorders
Lizhi Zhang, Nenggui Xu, Ruliang Li, Lin Wang
OBJECTIVE: To observe the effects of electroacupuncture (EA) with different frequencies based on the western conventional treatment and rehabilita tion training for stroke dysphagia. METHODS: Sixty patients with dysphagia after stroke were randomized assigned into a low frequency (2 Hz) group and a high frequency (100 Hz) group, 30 cases in each one. Basic treatment was applied in the two groups. The acupoints were Fengfu (GV 16) and Lianquan (CV 23). EA with continuous wave and tolerant intensity were connected for 30 min, once a day for 14 days...
February 12, 2018: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
Paul Muhle, Sonja Suntrup-Krueger, Rainer Dziewas, Tobias Warnecke
Varicella zoster virus reactivation is a rare cause of pharyngeal dysphagia with long-term sequelae persisting in most cases. A 76-year-old immunocompetent woman presented with a 4-week history of dysphagia and dysphonia. Brain magnetic resonance imaging displayed a negative finding. Fiberoptic endoscopic evaluation of swallowing showed a severe dysphagia leading to a percutaneous gastrostomy eventually. Cerebrospinal fluid analysis revealed a lymphocytic pleocytosis and polymerase chain reaction amplified Varicella zoster virus DNA...
2018: SAGE Open Medical Case Reports
Ryuichi Azuma, Shimpo Aoki, Masahiro Kuwabara, Tetsushi Aizawa, Hisato Nagano, Tomoharu Kiyosawa
Hinge flaps are commonly used for closure of a pharyngocutaneous fistula (PCF) or laryngocutaneous fistula. These flaps are employed to augment the wall of the pharynx or larynx, but the junction between the reconstructed and native lumens can eventually become narrow and irregular after reconstruction with standard hinge flaps. We devised a method of adding a triangular extension to the end of either or both flaps and used it to treat 3 patients. In 1 patient who developed a PCF (4 × 10 cm) after laryngectomy followed by radiotherapy, the fistula was closed with 2 hinge flaps...
January 2018: Plastic and Reconstructive Surgery. Global Open
Hai-Xiang Yu, Chun-Shan Han, Jin-Ru Xue, Zhi-Feng Han, Hua Xin
Esophageal hiatal hernia involves abnormal abdominal entry into thoracic cavity. It is classified based on orientation between esophageal junction and diaphragm. Sliding hiatal hernia (Type-I) comprises the most frequent category, emanating from right crus of diaphragm. Type-II esophageal hernia engages both left and right muscular crura. Type-III and IV additionally include the left crus. Age and increased body mass index are key risk factors, and congenital skeletal aberrations trigger pathogenesis through intestinal malrotations...
April 2018: Expert Review of Gastroenterology & Hepatology
Rebecca F D'Cruz, Patrick B Murphy, Georgios Kaltsakas
Motor neurone disease (MND) is a neurodegenerative disease defined by axonal loss and gliosis of upper and lower motor neurones in the motor cortex, lower brainstem nuclei and ventral horn of the spinal cord. MND is currently incurable and has a poor prognosis, with death typically occurring 3 to 5 years after disease onset. The disease is characterised by rapidly progressive weakness leading to paralysis, fasciculations, bulbar symptoms (including dysarthria and dysphagia) and respiratory compromise. Respiratory complications arise as a result of weakness of upper airway (pharyngeal and laryngeal) muscles and respiratory muscles (diaphragm, intercostal and accessory muscles) leading to respiratory failure...
January 2018: Journal of Thoracic Disease
Louisa Ferrara, Ranjith Kamity, Shahidul Islam, Irene Sher, Dan Barlev, Laurie Wennerholm, Fran Redstone, Nazeeh Hanna
Cold stimulation reduces airway compromise in adults with dysphagia. However, there is no sufficient evidence to support its use in the pediatric population. The primary goal of this pilot study is to assess the effect of cold liquid on the pharyngeal swallow mechanism in preterm infants with dysphagia. We hypothesized that thermal stimulation from cold liquid will decrease the risk of airway compromise in dysphagic preterm infants. Nine preterm infants with clinical symptoms of dysphagia were included. Video fluoroscopic swallow studies were used to assess the swallowing mechanism of each participant...
February 12, 2018: Dysphagia
Sauid Ishaq, Haleema Sultan, Keith Siau, Toshio Kuwai, Chris J Mulder, Helmut Neumann
Zenker's diverticulum (ZD), or pharyngeal pouch, is an anatomical defect characterized by herniation of the posterior pharyngeal wall through Killian's dehiscence, and may result in dysphagia and regurgitation. Multiple therapeutic modalities including surgery, rigid and flexible endoscopy have been developed to manage ZD. Although surgical management with open and endoscopically assisted techniques have historically been the mainstay of ZD treatment, minimally invasive flexible endoscopic techniques, carried out under conscious sedation, are increasingly favored...
February 9, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Nicole Pizzorni, Antonio Schindler, Marco Fantini, Andy Bertolin, Giuseppe Rizzotto, Federico Ambrogi, Giovanni Succo, Erika Crosetti
BACKGROUND: Several studies have previously analyzed the relationship between QOL and signs of dysphagia in patients treated for head and neck cancer and have reported heterogeneous findings. To the best of our knowledge, no study has previously investigated this relationship among patients who underwent open partial horizontal laryngectomy (OPHL). The aim of the study is to determine if patient-reported swallowing-related QOL can discriminate between safe and unsafe swallowing in OPHL patients...
February 8, 2018: European Archives of Oto-rhino-laryngology
Ebru Karaca Umay, Fatih Karaahmet, Eda Gurcay, Fatma Balli, Erhan Ozturk, Ozgur Karaahmet, Yasemin Eren, Tijen Ceylan
We evaluated swallowing function in patients with myasthenia gravis (MG) with or without dysphagia symptoms using different evaluation parameters and compared the results with those of healthy subjects. A total of 36 patients with MG and 25 healthy volunteers were included in the study. The subjects were classified into three groups; patients without dysphagia (group 1), patients with dysphagia (group 2), and healthy participants (group 3). The presence and severity of dysphagia, the oropharyngeal, pharyngeal, pharyngoesophageal, and esophageal phases were assessed using a screening test, manometric test, electrophysiologic studies [electroneuromyography (EMG)], fiberoptic endoscopic evaluation of swallowing (FEES), and barium swallow pharyngeal esophagography (BSPE), respectively...
February 7, 2018: Acta Neurologica Belgica
Mariko Matsubara, Haruka Tohara, Koji Hara, Hiromichi Shinozaki, Yasuhiro Yamazaki, Chiaki Susa, Ayako Nakane, Yoko Wakasugi, Shunsuke Minakuchi
Purpose: This study was aimed to examine the effectiveness of a high-speed jaw-opening exercise, which targets the contraction of fast-twitch muscle fibers, in improving swallowing function. Subjects and methods: Twenty-one subjects (mean age 74.0±5.7 years) with dysphagia-related symptoms, such as coughing or choking during eating, performed the exercise. None of the included subjects had neurological symptoms or history of surgery that could cause significant dysphagia...
2018: Clinical Interventions in Aging
Paul Muhle, Inga Claus, Thomas Marian, Jens B Schröder, Andreas Wollbrink, Christo Pantev, Tobias Warnecke, Rainer Dziewas, Sonja Suntrup-Krueger
BACKGROUND/AIMS: Performing neurophysiological and functional imaging studies in severely affected patients to investigate novel neurostimulation techniques for the treatment of neurogenic dysphagia is difficult. Therefore, basic research needs to be conducted in healthy subjects. Swallowing is a motor function highly dependent on sensory afferent input. Here we propose a virtual peripheral sensory lesion model to mimic pharyngeal sensory impairment, which is known as a major contributor to dysphagia in neurological disease...
January 25, 2018: Neuro-Signals
Elisa Andrenelli, Federica Lucia Galli, Rosaria Gesuita, Edlira Skrami, Francesco Ottavio Logullo, Leandro Provinciali, Marianna Capecci, Maria Gabriella Ceravolo, Michela Coccia
BACKGROUND: Dysphagia is a critical symptom of Neuromuscular Diseases and is often associated with considerable morbidity and mortality. OBJECTIVE: This study is designed to investigate the prevalence of dysphagia and to identify different clinical profiles of swallowing disorders in Myotonic Dystrophy type 1 (DM1) and Amyotrophic Lateral Sclerosis (ALS), the most common Neuromuscular Diseases in the adult age. METHODS: Consecutive DM1 and ALS patients from 2013 to 2015 referred to a Centre for Neuromuscular Disease were enrolled...
2018: NeuroRehabilitation
Jamie Dean, Kee Wong, Hiram Gay, Liam Welsh, Ann-Britt Jones, Ulricke Schick, Jung Hun Oh, Aditya Apte, Kate Newbold, Shreerang Bhide, Kevin Harrington, Joseph Deasy, Christopher Nutting, Sarah Gulliford
Severe acute dysphagia commonly results from head and neck radiotherapy (RT). A model enabling prediction of severity of acute dysphagia for individual patients could guide clinical decision-making. Statistical associations between RT dose distributions and dysphagia could inform RT planning protocols aiming to reduce the incidence of severe dysphagia. We aimed to establish such a model and associations incorporating spatial dose metrics. Models of severe acute dysphagia were developed using pharyngeal mucosa (PM) RT dose (dose-volume and spatial dose metrics) and clinical data...
January 2018: Clinical and Translational Radiation Oncology
F Espitalier, A Fanous, J Aviv, S Bassiouny, G Desuter, N Nerurkar, G Postma, L Crevier-Buchman
OBJECTIVE: To present international recommendations regarding the proper evaluation of oropharyngeal dysphagia (OD), both objectively and subjectively (self-evaluation). METHODS: Following a thorough review of the literature, 5 experts in the field from 4 different continents answered separately a questionnaire regarding the work-up of OD. Individual answers were presented and discussed during the world ENT conference that was held in Paris in June 2017. This article will present the recommendations issued from that meeting...
January 26, 2018: European Annals of Otorhinolaryngology, Head and Neck Diseases
Xiaoning Li, Lei Wu, Fan Guo, Xuesong Liang, Hao Fu, Nuo Li
RATIONALE: Dysphagia following stroke is a major complaint among patients, and effective treatment of post-stroke dysphagia can be difficult. We present a case report describing a new treatment for dysphagia, namely, quick needle insertion at pharyngeal acupoints. PATIENT CONCERNS: A 70-year-old man developed pharyngeal dysphagia after a stroke. Three months after the patient experienced a sudden stroke leading to liquid dysphagia, acupuncture, one of the most important therapies in Traditional Chinese Medicine, was used to treat the patient...
December 2017: Medicine (Baltimore)
Stefania Gallo, Francesco Bandi, Marco-Paolo Maffioli, Marco Giudice, Paolo Castelnuovo, Enrico Fazio, Apostolos Karligkiotis
Introduction: Retropharyngeal space schwannomas are rare entities. About 20-45% of schwannomas occur in the head and neck region; however, they represent less than 1% of all head and neck tumors. Case Report: We present the case of a 36-year-old woman complaining of dysphagia caused by a large schwannoma arising in the posterior pharyngeal wall with remarkable reduction of the oropharyngeal space. The tumor was resected through a combined transoral and cervicotomic transmandibular approach due to its dimension...
November 2017: Iranian Journal of Otorhinolaryngology
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