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Pharyngeal dysphagia

Roxann Diez Gross, Ronit Gisser, Gregory Cherpes, Katie Hartman, Rishi Maheshwary
Prader-Willi Syndrome (PWS) is caused by a genetic imprinting abnormality resulting from the lack of expression of the paternal genes at 15q11-q13. Intellectual disability, low muscle tone, and life-threatening hyperphagia are hallmarks of the phenotype. The need for the Heimlich maneuver, death from choking, and pulmonary infection occur in a disproportionally high number of persons with PWS. The widely held belief is that eating behaviors are responsible for choking and aspiration; yet, no investigation had sought to determine if swallowing impairments were present in persons with PWS...
October 19, 2016: American Journal of Medical Genetics. Part A
F Bootz, S Greschus, T van Bremen
The parapharyngeal space extends from the nasopharynx to the oropharynx. It is bordered medially by the pharyngeal wall and the constrictor pharyngis muscles, and laterally by the mandible. One distinguishes between a pre- and a poststyloid space. Tumors of the parapharyngeal space are rare and represent less than 1 % of all head and neck neoplasms. Benign (70-80 %) as well as malignant (20-30 %) tumors arise from different structures of the parapharyngeal space, mainly from salivary glands and nerve structures...
October 18, 2016: HNO
N M Giannantoni, M Minisci, V Brunetti, E Scarano, E Testani, C Vollono, E De Corso, G Bastanza, L D'Alatri, G Della Marca
Oro-pharyngeal dysphagia is frequently present during the acute phase of stroke. The aim of the present study was to evaluate whether the recording of surface EMG using a nasopharyngeal (NP) electrode could be applied to evaluation of pharyngeal muscle activity in acute stroke patients and if this neurophysiological measure is related with clinical assessment of swallowing. Patients were examined and clinical severity was assessed with the National Institute of Health Stroke Scale (NIHSS) score; dysphagia was evaluated through bedside screening test using the Gugging Swallowing Scale (GUSS)...
August 2016: Acta Otorhinolaryngologica Italica
Imran Petkar, Keith Rooney, Justin W G Roe, Joanne M Patterson, David Bernstein, Justine M Tyler, Marie A Emson, James P Morden, Kathrin Mertens, Elizabeth Miles, Matthew Beasley, Tom Roques, Shreerang A Bhide, Kate L Newbold, Kevin J Harrington, Emma Hall, Christopher M Nutting
BACKGROUND: Persistent dysphagia following primary chemoradiation (CRT) for head and neck cancers can have a devastating impact on patients' quality of life. Single arm studies have shown that the dosimetric sparing of critical swallowing structures such as the pharyngeal constrictor muscle and supraglottic larynx can translate to better functional outcomes. However, there are no current randomised studies to confirm the benefits of such swallow sparing strategies. The aim of Dysphagia/Aspiration at risk structures (DARS) trial is to determine whether reducing the dose to the pharyngeal constrictors with dysphagia-optimised intensity- modulated radiotherapy (Do-IMRT) will lead to an improvement in long- term swallowing function without having any detrimental impact on disease-specific survival outcomes...
October 6, 2016: BMC Cancer
Keiko Tamaki, Jun Tsugawa, Takeshi Murakami, George Umemoto, Yoshio Tsuboi
A 59-year-old man developed a sudden onset of vertigo and nausea, and after a few hours, he could not swallow at all. On admission, neurological examination revealed severe dysphagia associated with other transient and mild neurological deficits, including left facial paresis, and hypesthesia in the right side of his body. MRI with diffusion weighted imaging showed a hyperintense signal lesion at the left rostral medial region of the medulla, prompting the diagnosis of an acute medial medullary infarction. His facial paresis and hypesthesia disappeared within 2 weeks...
October 2016: Brain and Nerve, Shinkei Kenkyū No Shinpo
Karin Söderström, Per Nilsson, Göran Laurell, Björn Zackrisson, Eva Levring Jäghagen
PURPOSE: To establish predictive models for late objective aspiration and late patient-reported choking based on dose-volume parameters and baseline patient and treatment characteristics, for patients with head and neck cancer undergoing definitive radiotherapy (RT). The impact of electively treated volume on late aspiration was also investigated. METHODS AND MATERIAL: This prospective cohort is a subsample of 124 survivors from the ARTSCAN study. Late aspiration was identified with videofluoroscopy, at a minimum of 25months after the start of RT...
September 26, 2016: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Stuart E Samuels, Avraham Eisbruch, Karen Vineberg, Jae Lee, Choonik Lee, Martha M Matuszak, Randall K Ten Haken, Kristy K Brock
PURPOSE: Strategies to reduce the toxicities of head and neck radiation (ie, dysphagia [difficulty swallowing] and xerostomia [dry mouth]) are currently underway. However, the predicted benefit of dose and planning target volume (PTV) reduction strategies is unknown. The purpose of the present study was to compare the normal tissue complication probabilities (NTCP) for swallowing and salivary structures in standard plans (70 Gy [P70]), dose-reduced plans (60 Gy [P60]), and plans eliminating the PTV margin...
November 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Toshiyuki Sakai, Masahide Kondo, Hidekazu Tomimoto, Yuko Yamagishi
We report a 28-year-old woman with the overlap of Fisher syndrome and pharyngeal-cervical-brachial variant of Guillain-Barré syndrome associated with urinary retention and constipation. She showed total ophthalmoplegia, dysphagia, dysarthria, upper extremity weakness, cerebellar ataxia, slightly diminished superficial sensations in her hands and feet, urinary retention and constipation 14 days after preceding infection. Laboratory data showed elevations of antiganglioside antibodies to GT1b, GD1b, GQ1b, GD3 and GT1a in the IgG subclass...
September 28, 2016: Rinshō Shinkeigaku, Clinical Neurology
K Ishikawa, M Inada, K Fukuda, H Tatebe, K Nakamatsu, S Kanamori, Y Nishimura
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Naomi Yagi, Shinsuke Nagami, Meng-Kuan Lin, Toru Yabe, Masataka Itoda, Takahisa Imai, Yoshitaka Oku
: The assessment of swallowing function is important for the prevention of aspiration pneumonia. We developed a new swallowing monitoring system that uses respiratory flow, swallowing sound, and laryngeal motion. We applied this device to 11 healthy volunteers and 10 patients with dysphagia. Videofluoroscopy (VF) was conducted simultaneously with swallowing monitoring using our device. We measured laryngeal rising time (LRT), the time required for the larynx to elevate to the highest position, and laryngeal activation duration (LAD), the duration between the onset of rapid laryngeal elevation and the time when the larynx returned to the lowest position...
September 24, 2016: Medical & Biological Engineering & Computing
N Makaram, R Gohil, Q Gardiner, J Manickavasagam
We report an unusual case of nasopharyngeal carcinoma (NPC), presenting initially as a retropharyngeal collection. We discuss the investigation, diagnosis and management of NPC and furthermore review the literature of NPC, emphasising the varied presentation. A 44-year-old Caucasian male ex-smoker presented with a 10-day history of a painless left-sided neck lump; progressive dysphagia and unintentional weight loss. Examination demonstrated a large left posterior pharyngeal swelling with soft palatal effacement, confirmed on nasoendoscopy...
2016: BMJ Case Reports
Hafiz Muhammad Sharjeel Arshad, Aleida Rodriguez, Faten Suhail
Background. The Syndrome of Inappropriate Antidiuretic Hormone (SIADH) is considered to be the most common cause of euvolemic hyponatremia. The most common malignancy associated with SIADH is small cell lung cancer. We present a rare case of a patient with SIADH secondary to well differentiated squamous cell carcinoma of the naso-oropharynx. Case. A 46-year-old Caucasian woman presented to emergency department with four-week history of progressive dysphagia. On examination, she was found to have a pharyngeal mass...
2016: Case Reports in Nephrology
Anna F Rumbach, Rebecca Cremer, Astra Chatwood, Sari Fink, Sadaf Haider, Michelle Yee
Purpose: Dysphagia is common sequelae of chemical ingestion injury, resulting from damage to critical swallowing structures. From a speech-language pathology perspective, this study outlines the physiological deficits in 2 individuals with severe injury (1 woman, acid; 1 man, alkali) and the pattern of dysphagia rehabilitation and recovery. Method: A retrospective chart review of clinical and instrumental assessments was conducted to examine swallow characteristics and speech-language pathology management (compensatory and rehabilitation strategies) at multiple time points...
September 14, 2016: American Journal of Speech-language Pathology
Yuka Miura, Gojiro Nakagami, Koichi Yabunaka, Haruka Tohara, Koji Hara, Hiroshi Noguchi, Taketoshi Mori, Hiromi Sanada
AIMS: Prevention of aspiration pneumonia is a great concern in the era of global aging. The assessment of pharyngeal post-swallow residue is important because remaining food and liquid in the pharyngeal area has a possibility of flowing into the lower airway which can cause aspiration pneumonia. Ultrasound examination has been recently used to assess swallowing disorders because of its noninvasiveness. The aim of this study was to investigate the performance for detecting pharyngeal post-swallow residue using an ultrasound examination by comparing with those using a fiberoptic endoscopic evaluation of a swallowing study as a reference...
September 2016: Medical Ultrasonography
Cheryl Hersh, Carissa Wentland, Sarah Sally, Marie de Stadler, Steven Hardy, M Shannon Fracchia, Bob Liu, Christopher Hartnick
INTRODUCTION: Radiation exposure is recognized as having long term consequences, resulting in increased risks over the lifetime. Children, in particular, have a projected lifetime risk of cancer, which should be reduced if within our capacity. The objective of this study is to quantify the amount of ionizing radiation in care for children being treated for aspiration secondary to a type 1 laryngeal cleft. With this baseline data, strategies can be developed to create best practice pathways to maintain quality of care while minimizing radiation exposure...
October 2016: International Journal of Pediatric Otorhinolaryngology
K Sudhakar, Y K Areti, L N Kurnutala, G Jibara, S M Lashley, S B Nanduri, P S Chami, M T Kakoory, C A Maynard
Objective: To evaluate the clinical features of angio-oedema (AE) and their correlation with fibre-optic nasolaryngoscopy (FNL) findings. Methods: The charts of adult AE patients for 225 episodes who were admitted as in-patients from January 2002 through December 2012 were reviewed. Results: Of the 51 episodes (22.6%) with laryngeal swelling, 16 had exclusively laryngeal swelling; without oropharyngeal swelling. Swelling of the laryngeal structures on FNL was not significantly associated with a suspected aetiology or history of AE or allergies...
March 9, 2016: West Indian Medical Journal
S Onodera, J Furuya, H Yamamoto, Y Tamada, H Kondo
Wearing dentures and dysphagia are common in older individuals; however, it is still unknown how dentures affect oral and pharyngeal swallowing. The purpose of this study was to reveal the effects of wearing and removing dentures on oropharyngeal movements during pharyngeal swallowing in the feeding sequence of solid food. Participants were 25 edentulous volunteers (nine men, 16 women; mean age 76·2 years) who wore complete dentures. The test food was minced agar jelly containing barium sulphate. Subjects were instructed to feed and swallow the test food with or without dentures during observation using videofluorography...
November 2016: Journal of Oral Rehabilitation
Kyung Rok Ko, Hee Jung Park, Jung Keun Hyun, In-Hyo Seo, Tae Uk Kim
OBJECTIVE: To investigate the effect of laryngopharyngeal neuromuscular electrical stimulation (NMES) on dysphonia in patients with dysphagia caused by stroke or traumatic brain injury (TBI). METHODS: Eighteen patients participated in this study. The subjects were divided into NMES (n=12) and conventional swallowing training only (CST, n=6) groups. The NMES group received NMES combined with CST for 2 weeks, followed by CST without NMES for the next 2 weeks. The CST group received only CST for 4 weeks...
August 2016: Annals of Rehabilitation Medicine
P Graff, V Woisard, S Racadot, J Thariat, Y Pointreau
Radio-induced pharyngolaryngeal chronic disorders may challenge the quality of life of head and neck cancer long survivors. Many anatomic structures have been identified as potentially impaired by irradiation and responsible for laryngeal edema, dysphonia and dysphagia. Some dose constraints might be plausible such as keeping the mean dose to the pharyngeal constrictor muscles under 50 to 55Gy, the mean dose to the supra-glottic larynx under 40 to 45Gy and, if feasible, the mean dose to the glottic larynx under 20Gy...
October 2016: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Takehiro Karaho, Junko Nakajima, Tetsuya Satoh, Keisuke Kawahara, Takeshi Nakayama, Naoyuki Kohno
OBJECTIVE: Mano-videoendoscopy (MVE) is a manometry technique with endoscopic confirmation of the pressure catheter. This study aimed to investigate the possibility of replacing a videofluorographic swallowing study (VFSS) with MVE for the precise evaluation of the pharyngeal contraction and the upper esophageal sphincter (UES) function. METHODS: The data from 69 patients with dysphagia were retrospectively reviewed. All of the patients underwent both MVE and a VFSS for the evaluation of dysphagia...
August 29, 2016: Auris, Nasus, Larynx
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