Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Extrinsic compression, neoplastic involvement of the trachea or left main bronchus, and esophago-airway fistula may cause airway obstruction and infection in patients with esophageal carcinoma. Further reduction of airway lumen may result from palliative treatment of dysphagia by radiation or esophageal stent insertion. In order to evaluate the extent of airway compromise, bronchoscopy was systematically performed in 39 consecutive patients with advanced carcinoma of the esophagus requiring esophageal endoprostheses. Airway obstruction observed in 10 patients (mean age, 60 years) resulted in the additional placement of a silicone stent in the trachea (five patients) or left main bronchus (five patients). Esophageal and airway procedures were performed under general anesthesia. All had squamous cell carcinoma of the middle third of the esophagus. Severe dyspnea at rest was documented in five patients prior to intervention. Esophago-tracheal fistula was present in five. Eight patients with associated, neoplastic invasion of the tracheo-bronchial tree required airway Nd:YAG laser therapy. The esophageal prosthesis contributed significantly to airway compromise in four patients. Symptomatic relief of dysphagia and dyspnea was obtained in all individuals. Mean survival was 121 days (range, 12 to 350 days). Complications were not serious, but included esophageal or tracheal stent migration in three patients.
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PMID:Double stents for carcinoma of the esophagus invading the tracheo-bronchial tree. 138 Sep 32

Airway obstruction, dysphagia and mediastinal masses are the most common causes for surgery of the mediastinum in the pediatric age group. From 1976-1990, 82 children underwent such surgery: 7 tracheoplasties, 4 endotracheal resection of a membrane, 6 stenoses due to haemangioma or lymphangioma, 2 papillomatosis of the trachea, 8 pexes of the aorta or the innominate artery due to tracheomalacia, 7 vascular rings (4 right descendent aorta, 3 double aortic arch), 4 congenital esophageal stenoses, 44 mediastinal tumors (20 malignant, 24 benign lesions).
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PMID:[Pediatric surgery emphasis in diseases of the mediastinum]. 198 70

Compression of the paediatric airway is a relatively common and often unrecognized complication of congenital cardiac and aortic arch anomalies. Airway obstruction may be the result of an anomalous relationship between the tracheobronchial tree and vascular structures (producing a vascular ring) or the result of extrinsic compression caused by dilated pulmonary arteries, left atrial enlargement, massive cardiomegaly, or intraluminal bronchial obstruction. A high index of suspicion of mechanical airway compression should be maintained in infants and children with recurrent respiratory difficulties, stridor, wheezing, dysphagia, or apnoea unexplained by other causes. Prompt diagnosis is required to avoid death and minimize airway damage. In addition to plain chest radiography and echocardiography, diagnostic investigations may consist of barium oesophagography, magnetic resonance imaging (MRI), computed tomography, cardiac catheterization and bronchoscopy. The most important recent advance is MRI, which can produce high quality three-dimensional reconstruction of all anatomic elements allowing for precise anatomic delineation and improved surgical planning. Anaesthetic technique will depend on the type of vascular ring and the presence of any congenital heart disease or intrinsic lesions of the tracheobronchial tree. Vascular rings may be repaired through a conventional posterolateral thoracotomy, or utilizing video-assisted thoracoscopic surgery (VATS) or robotic endoscopic surgery. Persistent airway obstruction following surgical repair may be due to residual compression, secondary airway wall instability (malacia), or intrinsic lesions of the airway. Simultaneous repair of cardiac defects and vascular tracheobronchial compression carries a higher risk of morbidity and mortality.
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PMID:Cardiovascular causes of airway compression. 1471 76