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

Chronic immunoglobulin administration decreases the incidence of bronchial and pulmonary infections in patients affected by chronic variable immunodeficiency (CVI). In this study, an ENT screening was carried out in 22 patients affected by chronic variable immunodeficiency and treated with chronic immunoglobulin administration. All the patients underwent ENT physical examination, nasal endoscopy by fiberoptics, mucociliary transport test (MTT), anterior rhinorheomanometry (RRM), nasal provocation test with cold water (ANPT), audiometry and impedentiometry, olfactory evaluation, and paranasal sinus X rays. Dysphagia was present in 91% of the patients, nasal secretion and obstruction in 77%, and hypoacusia, tinnitus, and otodinia in 57%. Rhinitis and pharyngitis were observed in 86% of the patients, and serous middle ear effusion in 50%. Confirmed maxillary sinusitis was observed in five patients. Hyposmia was observed in 50% of the patients. MTT was significantly longer in the patients than in the controls (18.0 +/- 10.5 vs. 11.2 +/- 2.4 min; p < .05). Nasal resistance was lower in patients than in controls (0.46 +/- 0.32 vs. 1.11 +/- 0.22 Pa/L.s-1; p < .001). ANPT was positive in 9 patients out of 25 versus 1 control out of 15 (p < .05). Finally, seven patients were affected by transmissive hypoacusia, and one patient by neurosensorial hypoacusia. Our results suggest that chronic immunoglobulin administration in CVI patients is not effective against ENT disorders, probably because of the important role played by nasal hyperreactivity. Frequent ENT examination and early treatment of ENT disorders are therefore suggested in order to prevent chronic disease.
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PMID:Screening patients affected by common variable immunodeficiency. 961 92

AbstractParacoccidioidomycosis is a systemic mycosis caused by Paracoccidioides brasiliensis. It occurs more frequently in its chronic form, which particularly affects male adults from rural areas. These patients present with pulmonary involvement and systemic symptoms. Skin and mucosal lesions are rather typical and might suggest the diagnosis. The involvement of the upper airway mucosa is common and the patients usually complain of dysphagia and dysphonia. Nonetheless, in endemic areas, physicians should maintain a high level of suspicion even when faced with some atypical symptoms. We present the case of an adult diagnosed with nasopharyngeal paracoccidioidomycosis after presenting with an unusual otolaryngologic syndrome including unilateral soft palate paralysis with velopharyngeal insufficiency and hearing loss secondary to middle ear effusion.
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PMID:Unusual Otolaryngologic Manifestations of Paracoccidioidomycosis: A Case Report and Review of Literature. 2850 Aug 5

Multiple anterior surgical approaches are available to obtain access to the nasopharynx, clivus, and craniocervical junction. These include the direct and transoral robotic surgery transpalatal, maxillary swing, and endoscopic endonasal approaches. In this article, we describe the indications for these techniques, surgical steps, and associated morbidities. This article is a PubMed literature review. A review of the literature was conducted to assess the techniques, surgical steps, and associated morbidities with transpalatal approaches to the skull base and nasopharynx. The transpalatal approach has been traditionally utilized to obtain surgical access to the nasopharynx, clivus, and craniocervical junction. Morbidity includes velopalatine insufficiency due to shortening of the soft palate from scar contraction or neuromuscular damage, thus leading to hypernasal speech and dysphagia. Middle ear effusion and oronasal or oronasopharyngeal palatal fistula are additional potential morbidities. The choice of surgical approach depends on a variety of factors including the disease location and extent, surgeon experience, and available resources.
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PMID:Transpalatal Approaches to the Skull Base and Reconstruction: Indications, Technique, and Associated Morbidity. 3239 Jul 77