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)

Swallowing disorders due to oro-pharyngo-laryngeal cancer, or due to the consequences of surgical resection and radiotherapy, should be accurately evaluated to manage properly both nutritional therapy and dysphagia rehabilitation techniques. The site, size, and local spread of such tumors and, especially, the nature and extent of surgical resection and reconstruction, are important factors which are closely related to the functional disorders of deglutition. The aim of this paper is to demonstrate video-fluoroscopy capability to evaluate the incidence, type, and severity of such functional disorders. For this purpose we studied by means of dynamic radiology 23 patients with oral cancer and 33 patients with pharyngeal-laryngeal cancer, most of them after surgical and/or radiological treatment. Eighty-four per cent of the patients had swallowing disorders such as poor oral processing (25%), retention of the bolus in the pharynx (41%), penetration (41%) or aspiration (37%) of the bolus in the airway, dysmotility of upper esophageal sphincter (9%), and structural lesions (61%). The association of these functional disorders was closely related to the pathological background of each patient. In conclusion, a dynamic radiological study is recommended for both pre and postoperative evaluation of these patients, to choose the appropriate nutritional therapy and dysphagia rehabilitation technique.
 ...
PMID:[Dynamic radiologic study of deglutition in oro-pharyngeal-laryngeal neoplasms and results of their treatment]. 209 8

The swallowing patterns of four patients with oral cancer with intraoral palate reshaping/lowering protheses were studied with and without their prostheses 3 months postoperatively. The prostheses resulted in improved swallow efficiency, increased duration of tongue contact to the pharyngeal wall, and improved speed of movement of the bolus from the valleculae to the pyriform sinus. These results emphasize the effects of the tongue on the pharyngeal as well as oral stage of the swallow.
Dysphagia 1989
PMID:Effects of intraoral prosthetics on swallowing in patients with oral cancer. 270 Oct 94

A 52-year-old man had been treated for oral cancer T3 N0 M0 by radical surgery, neck dissection on the right and cervical irradiation (60 Gy). Two months after therapy he presented with dysphagia and hemoptysis. Admission chest X-ray revealed a pneumopericardium. It was caused by a bronchomediastinal fistula due to necrotic metastatic lymph nodes as shown by CT, which also revealed a concomitant pneumomediastinum. The patient died 10 days later from pneumonia. The CT findings were confirmed at autopsy. We conclude that malignant mediastinal lymphadenopathy is a potential cause of pneumopericardium and pneumomediastinum.
 ...
PMID:Pneumomediastinum and pneumopericardium due to malignant subcarinal lymphadenopathy: CT demonstration. 920 46

Head and neck surgery is an important part of general surgery. There is, however, little information about the quality of residents' clinical skills in this important field. In an Objective Structured Clinical Examination (OSCE), residents encounter multiple patients with various clinical problems and are rated by faculty members using objective criteria. This study was undertaken to assess the head and neck surgery skills of a group of general surgical residents. Fifty-one general surgery residents examined the same nine patients with head and neck disease. Faculty members graded each clinical interaction according to preset objective criteria. Both actual (e.g., thyroid nodule, oral cancer follow-up examination) and simulated (e.g., dysphagia) patients were used in the OSCE. The reliability of the examination was assessed by coefficient alpha. The construct validity was determined by a two-way analysis of variance with one repeated measure. The reliability was 0.75 for the clinical examination. Performance varied by level of training: Residents performed at a higher level than interns (p < 0.0001), but overall scores were poor (mean score 55%). Important deficits in skills were identified at all levels of training. It is concluded that more attention should be focused on specific outcome assessments of surgical training programs and on strategies for upgrading the clinical skills of surgical residents.
 ...
PMID:Critical assessment of the head and neck clinical skills of general surgery residents. 949 13

Diadochokinetic rate has traditionally been used for assessment, diagnosis and therapy in patients who suffered from oral cancer resection, glossectomy, oral myofunctional disease, dysphagia, dysarthria, functional articulation disorders or apraxia of speech. This is because diadochokinetic rate shows the documented structural and physiological changes in the central nervous system and the peripheral components of oral and speech production mechanism. Diadochokinetic rates were obtained from seventy-six normal subjects by counting the repetition of oral function (/a:-u:/; /u:-i:/; and /i:-a:/), tongue function (tongue movement from side to side of lip corner and lan lan lan lan la), and lip-tongue function (/p-t-k/ and /ph-th-kh/) in 15 seconds. The Count-by-Time test was used for data collection. The finding showed average diadochokinetic rates (syllables or times per 15 seconds) were 33.6, 33.16, 30.58; 24.21, 15.10, 26.50 and 26.30 for /a:-u:/, /u:-i:/, /i:-a:/, tongue movement from side to side of lip corner, lan lan lan lan la, /p-t-k/, and /ph-th-kh/. Most of the correlation analysis showed a high positive relationship. The results of this study are guidelines of normal diadochokinetic rates. In addition, they can indicate the severity of diseases and evaluation of treatment.
 ...
PMID:Oral diadochokinetic rate in adults. 980 70

Oral cancer is an important health issue. The WHO predicts a continuing worldwide increase in the number of patients with oral cancer, extending this trend well into the next several decades. In the US the projected number of new cases of oral and oropharyngeal cancer will exceed 31,000 per year. Mortality due to cancers in this region exceeds the annual death rate is the US caused by either cutaneous melanoma or cervical cancer. Significant agents involved in the etiology of oral cancer in Western countries include sunlight exposure, smoking and alcohol consumption. Use of the areca or betel nut in many cultures is a major etiological factor outside of the USA. Other etiologic factors associated with oral squamous cell carcinoma, but far less significant statistically, include syphilis and sideropenic dysphagia. Recently, strong evidence for an etiological relationship between human papilloma virus and a subset of head and neck cancers has been noted. It is generally accepted that most sporadic tumors are the result of a multi-step process of accumulated genetic alterations. These alterations affect epithelial cell behavior by way of loss of chromosomal heterozygosity which in turn leads to a series of events progressing to the ultimate stage of invasive squamous cell carcinoma. The corresponding genetic alterations are reflected in clinical and microscopic pathology from hyperplasia through invasiveness. A wide range of mucosal alternations fall within the rubric of leukoplakia. Proliferative verrucous leukoplakia represents a relatively new type of leukoplakia that is separate from the more common or less innocuous form of this condition. Erythroplakia is particularly relevant considering its almost certain relationship with dysplasia or invasive carcinoma. Squamous cell carcinoma will develop from antecedent dysplastic oral mucosal lesions if an early diagnosis has not been made and treatment given. Early diagnosis within stages I and II correspond to a vastly improved 5-year survival rate when compared with more advanced stage III and IV lesions. Surgical management of this disease remains the mainstay of treatment. Other therapies include radiation and chemotherapy options that may be used adjunctively and palliatively. Following treatment, it is important to understand the significant risks of second primary cancers developing within the upper aerodigestive tract as a result of field cancerization. The most important message is that early detection of the asymptomatic early stage oral cancer translates in general terms to satisfactory clinical outcome and cure in most patients.
 ...
PMID:Oral cancer. The importance of early diagnosis and treatment. 1170 51

Cine-magnetic resonance imaging (cine-MRI) creates moving pictures by a video system and turbo-flash method that allow for high-speed MRI. This report describes our experience using this new technique for dynamic imaging using the fast spoiled GRASS (SPGR) sequence to study swallowing in patients with dysphagia following radical surgery for oral cancer. We defined two new parameters, laryngeal elevation and the angle of the epiglottis, to quantify swallowing ability by cine-MRI. These variables were markedly different in patients with dysphagia than they were in healthy controls. Cine-MRI not only provides dynamic images of swallowing but can generate objective measures of swallowing ability as well.
Dysphagia 2002
PMID:The evaluation of dysphagia following radical surgery for oral and pharyngeal carcinomas by cine-magnetic resonance imaging (Cine-MRI). 1214 Jun 43

The ability to diagnose oral cancer depends in part on the knowledge, attitudes, and practices of the health professional. On the other hand, the patients' choice of health professional depends on their perceptions of the ability of such professionals to diagnose and treat what they believe their health problem is. In this study, we investigated the clinical profiles of patients with oral cancer ( n=354) when first seen by dentists ( n=129) or physicians ( n=225) in a teaching hospital. The charts of patients with oral squamous cell carcinoma were analyzed for the following variables: age, sex, race, signs and symptoms by the time of presentation to the health professional, size and site of the tumor since first manifestation, and clinical stage of the disease. Our results demonstrate that dentists and physicians assessed patients comparably regarding age, sex, and race. Patients complaining of dysphagia and odynophagia were seen more often by physicians than dentists (45/225 vs 9/129 [20.0% vs 7.0%] and 30/225 vs 4/129 [13.3% vs 3.1%], respectively), whereas those with local pain and burning preferentially sought dentists (77/129 vs 56/225 [59.7% vs 24.9%] and 4/129 [3.1%] vs 0/225, respectively). Physicians diagnosed oropharyngeal (45/208 vs 9/116 [21.6% vs 7.8%]) and lip lesions (71/208 vs 7/116 [34.1% vs 6.0%]) more often, whereas dentists saw more cases of cancer of the alveolar ridge (42/116 vs 7/208 [36.2% vs 3.4%]) and floor of the mouth (19/116 vs 10/208 [16.4% vs 4.8%]). Our findings suggest that patients have different perceptions of the roles of dentists and physicians regarding the ability to diagnose and treat oral lesions. Signs, symptoms, and location of the cancer lesions appear to be the most important variables associated with the choice of health professional.
 ...
PMID:Clinical presentation of patients with oral squamous cell carcinoma when first seen by dentists or physicians in a teaching hospital in Brazil. 1267 38

Radiotherapy thought vital in treating head and neck cancer, occasionally causes seriously local complications such as mandibular osteoradionecrosis (ORN). An analysis of mandibular ORN cases showed 16 in 638 subjects treated by radiotherapy, for an ORN rate of 2.5%. This rate was highest in subjects with oral cancer excluding the tongue, administered 81 Gy radiation dose, using X-ray plus electronic beams. 8 cases of ORN occurred within 1 year following radiation, and the 8 others within 5 years. Preservation treatment was successful in 44% of ORN cases, including surgery, for which the rate of final cure was 63%. With case of cancer recurrence, the rate was 25%. In 2 subjects dying of aspiration pneumonia, the cause should be a particular point for reflection. Radiotherapy involving mandibular bone should include special consideration related to the radiation source, radiation dose. Once ORN occurred, we should take care of the mixed cancer and dysphagia in the treatment.
 ...
PMID:[Clinical analysis of mandibular osteoradionecrosis]. 2140 17

Dysphagia is an important postoperative problem in patients with oral cancer. We evaluated the usefulness of a technique to modify the flap and scar for the alleviation of swallowing disorders. The modifications were made while tongue pressure was being measured to improve excursion of the residual tongue in nine patients. They had been operated on for oral cancer and reconstruction was with a forearm free flap, or the wound was closed primarily. After a 5 ml bolus of liquid barium had been given orally, lingual movement, barium inflow into the pharynx before swallowing, stasis in the epiglottic valleculae, and stasis in the oral cavity after swallowing, were evaluated by videofluorography before and after modification. Oral transit time, pharyngeal transit time, and total transit time were also measured. Lingual movement improved in eight patients. Barium inflow into the pharynx before swallowing improved slightly in all patients. Stasis in the epiglottic valleculae was improved in six patients. Stasis in the oral cavity improved in all patients. Oral transit time and total transit time were significantly shorter after modification of the flap and scar than before operation. Pharyngeal transit time was unchanged. We conclude that our technique for modification of the flap and scar can alleviate postoperative swallowing dysfunction in patients with oral cancer.
 ...
PMID:Videofluorographic evaluation of dysphagia before and after modification of the flap and scar in patients with oral cancer. 2168 10


1 2 Next >>