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)

The therapy for spontaneous or artificial perforation of the esophagus remains a controversial matter. The following case report deals with the medical history of an artificial esophageal perforation after operative treatment of cervical disc disease. A 68-year-old male patient underwent a C4/C5 and C5/C6 discectomy with interbody fusion of C7-T1 vertebral body, according to Smith-Robinson. During this operation, a 3-cm-long lesion was made in the posterior wall of the esophagus, which was treated 24 h later with a primary suture. The clinical follow-up was complicated by mediastinitis with subsequent multiorgan failure. After recovery from this critical condition the patient dysphagia, which was related to a persistent lesion in the posterior esophageal wall with endoscopically demonstrated dislocation of a screw. After removal of the screw, the lesion was covered by means of sternocleidomastoid myoplasty. Moderate postoperative dysphagia was successfully treated by bougienage.
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PMID:[Perforation of the cervical esophagus after ventral fusion of the cervical spine. Defect coverage by muscle-plasty with the sternocleidomastoid muscle: case report and review of the literature]. 930 48

The increased detection rate of spinal tumours is due to more precise methods used for imaging the spinal column and better survival of cancer patients. It is therefore associated with greater incidence of metastatic complications. Primary tumours of the spine, both malignant and benign, are very rare. Histopathological confirmation is a prerequisite of correct treatment. Two patients with pain in the neck area, progressive paresis, breathing disorders and dysphagia were admitted to our hospital. In the first patient, a 78-year-old woman, imaging examinations revealed a large exophytic tumour originating from C5-C7 vertebrae and compressing other neck structures. In view of the progressive paresis and dyspnoea, we decided to perform surgical resection of the tumour without a prior biopsy. We used the Southwick and Robinson approach on the right side and the tumour was removed together with damaged vertebral bodies, which were replaced by an implant. The next stage of the treatment involved stabilisation of the spine from C3 to Th2. Histopathological evaluation confirmed a diagnosis of chordoma. The second patient was a 73-year-old man. Imaging examinations revealed destruction of the C6 to Th1 vertebral bodies by a tumour with pathological fractures and compression of the spinal canal. The tumour was approached from the left side and removed according to the method presented by Southwick and Robinson. The removed vertebral bodies were replaced with implants. The spine was stabilised in the second stage of treatment. A diagnosis of metastatic adenocarcinoma was confirmed by a histopathological examination. Tumours located in the cervical spine, especially at the C7-Th1 level, cause considerable diagnostic and therapeutic problems. Southwick and Robinson's anterior approach allows for good exposure of vertebral bodies down to the Th2 level.
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PMID:Corpectomy of three cervical vertebral bodies for malignant tumours--a study of two cases. 2443 Dec 74

The Smith-Robinson approach to the anterior cervical spine is being increasingly used, but it is not without complication. Dysphagia and dysphonia are the most common complications of the procedure. Many classification systems have been developed to stage and grade postoperative dysphagia and dysphonia, but inconsistent usage and lack of consensus adoption has limited research progress. A discussion of the merits and limitations of the most common classification systems is outlined within this review. Broad adoption of comprehensive and simple classification metrics is needed, but, first, prospective reliability and validity must be established in the anterior cervical fusion population.
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PMID:Dysphagia and Dysphonia Assessment Tools After Anterior Cervical Spine Surgery. 2697 78

Cervical osteophytes may be seen in diffuse idiopathic skeletal hyperostosis, ankylosing spondylitis, posttraumatic, postoperative, degenerative causes, cervical spondylosis, and infectious spondylitis. A cervical osteophyte is very rarely considered among the differentials for symptoms of dysphagia. C5-C6 as well as C6-C7 being a site of greater load-bearing and mobility, the propensity to form osteophytes is high, with a small osteophyte leading to local mass effect. A 42-year-old male patient presented with mild dyspnea and significant dysphagia since 8 months, accompanied by dysphonia, weight loss, and intermittent aspiration. Clinical examination including neurological examination was normal. A barium swallow showed that osteophytes were severely protruding and displacing the lower pharynx and the proximal esophagus anterosuperiorly. The patient underwent surgical removal of the osteophyte through Smith-Robinson approach. Complaints of dysphagia were significantly decreased in postoperative period. A thorough evaluation is necessary to rule out other causes of dysphagia. Surgical management of this uncommon condition might be considered after confirmation of the osteophyte to be the offending lesion as it has favorable clinical outcomes.
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PMID:Dysphagia in a Young Adult: Rare Case of Giant Cervical Osteophyte. 3218 Dec 7