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)

Rare upper airway lesions may be mistaken for asthma. A 16-year-old Hispanic male athlete presented to our allergy clinic with a 4-month history of wheezing and snoring with hoarseness and progressive fatigue on exertion or during sleep. His mother taped periods of harsh stridor and sleep apnea. There was no family history of vocal cord abnormalities. A year before the onset of symptoms, he suffered injury to his oral cavity with a loss of consciousness during a wrestling match. He denied dysphagia or dysphonia. He failed to respond to bronchodilators, cromolyn, or prednisone therapy during 4 weeks. On referral to our clinic, his physical examination and tape recording were characterized by harsh inspiratory stridor. His pulmonary function tests were significant for peak flow depressed out of proportion to FEV1 with reduced FVC, no response to bronchodilator, and flattened inspiratory loop unresponsive to cough or panting. Fluoroscopy and endoscopy of the upper airway was consistent with "marked bilateral limitation of vocal cord abduction." Sleep study demonstrated desaturation with CO2s in the 60s during sleep. He was started on continuous positive airway pressure, 10 cm at night, with no desaturation or sleep disturbance on follow-up.
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PMID:Bilateral abductor paresis masquerading as asthma. 337 24

Obstructive sleep apnea in children is most often secondary to severe adenotonsillar hypertrophy. A 5 1/2-year-old boy presented with loud snoring, increasing dysphagia, nocturnal choking, and apnea. Extensive papillomatosis of the uvula, soft palate, and nasopharynx was found to be causing the obstruction. Although multiple papillomas of the larynx and tracheobronchial tree are well known, the occurrence of extensive papillomas of the oral cavity is rare. The unusual clinical presentation and pathologic significance are discussed.
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PMID:Massive oropharyngeal papillomatosis causing obstructive sleep apnea in a child. 362 Jan 53

Lipomas of the larynx and hypopharynx are uncommon mesenchymal neoplasms. This report discusses the clinical and pathological features of three cases of laryngeal and hypopharyngeal lipomas. Two of the cases occurred in females and one in a male. The ages of the patients were 28, 51 and 51 years respectively. Two of the cases involved the supraglottic larynx (left arytenoid and left vestibular fold); the third involved the pyriform sinus. Symptoms included airway obstruction, dysphagia, throat discomfort, a sensation of excessive secretions in the throat and an increase in snoring. The complaints occurred over periods ranging from several months to one year in duration. Clinically, a polypoid lesion described as yellow in appearance was seen. Histologically, the tumours were composed of mature adipocytes without evidence of pleomorphism, lipoblasts or infiltrative growth. Surgery was the treatment of choice and included simple but complete excision in two of the cases. In these two cases, surgery proved curative with follow-up periods of 11 and seven years, respectively. In one case, the initial tumour was removed in pieces. This lesion recurred 15 years after the initial resection and was totally excised at that time. This patient has been free of tumour for more than five years.
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PMID:Lipomas of the larynx and hypopharynx: a review of the literature with the addition of three new cases. 778

Malignant mesenchymoma is a very rare head and neck tumour. To date only 15 cases have been reported in world literature and all in children under 16 years of age. We present here a case of a 40-year-old man with malignant mesenchymoma of the retropharyngeal space. The clinical picture is that of progressive dysphagia, voice change, snoring and dyspnoea. CT scan showed a soft tissue space-occupying lesion of the retropharyngeal space which enhanced very well with intravenous contrast. The tumour was excised in toto and the patient given post-operative radiotherapy. Histopathology showed two unrelated differentiated tissue types (bone and fat) in addition to the fibrosarcomatous element thus satisfying Stout's criteria (Stout, 1948) for a diagnosis of malignant mesenchymoma.
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PMID:Malignant mesenchymoma of the retropharyngeal space. 828 11

Chordomas are rare neoplasms of notochordal origin that arise along the vertebral axis. In the cervicofacial area, they show a marked proclivity for the sphenooccipital region. These slow-growing and infiltrating tumors are often discovered because of neglected symptoms related to the ENT field such as nasal obstruction, snoring, dyspnea or dysphagia in the case of anterior development, serous otitis media, cervical pain, or even palsy of the X, XI, or XII cranial nerves when the tumor develops toward the foramen jugulare or the foramen magnum. Prognosis is usually poor because of local malignancy, proximity to critical central nervous system structures, and volume of the tumor. Surgery is the preferred treatment for these extradural tumors, but most authors recommend postoperative irradiation because of surgical spillage or residual tumor. However, conventional irradiation is limited by the sensitivity of surrounding structures, which results in a poor rate of local control. We present 9 cases of histologically proven diagnosis of chordoma treated from 1984 to 1994 at our institution. Prognosis and therapeutic modalities are discussed. Therapeutic improvement might be brought the protontherapie, which ensures a better local control, and therefore may transform the prognosis of the disease.
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PMID:[Therapeutic management of craniocervical chordoma]. 876 68

Advanced forms of diffuse idiopathic skeletal hyperostosis or Forestier's disease can induce dysphagia and significant respiratory symptoms such as hoarseness, dyspnea, snoring and laryngeal stridor. Severe respiratory distress is very rare. Two identical cases of chronic respiratory distress due to bilateral vocal cord adduction-fixation in conjunction with skeletal pathology in the cervical area are presented. The clinical, diagnostic and therapeutic work-up and the prognostic outcome of the laryngeal pathology are discussed.
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PMID:Vocal cord immobilisation in diffuse idiopathic skeletal hyperostosis (DISH). 958 Dec 3

The patency of the upper airways during inspiration is maintained by reflexogenic muscular dilation, mediated by afferent nerves. Our hypothesis is that a local disturbance in these nerves might explain the increased tendency of upper airways to collapse in patients with obstructive sleep apnea. The vascular reaction in the mucosal microcirculation is regulated by afferent nerves. To investigate this, we developed the laser Doppler perfusion monitoring method and electrical nerve stimulation for investigations of the soft palatal mucosa in non-snoring subjects. A 12 cm probe with integrated bipolar electrodes and a special probe-holder were designed. The bandwidths 12 and 24 kHz were compared and the latter was better able to detect a high blood-flow. A dose response relation was found between the voltage stimulation level and percentage increase in blood-flow. Three series of stimuli (40 V) in 10 subjects caused reproducible vascular reactions. In conclusion, this method seems to be safe, tolerable and valuable for investigations of patients with obstructive sleep apnea or other pharyngeal disorders, e.g. dysphagia, in the search for local nerve lesions.
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PMID:Evaluation of the vascular reaction in pharyngeal mucosa. 965 19

In a randomized, controlled trial, 62 patients (47 men and 15 women) with severe antisocial snoring, but no sleep apnea, were allocated to one of three surgical treatments. These were uvulopalatopharyngoplasty, laser palatoplasty, and diathermy palatoplasty. Postoperative morbidity was measured on a visual analogue scale of severity of pain, dysphagia, and nasal regurgitation at 1, 2, and 7 days after the operation. Efficacy of each procedure was measured by asking the sleeping partner to record the severity of snoring before and after the operation, again on a visual analogue scale. Measurements were taken at 1, 3, and 6 months. There were no significant differences in early postoperative morbidity among the treatment groups. Diathermy palatoplasty is a new technique for the relief of snoring that is associated with low morbidity and requires little in the way of expensive equipment.
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PMID:Palatoplasty for snoring: a randomized controlled trial of three surgical methods. 974 85

The REPOSE system is a new, mini-invasive technique with which the base of the tongue is suspended to treat sleep breathing disorders (SBD) induced by hypertrophy of the base of the tongue. The surgical technique calls for the intra-oral insertion of a small titanium screw in the anterior portion of the mandible. Two polypropylene threads are attached to the screw and these are passed through the base of the tongue and then tied at the point where it is inserted in the floor of the mouth, thus effectively suspending the base of the tongue. 10 patients with SBD due to hypertrophy of the base of the tongue underwent this procedure. Only one major complication was found: an infection requiring sectioning of the suspension thread. For an average 7 to 30 days all patients showed signs of odinophagia, bilateral otalgia, dysphagia and dislalia. In all patients snoring either disappeared altogether or was significantly reduced. Statistical analysis of the pre- and post-operative polysonnograph data showed a significant reduction in the apnea index (AI), the respiratory distress index (RDI) (p = 0.009) as well as a significant improvement in the degree of oxygen saturation (SaO2) (p = 0.008). The results were independent from the body mass since the patients did not lose weight during the follow-up period.
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PMID:[A new mini-invasive technique for the treatment of sleep breathing disorders: preliminary results of a clinical experience]. 1041 88

Velopharyngeal competence as indicated by nasalance of speech was tested in 18 men before and after a cautery-assisted palatal stiffening operation for snoring. Nasalance was measured preoperatively and postoperatively, with no significant changes noted following surgery. Although there were no objective or subjective changes in nasality of voice, these findings do not rule out all possible changes in velopharyngeal competence, since there were subjective complaints of nasal regurgitation and dysphagia.
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PMID:Cautery-assisted palatal stiffening operation and nasalance of speech. 1043 33


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