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)

Pleomorphic adenoma is the most common tumor of minor salivary glands, but it is rarely located in the soft palate. It is generally a small mass at the time of diagnosis, but if it is neglected it can rarely become larger, leading to obstructive symptoms such as snoring, hypernasal speech, and dysphagia. Surgical removal of the mass is curative. In this paper, we present a case of an unusually large pleomorphic adenoma of the soft palate leading to snoring and hypernasal speech. The defect that resulted from the excision of the mass is covered with a uvular flap.
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PMID:Giant pleomorphic adenoma of soft palate leading to obstruction of the nasopharyngeal port. 1700 33

We compared radiofrequency techniques used in the treatment of snoring and obstructive sleep apnea [radiofrequency assisted uvulopalatoplasty (RAUP) and channeling] as regard the efficacy and morbidity. A pilot, prospective randomized single blinded study was conducted on 40 patients in the ENT Department, Kasr Al-Aini Hospital, Cairo University during the period from April to December 2003. Patients were randomized into two groups each consisting of 20 patients. The first group was treated by submucosal channeling of the palate, while the second group was treated by radiofrequency assisted uvulopalatoplasty (RAUP). Patients were followed for 4 months, filling a questionnaire in a standard visual analogue score pattern. Assessment was done prior to the surgery and was repeated 3, 10 days and 3 weeks postoperatively. Visual analogue scores were done for the following parameters: pain, speech deficits, dysphagia, and snoring (by the bed partner). Polysomnography was done pre to intervention and was repeated 4 months postoperatively. This work confirms the favorable effects of radiofrequency in the treatment of patients with snoring and mild to moderate obstructive sleep apnea (OSA) particularly on snoring, confirming the results of the previous studies and highlighting the more rapid relief of snoring and apnea in RAUP group compared to channeling group but with more postoperative pain and morbidity.
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PMID:Bipolar radiofrequency treatment for snoring with mild to moderate sleep apnea: a comparative study between the radiofrequency assisted uvulopalatoplasty technique and the channeling technique. 1729 8

We describe the case of a 37-year old male who presented with a schwannoma in his right palatine tonsil. The tumour and tonsil were surgically removed transorally. Tonsillar schwannomas are slow growing, and the main symptoms were a foreign body feeling in the throat, dysphagia and snoring. The presence of a round, well-defined mass lesion with heterogeneous density on computed tomography (CT) may aid in differentiation from other tonsillar tumours. The CT findings in the reported case were different to those of schwannomas in other locations; the particular CT manifestations of tonsillar schwannomas seem to relate to the various pathological changes seen within the tumour.
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PMID:Palatine tonsil schwannoma: correlation between clinicopathology and computed tomography features. 1883 13

The purpose of this study was to determine the frequency of obstructive sleep apnea in patients with inflammatory myopathy. An observational and prospective study was performed on a cohort of adult patients with inflammatory myopathy followed at a specialized outpatient clinic. Sixteen consecutive adult patients were evaluated by the Epworth Sleepiness Scale (ESS) and by complete polysomnography study. Disease activity and severity were assessed using the Myositis Disease Activity Assessment Tool (MDAAT) and Myositis Damage Index (MDI), respectively. Associations between sleep parameters and other factors were calculated using the chi-square test, Fisher's exact test, Mann-Whitney U-test, and Wilcoxon's test. A serum autoantibody profile was determined for all patients. The mean apnea-hypopnea index was 28.7 (23.8), and 14 patients (87%) had an apnea-hypopnea index >5. The mean frequency of respiratory arousals was 20.1 (12.5). Eleven (68%) patients reported frequently-always snoring, and 3 (19%) had excessive daytime sleepiness (ESS >10). Seven patients were offered continuous positive airway pressure (CPAP) therapy; 4 tolerated the procedure well and reported a clear improvement in daytime sleepiness and/or sleep quality. No significant association was observed between the apnea-hypopnea index and clinical or immunological groups. Dysphagia, disease activity, and disease severity were not significantly associated with any sleep parameters. The frequency of obstructive sleep apnea in adult patients with inflammatory myopathy is high. The possibility that these alterations play a role in persistent fatigue in these patients cannot be ruled out.
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PMID:Obstructive sleep apnea in patients with inflammatory myopathies. 1914 52

Retropharyngeal tumors are rare. They typically originate from the neighboring anatomical structures or from the retropharyngeal space itself. Retropharyngeal lipomas are even rarer. A 75-year-old male patient presented with complaints of dyspnea, dysphagia, snoring, and obstructive sleep apnea. Computed tomography showed a giant mass measuring 125 x 81 x 27 mm in the retropharyngeal space, compressing the larynx, trachea, and esophagus, and extending to the thoracic inlet. The mass had regular margins, exhibited low attenuation, and was homogeneously hypodense. After intravenous contrast administration, there were thin septa formations within the lesion that did not show contrast enhancement. There was no invasion to the neighboring muscular structures. The lesion was considered a lipoma. Surgery was not performed due to the cardiovascular problems of the patient. During a two-year follow-up, there were no changes in the size and tissue characteristics of the mass, nor any mass-related clinical problems.
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PMID:[A giant retropharyngeal lipoma showing no change in clinical presentation and size within a two-year follow-up: a case report]. 1929 28

Osteophytes of the cervical spine are usually seen in elderly adults. When prominent, they have been blamed for dysphagia, cough, dysphonia and dyspnoea. This paper reports on an obstructive sleep apnoea (OSA) patient with cervical spinal osteophytes, one cause of airway obstruction. A 75-year-old male complained of pronounced snoring. The diagnosis was mild OSA, apnoea hypopnoea index was 9.4. Patient reported no restrictions in neck movements, experiences of neck pain or neck trauma. Previously, patient underwent a tonsillectomy due to discomfort in the pharyngeal region. A lateral cephalometric image was taken to observe airway before oral appliance therapy. The image revealed the presence of large osteophytes or sclerotic enthesopathy, lying on anterior surfaces from the fourth to seventh cervical vertebrae. A computed tomography (CT) image revealed the relationship of airway position to the spine. In the reconstructed three-dimensional (3D) image, the airway appeared displaced to the right of the craniomandiblar bone, with the hyoid bone similarly displaced in a manner to that of the airway. The spine also appeared displaced to the left side ofcraniomandiblar bone. Additionally, the 3D image revealed calcification of the stylohyoideum ligament and ligamentum nuchae. This present case highlights the necessity of CT examination for OSA patients. There were several ligament calcifications in the head and neck region. Cervical spine osteophytes, as a component of Forestier's or cervical spine disease, have been associated with dysphagia and dysphonia. It was reported that bilateral vocal cord paralysis was caused by osteophytes compressing the post-cricoid area of larynx.
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PMID:A case of obstructive sleep apnoea with anterior cervical osteophytes. 1970 80

Nasopharyngeal stenosis as a postoperative complication following pharyngeal surgery (tonsillectomy/adenoidectomy) is rare and may be difficult to treat. All patients with severe nasopharyngeal stenosis treated at UCLA with a bilateral Z-pharyngoplasty procedure from 1999 to 2006 were studied (n = 6). Degree of pharyngeal stenosis preoperatively and following a bilateral Z-pharyngoplasty was graded 0-4 based on (1) symptomatology (snoring, hyponasal speech, difficulty with nasal breathing, difficulty breathing during exercise, obstructive sleep apnea, daytime fatigue, anosmia, rhinorrea, dysphagia, or difficulty in blowing nose) and (2) measurement of stricture at the time of direct nasolaryngoscopy. Nasopharyngeal stenosis after pharyngeal surgery (adenotonsillectomy--67%, uvuloplasty--17%, pharyngoplasty--17%) failed to be alleviated by a mean of 2.3 procedures (kenalog injection or scar excision) and required corrective bilateral Z-pharyngoplasty a mean of 9.2 months after the original surgery. Symptomatic grading of the nasopharyngeal stenosis improved from a mean score of 3.3 (severe stenosis) preoperatively to a score of 0.2 (minimal to no stenosis) in follow-up. Endoscopic stricture measurement improved from 6.1 x 6.3 mm preoperatively to 28.1 x 39.3 mm in follow-up. Bilateral Z-pharyngoplasty was effective in alleviating severe postsurgical nasopharyngeal stenosis.
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PMID:Amelioration of acquired nasopharyngeal stenosis, with bilateral Z-pharyngoplasty. 2048 3

Abnormalities of the atlantoaxial spine are very rare variants. Bony outgrowths, osteophytes, clefts and aplasia may be misinterpreted as degenerative diseases. One patient presented with intermittent dysphagia and snoring and CT and MRI scans of the cervical spine showed an accessory bone located anterior to the atlas and axis. Atlantoaxial anomalies are often incidental findings without clinical symptoms. Such changes are rarely the cause of intermittent dysphagia and snoring.
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PMID:[Atlantoaxial malformation as a rare cause of dysphagia and snoring]. 2082 Nov 82

Adenotonsillar disease (adenoiditis and recurrent tonsillitis) is a prevalent otolaryngologic disorder aetiologically based on chronic inflammation triggered by a persistent bacterial infection. These bacteria, mostly Staphylococcus aureus, Haemophilus sp., and Streptococcus sp., persist predominantly intracellular and within mucosal biofilms. The recurrent or chronic inflammation of the adenoids and faucial tonsils leads to chronic activation of the cell-mediated and humoral immune response, resulting in hypertrophy of the lymphoid tonsillar tissue. This hypertrophic tissue is the cause for the prominent clinical symptoms: obstruction of the upper airways, snoring, and sleep apnea for adenoiditis or sore throat, dysphagia and halitosis for recurrent tonsillitis. Treatment strategies should target the persisting bacteria within their biofilm or intracellular shelter. Macrolide antibiotics like clarithromycin are able to modulate the immune system and to interfere in bacterial signaling within biofilms. Clindamycin, quinupristin-dalfopristin, and oritavancin are intracellular high active compounds. Surgical removal of the hypertrophic tissue by modern procedures like laser tonsil ablation, eliminates not only a mechanical obstacle of the airways, it removes also the basis for the aetiologic cause, the "biofilm carrier". This review summarizes the role of bacterial persistence in mucosal biofilms for the aetiology, diagnosis and treatment of adenotonsillar disease and relevant patents.
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PMID:Adenotonsillar disease. 2245 46

Radiofrequency surgery was introduced to minimize thermal damage to the tissue. A radiofrequency electrode can be used to make cuts in the free edge of the soft palate like those done in laser-assisted uvulopalatoplasty [radiofrequency-assisted uvulopalatoplasty (RAUP)]. Tonsillectomy can enlarge the lateral diameter of the pharynx. The aim of our study was to evaluate the efficacy of RAUP with tonsillectomy in treatment of obstructive sleep apnea syndrome (OSAS). Ninety-two patients with obstructive sleep apnea were included in this study. Patients were categorized according to disease severity and Friedman's staging system. Patients were assessed with the preoperative visual analog scale (VAS) for snoring, Epworth Sleepiness Scale (ESS) and apnea-hypopnea index (AHI) at baseline and repeated at 6 months postoperatively. The intensity of postoperative pain, speech deficits and dysphagia were also recorded. There was a significant improvement in the VAS score for snoring, ESS and AHI before and after surgery. Overall, the results of the present study indicated a surgery success rate (a 50 % decrease in AHI and AHI <20) of 66 % (61 of 92 patients). Postoperative pain, speech deficits and dysphagia were reduced at 2 weeks after surgery. The results of this study suggest that RAUP with tonsillectomy is an effective treatment for patients with OSAS.
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PMID:Treatment of obstructive sleep apnea syndrome using radiofrequency-assisted uvulopalatoplasty with tonsillectomy. 2272 47


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