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)

Acute epiglottitis in adults is a fulminant disease characterized by local cellulitis of supraglottic structures. Symptoms include sore throat, dysphagia, respiratory difficulty and muffled voice. Signs are pharyngitis, swollen and inflamed epiglottis, epiglottic abscess and/or cervical swelling. Diagnosis is facilitated by an upright, lateral neck x-ray and indirect laryngoscopy. The mainstays of treatment are airway maintenance, antibiotics, steroids, hydration, cool mist, oxygen and supportive care.
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PMID:Acute epiglottitis in adults. 710 96

Acute epiglottitis, considered primarily a disease of infancy and early childhood, is seen rarely in adulthood but may be increasing in incidence. Although it may appear more slowly in adults, it is imperative to establish a rapid diagnosis and promptly assure care for this life-threatening disease. Epiglottitis may cause total obstruction of the upper airway, and it often falls to the primary care physician to discriminate this disease from the many self-limiting infections of the upper airway. The diagnosis should be considered if dysphagia and sore throat are not accompanied by hoarseness. Management of the airway is the first priority, but intravenous antibiotic use is justified.
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PMID:Obstructive epiglottitis in adults. 713 Sep 17

Calcific retropharyngeal tendinitis is an inflammation of the longus colli muscle tendon which is located on the anterior surface of the vertebral column extending from the atlas to the third thoracic vertebra. The acute inflammatory condition is self-limiting with symptoms consisting of a gradually increasing neck pain often associated with throat pain and difficulty swallowing. The pain is aggravated by head and neck movement. Clinically the condition can be confused with retropharyngeal abscess, meningitis, infectious spondylitis, and post-traumatic muscle spasm. The radiographic features of this condition consist of pre-vertebral soft tissue swelling from C1 to C4 and amorphous calcific density in the longus colli tendon anterior to the body of C2 and inferior to the anterior arch of C1.
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PMID:Calcific retropharyngeal tendinitis. 733 Jun 78

The styloid process is a slender spike-like bony process that is attached to the base of the skull that has been of interest to physicians for centuries. From this process is the attachment for five structures--three muscles and two ligaments are attached to it. Any of these soft tissues of the styloid process are prone to be torn due to trauma by way of detachment of the periosteum from the bone. These lesions may occur from auto accidents, falls, sports injuries, to prolonged medical or dental procedures requiring excessive mouth opening. The detachment of Sharpey's fibres results in the release of noxious chemicals such as kinins, histamines, prostaglandins, etc, which can produce a withdrawal reflex, causing muscle tension, ischaemia, spasm and pain. Pain transmission via C fibres may induce a host of autonomic responses as well. We have observed 11 common pains and symptoms that are associated with soft tissue lesions of the styloid process and stylomandibular ligament. They are (1) headaches localised in the anterior temporal fossa, (2) sore throat and difficulty swallowing in the absence of inflammation, (3) pain radiating to the temporomandibular joint and ear, (4) voice alteration, (5) dry, non-productive cough, (6) pain in the masseter muscle, (7) restricted mandibular opening or the "closed lock", (8) development of the "open lock", (9) sinusitis, congested stuffy nose or post nasal drip, (10) tinnitus, and (11) excessive lacrimation and bloodshot eyes. A few drops of local anesthetic into the styloid process and stylomandibular ligament attachment can temporarily relieve the pain and symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Temporal headaches and associated symptoms relating to the styloid process and its attachments. 760 81

The histologically benign hypopharyngeal lipoma is a potentially fatal tumour because of the risk of upper airway obstruction. It may be asymptomatic or present with symptoms ranging from vague foreign-body sensation to sore throat, dysphagia or dysphonia. The diagnosis may be suggested by indirect or fibreoptic laryngoscopy. Lateral neck soft tissue X-ray and barium swallow may help but CT imaging of the pharynx enables a more precise preoperative diagnosis. Treatment is by surgical excision of the lesion either perorally, endoscopically or via a lateral pharyngotomy. Long-term follow-up is recommended due to the possibility of recurrence and metachronous lesions.
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PMID:Lipoma of hypopharynx. 793 28

Transesophageal echocardiography (TEE) is a new semi-invasive diagnostic tool in cardiology. We studied tolerance of TEE. 95 out of 121 consecutive patients were interviewed using a detailed, structured questionnaire (42 questions). Most patients (97%) received midazolam prior to TEE. TEE was tolerated well by 89% (n = 84) of the patients. Patients receiving a higher dose of midazolam (> 0.04 mg/kg bodyweight) tolerated TEE better than those in the lower-dose group (p < 0.0005), but they experienced side effects more often (p < 0.05) and did not tolerate fatigue as well (p < 0.0005). TEE was tolerated less well by younger patients (age < or = 45 years); they experienced more often local irritation than older patients due to the endoscope (52% versus 20% in older patients, p < 0.005) and complained more often about dysphagia (70% versus 24%) and sore throat (60% versus 19%) (p < 0.0005) after TEE. Patients < or = 45 years reported more side effects by midazolam than older patients, such as palpitations (30% versus 2%), hiccups (17% versus 0%), poor concentration (20% versus 3%), nausea (13% versus 2%), ataxia (17% versus 3%) or fatigue (88% versus 59%) (p < 0.05 to 0.0005). Females were more often afraid of TEE (53%) and the endoscope (56%) than males (35% and 23%, p < 0.08 and p < 0.002) and also disliked the endoscope more often (42%) than men (19%, p < 0.03). Some women complained about headaches after TEE (10%), whereas men did not (p < 0.05). Thus, TEE, after premedication with midazolam, is subjectively well tolerated.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Subjective tolerance to transesophageal echocardiography]. 815 9

One hundred ASA grade 1 and 2 patients requiring orotracheal intubation for various general surgical procedures were randomly assigned to receive either expert rigid laryngoscopic or novice fibreoptic orotracheal intubation under total intravenous anaesthesia. Five anaesthesia residents in the 4th year, with no prior experience in fibreoptic laryngoscopy, participated in a fibreoptic training course, viewing two instructional videos and practising on the intubation manikin. Each resident intubated 20 patients in a randomised fashion either as an expert laryngoscopist or as a fibreoptic novice. The time (SEM) to achieve successful intubation was statistically different for fibreoptic and rigid intubation (77.2 (5.1) s vs 17.7 (1.6) s, p < 0.01). The time to achieve successful rigid laryngoscopic intubation remained constant over the ten intubations, whereas time required for fibreoptic intubation decreases significantly (p < 0.01). The learning objectives (fibreoptic intubation times in 60 s or less and with 90% or greater success rate on the first intubation attempt) were met by all residents. The haemodynamic profile was similar for fibreoptically intubated and conventionally intubated patients and there was no difference between the first two or the last two fibreoptic or rigid intubations. The study was designed to detect a difference of 10% in means (assuming alpha = 0.05 and beta < or = 0.2). The incidence of postoperative sore throat, dysphagia or hoarseness was similar in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Teaching fibreoptic intubation in anaesthetised patients. 817 44

In 511 patients with T3N0-3M0 laryngeal carcinoma, 24 possible prognostic factors were analysed retrospectively. The factors were age, sex, mode of treatment, duration of several clinical symptoms, the presence of sore throat, otalgia, dyspnoea, and dysphagia, previous tracheotomy, tumour extension, lymph node status (five items), histologic grading, smoking habits, and alcohol intake. For 300 patients in whom surgery was part of the primary treatment, pathologic staging of the primary tumour and of lymph nodes in neck dissection specimens, cartilage invasion, radicality of the operation, differentiation grade, and subglottic extension were also evaluated. Univariate analysis revealed prognostic significance on survival for tumour extension (limited to the glottic region), lymph node status (clinically palpable lymph nodes, cytologically confirmed positive lymph nodes), level of lymph node metastasis (high and midjugular site), histologic grading (poor differentiation grade), and treatment modality (planned combined therapy). In the group that underwent surgery, all factors derived from specimens of the larynx and neck dissections had prognostic significance. Multivariate analysis revealed that the glottic site of the tumour, the presence of cyto- and histopathologically proven metastatic lymph nodes, pretreatment tracheotomy, positive resection margins, and planned combined treatment had a significant influence on corrected actuarial survival.
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PMID:[Uni- and multivariate analysis of prognostic factors in T3 laryngeal cancers]. 830 23

Spontaneous hemorrhage of a parathyroid adenoma is a rare occurrence which may manifest with a variety of symptoms including cervical pain, hoarseness, respiratory distress, and dysphagia. We report a case of an elderly woman with a parathyroid adenoma diagnosed 10 years ago and for which she had refused surgery. Throughout this period her hypercalcemia was carefully monitored, and she experienced no symptoms or adverse sequelae from her disease. However, the patient subsequently presented with a 1 day history of a sore throat and a nonproductive cough followed by the acute onset of dysphagia. At this time she was found to have an anterior neck hematoma extending to the midthorax. Computerized tomography and direct laryngoscopy were suggestive of the diagnosis and neck exploration confirmed the presence of a large hematoma beginning at the site of the 3 x 4 cm parathyroid adenoma and extending into the left strap musculature. We report this case of spontaneous hemorrhage of a cervical parathyroid adenoma to bring to mind a rare etiology of acute pharyngoesophageal dysphagia.
Dysphagia 1993
PMID:Acute pharyngoesophageal dysphagia secondary to spontaneous hemorrhage of a parathyroid adenoma. 843 23

Transesophageal echocardiography (TEE) has increasingly been used in cardiology and cardiac surgery with few reported complications. This study was undertaken to determine whether TEE is associated with an increased incidence of gastroesophageal (GE) bleeding or postoperative GE symptoms of anorexia, dysphagia, or sore throat. Forty-one patients who underwent TEE during cardiac surgery and 40 control patients who underwent cardiac surgery without TEE were prospectively followed. In addition, a retrospective chart review of 200 patients who underwent TEE during cardiac surgery was also performed. The following information was derived from the patient interviews and chart reviews: (1) The development of both frank and occult upper gastrointestinal tract (UGI) bleeding; (2) the patient's preoperative anticoagulation status; and (3) the patient's subjective complaints of anorexia, dysphagia, or sore throat. The incidence of postoperative occult or frank UGI bleeding was not increased in the groups who underwent TEE. Additionally, the incidence of postoperative GE symptoms was comparable in the three groups. These findings are discussed in the context of reported complications associated with UGI endoscopy. Based on this analysis, recommendations for the safe performance of TEE have been provided.
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PMID:Low risk of gastroesophageal injury associated with transesophageal echocardiography during cardiac surgery. 847 22


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