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)

Experience from the use of feeding plates for babies with cleft palate and from the treatment of dysphagia in patients recovering from stroke led to the design of a simple intraoral appliance. This device has been used successfully in treating twelve babies with feeding difficulties caused by incoordination, when other methods had failed.
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PMID:A new way to treat sucking and swallowing difficulties in babies. 287 22

Eighteen patients were evaluated for primary symptoms of cervical dysphagia and/or laryngeal aspiration and subsequently had a cricopharyngeal myotomy. Twelve patients had a neurologic lesion as the cause of the symptoms. Four patients had a Zenker's diverticulum as demonstrated by barium contrast roentgenograms. Two patients complained of persistent suprasternal dysphagia following one or more antireflux repairs for gastroesophageal reflux disease. Esophageal manometry identified a pharyngoesophageal motor disorder in all but four patients, two of the four with Zenker's diverticulum and the two who had an antireflux procedure. The results show that cricopharyngeal myotomy should be reserved for patients with an identifiable motor disorder confined to the pharyngeal phase of swallowing, ie, failure of the pharyngeal pump or cricopharyngeal incoordination and/or incomplete relaxation. Exceptions to this rule are as follows: Zenker's diverticulum, in which an abnormality may not always be detected but of which the results of surgery demonstrate the effectiveness of this procedure; and pharyngoesophageal complaints associated with reflux, most of which resolve with the restoration of distal esophageal sphincter competence. In those few patients in whom these conditions persist, a cricopharyngeal myotomy may be beneficial. Caution should be used in applying the procedure to individuals who have had multiple antireflux repairs.
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PMID:Pharyngoesophageal dysfunctions. The role of cricopharyngeal myotomy. 392 Oct 4

Cineradiography of pharyngeal swallowing was performed in 854 patients (389 males and 465 females) with dysphagia and analyzed for pharyngeal function. Epiglottic dysmotility was registered in 206 patients (24%), defective closure of the laryngeal vestibule in 318 patients (37%), paresis in pharyngeal constrictors in 130 patients (15%), dysfunction of the cricopharyngeal muscle in 215 patients (25%), webs in 130 patients (15%), Zenker diverticula in 20 patients (2%) and Killian-Jamieson diverticula in 16 patients (2%). The symptom dysphagia was more frequent among young women compared with young men. Over the age of 65 the relation was reversed. Pharyngeal dysfunction was more common among young men than young women and this was due to a high frequency of dysfunction of the laryngeal vestibule in young men. Epiglottic dysfunction and dysfunction of the laryngeal vestibule, pharyngeal paresis, cricopharyngeal incoordination and webs showed an increased frequency with age, while diverticula did not. Pharyngeal constrictor paresis was more common in men. Defective relaxation of the cricopharyngeal muscle and webs were more common among old women compared with old men.
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PMID:Dysfunction of pharyngeal swallowing. A cineradiographic investigation in 854 dysphagia patients. 393 23

Radiologic examinations of the pharynx were performed in 13 patients presenting with dysphagia following treatment of pharyngeal cancer with excision and radiotherapy. The conventional single-film technique or double-contrast examination was unremarkable, although 2 patients had clinical evidence for local recurrence. The patients were also examined with cineradiography using a film speed of 50 and 100 frames/sec. Various functional abnormalities (pharyngeal paresis, epiglottic dysfunction, dysfunction of the laryngeal vestibule, cricopharyngeal incoordination, and cervical esophageal webs) were found in all but 1 patient. The results indicate that functional abnormalities of the pharynx secondary to radiotherapy and surgery are common in patients who have dysphagia after treatment. These functional pharyngeal disorders are accurately diagnosed with cineradiography.
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PMID:Pharyngeal dysfunction after treatment for pharyngeal cancer with surgery and radiotherapy. 634 74

Twenty patients with cervical esophageal dysphagia were treated by cricopharyngeal myotomy. Of these 20 patients, ten had pharyngoesophageal diverticula, four had a hypertensive upper esophageal sphincter (UES), four had bulbar palsy, and two has miscellaneous forms of cricopharyngeal dysfunction. Preoperative esophageal manometric examination revealed mean UES pressures of 37.2 mmHg +/- 4.8 SEM in patients with diverticula-markedly lower (p = 0.01) than in normal patients (55.9 mmHg +/- 5.0 SEM). In patients with hypertensive UES the mean pressure was 166.2 mmHg +/- 13.4, significantly higher (p less than 0.001) than normal. Incoordination of the deglutitive response of the UES characterised by premature relaxation and contraction was present in all patients with diverticula and in one other patient. Another patient exhibited incomplete sphincteric relaxation (achalasia). A 4-5 cm myotomy of the cricopharyngeus muscle and adjacent esophageal muscle was performed in all patients. On the patients with diverticula two also had diverticulectomy. No patient with bulbar palsy was benefited. All other patients were relieved of dysphagia by the operation, with the exception of one patient with a diverticulum. A subsequent diverticulectomy was required in this patient. Postoperative manometric examination revealed an average decrease in UES pressure of 63% and an average decreased in length of the high pressure zone of 1.4 cm.
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PMID:Cervical esophageal dysphagia: indications for and results of cricopharyngeal myotomy. 679 98

A series of 250 patients with dysphagia examined by cine-radiography and conventional single film technique revealed oesophageal webs in 38 and 26 patients respectively. In four patients there were two webs. There were eight males and 30 females which corresponds to an incidence of 8 and 20%, respectively (mean 15%), in patients referred for X-ray examination of the hypopharynx or oesophagus. Concomitant functional abnormalities in the act of swallowing were seen in 25 patients, i.e. pharyngeal constrictor muscle paresis of varying degree, cricopharyngeal incoordination, misdirected swallowing, epiglottic dysfunction and Zenker diverticulum. In five patients there was a malignant lesion as well, i.e. in the larynx, oesophagus, pharynx or stomach. With the aid of cine-radiography it is possible to show the presence of webs in a significantly higher proportion of patients with dysphagia compared with the conventional spot film technique. With cine-radiography it is also possible to demonstrate concomitant functional abnormalities which are frequently present in these patients.
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PMID:Cervical oesophageal webs in patients with dysphagia. 730 35

Cricopharyngeal dysphagia, a disorder of uncertain pathogenesis, is most frequently found in patients with associated gastroesophageal reflux. Seven patients who had dominant cricopharyngeal dysphagia were evaluated. Manometry showed characteristic motor incoordination. Biochemical profiles and endoscopy were normal. Electronmicroscopic examination of the cricopharyngeal muscle biopsy specimens obtained during myotomy showed significant ultrastructural abnormalities. These included numerous and aberrant mitochondria, increased glycogen, lipid inclusions, and phagolysozomes. A striking finding was the presence of numerous nemaline rods in five of seven biopsy specimens examined. The pathologic changes in this muscle in cryopharyngeal dysphagia have not been reported previously. Structural changes are thought to be a secondary response to reflux injury. Nemaline rods form part of the structural abnormality of muscle in patients who have cricopharyngeal dysphasia with no evidence of underlying generalized disease or myopathy.
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PMID:Nemaline rods in cricopharyngeal dysphagia. 740 97

We describe the manometric findings in a patient with hepatolenticular degeneration (Wilson's disease). After 21 years of penicillamine therapy, one of the principal neurological problems remaining in a 49-year-old white man with Wilson's disease is food-induced dysphagia. Barium contrast studies showed gross incoordination of the upper esophagus; the manometric study revealed dysmotility of the mid and distal esophagus.
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PMID:Disordered esophageal motility in Wilson's disease. 745 24

Pharyngoesophageal diverticulum is an acquired defect resulting from an incoordination of the cricopharyngeal muscle. Common symptoms are dysphagia, regurgitation, and aspiration. The defect is repaired through a cervical incision and should include a diverticulectomy and a myotomy. Results are excellent and complications are unusual.
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PMID:Pharyngoesophageal diverticulum: technique of repair. 758 31

Patients with cerebral palsy usually suffer from lack of coordination in the neuromuscular mechanism in their upper airway and digestive tract. Difficulty in swallowing and aspiration are common problems in these patients, and stridorous breathing sometimes develops as a secondary symptom. Laryngoscopic examination revealed that redundant tissue in the aryepiglottic fold area was the cause of stridor and upper airway obstruction in four patients with cerebral palsy. We report on these four patients in whom laser reduction of the redundant mucosa led to dramatic improvements in stridor. Secondary benefits to family members and others were equally impressive.
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PMID:Laser aryepiglottoplasty for the treatment of neurasthenic laryngomalacia in cerebral palsy. 777 14


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