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Query: UMLS:C0011168 (dysphagia)
 15,644 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Functional laryngectomies permit a more or less ideal preservation of laryngeal functions whose recovery, especially in les conservative operations, occurs very slowly and depends on several conditions: post operative course, sensitivity and motility of the hypopharynx, patient's ability to restore swallowing mechanisms. The Authors relate their experience concerning use of a rehabilitative program partially based on the experiences of some French logopedic schools and partially original. They illustrate the steps and goals of this program which starts on the fifth post-operative day with respiration exercises immediately followed by eight days of exercises to re-establish arytenoid mobilization and swallowing movements. If deglutition is not completely recovered and important inhalation problems persist, the logopedic approach is integrated with surgical rehabilitation consisting of one or more injection of gax-collagen. It is possible to use the same surgical technique later, after hospital discharge, if a slight dysphagia is still present in spite of continuous logopedic rehabilitation. Voice restoration exercises are introduced in the last days of the hospital stay when the patient is tube-free and continues at the office or outpatient clinic for two or three times every week. Concerning removal priority (tracheotomy tube followed by nasogastric tube or vice versa), we propose a diversified strategy for each patient, depending on the anatomicofunctional postoperative situation. Up to now 25 patients have taken part in this rehabilitation program (14 cricohyoidopexy, 6 Cricohyoidoepiglottopexy, 5 supraglottic laryngectomies). The results with regard to the amount of time that nasogastric feeding as well as tracheal tube are kept and the length of the hospital stay, were compared to those ones of a similar number of consecutive cases operated at our institution (ENT Department of Modena University) before February 1990 but not rehabilitated. In the early rehabilitated group, we observe a quicker functional recovery with a shorter hospital stay (about a week).
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PMID:[The experience of early rehabilitation]. 129 52

The present study deals with data from an on-going collaborative programme of early diagnosis for upper aero-digestive tract tumors established since 1990 by three ENT Departments of the Friuli-Venezia Giulia Region, Northeastern Italy. The aim of the study was firstly to evaluate the socio-economic characteristics and clinical features of alcoholics in treatment who were offered a free ENT check-up, and secondly to test the feasibility of this type of referral of high-risk patients from non-medical associations to the ENT specialist. A total of 683 patients, of which 151 (78%) were males and 151 (22%) were females, underwent ENT examination. About 25% of the patients were symptomatic, the most frequent symptom being dysphonia (50%) followed by cough (19%), while dyspnoea, dysphagia and pain were present in about 5% of the patients. Other than nearly 50% negative findings, ENT examination revealed a high percentage of inflammatory lesions (30%) of the upper aero-digestive tract. In 37 patients (6%) a precancerous lesion was found and in four cases an histologically confirmed tumor was diagnosed. Although the present study cannot be considered a complete screening, it did clearly evaluate the amount of response given by this high-risk population of alcoholics in treatment to the offer of an ENT examination and gives encouraging results concerning the feasibility of early diagnosis programmes for upper aero-digestive tract tumors which do not follow the normal routine of a sanitary referral by a general practitioner.
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PMID:[The program for early diagnosis of the upper respiratory tract and digestive system neoplasms offered to alcoholics in the region of Friuli-Venice Giulia]. 130 70

A 65-year old man suffering from dysphagia with aspiration was examined. ENT examination showed a Horner syndrome and cranial nerve palsy with paralysis of the soft palate and one vocal cord (palatolaryngeal hemiplegia, Avellis' syndrome). Pharyngeal manometry and videofluoroscopy depicted an asynergic swallowing with cricopharyngeal achalasia. CT scans of mediastinum, head, neck, and skull base showed no signs of abnormality. MR imaging of the brain stem demonstrated an enrichment of contrast medium in the dorsal region of the upper medulla oblongata in the level of the centre of the glossopharyngeal and vagus nerve. This case demonstrates an uncommon cause of dysphagia which was related to transitory brain stem ischaemia. After a period of three weeks the patients' complaints vanished as well as the clinical features. In a follow-up of MR-imaging three months later no focal enhancement of contrast medium was seen confirming the diagnosis of a brain stem ischaemic lesion.
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PMID:["Palatolaryngeal hemiplegia" in transient brain stem ischemia--a contribution to neurogenic dysphagia]. 146 69

Dysphagia is a common symptom presenting to ENT departments. Two cases of tetanus with dysphagia as a major symptom are discussed, together with a review of previously reported cases. Although tetanus is a rare disease in the United Kingdom, the possibility of this diagnosis should be borne in mind in patients presenting with progressive dysphagia, especially if there are other head and neck symptoms present.
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PMID:Dysphagia as a major symptom of tetanus. 147 20

We report three patients with metastases to the ENT-region mimicking a primary malignant tumour. A 36-year-old woman presented with vertigo, sudden hearing loss, partial facial palsy and headaches. CT scan suggested a meningioma or an acoustic neuroma. Histological examination of the neoplasm removed surgically showed a metastasis from an amelanotic melanoma. A 38-year-old woman with nodules in the tongue had dysphagia. The history revealed that she had been treated successfully with chemotherapy for a carcinoma of the uterine cervix one year ago. Histological examination of a tongue biopsy showed a metastasis from the uterine carcinoma. The primary tumour was in complete remission. The third patient was treated for recurrent epistaxis. Physical examination showed a tumour in the right nasal cavity. A CT scan showed a tumour of the ethmoid cells and of the maxillary sinus, protruding into the nose. Histology and immunohistology proved a metastasis from a primary carcinoma of the liver. Ultrasound and CT scan of the liver confirmed the diagnosis.
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PMID:[Metastasis to the ENT area]. 165 38

A 69-year-old woman was examined because of progressive dysphagie. A barium esophagogram showed no obstruction but a swallowing in trachea suggested a neuromuscular disorder. ENT examination showed no specific signs of infection. The clinical diagnosis of tetanus was confirmed by electromyography. This case demonstrates an uncommon cause of dysphagia where the classical signs of tetanus in the early stages of this disease were absent and dysphagia was the initial and sole presenting symptom.
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PMID:[Dysphagia as initial symptom in tetanus. A case report]. 175 7

During the last three years, 79 adults suffering from acute epiglottitis have been treated in the ENT departments of the university hospital Rudolf Virchow, Berlin, 36 women (41 years of age as an average) and 43 men (average age 39 years). Acute epiglottitis developed either all of a sudden, within hours, or gradually, within days. All patients complained of dysphagia and pain in the throat; dyspnea could be observed in 20%. During examination, we could see an inflamed, thickened epiglottis with edema of the arytenoid cartilages. 55 patients reported an infection of the upper airway prior to the onset of symptoms of acute epiglottitis, epiglottic abscess developed in 11 adults. The inflammation responded satisfactorily to conservative antibiotic management (broad spectrum penicillin). Only one patient had to undergo intubation, none of the adults required tracheotomy.
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PMID:[Clinical aspects of acute epiglottitis in adults]. 175 15

Presenting the case of a 56-year-old man diagnosed of an idiopathic ankylotic hyperostosis, with pronounced osteophytosis of the neck and bulged rear wall of the oropharynx, producing dysphagia as associated ENT symptom. Some clinical, diagnostic and therapeutic aspects of the case are contemplated by the AA.
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PMID:[Cervical ankylosing hyperostosis as a cause of dysphagia. A case report and review of the literature]. 177 66

The diagnostic procedure for the symptom oropharyngeal dysphagia is described from an otorhinolaryngologic point of view, with emphasis on an interdisciplinary team approach. The various methods used in modern otorhinolaryngology both by the practitioner and the clinician are discussed with regard to a step-like diagnostic approach. The diagnosis should be made on the basis of aetiology, anatomy and function. First all organic changes causing oropharyngeal dysphagia must be recognized, both "typical ENT diseases" and malignant tumors of the oropharynx and hypopharynx which are usually diagnosed only in an advanced stage. If there is no evidence of an organic cause in the field of otorhinolaryngology, as a differential diagnosis a dysfunction of the upper esophageal sphincter and a "globus pharyngus" have to be ruled out.
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PMID:[Diagnostic approach to dysphagia from the ENT viewpoint]. 204 19

In myasthenia gravis and amyotrophic lateral sclerosis the ENT specialist or the phoniatrician may be consulted first, because in about 30 percent of all cases the initial symptoms are dysarthria, dysphagia or dyspnea. Three typical cases of each condition are presented. The quality of life of the patients can be improved considerably by early diagnosis and treatment. Special diagnostic and therapeutic procedures are described.
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PMID:[Dysarthria, dysphagia or dyspnea as a reason for the initial consultation in pseudoparalytic myasthenia gravis and amyotrophic lateral sclerosis]. 231 Apr 61


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