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)

In spite of the development of upper digestive tract fiberoptic endoscopy (FE) within the last 10 years, early detection of esophageal carcinoma (EC) is rare except in certain high-risk groups such as patients with head and neck cancers. The aim of this study was to assess the value of a meticulous histoendoscopic examination with vital toluidine blue (TB) staining in all alcohol and tobacco abusers undergoing FE for any reason except dysphagia. In 18 months, 100 patients (90 men, 10 women) who were over 40 years old and who consumed more than 80 g of alcohol and 20 g of tobacco per day underwent FE. No patient had a history of head and neck or esophageal cancer. FE was decided in 48 patients for epigastric pain, in 28 for esophageal varices, in 8 for weight loss, in 8 for anemia, in 7 for peptic disease, and in 1 for diarrhea. Staining with TB was carried out at the end of the examination and two routine biopsies were obtained 5 cm above the lower esophageal sphincter. Specimens were obtained from each abnormal area (TB + or TB -). Clinical ENT examination was recommended for all patients. Two esophageal carcinomas (1 microinvasive, 1 in situ) and 15 cases of dysplasia were detected. Dysplasia was classified as severe in 1 case, moderate in 9 cases, and mild in 5 cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Endoscopic detection of dysplasia and subclinical cancer of the esophagus. Results of a prospective study using toluidine blue vital staining in 100 patients with alcoholism and smoking]. 231 48

Nutritional assistance was indicated in 31 patients with an ENT tumour at different stages of treatment and different stages of the disease. These patients presented with disorders of deglutition with false passages (68%), aspiration pneumonia (10%), dysphagia (35%) or denutrition (17%). We used an endoscopic percutaneous gastrotomy kit produced by the Bioser company (pull technique). In 29 patients, the tube was inserted under general anaesthesia in the operating theatre to prevent dyspnoea during introduction of the tube in these patients with alteration of the airway-gastrointestinal tract junction or because the tube was inserted at the beginning of anaesthesia for ENT surgery. The tube was able to be inserted in every case, with cardiac arrest in one patient who was effectively resuscitated without sequelae, two obstructions of the cuff requiring advancement of the tube with a bougie, 2 ruptures of the thread and one case of dyspnoea. Two patients subsequently developed a wound abscess which was drained and one patient required removal of the tube. Follow-up of the patients demonstrated the good tolerance of this tube which was maintained for an average of 2.9 +/- 0.5 months (0.1 to 9 months) without any major complications. 3 benign wound infections, 4 inflammatory reactions, 4 minimal leaks, 1 case of hyperthermia, 12 cases of abdominal distension and 2 cases of displacement of the tube were observed. The weight gain was equal to 4%. The authors believe that this technique of endoscopic gastrostomy should be preferred to surgical gastrostomy.
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PMID:[Percutaneous endoscopic gastrostomy. Indications and results in 31 patients]. 271 44

The dysphagia encountered by patients with neurological disorders can be both distressing and life threatening because of the associated problems of aspiration. Decisions regarding management are often difficult because the exact nature of the underlying disorder varies from patient to patient and is frequently complex. A new approach to the assessment and evaluation of acquired neurological dysphagia is presented. Management of the first 50 patients assessed by this method is described. The advantages of a joint dysphagia clinic comprising neurology, speech therapy, ENT and radiology departments are discussed.
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PMID:A combined approach to the assessment of neurological dysphagia. 303 33

Acute epiglottitis in adults is a potentially fatal but self-limiting disease of increasing incidence world-wide. Forty-two patients, seen consecutively over a four year period at the ENT Department, Singapore General Hospital were reviewed retrospectively. A strong male predominance with a peak age incidence in the sixth decade was noted. A severe sore throat and dysphagia with disproportionate signs of oropharyngeal inflammation was the main presenting picture. Only three patients had stridor on presentation. Vigilant monitoring of the airway with empirical high-dose intravenous ampicillin, cloxacillin and steroids resulted in a dramatic clinical improvement in most patients and none developed stridor after admission. The yield from throat swabs and blood cultures were low. Two patients developed complications, a Ludwigs angina and an epiglottic abscess. Recurrent epiglottitis was a problem in one patient. There was low morbidity and no mortality on the management regime outlined.
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PMID:Acute epiglottitis in adults (the Singapore experience). 320 35

A number of typical ENT complaints which do not involve organic signs or symptoms are presented, such as sinusitis-like headache, otitis-like earache and tonsillo-pharyngitis-like dysphagia. Since patients with such complaints usually visit an ENT specialist first, an introduction of additional diagnostic and therapeutic measures is imperative. Without having been trained in chirotherapy, it is possible to identify painful locations, myogeloses and functional disorders in the craniocervical area. In many cases treatment of these disorders leads to disappearance of associated irritational complaints. In addition to local treatment of the neck, the ENT specialist may employ a procedure as described. Superficial infiltration of the mucous membrane is performed with a local suprarenin-free anaesthetic in an area around the upper wisdom tooth and on the palatoglossal arch. This procedure often leads to spontaneous and lasting relief of symptoms. It is assumed that this has the effect of inhibiting the pathologically irritated afferents and thus of interrupting an altered reflex arc. Relief from the complaints is improved by physiotherapy and by avoiding the detrimental influence of bad posture, nervous stress, air draughts, cold chills etc. Extensive massage therapy can result in worsening of complaints.
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PMID:[Neck-induced myoneural irritation pain--a recommendation for therapy by the ENT physician]. 328 78

External ophthalmoplegia, retinal pigmentary degeneration and heart block constitute the trias of Kearns-Sayre's syndrome. The aetiology of this disorder of oxidative metabolism is unknown. This syndrome must be more frequent than described. In the ENT field there is an extensive lack of differentiated data. Central neural and peripheral hearing disorders and vestibular disorders are in fact significant, as are also dysphagia, hoarseness and dysarthria in consequence of central and peripheral disorders in muscular function. The authors report on ENT findings in 4 patients with verified Kearns-Sayre's syndrome. Progression of central disorders enhances an unfavourable prognosis. Histochemical, biochemical and electron microscopic data are still lacking for the proper grading and assessment of clinical findings.
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PMID:[Kearns-Sayre syndrome from the otorhinolaryngologic viewpoint]. 660 92

A small series of pain syndrome patients shows that disturbances of the head and neck motor system can lead to various pain syndromes as the vicious circle between pain and muscle tension is initiated by a triggering factor. These pain syndromes include varying combinations of the following symptoms: headache, referred otalgia, arthralgia of the temporomandibular joint, styloid syndrome, tendopathia of the hyoid bone, carotidynia, cervical dysphagia and probably most patients with superior laryngeal nerve neuralgia or glossopharyngeal neuralgia. A detailed differentiation of those syndromes is of little value for diagnostic and therapeutical purposes, because the mixed distribution of the pain irradiation does not indicate the localisation of the primary pathology. The pain syndromes of the head and neck motor system can be caused by temporomandibular joint pathology as well as by anatomical or functional alterations of the cervical spine. Acute exacerbations are triggered off by various influences such as inflammation, trauma, scarring after surgery or radiotherapy. Thus diagnostic and therapeutic measures must take into consideration both the motor system itself and any possible triggering factors. The problem frequently needs interdisciplinary co-operation. An attempt to handle the problem within the boundaries of a single discipline such as ENT, may lead to unnecessary and misleading steps. Guidelines for the management of such pain syndromes are outlined.
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PMID:[Pain syndromes of the head, neck and locomotor system--determining current status]. 674 25

The authors report two cases of bullous rashes with an ENT onset: 1. a benign mucosal pemphigoid; 2. a pemphigus vulgaris. On the basis of these cases, they indicate the need to consider the possibility of bullous lesions in the presence of any persistent erosion of the nasal or bucopharyngeal mucosa, the diagnosis of which should be dominated by the identification of a possible pemphigus, the prognostic and therapeutic consequences of which remain serious. The clinical onset may be confined for a long period to the E.N.T. musoca. It may present with dysphagia and pain, or sometimes by simple epistaxis. The commonest diagnostic errors are aphthous ulcers and candidiasis which may, in the case of the latter, be associated with bullous lesions. They also report the possible problems which may result from endoscopic manoeuvres in the case of pemphigus. Any persistent erosion of the mucosae in the E.N.T. area should be evaluated by diagnostic cytology which would offer positive identification of pemphigus.
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PMID:[Problems of bullous lesions in E.N.T. Based upon two cases (author's transl)]. 699 56

For precise differentiation between organic and functional disorders of the oesophagus, the gastroenterologist makes use of radiology, endoscopy, and manometry, although a questionnaire may establish the final diagnosis in dysphagia with 95% accuracy. Combined therapy is gaining in increasing importance, such as dilatation of achalasia, bouginage of peptic strictures, implantation of prostheses and sclerosing of varices during endoscopy. For early diagnosis of carcinoma, close interdisciplinary cooperation between the ENT-specialist and the gastroenterologist is mandatory in panendoscopy of the squamous epithelium-lined aero-digestive system.
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PMID:[Oesophageal disorders: a gastroenterologist's view]. 712 Nov 43

The feeling of having a lump in the throat is a common complaint of ENT outpatients. The symptom is associated with a multitude of pharyngoesophageal abnormalities. Our study compares the diagnostic yield of videofluoroscopy to that of static radiography in patients suffering from globus pharnygis. A total of 150 consecutive patients complaining of a lump in the throat, but without evidence of dysphagia, were studied in a standardized fashion with both methods. Videofluoroscopy combined with static radiography revealed morphological or functional abnormalities in 75% of our patients. The combination of the two methods yielded significantly more abnormalities in the pharynx and esophagus than videofluoroscopy (P < 0.0001) or static radiography alone (P < 0.0001). Esophageal motor disorders, pharyngoesophageal sphincter dysfunction and pharyngeal residue of contrast material proved to be the most common abnormalities. In conclusion, videofluoroscopy combined with static radiography is mandatory in the radiological assessment of patients suffering from the globus sensation.
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PMID:[Radiologic assessment of globus pharyngis. Comparison of the diagnostic value of conventional roentgen with videocinematography]. 750 99


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