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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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

The luxation of the arytenoid cartilage is a very uncommon complication of endotracheal intubation. Symptoms usually are aphonia, dysphonia, pain or discomfort in the throat, odynophagia and laryngeal stridor. It may be due to several factors: the pressure of the convex aspect of the tube on the arytenoid, traumatic or prolonged intubations, reintubations within a short period, or some systemic diseases. We report a case of posterior luxation of the left arytenoid in a patient who had been anesthetized for the radical cure of a left inguinal hernia. The clinical features developed when he recovered from anesthesia, with aphonia and discomfort in the throat. The diagnosis was made by indirect laryngoscopy. Treatment with nonsteroidal antiinflammatory agents was instituted. Aphonia disappeared after 2 weeks and dysphonia persisted. The patient became asymptomatic with corticosteroids on the fourth week after operation. Early diagnosis under laryngoscopic vision is recommended, with adequate therapy to prevent fibrosis of the cricoarytenoid joint with permanent sequelae.
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PMID:[A rare complication of endotracheal intubation: posterior luxation of the left arytenoid cartilage]. 187 34

A 48-year-old woman whose past history was unrevealing presented with sudden swelling of the neck with pain and dysphonia. Neck ultrasonography suggested the possibility of hemorrhage in a parathyroid adenoma. Surgical exploration revealed a hemorrhagic parathyroid adenoma of the chief cell type. This event is exceedingly rare, but should be considered in the differential diagnosis of suddenly appearing masses of the neck region.
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PMID:Asymptomatic parathyroid adenoma manifested by intratumoral hemorrhage. 227 8

ENT symptoms due to disorders of the cervical spine are rarely caused by pathological lesions of the cervical spine that can be demonstrated by radiography, but are mostly caused by functional disorders of the upper cervical spine. They include: globus symptoms and dysphonia; pain syndromes in the head and neck; and otoneurological disorders. ENT symptoms resolve as soon as the function of the cervical spine and vertebral joints has returned to normal.
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PMID:[Functional disorders of the craniocervical transition and ENT symptoms--a status determination]. 268 30

We report an unusual case of dysphonia secondary to Eagle's syndrome. Despite documentation of the stylohyoid syndrome in the literature, the appropriate diagnosis in this case eluded several clinicians. Once the diagnosis was made, surgical therapy rendered the patient completely free of her symptoms. Although the patient's pain was somewhat atypical for the stylohyoid syndrome, we believe that this case underscores the importance of the head and neck surgeon's need for familiarity with the various causes of head and neck pain.
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PMID:Eagle's syndrome: an atypical cause of dysphonia. 272 7

The term ameloblastic carcinoma is differentiated from the term malignant ameloblastoma and is defined as an ameloblastoma in which there is histologic evidence of malignancy in the primary tumor or the recurrent tumor (or metastasis), regardless of whether it has metastasized. Eight cases of ameloblastic carcinoma from the Armed Forces Institute of Pathology (AFIP) are reported. The mean age of patients was 30.1 years, with no sex predilection noted. Seven cases involved the mandible and one involved the maxilla, with the posterior regions favored. The most common sign was swelling, although pain, rapid growth, trismus, and dysphonia also occurred. Lesions characteristically were evident as ill-defined destructive radiolucencies, with occasional radiopacities noted. Histologic features generally resembled those of conventional ameloblastoma but with cytologic features of epithelial malignant disease. The clinical course was uniformly aggressive with extensive local destruction and spread, frequent recurrences, and one case of neck node metastasis. The nomenclature and classification of odontogenic carcinomas are discussed, as well as entities that should be included in the differential diagnosis. Further reporting of ameloblastic carcinoma is encouraged.
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PMID:Ameloblastic carcinoma: a clinicopathologic study and assessment of eight cases. 331 52

Medical treatment of dystonia usually results in an incomplete response and is frequently unsuccessful. Peripheral surgical therapy is available for some focal dystonias, but may only offer temporary relief and may have unacceptable complications. We have used local injections of botulinum toxin into the appropriate muscles for treatment of disabling focal or segmental dystonia in 93 patients with torticollis, blepharospasm, oromandibular dystonia (OMD), limb dystonia, lingual dystonia, and dystonia adductor dysphonia, in addition to four patients with hemifacial spasm. Significant relief of motor symptoms was seen in 69% of the patients with blepharospasm and 64% of patients with torticollis; 74% of the latter group with pain experience relief. Relief of symptoms was noted in most patients with OMD and limb dystonia, and all with lingual dystonia, dystonic adductor spastic dysphonia, and those with hemifacial spasm. Benefit averaged 2 1/2-3 months initially; however some patients experienced longer relief with subsequent injections. Adverse effects were transient, although 2 patients developed antibodies against the toxin, and we documented evidence for distant effects in others. This approach of chemically weakening contracting muscles in focal dystonia offers many advantages over pharmacotherapy and surgical therapy. Additional experience is needed to explore the proper doses, and potential for long term adverse effects.
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PMID:Localized injections of botulinum toxin for the treatment of focal dystonia and hemifacial spasm. 350 53

Four cases of acute laryngeal fracture that demonstrate the history and clinical findings characteristic of blunt laryngotracheal trauma are presented. Symptoms in these patients included shortness of breath, neck pain, dysphasia, dysphonia, and hemoptysis. Physical examination findings suggesting acute laryngeal injury included pain on palpation of neck, swelling or edema of the neck, subcutaneous emphysema, and loss of landmarks in the neck. All four patients were admitted to the surgical intensive care unit and had the diagnosis of laryngeal fracture confirmed at laryngoscopy. Airway obstruction is a potential complication in all patients sustaining blunt laryngotracheal trauma. Early diagnosis and management may lead to a good outcome, as with these four patients.
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PMID:Blunt laryngotracheal trauma. 372 9

A 72-year-old woman with severe rheumatoid arthritis developed atlantoaxial subluxation requiring surgery. Tracheal intubation was performed during the procedure. Gradually worsening dysphonia and dyspnea developed postoperatively. Laryngoscopy showed palsy of both vocal cords and coalescence of the arytenoid cartilages. Despite surgical treatment, permanent tracheostomy was required. There is evidence that laryngeal involvement is common but usually subclinical or mild in rheumatoid arthritis patients. Tracheal intubation can cause the laryngeal lesions to flare. Clinical manifestations are nonspecific and sometimes misleading (e.g., cough or pharyngeal and laryngeal pain). Direct laryngoscopy and computed tomography of the larynx allow evaluation of the lesions of the different components of the larynx. The case reported herein demonstrates that rheumatoid arthritis patients should be screened for laryngeal involvement by history and ENT examination and that any laryngeal abnormalities should be reported to the anesthesiologist if tracheal intubation is planned.
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PMID:[Severe laryngeal involvement in rheumatoid arthritis requiring permanent tracheostomy]. 783 91

Local injections of botulinum toxin is a well-accepted treatment for focal dystonias, hemifacial spasms and strabismus. Its use by skilled neurologists has been reported to be safe and effective. We report our experience with botulinum toxin injections in 108 patients with various central nervous system disorders. Botox was effective in upper face dystonia (86% improvement), spastic dysphonia (92% improvement), platysma muscle spasms and spasmodic torticollis (range of movement 61%, pain and tension 90%). It was also very effective in a few patients with apraxia of eyelid opening, parkinsonian jaw tremor, teeth clenching, palatal myoclonus and adductor leg spasticity. No serious side effects were recorded. Botulinum toxin is a useful symptomatic treatment for many neurological disorders, and one of the leading mode of treatments in the new subspecialty in neurology called "Interventional neurology."
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PMID:Interventional neurology: botulinum toxin as a potent symptomatic treatment in neurology. 798 70


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