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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

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

The function of the pharyngoesophageal stage of deglutition was studied by cineradiography in 45 patients with an acute onset of dysphagia. None of the patients had any radiographically detectable foreign body in the pharynx or esophagus. In 34 of the patients (76%) a functional or morphodynamic abnormality was disclosed; a defective closure of the laryngeal vestibule (26 patients), defective movements of the epiglottis (18 patients), uncoordinated relaxation of the cricopharyngeal muscle (14 patients), paresis of pharyngeal constrictor muscles (9 patients), and cervical webs (9 patients). In 21 of the patients more than 1 type of dysfunction was present. The results of this study suggest that cineradiography of the pharyngoesophageal stage of deglutition is useful in patients with acute dysphagia, without a foreign body, as functional abnormalities often can explain the patients' complaints.
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PMID:Cineradiography in 45 patients with acute dysphagia. 664 45

Forty adult patients have undergone a 7 to 10 cm cervical esophagomyotomy (from the superior cornu of the thyroid cartilage to behind the clavicle) for cricopharyngeal dysfunction. A Zenker's diverticulum was present in 12 patients (30%) and in five was recurrent. Preoperative symptoms included cervical dysphagia (85%), expectoration of saliva (40%), and intermittent hoarseness (30%). Four patients were being fed through tubes because of total inability to swallow. "Heartburn" was experienced by one half of the patients, but only 12 had acid or food regurgitation. The duration of symptoms ranged from 1 month to 11 years (average 3.9 years). Weight loss had occurred in 15 patients (38%) and ranged from 5.5 to 40.9 kg (average 16 kg). Barium swallows showed no abnormalities in 10 patients. Abnormal findings included a Zenker's diverticulum (12), prominent cricopharyngeal sphincter (11), nasopharyngeal reflux or incoordinated initiation of deglutition, or both (seven), a sliding hiatal hernia (11), and abnormal esophageal motility (seven). Esophageal manometry revealed abnormalities of upper esophageal sphincter (UES) function in only 16 patients. Of 36 patients undergoing standard acid reflux testing, one third had moderate-to-severe gastroesophageal reflux. Seven patients underwent staple resection of a Zenker's diverticulum at the time of cervical esophagomyotomy. Postoperative complications included transient vocal cord paresis (four), vocal cord paralysis (one), and salivary fistula (one). There were no postoperative deaths. After 2 to 48 months (average 16 months) of follow-up, 34 patients (85%) have had a good to excellent result, and six (15%) have not been benefited by operation.
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PMID:Extended cervical esophagomyotomy for cricopharyngeal dysfunction. 677 51

Among 250 patients with dysphagial complaints, 83 had dysfunction of the epiglottis as revealed by high-speed cineradiography. Nineteen patients had a totally immobile epiglottis and of these 11 had concomitant pharyngeal constrictor paresis. Sixteen of the patients with immobile epiglottis had misdirected swallowing. An absence of the second movement of the epiglottis during deglutition was registered in 53 patients. Thirteen of these had pharyngeal constrictor paresis and 45 had misdirected swallowing. In 11 patients the epiglottis attained an obliquity of 30 degrees to 90 degrees as seen in the anteroposterior projection during its second movement. One of these had a pharyngeal constrictor paresis, while four had misdirected swallowing. The results of this study indicate that epiglottic dysfunction is common among patients with dysphagia and is often accompanied by other functional abnormalities.
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PMID:Epiglottic dysfunction during deglutition in patients with dysphagia. 684 97

In order to define the diagnostic outcome of cineradiographic examination of the swallowing act (pharyngeal stage) in patients with dysphagia, 250 such patients were consecutively examined at filmspeeds of 50 and 100 frames per second. Synchronous and symmetrical swallowing was observed in 20% of the patients while 80% exhibited functional abnormalities i.e., epiglottic dysfunction (33%), misdirected swallowing and aspiration (41%), cricopharyngeal dysfunction (22%), paresis of the pharyngeal constrictor musculature (10%), webs (15%) and Zenker diverticula (2%). These results clearly indicate that cineradiography can frequently disclose functional abnormalities in the act of swallowing among patients with dysphagia and explain the symptoms of these patients. Cineradiography is clearly superior to conventional single-film technique in revealing functional abnormalities in the act of swallowing.
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PMID:Cineradiography of the pharyngeal stage of deglutition in 250 patients with dysphagia. 706 34

Of 250 consecutive patients with dysphagia studies by cineradiography, 55 (22%) had dysfunction of the cricopharyngeal muscle, indicated by an indentation of the pharyngo-esophageal junction during swallowing. The indentation measured less than 25% of the esophageal diameter in 29 patients, less than 50% in 18, and greater than 50% in 8 and was transient in 36 patients and continuous in 19. In 35 patients, abnormalities of swallowing were seen, including pharyngeal constrictor paresis [8], epiglottic dysfunction [17], misdirected swallowing [23], and esophageal webs [19]. Cineradiography during swallowing is important in the diagnosis, since dysfunction is often overlooked on a routine examination.
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PMID:Dysfunction of the cricopharyngeal muscle. A cineradiographic study of patients with dysphagia. 707 51

Among 250 patients examined by cineradiography because of dysphagia 25 were found to have a more or less pronounced paresis of the pharyngeal constrictor muscle. The paresis included all three portions of the muscle in six patients. A localised lesion was found in 19 patients and included the superior portion of the pharyngeal constrictor muscle in one patient, the middle portion in 16 patients and the middle and inferior portions in two patients. All 25 patients exhibited concomitant cineradiographic abnormalities, including impairment of the tilting down of the epiglottis, dysfunction of the cricopharyngeal muscle and retention of barium in the pharynx. With the aid of cineradiography it is possible to disclose an underlying pharyngeal constrictor paresis in about 10% of patients with dysphagia who are referred for radiographic examination. In most patients suffering from a localised pharyngeal paresis the diagnosis will be overlooked in a routine examination, but will be easily demonstrated with cineradiography.
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PMID:Pharyngeal constrictor paresis in patients with dysphagia: a cineradiographic study. 707 27

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

Eleven cases presenting a syndrome of the medulla oblongata are discussed with reference to the findings of clinical and angiographic investigation. The diagnosis of Wallenberg's syndrome is justified when the classic symptoms are apparent (Horner's syndrome, nystagmus, dysphonia and dysphagia, ataxia, ipsilateral sensory impairment of the face and contralateral elsewhere, and accompanying vegetative disturbances). If additional symptoms such as a facial or extra-ocular muscle paresis, especially hemiparesis, exist, another, more lateral or medial, syndrome of the oblongata should be considered. Angiographic findings vary considerably, ranging from a normal vertebral artery or posterior inferior cerebellar artery (PICA) to an occlusion of these arteries (in three and two of the 11 cases respectively). Modification are often seen in the anterior inferior cerebellar artery (AICA). A kind of complementary supply in the PICA-AICA region must occasionally exist. Localised processes affecting these vessels rather than diffuse multifocal vascular processes would lead to Wallenberg's syndrome. It is difficult to conclude from the clinical picture where a possible responsible vascular narrowing or obliteration may lie, even if pareses of the limb were present.
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PMID:[Clinical and angiographic findings in vascular medullary syndromes (author's transl)]. 731 26

Results of otoneurological examinations of 16 patients (from 6 families) with hereditary cerebellar ataxia have been analyzed. It has been found that all the patients exhibit vestibular function disturbances that manifest clinically by the truncal and supranuclear syndrome. Of other otoneurological signs the most frequent is dysphagia (in 10 out of the 16 patients) which is due not only to the dyscoordination of the glottal muscles, but also to a paresis of the epiglottis, this paresis also being a sign of supranuclear pathology. The absence of the otoneurological disturbances in practically healthy relatives of the patients (12 persons) requires further accumulation of the experimental material, since it can be a proof, that there is no pathological carrying of the gene of hereditary cerebellar ataxia (Pierre Marie's disease) and this may be used subsequently for medico-genetic consultations.
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PMID:[Otoneurologic symptomatology in hereditary cerebellar ataxia (Pierre Marie disease)]. 739 12


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