Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Twenty patients with a remote history of poliomyelitis and recent or progressive dysphagia were evaluated with cinefluorography. Radiographic abnormalities were present in the pharynx in varying degrees in all but one of the patients. Findings included atrophy of the prevertebral soft tissues, unilateral or bilateral weakness of the tongue or soft palate, paresis or paralysis of the pharyngeal constrictor muscle, incomplete or absent epiglottic tilt, poor laryngeal elevation, poor laryngeal closure with laryngeal penetration, aspiration (often without a cough), and luminal narrowing at the cricopharyngeal level. Other structural lesions included a Zenker diverticulum in one patient, bilateral pharyngeal pouches in five, and a unilateral pouch in one. Additional structural lesions contributing to dysphagia were found in two other patients, including a focal stricture in the cervical esophagus in one patient and two stenotic rings in the distal esophagus in another. In four patients (one of whom had the Zenker diverticulum), the inferior constrictor muscle contracted forcibly above a prominent cricopharyngeus muscle, perhaps contributing to the formation of the diverticulum. It is important to examine postpolio patients with dysphagia carefully with dynamic imaging to assess the severity of decompensation and to detect other lesions that may be treatable. The information derived can be used to guide management.
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PMID:Swallowing dysfunction in the postpolio syndrome: a cinefluorographic study. 172 82

During a period of 25 years, 115 patients with Zenker's diverticulum were submitted to diverticulectomy in the Ear-Nose and Throat Department of Arhus Municipal Hospital. The condition recurred in 18 of the patients treated operatively. In 24 patients (21%), local complications most of which were infective occurred. Ten patients developed paresis of the recurrent nerve and this was permanent in half of these. Thirteen patients (11%) developed other complications which were most frequently infective and one death occurred. It was found that postoperative prophylactic antibiotic treatment could reduce the number of local infective complications significantly and that there was a correlation between the occurrence of local infective complications and subsequent recurrences. No connection was found between the occurrence of local or other complications and the age of the patient. The endoscopic operative technique with CO2-laser has proved a rapid and safe method of treatment which appears to result in fewer complications and briefer periods of hospitalization.
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PMID:[Zenker's diverticulum]. 211 79

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

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

In the Otolaryngology Department of Pomeranian Medical Academy in Szczecin since 1980-1999 14 patients with pharyngo-oesophageal diverticulum were diagnosed and treated. Diverticulectomy was performed in 13 cases. Not dangerous complications during the postoperative period were observed in four cases. In one case it was abscess in postoperative wound, in two cases fistula to soft tissue in prevertebral region and in one case paresis of vocal cord. In all these cases complications retreated spontaneous. We had not observed any recurrence of pharyngo-oesophageal diverticulum. In 6 cases control radiological examination was performed (from 2 months to 7 years after surgical treatment). In all cases we hadn't observed any recurrence of diverticulum. In one case radiological examination revealed diverticulosis in all digestive system. But even in this case we hadn't found recurrence of Zenker's diverticulum. In this paper we discuss other methods of treatment of pharyngoesophageal diverticulum.
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PMID:[Diverticulectomy for hypopharyngeal diverticula]. 1096 Oct 69

Pharyngoesophageal diverticulum is a rare complication following anterior cervical discectomy and fusion (ACDF). Dysphagia is a well-documented complication associated with ACDF. It may result postoperatively from a variety of etiologies, including hardware displacement, pharyngeal edema, or vocal fold paresis. One rare cause of persistent dysphagia is the formation of a hypopharyngeal diverticulum, reported in the literature in 9 previous cases. Such diverticula after ACDF surgery may have pathogenesis that is distinct from that of typical Zenker diverticula. We report 3 new cases of hypopharyngeal diverticula in patients who underwent revision ACDFs. Variables assessed included age, sex, level of fusion, ACDF-related complications, and diverticulum management. Two patients underwent successful open surgical diverticulectomy and cricopharyngeal myotomy. In the third case, the patient had a small diverticulum close to the surgical hardware and minimal symptoms and was managed conservatively. Our cases, combined with the 9 previous cases, demonstrate commonalities, particularly with regard to the risk of revision spinal surgery and infection and subsequent hypopharyngeal diverticula development. Hypopharyngeal diverticulum can occur as a complication of ACDF and should be considered in patients with persistent dysphagia after surgery. In this patient population, open resection and cricopharyngeal myotomy are recommended.
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PMID:Hypopharyngeal diverticulum formation following anterior discectomy and fusion: case series. 2108 70