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Query: UMLS:C0032290 (aspiration pneumonia)
 2,291 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Four cases of pharyngeal trauma in cattle due to improper administration of oral medications are discussed. These cases presented for suspected gastro-intestinal disorders and anorexia. Physical findings included copious drooling of saliva, pharyngeal pain, extended head and neck, forestomach stasis, fever, dysphagia, and pneumonia. Diagnosis was made by manual examination of the oral cavity or endoscopy. Ancillary diagnostic aids included clinical pathology and radiography. Hemograms were consistent with infection, serum electrolytes were normal. Radiographs in 3 of 4 did reveal significant evidence of retropharyngeal cellulitis. The signs of dysphagia and forestomach dysfunction were explained by either a pain induced inhibition of swallowing and eructation or direct involvement of the vagus nerve itself in the retropharyngeal region. An additional consequence of laryngeal motor dysfunction was aspiration pneumonia. Response to treatment with broad spectrum antibiotics, analgesics and symptomatic supportive care over a 7 to 14 day period was good.
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PMID:Pharyngeal trauma in cattle. 722 42

Few adverse effects of the surgical treatment of drooling are reported in the literature. This report describes a young man with severe extrapyramidal cerebral palsy and profuse drooling whose oral feeding behavior deteriorated following bilateral submandibular gland excision and parotid duct rerouting. Before surgery the patient had safe, functional oral feeding skills, and eating was enjoyable. Following surgery he developed progressive feeding difficulties, weight loss, and aspiration pneumonia. His deterioration led to the placement of a feeding gastrostomy and the end of all oral feedings. Surgery had a disturbing and apparently irreversible negative impact on the patient's quality of life.
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PMID:Deterioration of feeding behavior following surgical treatment of drooling. 813 21

We describe 2 children with severe spastic quadriplegic cerebral palsy (CP) who have significant drooling and frequent aspiration pneumonia. They underwent simultaneous botulinum toxin type A (BTX-A) injections to salivary glands for drooling and prevention of aspiration pneumonia along with single-event multilevel chemoneurolysis (SEMLC) with BTX-A and 5% phenol for severe diffuse spasticity. There was significant improvement in drooling, frequency of aspiration pneumonia, and spasticity without adverse effect. BTX-A injections into the salivary glands, in addition to SEMLC, for these 2 children with medically complicated severe spastic quadriplegic CP, were safe and highly successful procedures, which improved their health-related quality of life.
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PMID:Botulinum toxin type a injections to salivary glands: combination with single event multilevel chemoneurolysis in 2 children with severe spastic quadriplegic cerebral palsy. 1640 53

The aim of this study was to investigate the efficacy and safety of radiosurgical bilateral submandibular duct relocation in neurologically impaired children and young adults suffering from excessive drooling. The enrolled patients were referred with excessive drooling after the failure of 6 months of oral-motor training and conservative methods. The exclusion criteria were dental caries and recurrent aspiration pneumonia. During 2000-2007, 14 children and young adults with persistent drooling underwent radiosurgical bilateral submandibular duct relocation and sublingual gland excision. A retrospective case note review was performed and a questionnaire study was conducted. The oral-motor function was assessed on a 4-degree scale preoperatively, 4 months postoperatively and after an average follow up time of 8-26 months. A majority of the patients (79%) achieved a satisfactory reduction in sialorrhoea. The average time of onset of an improvement in the drooling was 3 weeks (ranging from immediately to 5 months). The parents of 10 (71%) patients were happy with the outcome and would recommend the procedure to the parents of other children. The complications included three cases of transient sublingual swelling in the early, and two cases of ranula in the late postoperative period. The average duration of surgery was 48 min, i.e., about 30% less than for the previously favoured cold knife technique. Radiosurgery furnishes a new therapeutic approach for neurologically disabled children suffering from excessive drooling. It combines the advantages of the cold knife and laser techniques: it is easy, safe, precise and effective, with excellent tactile and haemostatic features.
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PMID:Bilateral submandibular duct relocation by high-frequency radiosurgery. 1824 37

Caring for children and adolescents with developmental disabilities is challenging because of their susceptibility to varying degrees of respiratory morbidity and mortality. This article discusses the common pulmonary problems affecting children with developmental disabilities. Topics to be discussed include gastroesophageal reflux, drooling, and dysphagia and their relation to aspiration and aspiration pneumonia, upper airway obstruction and obstructive sleep apnea, and the role of airway clearance. Case studies are used to introduce a discussion of the underlying etiology, currently accepted methods to evaluate the conditions, and evidence-based treatment options. The goal of managing these problems is to use anticipatory guidance when possible and choose therapies that improve the child's quality of life with minimal side effects.
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PMID:Pulmonary care of children and adolescents with developmental disabilities. 1904 59

Pathological investigation of progressive anterior operculum syndrome has rarely been reported. We describe clinico-pathological findings in a patient with progressive anterior operculum syndrome. A 74-year-old right-handed man had noticed speech and swallowing difficulties 1 year previously. Neurological examinations showed no abnormality other than a slight limitation of upward gaze and slow tongue movement without fibrillation. We investigated the patient using neuroimaging and neuropsychological examinations and observed him for 2 years until his death, at which point we obtained pathological findings. The patient's facial and masseteric muscles seemed hypotonic with drooling, but he could laugh and yawn normally, showing automatic voluntary dissociation. Palatal and pharyngeal reflexes were normal. Magnetic resonance imaging showed cortical atrophy in the temporal lobes bilaterally. (123)IMP single photon emission computed tomography and positron emission tomography showed decreased blood flow and activity in the frontotemporal lobes, predominantly on the left side. Neuropsychological examinations showed no aphasia, dementia or other neuropsychological abnormality. Intubation fiberscopy, laryngoscopy and video fluorography showed no abnormality. After 6 months his anarthria and dysphagia became aggravated. He died of aspiration pneumonia 2 years after onset. Postmortem examination revealed neuronal degeneration with TDP-43-positive inclusions in the frontal, temporal and insular cortices, consistent with frontotemporal lobar degeneration with TDP inclusions (FTLD-TDP). However, neuronal loss with gliosis was more prominent in the inferior part of the motor cortices, bilaterally. Progressive anterior operculum syndrome could be classified as a variant of FTLD-TDP.
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PMID:Progressive anterior operculum syndrome due to FTLD-TDP: a clinico-pathological investigation. 2017 96

Between 50% and 60% of patients with parkinsonism suffer from severe drooling (sialorrhoea). Sialorrhoea is a major social problem with medical risks as well, e.g. aspiration pneumonia. Sialorrhoea is not caused by increased production of saliva, but by impaired swallowing, leading to storage of saliva in the anterior part of the mouth. Sialorrhoea can be treated by anticholinergics, botulinum toxin injections, surgery and radiotherapy of the salivary glands. The optimal treatment of sialorrhoea needs to be determined individually, for which a decision tree is available.
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PMID:[Treatment of drooling in patients with parkinsonism]. 2108 50

Cerebral palsy (CP) is the most common physical disability in early childhood. The worldwide prevalence of CP is approximately 2-2.5 per 1,000 live births. It has been clinically defined as a group of motor, cognitive, and perceptive impairments secondary to a non-progressive defect or lesion of the developing brain. Children with CP can have swallowing problems with severe drooling as one of the consequences. Malnutrition and recurrent aspiration pneumonia can increase the risk of morbidity and mortality. Early attention should be given to dysphagia and excessive drooling and their substantial contribution to the burden of a child with CP and his/her family. This review displays the important functional and anatomical issues related to swallowing problems in children with CP based on relevant literature and expert opinion. Furthermore, based on our experience, we describe a plan for approach of investigation and treatment of swallowing problems in cerebral palsy.
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PMID:Clinical practice: swallowing problems in cerebral palsy. 2193 13

Hypersalivation is a common and distressing complaint in children with neuromuscular disorders such as cerebral palsy. Complications associated with severe drooling include daily changes of clothing, perioral dermatitis, dental problems, dehydration, and aspiration pneumonia, which potentially have a detrimental effect on the quality of life of the patient and carer. In this paper we update our previous work to show the potential benefits of ultrasound-guided injection of botulinum toxin A (BTX-A) into the submandibular gland and report on new patients and follow-up data on the existing group.
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PMID:Ultrasound-guided injection of botulinum toxin A into the submandibular gland in children and young adults with sialorrhoea. 2293 93

The purpose of this review is to assess the current state of the literature on the topic of deep brain stimulation (DBS) and its effects on swallowing function in Parkinson's disease (PD). Pubmed, Cochrane review, and web of science searches were completed on all articles addressing DBS that contained a swallowing outcome measure. Outcome measures included the penetration/aspiration scale, pharyngeal transit time, oropharyngeal residue, drooling, aspiration pneumonia, death, hyolaryngeal excursion, epiglottic inversion, UPDRS scores, and presence of coughing/throat clearing during meals. The search identified 13 studies specifically addressing the effects of DBS on swallowing. Critical assessment of the 13 identified peer-reviewed publications revealed nine studies employing an experimental design, (e.g. "on" vs. "off", pre- vs. post-DBS) and four case reports. None of the nine experimental studies were found to identify clinically significant improvement or decline in swallowing function with DBS. Despite these findings, several common threads were identified across experimental studies and will be examined in this review. Additionally, available data demonstrate that, although subthalamic nucleus (STN) stimulation has been considered to cause more impairment to swallowing function than globus pallidus internus (GPi) stimulation, there are no experimental studies directly comparing swallowing function in STN vs. GPi. Moreover, there has been no comparison of unilateral vs. bilateral DBS surgery and the coincident effects on swallowing function. This review includes a critical analysis of all experimental studies and discusses methodological issues that should be addressed in future studies.
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PMID:Swallowing and deep brain stimulation in Parkinson's disease: a systematic review. 2372 61


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