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Query: UMLS:C0262471 (ENT)
 5,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between 1968 and 1974 10 patients (4 men, 5 women, and 1 10-year-old girl) with spastic dysphonia were observed at the Phoniatric Department of the ENT clinic in Lucerne. According to the clinical documentation, the probable etiologic factors, the clinic appearance as well as the therapeutic measures and their results are discussed.
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PMID:[Spastic dysphonia]. 103 53

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

Since the last 30 years metered-dose pressurised aerosols have largely contributed to the treatment of asthma with inhaled beta-2 stimulants and corticosteroids. Two problems, however, are associated with these aerosols: (1) small amounts of active substance are deposited in the lungs and larger amounts in the mouth and pharynx; (2) aerosols are uneasy to use because of lack of coordination between actuation and inhalation and absence of apnoea at the end of inspiration. An elegant solution of these problems is the inhalation chamber: a reservoir inserted between the patient's mouth and the aerosol, which increases the lung deposition, reduces the ENT deposition and makes coordination unnecessary. The inhalation chamber is primarily indicated for patients with poor coordination. When beta-2 stimulants are inhaled the therapeutic benefit can be measured by a gain of efficacy in poor coordinators. When corticosteroids are inhaled the benefit is measured by a better local tolerance and, to some extent, by a gain in therapeutic effectiveness; the inhalation chamber here is indicated for patients with ENT complications (e.g. candidiasis, dysphonia) or for the most severe cases requiring high-dose therapy. The introduction of inhalation chamber must be regarded as an improvement in the management of asthma, taking into account the potential risk of poor compliance, and in such cases the development of powder inhalers may be envisaged.
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PMID:[Inhalation chambers]. 168 75

In order to have a visual picture of the larynx, laryngeal preparations and larynxes of 50 healthy children were exposed to ultrasonic scanning. Also, 48 children, aged 9 months to 15 years, were examined 77 times: their complaints were dysphonia and/or impaired breathing. On the basis of the findings sonographic signs of laryngeal papillomatosis were described (18 children). Ultrasonic observations were in the norm in catarrhal laryngitis (10 children) and limited forms of hyperplastic laryngitis (18 children). Ultrasonic examination helped diagnose impaired mobility of vocal cords. It is recommended to use ultrasonic visualization for rapid diagnosis of ENT diseases in children as well as for surveillance of children with laryngeal papillomatosis.
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PMID:[The role of ultrasonic diagnosis in pediatric laryngology]. 195 32

Of 121 consecutive outpatients seen in an ENT clinic who received a diagnosis of functional dysphonia, 71 who were referred to the speech therapy department were interviewed. Sixty one (86%) were women, and the mean age of the group was 47.6 yr. The commonest voice disorder was huskiness or hoarseness, and only five patients had a pure 'whispering' dysphonia. There was little evidence of major psychiatric disorder in the group: eight patients had a past psychiatric history; two had histrionic personality disorder, and 22 (33%) had clinically diagnosable mood disorders which were mainly anxiety/tension states. This descriptive study formed the background for an investigation of the psychosocial stressors preceding onset of functional dysphonia.
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PMID:The psychiatric and social characteristics of patients with functional dysphonia. 366 86

It is very difficult to give a valid classification of functional voice disorders. Many patients with voice disorder initially consult an ENT specialist. Important aspects of differential diagnosis are presented based on a study of the literature which should help the ENT specialist discriminate between hyperfunctional and hypofunctional dysphonia, which is very important for therapy. An early tentative diagnosis should be followed by a phoniatric examination.
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PMID:[Differential diagnostic considerations in functional voice disorders]. 407 89

Functional dysphonia is a voice impairment without any organic lesion of the phonating system. It may be classified into two categories: functional dysphonia itself where no lesions are found and functional laryngopathies where vocal cord lesions may be attributed to vocal abuse or misuse. The clinical evaluation of a dysphonic patient is performed in three steps: history taking, vocal evaluation, and examination. History taking helps the diagnosis and may be considered also as a therapeutic procedure. Vocal evaluation is oriented toward the voice itself and how it is produced. Then an ENT examination is performed with special attention to the larynx. In functional dysphonia, usually, everything looks normal but there may be signs of inflammation, hyperkinetism, hypokinetism, excessive laryngeal movements, etc. Functional laryngopathies include vocal nodules, laryngitis, polyps, and contact ulcer.
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PMID:Clinical evaluation of functional dysphonia. 664 59

With 5,000 cases yearly, laryngeal carcinomas account in France for the third of squamous cell cancers of the upper digestive and respiratory tract. The crude survival rate is 50% at 5 years. Carcinomas of vocal cords are often diagnosed as early stages if dysphonia leads the patients to the ENT specialist within 2 weeks. Cure of the primary is achieved in 90% of the early stages by radiotherapy with narrow fields or partial surgery, with a 80% 5 years survival rate. Advanced tumors are often treated by total laryngectomy and postoperative radiotherapy. Supra-glottic cancers (epiglottis) are more serious. Unilateral dysphagia or upper cervical neck node often delay early diagnosis. A total laryngectomy is the commonest treatment. The 5 years survival rate of 40% is due to local and/or regional failures and metachronous cancers in head and neck, and radiotherapy remains the two major treatments. Primary prevention is based upon suppression of tobacco and reduction of alcoholic consumption, secondary prevention on resection of leucoplakia and close follow-up of patients with chronic laryngitis.
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PMID:[Management of laryngeal cancers]. 776 53

A previously healthy 39-yr-old man was scheduled for exploratory laparotomy due to acute abdomen. There was no sign of difficult intubation. After induction of anesthesia with thiopental and succinylcholine, the trachea was easily intubated with a 7.0 mm cuffed endotracheal tube. Surgery for a ruptured appendix with 2 drainage tubes lasted for 75 min was uneventful. At the end of surgery, the endotracheal tube was removed without difficulty. On the 1st postoperative day, the patient developed stridor. The symptom persisted even after conservative treatment and removal of NG tube. On the 12th postoperative day, a telescopic videolarygoscopy revealed immobile right vocal cord with anterior and medial displacement to the right. Arytenoid cartilage was moderately edematous. A diagnosis of right arytenoid subluxation was then made. On the 17th postoperative day, a closed reduction of right arytenoid cartilage using direct laryngoscope was performed successively under general anesthesia. Eight weeks after the reduction, his voice and laryngoscopic findings were normal. There has been only 18 reports with 27 cases of this complication found in the literature. However, it is generally believed that it is not so unusual. The post-intubation syndromes, such as sore throat, dysphonia, odynophagia, difficulty in swallowing or breathing which persists beyond 5 days warrant ENT consultation. Abnormal mobility of vocal cord, edema over arytenoid area found by indirect laryngoscopy should suggest the complication. Further confirmation is then needed. Although the result of our case is good, the reduction should ideally be done within 24-48 h after the incidence to avoid unfavorable long-term sequelae.
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PMID:[Arytenoid subluxation following endotracheal intubation--a case report]. 778 99

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


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