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Dysphagia fluoroscopy

Kulwinder S Dua, John M DeWitt, William R Kessler, David L Diehl, Peter V Draganov, Mihir S Wagh, Michel Kahaleh, Louis M Wong Kee Song, Harshit S Khara, Abdul H Khan, Murad M Aburajab, Darren Ballard, Chris E Forsmark, Steven A Edmundowicz, Brian C Brauer, Amy Tyberg, Najtej S Buttar, Douglas G Adler
BACKGROUND AND AIMS: Self-expanding metal stents (SEMSs) when deployed across the gastroesophageal junction (GEJ) can lead to reflux with risks of aspiration. A SEMS with a tricuspid anti-reflux valve (SEMS-V) was designed to address this issue. The aim of this study was to evaluate the efficacy and safety of this stent. METHODS: A phase 3, multicenter, prospective, noninferiority, randomized, controlled trial was conducted on patients with malignant dysphagia requiring SEMSs to be placed across the GEJ...
January 23, 2019: Gastrointestinal Endoscopy
Omid B Mehdizadeh, Peter Wickwire, Mena Said, Peter C Belafsky
OBJECTIVE: Cricopharyngeal webs (CPW) are a frequent cause of solid food dysphagia. They are difficult to diagnose and are often missed on swallowing fluoroscopy. The prevalence of CPWs is uncertain. The purpose of this study was to determine the prevalence of CPWs in elderly cadavers. METHODS: Direct laryngoscopy and cervical esophagoscopy were performed in 19 embalmed cadavers by independent two-clinician consensus. Cadaver demographics and the presence and laterality of a CPW were recorded...
November 8, 2018: Laryngoscope
Laura H Swibel Rosenthal, Kathleen Walsh, Dana M Thompson
PURPOSE OF REVIEW: The purpose of this manuscript is to highlight the latest advances in diagnosis and management of velopharyngeal incompetence (VPI) as it pertains to swallowing deficits in children. This is timely and relevant as otolaryngologists are often amongst the first to diagnose and treat VPI. Although nasal regurgitation of a bolus is frequently transient, persistent problems can be associated with other swallowing problems and other significant medical problems. Furthermore, velopharyngeal incompetence has implications for speech production...
December 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
D Agrawal, M Kern, F Edeani, G Balasubramanian, A Hyngstrom, P Sanvanson, R Shaker
BACKGROUND: Recent studies have shown high prevalence of oropharyngeal dysphagia associated with frailty- and age-related muscle weakness. Strength training exercises have been advocated for locomotive health maintenance in the elderly and have shown positive outcomes. As muscles involved in oropharyngeal phase of swallowing are also comprised of striated muscles, the aim of this study was to determine biomechanical effect of a novel resistance exercise program, Swallowing Against Laryngeal Restriction (SALR), on pharyngeal phase swallowing in the healthy elderly...
October 2018: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Kazumasa Muta, Eikichi Ihara, Yusuke Kitagawa, Shohei Hamada, Keita Fukaura, Tsutomu Iwasa, Akira Aso, Haruei Ogino, Kazuhiko Nakamura, Yoshihiro Ogawa
A 20-year-old man was referred to our hospital with dysphagia and chest pain. Heart disease was denied. No abnormality was observed in upper esophagogastroduodenoscopy and fluoroscopy;furthermore, no gastric acid-related symptoms were observed on combined esophageal multichannel intraluminal impedance and pH monitoring. Esophageal high-resolution manometry (HRM) performed by liquid swallow revealed normal peristalsis;however, HRM performed while the patient was taking solid meals showed abnormal contraction, and the patient simultaneously complained of chest pain...
2018: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Hitoshi Kagaya, Mao Ogawa, Shino Mori, Yoichiro Aoyagi, Seiko Shibata, Yoko Inamoto, Hitoshi Mori, Eiichi Saitoh
OBJECTIVES: Neuromuscular electrical stimulation has been widely used in patients with dysphagia. However, obtaining sufficient hyoid bone movement through surface electrodes seems difficult. The aim of this study was to evaluate hyoid bone movement at rest through peripheral magnetic stimulation of the suprahyoid muscles in normal individuals. METHODS: Healthy adult men were recruited. A specially designed coil was connected to the peripheral magnetic stimulator...
April 2, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Y C Lui Jonathan, P Sayal, G Prezerakos, V Russo, D Choi, A T H Casey
OBJECTIVE: This study reviews the management pathway and surgical outcomes of patients referred to and operated on at a tertiary neurosurgical centre, for dysphagia associated with anterolateral cervical hyperostosis (ACH) in diffuse idiopathic skeletal hyperostosis (DISH). PATIENTS & METHODS: Electronic patient records for 6 patients who had undergone anterior cervical osteophytectomy for dysphagia secondary to ACH were reviewed. ACH diagnosis was made by an Ear, Nose and Throat (ENT) specialist and patients were referred to a neurosurgical-led multidisciplinary team (MDT) for review...
April 2018: Clinical Neurology and Neurosurgery
Mojgan Forootan, Morteza Tabatabaeefar, Nariman Mosaffa, Hormat Rahimzadeh Ashkalak, Mohammad Darvishi
Background: Esophageal stent insertion in patients with inoperable esophageal cancer is usually accompanied with relatively high adverse symptoms and even mortality. The current study aims at investigating the outcomes of esophageal stenting in patients with inoperable non-cervical esophageal cancer. Materials and Methods: The current descriptive-analytical research evaluates 25 patients with esophageal cancer. The stent was placed in esophagus based upon endoscopy analysis with or without fluoroscopy and then the stent position and its opening was investigated by making use of CXRand Gastrografin studies...
2018: Journal of Cancer
Daan Nevens, Ann Goeleven, Fréderic Duprez, R Braeken, E Decabooter, M De Smet, L Lutters, Eddy Dejaeger, Wilfried De Neve, Sandra Nuyts
OBJECTIVE: The purpose of this study was to correlate the total dysphagia risk score (TDRS) with swallowing function as measured by videofluoroscopy of swallowing using the swallowing performance scale (SPS) and the penetration aspiration scale (PAS). METHODS: 63 patients from two different centres treated with radiotherapy for head and neck cancer were evaluated in the current study. Swallowing videofluoroscopies at baseline, 6 and 12 months following radiotherapy were evaluated by two observers...
February 2018: British Journal of Radiology
S Waqar H Shah, Arshad K Butt, K Malik, Altaf Alam, Anwaar A Khan
Objective: Achalasia Cardia is treated by Pneumatic balloon dilatation, Heller's Myotomy and recently, by Peroral Esophagaeal Myotomy. This study reports the efficacy of pneumatic balloon dilatation as a non-surgical motility in achieving relief of dysphagia, clinical improvement and recurrence. Long-term complications were reported. Methods: Eight hundred ninety two adult achalasia patients of both genders were treated from January 1988 till December 2011, with pneumatic balloon (Rigiflex Microvasive® ) dilatation, under fluoroscopy Barium swallow was obtained prior to and five minutes after dilatation to evaluate for efficacy of dilatation as well as for complications...
September 2017: Pakistan Journal of Medical Sciences Quarterly
Aleksi Schrey, Laura Airas, Manu Jokela, Jaakko Pulkkinen
OBJECTIVES: Oropharyngeal dysphagia is a disabling and undertreated symptom that often occurs in patients with sporadic inclusion body myositis (s-IBM). In this study, we examined the effect of botulinum neurotoxin A (BoNT-A) injections to the cricopharyngeus muscle (CPM) of patients with s-IBM and dysphagia. PATIENTS, MATERIALS AND METHODS: A single-center retrospective study involving 40 biopsy-proven s-IBM-patients treated in the District of Southwest Finland from 2000 to 2013...
September 15, 2017: Journal of the Neurological Sciences
Christopher M Johnson, Naren N Venkatesan, M Tausif Siddiqui, Daniel J Cates, Maggie A Kuhn, Gregory M Postma, Peter C Belafsky
OBJECTIVES/HYPOTHESIS: To evaluate the efficacy of various techniques of laryngohyoid suspension in the elimination of aspiration utilizing a cadaveric ovine model of profound oropharyngeal dysphagia. STUDY DESIGN: Animal study. METHODS: The head and neck of a Dorper cross ewe was placed in the lateral fluoroscopic view. Five conditions were tested: baseline, thyroid cartilage to hyoid approximation (THA), thyroid cartilage to hyoid to mandible (laryngohyoid) suspension (LHS), LHS with cricopharyngeus muscle myotomy (LHS-CPM), and cricopharyngeus muscle myotomy (CPM) alone...
December 2017: Laryngoscope
Maddala Sundeep, Yoshitaka Hirano, Susumu Iketani, Akiyoshi Konno
BACKGROUND: Ossified anterior longitudinal ligament (OALL) of the cervical spine can cause dysphagia, dyspnoea, and dysphonia, although these symptoms are rare. CASE DESCRIPTION: A 71-year-old male presented with gradually progressive dysphagia secondary to OALL. He underwent fiber optic endoscopy and lateral video fluoroscopy. The OALL extended from C4 to C7 and contributed to significant compression of the pharynx as demonstrated on plain cervical radiography, magnetic resonance (MR) imaging, and computed tomography (CT)...
2017: Surgical Neurology International
Sam McCann, M le Chevoir, L Lacorcia, Bgj Wernham, C S Mansfield
CASE REPORT: An 11-year-old male neutered Miniature Poodle was investigated for ptyalism, weight loss and anorexia. Cricopharyngeal dysphagia was diagnosed using fluoroscopy, and non-inflammatory salivary disease was diagnosed using a combination of cytology and computed tomography. The dog was successfully managed with phenobarbitone. CONCLUSION: To the authors' knowledge this is the first time acquired cricopharyngeal dysphagia and phenobarbitone-responsive sialoadenosis have been described together...
July 2017: Australian Veterinary Journal
F C Okeke, S Raja, K L Lynch, S Dhalla, M Nandwani, E M Stein, B Chander Roland, M A Khashab, P Saxena, V Kumbhari, N K Ahuja, J O Clarke
BACKGROUND: Esophagogastric junction (EGJ) outflow obstruction (EGJOO) is characterized by impaired EGJ relaxation with intact or weak peristalsis. Our aims were to evaluate: (i) prevalence, (ii) yield of fluoroscopy, endoscopy, and endoscopic ultrasound (EUS), (iii) outcomes, and (iv) whether this data differed based on quantitative EGJ relaxation. METHODS: Studies that met criteria for EGJOO were identified. Demographics, encounters, endoscopy, radiology, treatment decisions, and outcomes were extracted...
June 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
C M Flader, C Rosendahl, T Günther
BACKGROUND: Almost 260,000 people in Germany suffer from a stroke each year. As a consequence, for more than 60% this leads to dysphagia. In order to prevent secondary diseases, such as pneumonia, malnutrition and dehydration, a differentiated diagnosis by a multiprofessional team in a stroke unit is required. The guidelines in 2015 for diagnosing neurologic dysphagia by the German Society of Neurology recommend a detailed anamnesis, a standardized screening, a clinical swallowing examination and additional instrumental diagnostics...
October 2017: Der Nervenarzt
Angela T T Wong, Stephen Y Lai, G Brandon Gunn, Beth M Beadle, Clifton D Fuller, Martha P Barrow, Theresa M Hofstede, Mark S Chambers, Erich M Sturgis, Abdallah Sherif Radwan Mohamed, Jan S Lewin, Katherine A Hutcheson
OBJECTIVE: The purpose is to examine the relationship between mandibular osteoradionecrosis (ORN) and chronic dysphagia in long-term oropharynx cancer (OPC) survivors, and to determine the perceived symptom burden associated with ORN. MATERIALS AND METHODS: Medical records of 349 OPC patients treated with bilateral IMRT and systemic therapy were reviewed. ORN was graded using a published 4-point classification schema. Patients were considered to have chronic dysphagia if they had aspiration pneumonia, stricture or aspiration detected by fluoroscopy or endoscopy, and/or feeding tube dependence in long-term follow-up ⩾1year following radiotherapy...
March 2017: Oral Oncology
N N Venkatesan, C M Johnson, M T Siddiqui, D J Cates, M A Kuhn, G N Postma, P C Belafsky
OBJECTIVES: To validate the ovine model of profound oropharyngeal dysphagia and compare swallowing outcomes of laryngotracheal separation with those of total laryngectomy. METHODS: Under real-time fluoroscopy, swallowing trials were conducted using the head and neck of two Dorper cross ewes and one human cadaver, secured in lateral fluoroscopic orientation. Barium trials were administered at baseline, pre- and post-laryngohyoid suspension, following laryngotracheal separation, and following laryngectomy in the ovine model...
April 2017: Journal of Laryngology and Otology
C Rajapakse
Dysfunction of upper pharyngoesophageal region in systemic sclerosis (SSc) is infrequent, poorly recognised and poorly documented in the literature. Yet, it can have very distressing and even fatal consequences that may yet be very responsive to appropriate management. This paper documents the findings and outcome of management of a series of five patients with SSc who had pharyngoesophageal dysphagia to demonstrate the above. Following the documentation of a patient with SSc that had severe pharyngoesophageal dysphagia in 1981, this paper reports the findings in five patients with SSc presenting thereafter, having the same manifestations...
November 2016: Internal Medicine Journal
Shuichi Kaneyama, Masatoshi Sumi, Masato Takabatake, Koichi Kasahara, Aritetsu Kanemura, Akihiro Koh, Hiroaki Hirata
STUDY DESIGN: Kinematic analysis of swallowing function using videofluoroscopic swallowing study (VFSS). OBJECTIVES: The aims of this study were to analyze swallowing process in the patients who underwent occipitospinal fusion (OSF) and elucidate the pathomechanism of dysphagia after OSF. SUMMARY OF BACKGROUND DATA: Although several hypotheses about the pathomechanisms of dysphagia after OSF were suggested, there has been little tangible evidence to support these hypotheses since these hypotheses were based on the analysis of static radiogram or CT...
December 1, 2016: Spine
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