16. Severe dysphagia of spastic upper esophageal sphincter following encephalitis treated with high doses of incobotulinumtoxinA (Xeomin NT 201): a case report

Toxicon ◽  
2015 ◽  
Vol 93 ◽  
pp. S6-S7
Author(s):  
Mario Basciani ◽  
Francesco Perri ◽  
Giuseppe Esposito ◽  
Comenico Intiso
Keyword(s):  
Case Report ◽  
Upper Esophageal Sphincter ◽  
Severe Dysphagia ◽  
Nt 201 ◽  
Esophageal Sphincter ◽  
High Doses

Hypertonic Upper Esophageal Sphincter in Down's Syndrome: A Case Report

2010 ◽  
Vol 21 (02) ◽  
pp. 136-138
Author(s):  
E. Carraro ◽  
P. Betalli ◽  
P. Gamba ◽  
R. Bardini ◽  
S. Masiero
Keyword(s):  
Case Report ◽  
Down's Syndrome ◽  
Down’S Syndrome ◽  
Upper Esophageal Sphincter ◽  
Esophageal Sphincter

Effect of Laryngeal Suspension and Upper Esophageal Sphincter Myotomy for Severe Dysphagia Due to Brainstem Disease

2020 ◽  
Vol 129 (7) ◽  
pp. 689-694
Author(s):  
Seiko Shibata ◽  
Hitoshi Kagaya ◽  
Yasunori Ozeki ◽  
Eiichi Saitoh ◽  
Yoichiro Aoyagi ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Tube Feeding ◽  
Inpatient Rehabilitation ◽  
Upper Esophageal Sphincter ◽  
Severity Scale ◽  
Severe Dysphagia ◽  
Long Time ◽  
Esophageal Sphincter ◽  
Penetration Aspiration Scale

Objectives: Surgical procedure is considered in patients with severe dysphagia when conservative treatment fails. This study aimed to evaluate laryngeal suspension (LS) and upper esophageal sphincter (UES) myotomy for treating severe dysphagia due to brain disease. Methods: Fourteen patients underwent LS and UES myotomy, with a median follow-up of 5 years and 6 months when conservative treatment failed. The penetration-aspiration scale (PAS), the Dysphagia Severity Scale (DSS), the Eating Status Scale (ESS), and diet contents were evaluated just before surgery, at discharge, and at the last follow-up. Results: Preoperative intake was tube feeding in all patients. The patients learned the extended head and flexed neck posture to open the esophageal inlet. PAS, DSS and ESS scores, and diet contents were significantly improved at discharge compared with before surgery, and were maintained until the last follow-up. Eight patients had pneumonia during their hospital stay, and five had pneumonia between discharge and at the last follow-up. Age was significantly, negatively correlated with DSS and ESS at the last follow-up. Conclusion: Although LS and UES myotomy require a long inpatient rehabilitation and the risk of pneumonia after surgery is high, the outcome is favorable and the effects last for a long time.

Premalignant and Malignant Lesions of the Heterotopic Pancreas in the Esophagus: a Case Report and Review of the Literature

2015 ◽  
Vol 24 (2) ◽  
pp. 235-239 ◽  
Author(s):  
Jan Ulrych ◽  
Vladimir Fryba ◽  
Helena Skalova ◽  
Zdenek Krska ◽  
Tomas Krechler ◽  
...  
Keyword(s):  
Case Report ◽  
Gastrointestinal Tract ◽  
Unusual Case ◽  
Accurate Diagnosis ◽  
Heterotopic Pancreas ◽  
Premalignant Lesions ◽  
Resected Specimen ◽  
Review Of The Literature ◽  
Severe Dysphagia ◽  
Malignant Lesions

Heterotopic pancreas is a congenital pathology of the gastrointestinal tract, particularly rare in the esophagus. Both symptomatology and findings during preoperative examinations are non-specific and therefore do not often lead to an accurate diagnosis, which is usually revealed only by histopathological assessment of a resected specimen. We report an unusual case of a patient suffering from severe dysphagia caused by heterotopic pancreas in the distal esophagus with chronic inflammation and foci of premalignant changes. This article also reviews 14 adult cases of heterotopic pancreas in the esophagus previously reported in the literature, with the aim of determining the clinical features of this disease and possible complications including rare premalignant lesions and malignant transformation. Especially with regard to those complications, we suggest that both symptomatic and incidentally found asymptomatic lesions should be resected.

scholarly journals Isolated Dysphagia in a Patient with Medial Medullary Infarction – Effects of Evidence-Based Dysphagia Therapy: A Case Report

2021 ◽  
pp. 190-199
Author(s):  
Samra Hamzic ◽  
Patrick Schramm ◽  
Hassan Khilan ◽  
Tibo Gerriets ◽  
Martin Juenemann
Keyword(s):  
Case Report ◽  
Vascular Occlusion ◽  
Evidence Based ◽  
Severe Dysphagia ◽  
First Case ◽  
Jaw Opening ◽  
Medial Medullary Infarction ◽  
Dysphagia Therapy ◽  
Evidence Based Therapy ◽  
Medullary Infarction

Medial medullary infarction (MMI) is a vascular occlusion in the medulla oblongata leading to certain constellations of neurological symptoms and seriously affecting the patient. Effective evidence-based treatment of severe dysphagia as sole symptom of MMI has not yet been reported. This case study aims to report successful effects of evidence-based therapy based on findings of dysphagia symptoms and pathophysiology of swallowing by flexible endoscopic evaluation of swallowing (FEES) in severe isolated dysphagia after MMI. FEES was performed to evaluate swallowing pathophysiology and dysphagia symptoms in a 57-year-old male with severe dysphagia after MMI. On the basis of FEES findings, simple and high-frequent evidence-based exercises for improvement of swallowing were implemented: thermal stimulation of faucial arches, Jaw Opening Exercise, and Jaw Opening Against Resistance. After 7 weeks of high-frequent evidence-based therapy and regular FEES evaluation the patient was set on full oral diet with no evidence of aspiration risk. In a first case report of isolated dysphagia in MMI our case illustrates that high-frequent evidence-based dysphagia therapy in combination with FEES as the method to evaluate and monitor swallowing pathophysiology can lead to successful and quick rehabilitation of severely affected dysphagic patients.

scholarly journals The Effect of Bolus Volume on Hyoid Kinematics in Healthy Swallowing

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Ahmed Nagy ◽  
Sonja M. Molfenter ◽  
Melanie Péladeau-Pigeon ◽  
Shauna Stokely ◽  
Catriona M. Steele
Keyword(s):  
Peak Velocity ◽  
Upper Esophageal Sphincter ◽  
Healthy Population ◽  
Bolus Volume ◽  
Velocity Increase ◽  
Movement Distance ◽  
Hyoid Movement ◽  
Laryngeal Vestibule ◽  
Esophageal Sphincter ◽  
Liquid Bolus

Hyoid movement in swallowing is biomechanically linked to closure of the laryngeal vestibule for airway protection and to opening of the upper esophageal sphincter. Studies suggest that the range of hyoid movement is highly variable in the healthy population. However, other aspects of hyoid movement such as velocity remain relatively unexplored. In this study, we analyze data from a sample of 20 healthy young participants (10 male) to determine whether hyoid movement distance, duration, velocity, and peak velocity vary systematically with increases in thin liquid bolus volume from 5 to 20 mL. The temporal correspondence between peak hyoid velocity and laryngeal vestibule closure was also examined. The results show that maximum hyoid position and peak velocity increase significantly for 20 mL bolus volumes compared to smaller volumes, and that the timing of peak velocity is closely linked to achieving laryngeal vestibule closure. This suggests that generating hyoid movements with increased power is a strategy for handling larger volumes.

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