scholarly journals Airway invasion in non-neurologically ill patients with dysphagia

Medicine ◽  
2020 ◽  
Vol 99 (45) ◽  
pp. e22977 ◽  
Author(s):  
Kang Lip Kim ◽  
Gi-Young Park ◽  
Dong Rak Kwon ◽  
Do Yun Kwon ◽  
Sang Gyu Kwak ◽  
...  
Keyword(s):  
Airway Invasion

Mechanism of Sequential Swallowing During Straw Drinking in Healthy Young and Older Adults

2004 ◽  
Vol 47 (1) ◽  
pp. 33-45 ◽  
Author(s):  
Stephanie K. Daniels ◽  
David M. Corey ◽  
Leslie D. Hadskey ◽  
Calli Legendre ◽  
Daniel H. Priestly ◽  
...  
Keyword(s):  
Older Adults ◽  
Young Adults ◽  
Movement Patterns ◽  
Leading Edge ◽  
Normal Aging ◽  
Significant Relation ◽  
Age Related ◽  
Laryngeal Penetration ◽  
Airway Invasion ◽  
Edge Location

Recent research has revealed differences between isolated and sequential swallowing in healthy young adults; however, the influence of normal aging on sequential swallowing has not been studied. Thus, the purpose of this investigation was to examine the effects of normal aging on deglutition during sequential straw drinking. Videofluoroscopic samples of two 10-s straw drinking trials were obtained for 20 healthy young men (age 29±3 years) and 18 healthy older men (age 69±7 years). Hyolaryngeal complex (HLC) movement patterns, leading edge of the bolus location at swallow onset, and occurrences of airway invasion were determined. Two HLC patterns were identified: (a) HLC lowering with the epiglottis returned to upright between swallows and (b) partially maintained HLC elevation with the epiglottis inverted between swallows. The bolus was frequently in the hypopharynx at swallow onset. Strong associations were identified between age and HLC pattern, age and leading edge of the bolus location, and HLC pattern and leading edge location. Laryngeal penetration was uncommon overall; however, it occurred more frequently in the older adults than in the young adults. A significant relation was identified between age and the average Penetration-Aspiration Scale score. Laryngeal penetration was associated with both HLC movement patterns and hypopharyngeal bolus location, particularly in older adults. Results indicate that subtle age-related differences are evident in healthy young and older adults with sequential straw drinking. These data suggest that specific inherent swallowing patterns may increase the risk of laryngeal penetration with normal aging.

scholarly journals Tracheal and Cricotracheal Resection With End-to-End Anastomosis for Locally Advanced Thyroid Cancer: A Systematic Review of the Literature on 656 Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Cesare Piazza ◽  
Davide Lancini ◽  
Michele Tomasoni ◽  
Anil D’Cruz ◽  
Dana M. Hartl ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Technique ◽  
Primary Anastomosis ◽  
Recurrent Laryngeal Nerve Palsy ◽  
Locally Advanced ◽  
Survival Rates ◽  
Oncologic Outcomes ◽  
Tracheal Resection ◽  
Clinical Issue ◽  
Airway Invasion

Airway involvement by advanced thyroid carcinoma (TC) constitutes a negative prognosticator, besides being a critical clinical issue since it represents one of the most frequent causes of death in locally advanced disease. It is generally agreed that, for appropriate laryngo-tracheal patterns of invasion, (crico-)tracheal resection and primary anastomosis [(C)TRA] is the preferred surgical technique in this clinical scenario. However, the results of long-term outcomes of (C)TRA are scarce in the literature, due to the rarity of such cases. The relative paucity of data prompts careful review of the available relevant series in order to critically evaluate this surgical technique from the oncologic and functional points of view. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement on the PubMed, Scopus, and Web of Science databases. English-language surgical series published between January 1985 and August 2021, reporting data on ≥5 patients treated for TC infiltrating the airway by (C)TRA were included. Oncologic outcomes, mortality, complications, and tracheotomy-dependency rates were assessed. Pooled proportion estimates were elaborated for each end-point. Thirty-seven studies were included, encompassing a total of 656 patients. Pooled risk of perioperative mortality was 2.0%. Surgical complications were reported in 27.0% of patients, with uni- or bilateral recurrent laryngeal nerve palsy being the most common. Permanent tracheotomy was required in 4.0% of patients. Oncologic outcomes varied among different series with 5- and 10-year overall survival rates ranging from 61% to 100% and 42.1% to 78.1%, respectively. Five- and 10-year disease specific survival rates ranged from 75.8% to 90% and 54.5% to 62.9%, respectively. Therefore, locally advanced TC with airway invasion treated with (C)TRA provides acceptable oncologic outcomes associated with a low permanent tracheotomy rate. The reported incidence of complications, however, indicates the need for judicious patient selection, meticulous surgical technique, and careful postoperative management.

scholarly journals Quantifying Airway Invasion and Pharyngeal Residue in Patients with Dementia

Geriatrics ◽  
2019 ◽  
Vol 4 (1) ◽  
pp. 13 ◽  
Author(s):  
Ashwini Namasivayam-MacDonald ◽  
Luis Riquelme
Keyword(s):  
Relative Risk ◽  
Pyriform Sinus ◽  
Future Research ◽  
Ratio Scale ◽  
Pharyngeal Residue ◽  
People With Dementia ◽  
Airway Invasion ◽  
Penetration Aspiration Scale

Previous research has begun to elucidate the physiological impairments associated with dysphagia in patients with dementia, but in order to select the most appropriate targets of intervention we need to better understand consequences of dysphagia. The purpose of this study was to quantify penetration, aspiration, and residue in people with dementia, and confirm if residue was associated with airway invasion on subsequent swallows. Videofluoroscopy clips of sips of thin and extremely thick liquid barium from 58 patients with dementia were retrospectively analyzed. Ratings of swallowing safety, using the Penetration–Aspiration Scale (PAS), and efficiency, using Normalized Residue Ratio Scale in the valleculae (NRRSv) and pyriform sinuses (NRRSp), were made on all swallows. Over 70% of both thin and extremely thick liquid swallows were found to be safe (PAS < 3). Results also revealed that residue was generally more common in the valleculae. However, the proportion of thin liquid swallows with significant NRRSp that were unsafe on the subsequent swallow was significantly greater than the proportion of swallows with significant NRRSp that were safe on the subsequent swallow. As such, there was a 2.83 times greater relative risk of penetration–aspiration in the presence of thin liquid pyriform sinus residue. Future research should determine the impaired physiology causing aspiration and residue in this population.

Laryngotracheal Invasion by Thyroid Carcinoma

1982 ◽  
Vol 91 (4) ◽  
pp. 363-369 ◽  
Author(s):  
Michael Friedman ◽  
Vicki K. Shelton ◽  
Frederick G. Berlinger ◽  
Emanuel M. Skolnik ◽  
Mohammad Arab
Keyword(s):  
Experimental Study ◽  
Thyroid Carcinoma ◽  
Retrospective Analysis ◽  
Total Laryngectomy ◽  
Cricoid Cartilage ◽  
Differentiated Thyroid Carcinoma ◽  
Airway Narrowing ◽  
Airway Invasion ◽  
Well Differentiated ◽  
Laryngotracheal Invasion

Laryngotracheal invasion by well-differentiated thyroid carcinoma is an uncommon occurrence. Recommendations for therapy have primarily included total laryngectomy or shaving of the tumor from laryngeal or tracheal cartilages. Clear guidelines have not been established for the applicability of partial laryngeal resections. In a retrospective analysis of patients with thyroid carcinoma, 13 patients had airway invasion. Of the five patients with laryngeal involvement, three were treated by a partial laryngeal resection. An experimental study was undertaken to determine more precisely the amount of cricoid cartilage which could be resected without reconstruction. Varying amounts of cricoid cartilage were resected. The results indicate that 25% of the cricoid cartilage may be resected without appreciable airway narrowing. On the basis of the retrospective analysis and experimental study, we feel a partial laryngeal resection is possible in most cases of airway invasion by thyroid carcinoma.

Conservative surgical management of invasive differentiated thyroid cancer

1985 ◽  
Vol 99 (12) ◽  
pp. 1255-1260 ◽  
Author(s):  
Y. Shvili ◽  
Y. Zohar ◽  
N. Buller ◽  
N. Laurian
Keyword(s):  
Thyroid Cancer ◽  
Thyroid Carcinoma ◽  
Surgical Management ◽  
Upper Airway ◽  
Differentiated Thyroid Carcinoma ◽  
Tracheal Resection ◽  
Low Grade ◽  
Tracheal Defect ◽  
Airway Invasion ◽  
Well Differentiated

AbstractThe majority of well differentiated thyroid carcinoma are tumours of low grade malignancy. Laryngotracheal invasion by well differentiated thyroid carcinoma is an uncommon occurrence. The surgical management of patients with thyroid cancer invading the upper airway has primarily been by total laryngectomy. Other surgeons recommend in selected cases partial laryngeal and/or tracheal resection.A total of 122 patients with thyroid carcinoma were treated in our department between 1967 and 1982. Only seven patients with well differentiated tumours had airway invasion. In these seven patients we used a partial laryngeal and/or tracheal resection. In three of the patients with tracheal invasion a myoperichondrial flap was used for closing the tracheal defect. A partial resection of the larynx and trachea, and end to end anastomosis between the trachea and the remaining part of the larynx was performed in another four patients.

Preoperative Bronchoscopic Assessment of Airway Invasion by Esophageal Cancer

CHEST Journal ◽  
1998 ◽  
Vol 113 (3) ◽  
pp. 687-695 ◽  
Author(s):  
Martin Riedel ◽  
Rainer W. Hauck ◽  
Hubert J. Stein ◽  
Leonard Mounyam ◽  
Christian Schulz ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Airway Invasion

Obstructive endotracheal lesions of thyroid cancer

2002 ◽  
Vol 116 (8) ◽  
pp. 613-621 ◽  
Author(s):  
Mohammed Ahmed ◽  
Muhammad Saleem ◽  
Abdullah Al-Arifi ◽  
Abdulraof Almahfouz ◽  
Zeyad Mahasin ◽  
...  
Keyword(s):  
Thyroid Cancer ◽  
Vocal Folds ◽  
Endoscopic Examination ◽  
Whole Body ◽  
Tracheal Wall ◽  
Serum Thyroglobulin ◽  
Total Occlusion ◽  
Positron Emission ◽  
Airway Invasion

Airway invasion is a life-threatening complication of thyroid cancer. An important issue that deserves better attention is the differentiation between the clinical features of tracheal wall invasion versus those of an obstructive endotracheal lesion. We present information on the clinical course, diagnostic modalities utilized, management instituted, along with the prognosis, and follow-up data on a group of patients presenting with obstructive endotracheal lesions of thyroid cancer. Two thousand four hundred and eighty-nine thyroid cancer patients were seen at our institution from December 1975 to May 2000. Thirteen patients presented with symptoms of respiratory distress related to obstructive endotracheal lesions. At presentation, 11 patients underwent endoscopic examination. Imaging studies consisting of I123 whole body scan (WBS), computed tomography/magnetic resonance imaging (CT/MRI) of neck and chest, whole body positron emission tomography using 18-fluoro-2-deoxy-D-glucose (FDGPET) were done, as also was determination of the tumour markers, serum thyroglobulin (TG) and calcitonin. Patients were followed for one to 108 months after the initial presentation. Intraluminal tracheal obstruction was severe in eight patients; five had near-total-occlusion. Paralysis of the vocal folds was present in five. Evidence of metastatic disease was present in most patients. Dissociation between iodine uptake and TG synthesis was evident in five patients during follow-up. Four patients died of cancer. Of the nine living patients; cancer persisted in six, recurred in two patients, and remitted in one. This study has identified obstructive endotracheal lesion of thyroid cancer as a distinct entity apart from tracheal wall disease. These data provide evidence that intraluminal tracheal invasion of thyroid cancer is an ominous sign and a frequent cause of morbidity.

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