Dysphagia and Dysphonia Secondary to Anterior Cervical Osteophytes

Neurosurgery ◽  
1986 ◽  
Vol 18 (1) ◽  
pp. 90-93 ◽  
Author(s):  
Greg Brandenberg ◽  
Lyal G. Leibrock

Abstract A 77-year-old man presented with a 4-year history of progressive dysphagia to the point that he could no longer swallow solid foods. During the past several months, he had developed dysphonia. Cervical spine x-ray films demonstrated massive anterior degenerative osteophytic spurs between C-3 and C-7. Evaluation with barium swallow and cervical computed tomography demonstrated esophageal and laryngeal compression. Resection of the anterior osteophytes resolved the dysphagia and dysphonia.

Author(s):  
Chinyere N. Asoegwu ◽  
Nkiruka A. Wakwe ◽  
Clement C. Nwawolo

<p class="abstract">Lipomas are uncommon in the head and neck region and rare in the retropharyngeal space. Lipoma of the retropharyngeal space may cause aerodigestive tract obstruction presenting as dyspnea and or dysphagia. The presenting symptoms will depend on the size and site of the lipoma in the retropharyngeal space. We present the case of a 57 years old male with 6 months’ history of progressive dysphagia to solid foods only and no positive sign on clinical examination. The barium swallow was normal. The computed tomography (CT) scan showed a moderate-sized homogenous mass of fat density in the hypopharyngeal section of the retropharyngeal space. Diagnosis of dysphagia caused by retropharyngeal lipoma was made. This was surgically excised via the trans-cervical route with no complications, complete resolution of symptoms, and no recurrence 2 years after on follow-up. In the dysphagia of unknown cause, retropharyngeal space lipoma should be considered.</p>


2020 ◽  
Vol 3 (1) ◽  
pp. V5
Author(s):  
Miki Katzir ◽  
Aboubakr T. Amer ◽  
Asad S. Akhter ◽  
Stephanus V. Viljoen ◽  
Ehud Mendel

The patient is a 69-year-old woman with a history of atlantoaxial instability and cervical pain who underwent an occipital-cervical fusion at an outside hospital. Five days following the procedure she required a PEG tube due to progressive dysphagia. Compared with preoperative imaging, x-ray shows cervical spine hyperextension with a significant decrease in the occipital–C2 angle. A swallow test confirmed aspiration and pharyngeal phase functional impairment. Two-stage surgery consisted of hardware removal, drilling the fused right C1–2 facet, reinstrumentation, and halo placement. The swallowing test confirmed there is no aspiration. We proceeded with rod placement. The patient recovered completely.The video can be found here: https://youtu.be/YzdJrOm46Y4


2020 ◽  
Vol 11 ◽  
pp. 69
Author(s):  
Manoj Kumar ◽  
Prem Bahadur Shahi ◽  
Nitin Adsul ◽  
Shankar Acharya ◽  
K. L. Kalra ◽  
...  

Background: Dysphagia due to diffuse idiopathic skeletal hyperostosis (DISH)-related anterior cervical osteophytes is not uncommon. However, this rarely leads to dysphonia and/or dysphagia along with life- threatening airway obstruction requiring emergency tracheotomy. Case Description: A 56-year-old male presented with progressive dysphagia and dysphonia secondary to DISH-related anterior osteophytes at the C3–C4 and C4–C5 levels. The barium swallow, X-ray, magnetic resonance imaging, and computed tomography scans confirmed the presence of DISH. Utilizing an anterior cervical approach, a large beak-like osteophyte was successfully removed, while preserving the anterior annulus. After clinic-radiological improvement, the patient was discharged with a soft cervical collar and nonsteroidal anti-inflammatory drug (NSAID). Conclusion: Large anterior osteophytes in Forestier disease/DISH may cause dysphagia and dysphonia. Direct anterior resection of these lesions yields excellent results as long as other etiologies for such symptoms have been ruled out.


Crystals ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. 676
Author(s):  
Tom L. Blundell

Over the past 60 years, the use of crystals to define structures of complexes using X-ray analysis has contributed to the discovery of new medicines in a very significant way. This has been in understanding not only small-molecule inhibitors of proteins, such as enzymes, but also protein or peptide hormones or growth factors that bind to cell surface receptors. Experimental structures from crystallography have also been exploited in software to allow prediction of structures of important targets based on knowledge of homologues. Crystals and crystallography continue to contribute to drug design and provide a successful example of academia–industry collaboration.


2020 ◽  
pp. 105-110
Author(s):  
Pat Croskerry

In this case, a 35-year-old male is brought to a community hospital emergency department by ambulance having suffered an apparent seizure in the street. He is well known to the nurses and physician who see him. He has had several visits for seizures, and he has a history of depression. He has had electroencephalography studies and a computed tomography scan of his head in the past and has had assessments by both neurology and psychiatry. While he is in the department, he has an atypical seizure. There is a consensus among the ED staff that his seizures may be factitious. After a period of observation, he is discharged. Approximately 6 months later, the physician hears that the patient has died and tracks down his autopsy report, which had a surprising finding.


2018 ◽  
Vol 12 (1) ◽  
pp. 18-28
Author(s):  
Nirmal D Patil ◽  
Sudhir K Srivastava ◽  
Sunil Bhosale ◽  
Shaligram Purohit

<sec><title>Study Design</title><p>This was a double-blinded cross-sectional study, which obtained no financial support for the research.</p></sec><sec><title>Purpose</title><p>To obtain a detailed morphometry of the lateral mass of the subaxial cervical spine.</p></sec><sec><title>Overview of Literature</title><p>The literature offers little data on the dimensions of the lateral mass of the subaxial cervical spine.</p></sec><sec><title>Methods</title><p>We assessed axial, sagittal, and coronal computed tomography (CT) cuts and anteroposterior and lateral X-rays of the lateral mass of the subaxial cervical spine of 104 patients (2,080 lateral masses) who presented to a tertiary care public hospital (King Edward Memorial Hospital, Mumbai) in a metropolitan city in India.</p></sec><sec><title>Results</title><p>For a majority of the parameters, males and females significantly differed at all levels (<italic>p</italic>&lt;0.05). Females consistently required higher (<italic>p</italic>&lt;0.05) minimum lateral angulation and lateral angulation. While the minimum lateral angulation followed the order of C5&lt;C4&lt;C6&lt;C3, the lateral angulation followed the order of C3&lt;C5&lt;C4&lt;C6. The lateral mass becomes longer and narrower from C3 to C7. In axial cuts, the dimensions increased from C3 to C6. The sagittal cut thickness and diagonal length increased and the sagittal cut height decreased from C3 to C7. The sagittal cut height was consistently lower in the Indian population at all levels, especially at the C7 level, as compared with the Western population, thereby questioning the acceptance of a 3.5-mm lateral mass screw. A good correlation exists between X-ray- and CT-based assessments of the lateral mass.</p></sec><sec><title>Conclusions</title><p>Larger lateral angulation is required for Indian patients, especially females. The screw length can be effectively calculated by analyzing the lateral X-ray. A CT scan should be reserved for specific indications, and a caution must be exercised while inserting C7 lateral mass screws.</p></sec>


2011 ◽  
Vol 2011 ◽  
pp. 1-2 ◽  
Author(s):  
Rayees Ahmad Dar ◽  
Sabiya Hamid Wani ◽  
Majid Mushtaque

Isolated fracture of a cervical rib is a very rare entity and usually presents as a painless swelling or as thoracic outlet syndrome. We describe a case of a 45-year-old woman with history of fall two months back. She presented with symptoms of neurogenic thoracic outlet syndrome for one month. Isolated left cervical rib fracture was documented on X-ray cervical spine. Her fractured cervical rib was resected through a supraclavicular approach, and symptoms resolved completely in the postoperative period.


2009 ◽  
Vol 2009 ◽  
pp. 1-4 ◽  
Author(s):  
Salvatore Maria Antonio Campo ◽  
Roberto Lorenzetti ◽  
Marina de Matthaeis ◽  
Cesare Hassan ◽  
Angelo Zullo ◽  
...  

We present an 82-year-old woman with a 3-month history of progressive dysphagia and a normal initial upper gastrointestinal endoscopy. The diagnosis of pseudoachalasia was suspected by oesophageal manometric and barium swallow studies, and confirmed by biopsies revealing an intestinal type carcinoma of the stomach at a repeated endoscopy. In view of the history of heart disease, diabetes, and old age, this patient was treated by a partially covered Ultraflex self-expanding metal stent (Boston Scientific, Natick, MA, USA) placed into the oesophageal body with no direct complications and obtaining the relief from dysphagia. During the 11-month follow-up she was treated for an iron deficiency anaemia due to reflux oesophagitis with ulcerations in the oesophageal body and died from myocardial infarction. According to the localization of the cancer, the old age, and the presence of comorbidities, we should recommend the insertion of a partially covered self-expanding metal stent as a reasonable palliative treatment in selected subjects with pseudoachalasia.


2015 ◽  
Vol 2015 ◽  
pp. 1-6
Author(s):  
Shadi Rezai ◽  
Stephen LoBue ◽  
Daniel Adams ◽  
Yewande Oladipo ◽  
Ramses Posso ◽  
...  

Background.Tuberculosis (TB) is a disease that affects hundreds of millions of people across the world. However, the incidence in developed countries has decreased over the past decades causing physicians to become unfamiliar with its unspecific symptoms. Pregnant individuals are especially difficult because many symptoms of active TB can mimic normal physiological changes of pregnancy. We present a case report of a 26-year-old multiparous woman, G4P3003, at 38-week gestation with a history of positive PPD who emigrated from Ghana 6 years ago. She came to the hospital with an initial complaint of suprapubic pain, pressure, and possible leakage of amniotic fluid for the past week. Patient also complained of a productive cough for the past 3 to 4 months with a decrease in vision occurring with the start of pregnancy. Visual acuity was worse than 20/200 in both eyes. Definitive diagnosis of active TB was delayed due to patient refusal of chest X-ray. Fortunately, delay in diagnosis was minimized since patient delivered within 24 hours of admission. Active TB was confirmed with intraocular dissemination. Patient had optic atrophy OS (left eye) and papillitis, choroiditis, and uveitis OD (right eye) due to TB infiltration. Fetus was asymptomatic and anti-TB therapy was started for both patients.


2020 ◽  
Vol 1 (3) ◽  
pp. 137-146
Author(s):  
Yun Chen ◽  
Gongfa Jiang ◽  
Yue Li ◽  
Yutao Tang ◽  
Yanfang Xu ◽  
...  

Abstract The coronavirus disease 2019 (COVID-19) has infected more than 9.3 million people and has caused over 0.47 million deaths worldwide as of June 24, 2020. Chest imaging techniques including computed tomography and X-ray scans are indispensable tools in COVID-19 diagnosis and its management. The strong infectiousness of this disease brings a huge burden for radiologists. In order to overcome the difficulty and improve accuracy of the diagnosis, artificial intelligence (AI)-based imaging analysis methods are explored. This survey focuses on the development of chest imaging analysis methods based on AI for COVID-19 in the past few months. Specially, we first recall imaging analysis methods of two typical viral pneumonias, which can provide a reference for studying the disease on chest images. We further describe the development of AI-assisted diagnosis and assessment for the disease, and find that AI techniques have great advantage in this application.


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