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Head & Neck Jan 2018No practice guidelines have been established for swallowing outcomes after cricopharyngeal myotomy (CPM). The purpose of this systematic review was to summarize evidence... (Review)
Review
BACKGROUND
No practice guidelines have been established for swallowing outcomes after cricopharyngeal myotomy (CPM). The purpose of this systematic review was to summarize evidence for swallowing outcomes in patients undergoing CPM to treat symptomatic cricopharyngeal dysfunction, in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocol.
METHODS
Swallowing outcomes examined included penetration/aspiration ratings, manometric measures, patient-rated dysphagia scales, clinician-rated dysphagia scales, diet level, and weight.
RESULTS
Three databases were queried for studies published between January 1995 and July 2015, resulting in a total of 122 full-text eligible records. Studies were screened and reviewed, culminating in 10 studies meeting inclusion criteria. Critical appraisal of study design, swallowing outcomes measures, and statistical analysis were summarized.
CONCLUSION
This systematic review revealed insufficient evidence for guiding clinical practice. Future investigations should use validated patient-rated and clinician-rated instruments as well as detailed high-resolution manometry measures to optimally capture postoperative swallowing outcomes.
Topics: Cricoid Cartilage; Deglutition; Deglutition Disorders; Female; Humans; Male; Myotomy; Pharyngeal Diseases; Pharyngeal Muscles; Recovery of Function; Severity of Illness Index; Treatment Outcome
PubMed: 29083513
DOI: 10.1002/hed.24977 -
American Journal of Otolaryngology 2021Pharyngocutaneous fistula (PCF) is a common complication after laryngopharyngeal surgery. It presents incredible difficulties to both doctors and patients and can lead... (Review)
Review
BACKGROUND
Pharyngocutaneous fistula (PCF) is a common complication after laryngopharyngeal surgery. It presents incredible difficulties to both doctors and patients and can lead to prolonged hospitalization.
OBJECTIVE
To analyze the pros and cons of the pedicled skin flap in the prevention and repair of PCF and put forward the authors' views and experience about the selection and application of flaps for the treatment of PCF.
METHODS
A literature review of pedicled flap application in PCF was carried out.
RESULTS
Based on the analysis of the characteristics of the pedicled flap in PCF treatment, the advantages and disadvantages are compared.
RESULTS
In the literature, the pectoralis major myocutaneous flap is the most widely used regional pedicled flap for PCF. Many other flaps can be used to prevent and treat PCF. Each kind of pedicled flap has advantages and limitations. This plays a role in the individualized selection and design of PCF to maximize the benefits of patients.
CONCLUSIONS
Taking unity of function, aesthetics, and proficiency of operators into account, choosing the appropriate flap to repair PCF can reduce the occurrence rate of PCF and improve the patient's quality of life.
Topics: Cutaneous Fistula; Humans; Otorhinolaryngologic Surgical Procedures; Pharyngeal Diseases; Postoperative Complications; Quality of Life; Respiratory Tract Fistula; Surgical Flaps; Treatment Outcome
PubMed: 34175692
DOI: 10.1016/j.amjoto.2021.103119 -
Pediatric Surgery International Dec 2018Branchial cleft anomalies are the second most common head and neck congenital lesions in children. It may sometimes be a part of branchio-oto-renal (BOR) syndrome, so in... (Review)
Review
Branchial cleft anomalies are the second most common head and neck congenital lesions in children. It may sometimes be a part of branchio-oto-renal (BOR) syndrome, so in patients with branchial cleft anomalies associated with a complaint of auricular deformity or a similar history and findings in other family members, we should take an additional examination to find the possibility of BOR syndrome. Complete excision is essential for good prognosis. For the management of branchial cleft anomalies, various methods have been reported. Endoscopically assisted dissection technique and transoral robot-assisted surgery were used in the management of fistula and allowed excellent visualization of the pharyngeal component of the lesion and a minimally invasive approach. It is essential for the surgeon to fully comprehend the congenital lesions to attain the correct preoperative diagnosis and plan for an appropriate surgical approach to prevent the most common complication and recurrence in these lesions. The following sections discuss the anatomy, common presentation, auxiliary examination, differential diagnosis, the current principles of surgical treatment and prognosis for second branchial cleft anomalies in children, and discussed the branchio-oto-renal syndrome.
Topics: Branchial Region; Child; Craniofacial Abnormalities; Diagnosis, Differential; Diagnostic Imaging; Humans; Incidence; Natural Orifice Endoscopic Surgery; Pharyngeal Diseases; Robotics
PubMed: 30251021
DOI: 10.1007/s00383-018-4348-8 -
Journal of Veterinary Internal Medicine Jul 2019Characterization of the clinical signs, response to treatment and prognosis can be useful information for decision-making when evaluating cattle with pharyngeal trauma.
BACKGROUND
Characterization of the clinical signs, response to treatment and prognosis can be useful information for decision-making when evaluating cattle with pharyngeal trauma.
OBJECTIVE
To describe the signalment, history, clinicopathologic, endoscopic, ultrasonographic, radiographic, and postmortem findings as well as treatments and outcomes of cattle diagnosed with pharyngeal perforation/trauma.
ANIMALS
Review of medical records of cattle >1 month of age admitted to a Veterinary Teaching Hospital from 1995 to 2017.
METHODS
Retrospective study. Review of medical records of cattle with pharyngeal perforation/trauma identified by oral or endoscopic examination in hospital setting.
RESULTS
Twenty-seven out of 7550 (0.36%) cases met the inclusion criteria. Pharyngeal perforation/trauma was associated with the administration of a bolus in 24 (89%) cows and a magnet in 3 (11%) cases. The boluses contained monensin (n = 12), calcium salts (n = 5), iodine (n = 1), aspirin (n = 1), vitamins (n = 1), and an unknown product (n = 4). The primary clinical signs were dysphagia, swelling of the throatlatch, subcutaneous emphysema, swelling, and pain on palpation of the throatlatch. Seventeen (63%) cows were discharged whereas 10 (37%) were euthanized. Median time between the suspected traumatic event and hospital admission was 1 day (range: 0.5-3 days) and 2 days (range: 0.5-15) for surviving and nonsurviving cattle, respectively. All 5 cows that suffered pharyngeal trauma associated with administration of calcium salt bolus were euthanized.
CONCLUSIONS AND CLINICAL IMPORTANCE
Pharyngeal trauma is a rare condition in cattle. Case fatality rate increases if not diagnosed and treated promptly. The nature of the penetrating foreign body influences the outcome.
Topics: Administration, Oral; Animals; Calcium Compounds; Cattle; Female; Foreign Bodies; Magnets; Monensin; Pharyngeal Diseases; Pharynx; Prognosis; Retrospective Studies
PubMed: 31058361
DOI: 10.1111/jvim.15510 -
European Archives of... Aug 2018Globus is a non-painful sensation of a lump or a foreign body in the throat, and it frequently improves with eating. Although globus is a common symptom, only little is... (Review)
Review
Globus is a non-painful sensation of a lump or a foreign body in the throat, and it frequently improves with eating. Although globus is a common symptom, only little is known about the etiology, and the causes have remained controversial. Previously, globus was labelled as a hysterical symptom. However, nowadays, the research has been mainly focused on somatic causes and it is suspected that the etiology is complex. Because of the unclear etiology, the diagnostics and treatment are varying, predisposing patients to possible unnecessary investigations. This review presents the current literature of globus: its etiology, diagnostics, and treatment. In addition, a special aim is to discuss the rational investigation methods in globus diagnostics and present a diagnostic algorithm based on recent researches.
Topics: Electric Impedance; Endoscopy; Esophageal Motility Disorders; Esophageal Sphincter, Upper; Esophageal pH Monitoring; Gastroesophageal Reflux; Humans; Manometry; Neck; Pharyngeal Diseases; Prognosis; Somatoform Disorders; Stress, Psychological; Ultrasonography; Video Recording
PubMed: 29943257
DOI: 10.1007/s00405-018-5041-1 -
Head & Neck Nov 2022The aim of this study is to determine whether the preventive positioning of a salivary bypass tube (SBT) after total laryngectomy (TL) reduces the incidence of... (Meta-Analysis)
Meta-Analysis Review
The aim of this study is to determine whether the preventive positioning of a salivary bypass tube (SBT) after total laryngectomy (TL) reduces the incidence of postoperative pharyngocutaneous fistula (PCF) and pharyngeal stenosis (PS). This study was conducted in conformity with the PRISMA statement. 1960 patients with a median age of 62.0 years were included. A SBT was placed in 980 (50%) patients (SBT group). The cumulative PCF incidence in the SBT group was 15.8% (95% CI: 9.3-23.6). The measured pooled OR comparing PCF incidence in patients with SBT compared to those without was 0.40 (95% CI: 0.24-0.65). The pooled PS incidence in the SBT group was 12.3% (95% CI: 5.4-21.6). The measured pooled OR comparing PS incidence in patients with SBT compared to those without was 0.43 (95% CI: 0.24-0.65). PCF and PS could be prevented by the intra-operative placement of a SBT.
Topics: Cutaneous Fistula; Humans; Laryngeal Neoplasms; Laryngectomy; Middle Aged; Pharyngeal Diseases; Postoperative Complications; Retrospective Studies
PubMed: 35920404
DOI: 10.1002/hed.27169 -
Otolaryngologic Clinics of North America Feb 2015Branchial cleft anomalies are a common cause of congenital neck masses and can present as a cyst, sinus, or fistula. A comprehensive understanding of the embryologic... (Review)
Review
Branchial cleft anomalies are a common cause of congenital neck masses and can present as a cyst, sinus, or fistula. A comprehensive understanding of the embryologic basis of these anomalies aids in diagnosis and surgical excision. Fistulas tend to present at an earlier age than sinuses or cysts, with most lesions presenting as either a neck mass, draining sinus, or recurrent infections. The eventual management of each is complete surgical excision, which is curative. A history of recurrent preoperative infections leads to a higher rate of recurrence.
Topics: Barium; Branchial Region; Child, Preschool; Craniofacial Abnormalities; Female; Humans; Incidence; Infant; Infant, Newborn; Magnetic Resonance Imaging; Male; Mediastinal Cyst; Multimodal Imaging; Otorhinolaryngologic Surgical Procedures; Pharyngeal Diseases; Prognosis; Risk Assessment; Thyroglossal Cyst; Tomography, X-Ray Computed; Ultrasonography, Doppler
PubMed: 25442127
DOI: 10.1016/j.otc.2014.09.002 -
Sexually Transmitted Diseases Oct 2022In December 2020, the Centers for Disease Control and Prevention updated its treatment guidelines for gonococcal infection and, for the first time, recommended universal...
BACKGROUND
In December 2020, the Centers for Disease Control and Prevention updated its treatment guidelines for gonococcal infection and, for the first time, recommended universal test-of-cure for all individuals treated for pharyngeal gonorrhea. After the release of these guidelines, data are lacking on rates of return for the test-of-cure, particularly in populations other than men who have sex with men.
METHODS
We analyzed the demographic characteristics, clinical characteristics, rate of return for the recommended test-of-cure, and percent positivity for Neisseria gonorrhoeae on repeat pharyngeal specimens at a local public health department in Durham, NC.
RESULTS
Of 101 individuals treated for pharyngeal gonorrhea between March 2021 and April 2022, 54.5% were men, 71.2% Black or African American, and 58.4% between the ages of 20 and 29 years. Most identified as either women who have sex with men (38.6%), men who have sex with men (24.8%), or men who have sex with women (22.8%). Of these individuals, 41 (40.6%) returned for a test-of-cure, with LGBTQ+ individuals more likely to return than men who have sex with women and women who have sex with men. Of those who returned for the test-of-cure, 4.9% of pharyngeal samples were equivocal and 2.4% positive for N. gonorrhoeae by nucleic acid amplification testing, likely reflecting false-positive tests.
CONCLUSION
Despite recommendations to perform a test-of-cure 7 to 14 days after treatment of pharyngeal gonorrhea, rates of return continue to be low. Alternative strategies should be investigated to increase test-of-cure rates.
Topics: Adult; Chlamydia Infections; Female; Gonorrhea; Homosexuality, Male; Humans; Male; Neisseria gonorrhoeae; North Carolina; Nucleic Acids; Pharyngeal Diseases; Sexual and Gender Minorities; Young Adult
PubMed: 35858472
DOI: 10.1097/OLQ.0000000000001679 -
Dysphagia Aug 2019Detailed information on the hypopharyngeal cyst presentation, terminology, classification, diagnosis, management, and possible complication is scarce though it would... (Review)
Review
Detailed information on the hypopharyngeal cyst presentation, terminology, classification, diagnosis, management, and possible complication is scarce though it would lead to life-threatening symptoms. This review article, therefore, meticulously presents and analyzes the majority of the pertaining literature. In this context, a particular emphasis has been placed on the embryological development of the branchial arches while discussing each entity that would improve the current understanding of different pharyngeal cyst's pathologies.
Topics: Cysts; Humans; Hypopharynx; Pharyngeal Diseases
PubMed: 30927081
DOI: 10.1007/s00455-019-10003-2 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Dec 2017Pharyngocutaneous fistula is a common and serious complication after total laryngectomy, and it will seriously affect patients' postoperative recovery. The treatment of... (Review)
Review
Pharyngocutaneous fistula is a common and serious complication after total laryngectomy, and it will seriously affect patients' postoperative recovery. The treatment of pharyngeal fistula mainly include conservative and surgery therapy. The use of negative-pressure wound therapy and endoscopic technique to treat post laryngectomy pharyngocutaneous fistula also acquire good result in recent years. However, specific therapy options should be choose according to the type and size of the fistula, the patient's overall health condition and preoperative chemoradiotherapy etc. This article will give a review on the status of treatment of pharyngocutaneous fistula after total laryngectomy.
Topics: Cutaneous Fistula; Humans; Laryngeal Neoplasms; Laryngectomy; Pharyngeal Diseases; Postoperative Complications; Salvage Therapy
PubMed: 29798405
DOI: 10.13201/j.issn.1001-1781.2017.23.020