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Medicine Jan 2022The nature of pharyngeal swallowing function during the course of recovery of dysphagia due to lateral medullary syndrome (LMS) is unclear. Vacuum swallowing is a...
INTRODUCTION
The nature of pharyngeal swallowing function during the course of recovery of dysphagia due to lateral medullary syndrome (LMS) is unclear. Vacuum swallowing is a compensatory swallowing method that improves the pharyngeal passage of a bolus by creating negative pressure during swallowing in the esophagus in patients with dysphagia due to LMS. We present a case involving a patient with dysphagia due to LMS who involuntarily acquired a swallowing method with prolonged and increased pharyngeal contraction and vacuum swallowing.
PATIENT CONCERNS
We report a unique case involving a 52-year-old patient with dysphagia due to LMS. His dysphagia was severe but improved gradually with swallowing rehabilitation. The patient involuntarily acquired a swallowing method with prolonged and increased pharyngeal contraction and vacuum swallowing.
DIAGNOSIS
The patient presented with dysphagia due to left LMS. A videofluoroscopic examination of swallowing revealed pharyngeal residue.
INTERVENTIONS
Forty-five days after the onset of the dysphagia, the swallowing pressure along the pharynx and esophagus was measured using high-resolution manometry.
OUTCOMES
Vacuum swallowing was observed in six out of 19 swallows (32.5%). The velopharyngeal contractile integral (CI) and mesohypopharyngeal CI values increased during swallowing, reflecting prolonged and increased pharyngeal contraction. We named this swallowing method "prolonged swallowing."
CONCLUSION
The findings in this case indicate that vacuum and prolonged swallowing may be compensatory swallowing methods observed in individuals recovering from dysphagia due to LMS. Further research is needed to clarify the relationship between these swallowing methods and the pathophysiology, prognosis, and treatment of dysphagia in patients with LMS.
Topics: Deglutition Disorders; Humans; Lateral Medullary Syndrome; Manometry; Middle Aged; Pharynx; Pressure; Vacuum
PubMed: 35029918
DOI: 10.1097/MD.0000000000028524 -
International Journal of Surgery Case... 2020Pedicled flap reconstruction still plays an essential role in head and neck surgery as an alternative to free grafts. Two standard methods are the pectoralis major and...
INTRODUCTION
Pedicled flap reconstruction still plays an essential role in head and neck surgery as an alternative to free grafts. Two standard methods are the pectoralis major and the deltopectoral flap, which are generally characterized by their reliable perfusion. This case describes bilateral arteriosclerosis of the subclavian artery as a possible cause of flap failure.
PRESENTATION OF CASE
We report on a 65-year-old patient with a multilevel carcinoma of the right pharynx. Due to the unique patient history, a free flap reconstruction was not possible. After resection of the primary, we performed reconstruction with a pedicled pectoralis major flap.
DISCUSSION
Postoperatively, we observed necrosis of the pectoralis major flap. Secondary defect reconstructions were performed with a deltopectoral flap first from the right and then, in the case of necrosis, from the left side. Stenosing arteriosclerotic plaques of the subclavian artery on both sides were the cause of flap failure.
CONCLUSION
Preoperative angiography of the subclavian artery is not a standard diagnostic procedure in the surgical planning of pedicled flap reconstruction in the head and neck region. In exceptional cases, we recommend angiographic imaging of the supplying vessels to make a more precise flap selection and avoid complications.
PubMed: 33086164
DOI: 10.1016/j.ijscr.2020.10.030 -
BMJ Case Reports Jul 2019
Topics: Adult; Anti-Bacterial Agents; Blepharoptosis; Cocaine; Cocaine-Related Disorders; Conjunctivitis; Drug Overdose; Fatal Outcome; Fusobacteriaceae Infections; Humans; Male; Nasal Septum; Necrosis; Nose Deformities, Acquired; Palate; Pharynx
PubMed: 31350235
DOI: 10.1136/bcr-2019-231743 -
Medicine Mar 2024Acute pharyngitis (AP) refers to the acute inflammation of the pharynx, characterized by swelling and pain in the throat. Shuangyang houbitong granules (SHG), a...
BACKGROUND
Acute pharyngitis (AP) refers to the acute inflammation of the pharynx, characterized by swelling and pain in the throat. Shuangyang houbitong granules (SHG), a traditional Chinese medicine compound, have been found to be effective in providing relief from symptoms associated with AP.
METHODS
The chemical components of SHG were screened using Traditional Chinese Medicine Systems Pharmacology database, HERB database, and China National Knowledge Infrastructure. The targets of the granules were predicted using SwissTargetPrediction database. A network was constructed based on the targets of AP obtained from Genecards database, and protein-protein interaction analysis was performed on the intersection targets using STRING database. Key targets were screened for Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis, and the binding activity of components and targets was predicted using AutoDockTools-1.5.7.
RESULTS
A total of 65 components of SHG that met the screening criteria were retrieved, resulting in 867 corresponding targets. Additionally, 1086 AP target genes were retrieved, and 272 gene targets were obtained from the intersection as potential targets for SHG in the treatment of AP. Molecular docking results showed that the core components genkwanin, acacetin, apigenin, quercetin can stably bind to the core targets glyceraldehyde 3-phosphate dehydrogenase, interleukin 6, tumor necrosis factor, serine/threonine protein kinase, tumor protein 53, and epidermal growth factor receptor.
CONCLUSION
The research results preliminarily predict and verify the mechanism of action of SHG in the treatment of AP, providing insights for further in-depth research.
Topics: Humans; Molecular Docking Simulation; Network Pharmacology; Pharyngitis; Pharynx; Neck; Drugs, Chinese Herbal; Medicine, Chinese Traditional
PubMed: 38552049
DOI: 10.1097/MD.0000000000037674 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Dec 2021In recent years, with the increase of magnetic toys, the intake of magnetic foreign bodies is an increasing problem in pediatric emergency.The strong suction of the...
In recent years, with the increase of magnetic toys, the intake of magnetic foreign bodies is an increasing problem in pediatric emergency.The strong suction of the magnetic foreign body can lead to necrosis, perforation, and infection of surrounding tissues.The site of magnetic foreign body injury is mainly the esophagus, intestines, stomach, a few in the pharynx, etc.This requires early assessment and appropriate intervention to avoid further harm.Because of its unique physical properties, magnetic foreign bodies in bilateral nasal cavity are rarely reported. Now we have a case of a bilateral magnetic foreign body in the nasal cavity.
Topics: Child; Esophagus; Foreign Bodies; Humans; Magnetic Phenomena; Nasal Cavity; Pharynx
PubMed: 34886632
DOI: 10.13201/j.issn.2096-7993.2021.12.017 -
Medicine Nov 2020Hyperthyroidism-related anterior circulation ischemic events have been well documented; however, posterior circulation infarction is rarely reported, not to mention with...
An extensive posterior circulation infarction secondary to primary hyperthyroidism accompanied with superior mesenteric artery syndrome: A case report and description of patho-physiological association.
INTRODUCTION
Hyperthyroidism-related anterior circulation ischemic events have been well documented; however, posterior circulation infarction is rarely reported, not to mention with superior mesenteric artery syndrome (SMAS), which has never been reported concurrently. We describe, to the best of our knowledge, the first case of hyperthyroidism-related cerebellar infarction accompanied with SMAS.
PATIENT CONCERNS
A 22-year-old women presented with palpitation, postprandial vomiting, and acute body weight loss. Enlarged thyroid gland was discovered in physical examination and Graves disease was diagnosed by blood test; therefore, Propylthiouracil and β-blocker were prescribed. Sudden onset conscious disturbance accompanied with apnea was noted during hospitalization.
DIAGNOSIS
Computed tomography (CT) revealed cerebellar infarction with severe cerebellar swelling and tonsil herniation; hence, emergent suboccipital craniotomy and bilateral tonsillectomy were performed.
INTERVENTIONS
Nevertheless, persisted poor passage of liquid diet during nasogastric tube feeding was noted after operation. CT of abdomen showed a sharp aorta-SMA angle (15°) and a short distance between aorta and SMA (6 mm) indicating a diagnosis of SMAS.
OUTCOMES
After parental nutrition supplement and progressive rehabilitation program, she recovered to a modified Rankin Scale of 3.
CONCLUSION
Although rarely reported, hyperthyroidism-related sympathetic hyperstimulation, vasculopathy could result in potentially deadly posterior circulation infarction. Furthermore, SMAS should be considered in the cases of hyperthyroidism with prolonged gastrointestinal symptoms even after treatment and should be treated simultaneously, since SMAS exacerbates depletion of intravascular volume. Further study to clarify the relation between hyperthyroidism and posterior circulation hemodynamic status is suggested.
Topics: Chest Pain; Craniotomy; Female; Humans; Hyperparathyroidism, Primary; Infarction; Palatine Tonsil; Paralysis; Superior Mesenteric Artery Syndrome; Tomography, X-Ray Computed; Vomiting; Young Adult
PubMed: 33181647
DOI: 10.1097/MD.0000000000022664 -
Journal of Stroke and Cerebrovascular... Sep 2020Coronavirus disease 19 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this scenario, managing...
Coronavirus disease 19 (COVID-19) is an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this scenario, managing acute medical conditions, such as stroke, requires a timely treatment together with proper strategies that minimize the risk of infection spreading to health care workers and other patients. We report the case of a 79-year-old woman, who was admitted for a wake-up stroke due to occlusion of the left middle cerebral artery. She was treated outside the COVID-19-dedicated track of the hospital because she had no concomitant signs or symptoms suggestive of SARS-CoV-2 infection nor recent contact with other infected individuals. Post-mortem nasal and pharyngeal swab was positive for SARS-CoV-2 infection. We propose that hyperacute stroke patients should be tested for SARS-CoV-2 infection at admission and then managed as having COVID-19 until cleared by a negative result. We are aware that such measure results in some delay of the acute treatment of stroke, which could be minimal using well-exercised containment protocols.
Topics: Aged; Betacoronavirus; COVID-19; COVID-19 Testing; Clinical Laboratory Techniques; Coronavirus Infections; Delayed Diagnosis; Fatal Outcome; Female; Humans; Infarction, Middle Cerebral Artery; Infectious Disease Transmission, Patient-to-Professional; Nose; Occupational Exposure; Pandemics; Pharynx; Pneumonia, Viral; Predictive Value of Tests; Risk Factors; SARS-CoV-2; Severity of Illness Index
PubMed: 32807416
DOI: 10.1016/j.jstrokecerebrovasdis.2020.104981 -
Emergencias : Revista de La Sociedad... Oct 2019
Topics: Adult; Carotid Artery, Internal, Dissection; Female; Humans; Infarction, Middle Cerebral Artery; Oropharynx; Wounds, Stab
PubMed: 31625313
DOI: No ID Found