Cases reported "Deglutition Disorders"

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1/8. Technological applications in the assessment of acquired neurogenic communication and swallowing disorders in adults.

    The role of technology is expanding rapidly in many aspects of the diagnostic process with patients who have neurogenic communication and swallowing disorders. In this article we discuss a broad selection of technological tools that enhance a wide range of diagnostic tasks, such as taking case histories, administering and scoring tests, performing acoustic, physiologic, cognitive, and linguistic analyses, making normative comparisons, profiling diagnostic results, and making diagnostic decisions. Clinicians are encouraged to scrutinize the relative value of all diagnostic tools to maintaining the quality of service. An appendix includes information for contacting vendors and manufacturers of the products discussed.
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keywords = communication
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2/8. Epiphrenic diverticulum composed of airway components attributed to a bronchopulmonary-foregut malformation: report of a case.

    Bronchopulmonary-foregut malformation (BPFM), defined originally as pulmonary sequestration with or without communication to the esophagus, has been acknowledged to include congenital foregut diverticula. We present herein the case of a 43-year-old woman with a 9-year history of dysphagia, in whom a barium meal examination demonstrated a 2.5-cm epiphrenic diverticulum and several fistulae. A laparotomy was performed and the lower esophagus without communication to the lung was pulled down and resected, followed by an esophagogastrostomy carried out with fundopexy. Since her operation, the patient has been free of symptoms. Histologically, the diverticulum was observed to be lined by stratified squamous cells, but its shape was formed by mural cartilage, smooth muscle cells, and three ciliated-cell cysts. The dysphagia was considered to have been derived from the kinked esophagus created by the rigid diverticulum, being the possible developmental arrest of a supernumerary lung bud. These findings indicate that this case may involve BPFM in the broad sense. Although several cases of bronchogenic cysts located beneath or across the diaphragm have been reported as a subgroup of BPFM, congenital epiphrenic diverticula has rarely been described.
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ranking = 0.4
keywords = communication
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3/8. Technological applications in the treatment of acquired neurogenic communication and swallowing disorders in adults.

    Clinicians can use the computer as an effective clinical tool by incorporating what is known about neurogenic communications disorders, treatment, and technology. computers can be used to administer activities designed by clinicians, vary stimulus characteristics, adjust response requirements, present cues, and select tasks, all in response to patient performance. Specialized devices can be used to measure small physiologic changes, help patients communicate with and control their environment, and allow clinicians to view closely what we could only imagine only a few years ago. Users of technology must focus not only on effectiveness and operational efficiency, but also ensure an optimal quality of treatment. This article reviews many of the ways technology is used in the treatment of people suffering from neurogenic communication and swallowing problems.
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ranking = 1.2
keywords = communication
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4/8. Tracheo-tracheal puncture for voice rehabilitation after laryngotracheal separation.

    For patients with intractable aspiration, laryngotracheal separation (LTS) may be the only means of protecting the airway. The LTS prevents pulmonary compromise caused by aspiration; however, airway separation from the larynx also prevents laryngeal phonation. This case report suggests a supplemental procedure to the LTS, which maintains airway protection yet allows for laryngeal communication.
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ranking = 0.2
keywords = communication
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5/8. Relearning to eat late after a stroke by systematic nursing intervention: a case report.

    Using a training programme developed by Heimlich, we have attempted to train swallowing in a 78-year-old man who had been fed by a nasogastric tube for 3 years after a stroke. The training was successful and, during a follow-up of 1 year, the patient was eating normal food. The training process is analysed as a two-level communication between the patient and his trainer; the therapeutic relationship and the training programme. The development of the patient's attitudes during training is interpreted with reference to Erikson's theory of 'eight stages of man'.
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ranking = 0.2
keywords = communication
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6/8. apnea in postsurgical hypnotherapy of an esophageal cancer patient: a brief communication.

    Use of clinical hypnosis in the postsurgical psychotherapy of an esophageal cancer patient who could not swallow involved reenactment of the successful surgery and producing hallucinations of taste and smell, as well as working through emotions relations to the surgery and her disease. An apnea that occurred in a late phase of the treatment was addressed with the familiar arm pumping technique that had been used as a deepening technique, resulting in the patient's resuming normal breathing. The experience reminds the practitioner of the possible unexpected professional demands when working in a medical environment. It also provides clues as to the underlying psychological mechanisms and their role in successful symptom removal. A 6-year follow-up confirmed the lasting effect of this brief psychotherapy.
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ranking = 0.8
keywords = communication
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7/8. Caustic and thermal epiglottitis in the adult.

    The presence of dysphagia, drooling, and stridor in an adult subsequent to thermal or caustic injury should alert the treating physician to the possibility of injury to the supraglottic structures with resultant epiglottitis. These adults possess many of the features seen in acute infectious epiglottitis and should be handled with the same consideration for potential upper airway obstruction. Epiglottic injuries of this type should be suspected in adults with mental disorders or communication difficulties.
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ranking = 0.2
keywords = communication
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8/8. patient selection for primary laryngotracheal separation as treatment of chronic aspiration in the impaired child.

    Chronic aspiration in the neurologically impaired child is associated with significant medical and social complications. Traditional surgical management has often relied on tracheotomy. This may well fail to control aspiration. The purpose of this retrospective study was to determine which neurologically impaired children would benefit from a laryngotracheal separation (LTS), as opposed to tracheotomy, as the primary surgical procedure to control chronic salivary aspiration. patient selection was based on neurologic status, verbal communication ability, likelihood of neurologic recovery, and failure of previous treatments to control aspiration. Nineteen neurologically impaired children aged 8-172 months with chronic salivary aspiration underwent LTS. A total of 73.6% of these patients had prior tracheotomies, yet they continued to aspirate. Two early and three late complications were noted. No instances of fistula formation were noted. There were no deaths related to complications of the surgery or persistent aspiration. Follow-up 1-62 months after surgery demonstrated that complete control of the aspiration was achieved in all of these children. Two of the children who had achieved verbal communication prior to the procedure lost this ability. Improved general health and ability to resume oral intake was noted in all patients. This, combined with a decrease in the need of frequent suctioning, was felt by the families of these children to be a major improvement in the quality of life. Laryngotracheal separation appears to be a simple and effective means of controlling chronic aspiration. It should be considered as a primary treatment of aspiration in the properly selected child with neurologic disease.
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ranking = 0.4
keywords = communication
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