Cases reported "Deglutition Disorders"

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1/51. tongue muscle activity after orthodontic treatment of anterior open bite: a case report.

    A case report of a Class I malocclusion with an anterior open bite and bimaxillary dental protrusion was presented. The patient had a tongue thrust swallow and slight lisping. After the treatment, significant adaptation in electromyographic pattern of genioglossus muscle activity during swallowing was determined. However, remarkable change in the electromyographic pattern of the genioglossus muscle did not occur during chewing.
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2/51. Foix-Chavany-Marie (anterior operculum) syndrome in childhood: a reappraisal of Worster-Drought syndrome.

    Foix-Chavany-Marie syndrome (FCMS) is a distinct clinical picture of suprabulbar (pseudobulbar) palsy due to bilateral anterior opercular lesions. Symptoms include anarthria/severe dysarthria and loss of voluntary muscular functions of the face and tongue, and problems with mastication and swallowing with preservation of reflex and autonomic functions. FCMS may be congenital or acquired as well as persistent or intermittent. The aetiology is heterogeneous; vascular events in adulthood, nearly exclusively affecting adults who experience multiple subsequent strokes; CNS infections; bilateral dysgenesis of the perisylvian region; and epileptic disorders. Of the six cases reported here, three children had FCMS as the result of meningoencephalitis, two children had FCMS due to a congenital bilateral perisylvian syndrome, and one child had intermittent FCMS due to an atypical benign partial epilepsy with partial status epilepticus. The congenital dysgenetic type of FCMS and its functional epileptogenic variant share clinical and EEG features suggesting a common pathogenesis. Consequently, an increased vulnerability of the perisylvian region to adverse events in utero is discussed. In honour of Worster-Drought, who described the clinical entity in children 40 years ago, the term Worster-Drought syndrome is proposed for this unique disorder in children.
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3/51. First report of a case of osteoma of the larynx.

    Osteomas are common in otolaryngology, as they often involve the skull and facial bones. On rare occasions, these tumors have also been found in the temporal bone and the tongue. Until now, osteomas have not been encountered in the larynx. We describe the case of a patient who came to our institution with hoarseness and dysphagia and who was found to have an osteoma of the larynx. Radiographic imaging, endoscopy, and pathologic classification confirmed the diagnosis. To our knowledge, this is the first reported case of an osteoma of the larynx.
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4/51. Orolaryngeal sarcoidosis presenting as obstructive sleep apnoea.

    A 53-year-old man was evaluated for snoring, dysphagia for solid foods and difficulty of breathing and a polysomnographic recording was consistent with a diagnosis of obstructive sleep apnoea syndrome (OSAS). A flexible fiberoptic bronchoscopy (FFB) showed the presence of a nodular lesion of the posterior ventral surface of the tongue strictly connected to the left lateral border of the epiglottis. The biopsy specimen taken from the lesion was consistent with sarcoidosis. No involvement of pulmonary parenchyma, lymph nodes or other organs was recognized. After two months of steroid treatment, symptoms disappeared and resolution of the nodular lesion at the FFB and normalization of the polysomnographic recording were observed. This is the first report of orolaryngeal sarcoidosis associated with OSAS as the only clinical presentation of the disease.
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5/51. Ectopic lingual thyroid as unusual cause of severe dysphagia.

    Ectopic lingual thyroid is an uncommon embryological aberration characterized by the presence of thyroid tissue located in a site different from the pretracheal region as in the normal. lingual thyroid is the most frequent ectopic location of the thyroid gland, although its clinical incidence varies between 1:3000 and 1:10,000. We present the case of a 26-year-old woman who presented severe dysphagia caused by a mass located on the base of the tongue in the midline. An endoscopic partial removal of the ectopic tissue allowed her to rapidly regain her swallowing capacity. The literature regarding the incidence and diagnosis of lingual thyroid is reviewed and the possibilities of treatment discussed.
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6/51. CT findings associated with Eagle syndrome.

    Eagle syndrome is an aggregate of symptoms caused by an elongated ossified styloid process, the cause of which remains unclear. This is a rare finding that often goes undetected in the absence of radiographic studies. In this case, we present the diagnostic CT and lateral view plain film radiography findings of a 39-year-old woman with clinical evidence of Eagle syndrome. Eagle syndrome can occur unilaterally or bilaterally and most frequently results in symptoms of dysphagia, headache, pain on rotation of the neck, pain on extension of the tongue, change in voice, and a sensation of hypersalivation (1, 2). We present rare and diagnostic radiographic evidence of this on both plain film radiographs and CT scans. Although well documented in otolaryngology literature and dentistry literature, this syndrome has not been reported in the radiology literature.
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7/51. Pharyngoesophageal pressure in patients with swallowing disorders.

    We developed and tested a pressure transducer to correctly determine swallowing pressure at different sites in the pharynx. In normal individuals three pressure peaks were obtained in the mesopharynx, hypopharynx and cervical esophagus, respectively. A patient with central dysphagia demonstrated markedly low mesopharyngeal and hypopharyngeal swallowing pressure. One tongue cancer patient who had undergone right hemiglossectomy, including partial resection of the root of the tongue and bilateral superior neck dissection, had markedly low swallowing pressure in the mesopharynx and vallecula area. Another supraglottic cancer patient treated by supraglottic horizontal partial laryngectomy showed extremely low swallowing pressure in the supraglottic area. Based on our findings, we suggest that measurements using a pressure transducer such as the one described here should be used in combination with radiographic study to diagnose swallowing anomalies correctly. Data obtained with the pressure transducer will allow the clinician to identify the site responsible for postoperative dysphagia as well as its severity, and facilitate planning of reconstructive surgery when required.
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8/51. Minimally invasive functional reconstruction after extended oropharyngeal resection including soft palate and base of tongue using a pectoralis major myocutaneous flap.

    Excision of large oropharyngeal carcinomas that affect the base of the tongue and the soft palate severely impairs swallowing and articulation. In the present study we describe a minimally invasive technique that effectively restores swallowing and articulation by the insertion of a pectoralis major myocutaneous flap with a bilobular skin island. One lobe of the skin island is used to reconstruct the base of the tongue and the other to reconstruct the oropharynx. The soft palate is reconstructed by folding the tip of the lobe that is used to reconstruct the oropharynx in half along the long axis to fill the rhinopharynx. We have done this procedure for 13 patients with oropharyngeal carcinoma. Six months postoperatively all 13 were able to swallow without aspiration. Nine of the 13 patients were able to hold a normal conversation, but the remaining four had severe rhinolalia aperta. However, this condition was easily corrected by secondary reconstruction using a pharyngeal flap and a palatal mucoperiosteal flap (n = 3) or by the use of a small speech aid (n = 1).
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9/51. tongue necrosis secondary to temporal arteritis: a case report and literature review.

    We report a case of tongue necrosis secondary to temporal arteritis. Temporal arteritis can have devastating consequences, leading to blindness or death unless recognized and treated appropriately. Initial presentation may be to an oral surgeon, and we discuss the pathogenesis, diagnosis, and management of temporal arteritis.
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10/51. Epithelioid sarcoma with metastatic spread to the tongue.

    Epithelioid sarcoma (ES) is a rare tumour that seldom presents to the otolaryngologist. It typically occurs in the extremities of young adolescents; however, it has the capability of metastasizing, often to the lungs or skin. The diagnosis is by histopathological examination and immunohistochemistry. We present a case of metastatic ES occuring in the tongue, a tumour not reported previously in the English literature.
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