Cases reported "Deglutition Disorders"

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11/51. Temporary tongue thrust: failure during orthodontic treatment.

    This report presents the case of a 25-year-old male patient who sought orthodontic treatment. Oral examination revealed an Angle Class I relation, with a bimaxillary dento-alveolar protrusion, evidence of anterior crowding, and a large overbite and overjet. Radiographic examination revealed a skeletal Class I occlusion. During the distal movement of the canines, occlusal interferences between the canines occurred and the commencement of a tongue thrust was observed. After correction of the applied forces, the canine movement was completed and the habit was no longer detectable. The incident indicates that an unusual oral habit suspiciously occurring during treatment should lead to an immediate reconsideration of the orthodontic treatment strategy.
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12/51. Use of an Innsbruck sensorimotor activator and regulator (ISMAR) in the treatment of oral motor dysfunctions: a single case report.

    Many patients with cerebral palsy have difficulties during the oral preparatory phase and also during the food transport phase (swallowing), and oral-sensorimotor therapy is practised with these individuals. With oral-sensorimotor therapies, the functioning of the lips, cheeks, tongue and pharyngeal structures, and the interplay between these structures, can be improved. An Innsbruck sensorimotor activator and regulator (ISMAR) is one of the appliances used for oral-motor therapy. The purpose of this study is to describe the appliance and report a patient using ISMAR.
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13/51. Spontaneous fracture of hypertrophied genial tubercles.

    A case of spontaneous fracture of hypertrophied genial tubercles is reported. This is an uncommon event with only six previously reported cases. This entity is usually associated with severe edentulous bone resorption, a condition related to the pathogenesis of this fracture. Clinical complaints include painful swelling of the floor of the mouth and impaired tongue function. If left untreated, mucosal inflammatory changes may appear and a biopsy should be performed. Total recovery is obtained after removal of the fractured fragments.
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14/51. Oropharyngeal dysphagia in a case of Huntington's disease.

    The aim of this study is to analyze dysphagic symptoms of a patient with Huntington's disease (HD) who had having difficulty in swallowing. The patient was a 66-year-old female with HD. Inspection of self-feeding at bedside and videofluorographic swallowing assessment were performed. The features at self-feeding were the tendency of rapid eating, inability for smooth transportation of food to oral cavity, weak lip closure, which resulted in falling of food and eating it again. The videofluorography indicated clumsy tongue movement and postural instability by chorea which caused discoordination between oral and pharyngeal stage. Those ended in spill of liquid to the pharynx and retention of bolus in the oral cavity and vallecula, and aspiration did not occur. Pudding was carefully chewed because of the patient's alertness to the examination. The cognitive disturbance and choreic movement caused dysphagia at the preparatory and oral stages, and chorea also produced the discoordication between the oral and pharyngeal stage. The change of the shape of cups and stable posture were advised to lessen the chance of her aspiration.
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15/51. Unilateral compression neuropathy of the hypoglossal nerve due to head suspension orthosis in mitochondriopathy.

    An 85-year-old woman with multisystem mitochondriopathy experienced tension headache, cervical pain, torque head-posture, and vertigo since 1980 for which she was continuously wearing a head-suspension-orthosis- since 1990. Since 1996 she developed severe left-sided weakness and wasting of the tongue. Needle-EMG of the left genioglossus muscle revealed abnormal spontaneous activity and reduced interference-pattern. No morphological alterations in the anatomical course of the hypoglossal nerve were found. Severe, unilateral weakness and wasting of the tongue was interpreted due to chronic compression of the hypoglossal nerve by long-standing use of a head-suspension-orthosis for cervical pain from cervical muscle weakness and resulting spinal degeneration.
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16/51. Rare case of pyogenic granuloma of the tongue in an 8-week-old infant.

    We present a case of a large pyogenic granuloma of the tongue causing swallowing difficulties in an 8-week-old infant. In the literature, we found no case reports of pyogenic granuloma in such a young infant. It is a quickly growing, hypertrophic inflammatory change consisting of exceptionally richly vascularized granular tissue. The granuloma was located in the central part of the tongue and appeared dark pink in color. It was an easily bleeding pedunculated tumor measuring 3 x 2.5 cm. The etiology of the tumor is unknown; it can arise in sites of previous injury, chronic irritation and infection. The course of the disease is benign and painless, though it can be recurrent. No recurrence was found in the control examination after 3 years.
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17/51. Parapharyngeal granular cell tumour: a unique surgical challenge.

    A granular cell tumour is a rare lesion of probable nerve sheath origin. It is typically benign but up to seven per cent may be malignant. Since its original description in the tongue in 1926, the tumour has been reported to occur at many other sites in the body. The authors report a case of a 49-year-old African woman with an oro-naso-parapharyngeal granular cell neoplasm causing mild dysphagia. The location of this tumour, which has not been reported previously, posed a unique surgical challenge. An initial attempt to remove the lesion transorally was only partially successful because it was too tough and adherent for conventional surgical dissecting instruments. Complete resection, however, was achieved with a carbon dioxide laser via the same approach. This information may be helpful in the management of other similar cases in the future.
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18/51. Swallowing dysfunction in 101 patients with nephropathic cystinosis: benefit of long-term cysteamine therapy.

    Nephropathic cystinosis is a rare, autosomal recessive lysosomal storage disorder caused by mutations in the CTNS gene that codes for a cystine transporter in the lysosomal membrane. Affected patients store 50-100 times the normal amounts of cystine in their cells, and suffer renal tubular and glomerular disease, growth retardation, photophobia, and other systemic complications, including a myopathy and swallowing dysfunction. Using videofluoroscopy and ultrasound examinations, we assessed the swallowing function of 101 patients with nephropathic cystinosis on their most recent admission to the National Institutes of health Clinical Center between 1987 and 2004. These patients ranged in age from 6 to 45 years; more than half had significant complaints of swallowing difficulty. On examination of barium swallow, the oral, pharyngeal, and esophageal phases of swallowing were abnormal in 24%, 51%, and 73% of patients, respectively. The frequency of dysfunction increased with age for each phase of swallowing. Both the Swallowing Severity Score (a measure of dysfunction on barium swallow) and the Oral Muscle Composite Score (a reflection of vocal strength, oral-facial movement, and tongue and lip function) increased (that is, worsened) with the number of years that a patient was not receiving treatment with cysteamine, the cystine-depleting agent of choice in cystinosis. The severity scores decreased with the number of years on cysteamine therapy. The Swallowing Severity Score varied directly with the severity of muscle disease, but was not correlated with the presence or absence of the 57-kb CTNS deletion that commonly occurs in nephropathic cystinosis patients. We conclude that swallowing dysfunction in cystinosis presents a risk of fatal aspiration, correlates with the presence of muscle atrophy, and, based on cross-sectional data, increases in frequency with age and number of years without cysteamine treatment. cystine-depleting therapy with cysteamine should be considered the treatment of choice for both pre- and posttransplant cystinosis patients.
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19/51. macroglossia secondary to systemic amyloidosis: case report and literature review.

    amyloidosis is characterized by an abnormal extracellular deposition of amyloid in different tissues and organs, where it usually causes some type of dysfunction. Its cause is unknown. The two main forms of amyloidosis are systemic and localized; the latter is rare. No satisfactory treatment for systemic amyloidosis has been discovered, and mean survival is poor, ranging from 5 to 15 months depending on the presence or absence of multiple myeloma. We report a case of primary systemic amyloidosis in a 71-year-old man. The diagnosis of amyloidosis was established by tongue biopsy, and its systemic nature was identified by analysis of aspirated abdominal fat. At the 1-year follow-up, the patient's clinical condition had not changed, and he was thereafter lost to follow-up.
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20/51. Necrotizing stomatitis in the developed world.

    We present a case of a malnourished 68-year old man with occult hypothyroidism who presented with malaise, pyrexia, tongue swelling, oral ulceration and dysphagia after a 6-month period of increasing lethargy and failing self-care. Severe necrotic oral ulcerative lesions were accompanied by cutaneous purpura, blood-filled blisters and bedsores. It was concluded that the patient's clinical condition reflected necrotizing stomatitis on a background of malnutrition with scorbutic skin lesions and hypothyroidism. The patient made a good recovery with scrupulous oral hygiene, debridement, intravenous metronidazole and nutritional support. Healing occurred with marked fibrosis and trismus, which has slowly improved with mouth-opening exercises. Necrotizing stomatitis is more commonly encountered in malnourished children in developing countries, and may subsequently result in devastating facial defects and death. patients in the developed world with poor oral hygiene, malnourishment and immunosuppression are also at risk, but early diagnosis and treatment is life-saving and reduces subsequent disability.
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