Cases reported "Pharyngeal Diseases"

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1/61. Cinefluorography in the diagnosis of pharyngeal palsies.

    (1) The aetiology of dysphagia may be difficult to diagnose when it presents without clinical signs or an associated clinical syndrome. (2) Pharyngeal palsies present in acute and chronic forms. (3) Cinefluorographic techniques are helpful in making an objective diagnosis of pharyngeal palsy. (4) Advice may be given to the patient on head and neck positions during swallowing that is based on the findings of the cinefluorographic examination, in order to alleviate symptoms. (5) Good fluoroscopy, preferably with video-tape recording facilities may be perfectly adequate provided that the diagnosis is considered at that time.
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ranking = 1
keywords = dysphagia
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2/61. Pharyngeal dysphagia caused by isolated myogen dystrophy of musculus cricopharyngeus.

    Five patients suffering from idiopathic cricopharyngeal dysfunction (without Zenker's diverticulum) were treated surgically. Together with cricopharyngeomyotomy biopsies were taken at the level of the cricopharyngeus. Histological, enzyme hystochemical and electronmicroscopic examinations were performed on all patients. In two cases the histology revealed myogen dystrophy (presence of necrosis, myophagocytosis, abnormal fiber structure, basophilic fibers, fibrosis, mild cellular reaction and predominancy of fiber type I). Since the complete patient evaluation (clinical features, electromyography, serum creatinin phosphokinase level, etc.) could rule out any general, muscle disorders, the cause of the idiopathic pharyngeal dysfunction must have been in these two cases an isolated myogen dystrophy of the cricopharyngeus.
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ranking = 4
keywords = dysphagia
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3/61. Pharyngeal thyroid: a case report.

    A 48-year-old woman presented with dysphagia. On examination of the pharynx, a mass was visible behind and adjacent to the right tonsil. It was excised and proved to be ectopic thyroid tissue.
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ranking = 1
keywords = dysphagia
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4/61. Severe pharyngeal stenosis treated with inferiorly based sternocleidomastoid myocutaneous flap.

    Severe pharyngeal stenosis is a debilitating condition associated with apnea and dysphagia. Treatment options include local flaps and free mucosal grafts. We present 2 cases of severe stenosis. apparently from adenotonsillectomy, that failed more conservative repairs. Both were treated successfully with a sternocleidomastoid myocutaneous flap rotated in through a lateral pharyngotomy. No further treatment has been required. Technical considerations and operative planning are discussed.
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ranking = 1
keywords = dysphagia
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5/61. Suboccipital meningocele presenting as a huge retropharyngeal mass in a patient with neurofibromatosis Type 1. Case report.

    The authors report an extremely rare case of neurofibromatosis Type 1 (NF1) with a suboccipital meningocele presenting as a huge retropharyngeal mass. A 73-year-old woman with typical cutaneous manifestations of NF1 presented with nasal obstruction and dysphagia due to a retropharyngeal mass. magnetic resonance imaging revealed a huge mass lesion extending from the right occipital bone defect to the retropharynx through the right paravertebral region. Computerized tomography scanning after intrathecal administration of contrast material confirmed that the mass was a meningocele protruding through a right occipital bone defect. The authors attempted to ligate this meningocele, most of which was excised via a suboccipital approach, but a second transcervical operation was required. Finally, the meningocele resolved and the patient was discharged without symptoms.
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ranking = 1
keywords = dysphagia
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6/61. Cricopharyngeal achalasia--a cause of major dysphagia in a newborn. A case report.

    Cricopharyngeal achalasia is a rare cause of neonatal dysphagia. Its treatment is based on surgical myotomy, which is to be avoided in the presence of prematurity and neurological diseases. The authors report a case of cricopharyngeal achalasia in a full-term four-month-old female baby. Coughing and choking during feeds were the major symptoms. The diagnosis was made peroperatively although barium meal and endoscopic findings were suggestive. After cricopharyngeal myotomy, symptoms took several weeks to disappear. Seven months after surgery, she feeds normally and weighs 7,700 g. Neonatal cricopharyngeal achalasia could be a foregoing state to cricopharyngeal diverticula in adult. Some cases may remain undiagnosed either due to lack of symptoms or sudden infant death.
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ranking = 5
keywords = dysphagia
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7/61. Gastric choristoma of the hypopharynx presenting in an infant: a case report and review of the literature.

    Normal gastric mucosa has been found throughout the alimentary tract, ranging from scattered rests of cells to well formed mucosa with submucosal smooth muscle. Many terms have been applied to these collections; however, the term gastric choristoma seems most appropriate. We present a case of hypopharyngeal gastric choristoma presenting with dysphagia and frequent emesis. Our literature review reveals that this is the seventh reported case of gastric choristoma found in the hypopharynx, and the first to present in an infant in the absence of respiratory distress. Excision or CO(2) laser ablation is useful for symptom relief; however, complete removal often requires multiple attempts.
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ranking = 1
keywords = dysphagia
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8/61. Endoscopic stapling of post-laryngectomy neopharyngeal anterior diverticulum.

    An anterior neopharyngeal diverticulum is a recognized cause of dysphagia following laryngectomy. It is easily treated by endoscopic stapling.
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ranking = 1
keywords = dysphagia
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9/61. The causes of dysphagia in carcinoma of the lung.

    Dysphagia occurs in only a small percentage of patients with lung cancer, but the frequency of this cancer means that large numbers are affected. Non-quantitative analysis of a large Scottish series of lung cancer cases indicates the following eight broad categories of dysphagia according to underlying mechanisms: mediastinal disease; cervical lymphadenopathy; brainstem lesions; gastrointestinal tract metastases; associated systemic disorders; second primaries; oropharyngeal and oesophageal infections; and radiation-induced oesophageal toxicity.
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ranking = 5
keywords = dysphagia
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10/61. Cricopharyngeus myotomy as the only treatment for zenker diverticulum.

    Cricopharyngeal dysfunction, one of the most common causes of pharyngeal dysphagia, exhibits a variety of manifestations, one of which is zenker diverticulum. This paper examines the physiology of swallowing, pathophysiology of its aberrations, and various methods of treating zenker diverticulum. It is our purpose to emphasize cricopharyngeus (CP) myotomy as the only needed treatment for this diverticulum. Even in its advanced stages, excision of the diverticulum is a needless surgical exercise. Seven cases of zenker diverticulum are reported in elderly patients; one of them had an excision of the diverticulum prior to presentation. Some were either completely obstructed or aspirating on esophagram. Cricopharyngeus myotomy, the only treatment provided, proved to be safe and effective without morbidity or fatalities. patients' ability to eat orally was restored on the night of or the morning after surgery. No Levin tube is necessary and there is no risk of suture line leakage after the conventional diverticulectomy and CP myotomy. Hospital stay is greatly reduced and there is no risk of structure formation. In contrast to endoscopic division of CP muscle, there is no risk of mediastinitis because there is no break through the mucosa.
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ranking = 1
keywords = dysphagia
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