Cases reported "pharyngeal diseases"

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1/494. 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. ( info)

2/494. The use of granulocyte colony stimulating factor to promote wound healing in a neutropenic patient after head and neck surgery.

    BACKGROUND: neutropenia and neutrophil dysfunction, in association with a variety of diseases, has been shown to play a role in poor wound healing. Wound breakdown with fistula formation in patients undergoing total laryngectomy results in significant morbidity and increased hospital stay. Although malnutrition, prior radiation, diabetes, and other diseases are recognized as factors predisposing patients with head and neck cancer to developing fistulas, neutrophil dysfunction should also be considered. Granulocyte colony stimulating factor (G-CSF) has been used successfully to treat neutropenia and neutrophil dysfunction. methods: This study was conducted as a case report. RESULTS: We present the first report of a neutropenic head and neck cancer patient with a persistent wound of 6 months' duration who showed dramatic improvement after treatment with G-CSF. CONCLUSION: We conclude that G-CSF may represent a useful adjunct in patients with persistent wound healing problems and neutropenia despite adequate treatment by conventional means. Further clinical experience with G-CSF in patients with delayed healing is indicated. ( info)

3/494. 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. ( info)

4/494. angioedema presenting in the retropharyngeal space in an adult.

    PURPOSE: Hereditary angioedema is a rare disorder of deficient or dysfunctional C1-esterase inhibitor and usually manifests as edema of the face, tongue, supraglottis, extremities, or gastrointestinal tract. We report the case of a 40-year-old man with known hereditary angioedema who presented with a sore throat and a sensation of evolving airway obstruction. After a thorough search of the medical literature, we believe this to be the first reported case of angioedema manifesting in the retropharyngeal space. The pathophysiological factors of angioedema are discussed, along with its variable presentation and management issues. METHOD: Laryngoscopic examination was suggestive of posterior pharyngeal fullness; therefore, a computed tomographic scan of the neck was obtained, which showed a non-contrast-enhancing retropharyngeal edema from the base of the skull to below the level of the glottis. The patient had a history of multiple episodes of angioedema requiring hospitalization and three prior tracheotomies. RESULTS: Familiarity with the patient's history directed his rapid treatment course (including intravenous stanozolol, Solu-Medrol, and diphenhydramine), which significantly reduced his edema and avoided the need for tracheotomy. CONCLUSION: Hereditary angioedema may present in atypical locations, and expeditious treatment in a patient with a known history may avert the sequelae of evolving airway obstruction. ( info)

5/494. 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. ( info)

6/494. Anaesthetic implications of rigid spine syndrome.

    The perioperative management of a 14-year-old girl, suffering from the muscular disorder rigid spine syndrome, is presented. The anaesthetic implications with regard to possible difficult intubation, cardiac involvement, malignant hyperthermia, neuromuscular blocking agents, and postoperative recovery are discussed. ( info)

7/494. Upper aerodigestive tract frostbite complicating volatile substance abuse.

    Volatile substance abuse has become increasingly popular among today's youth. It has reportedly been used by up to 13% of teenage populations. physicians need to be aware of the potential complications which may arise from this form of substance abuse. We describe the case of a young male who presented with massive edema affecting his lips, oral cavity, oropharynx and trachea. It was later discovered that his injury was secondary to thermal trauma related to the abuse of a fluorinated hydrocarbon propellant. This presentation may easily be confused with allergic or angioneurotic edema. Denial by the patient can lead to a further delay in diagnosis. This case is especially notable since frostbite injury involving the upper aerodigestive tract is extremely rare. We discuss the differential diagnosis and the management principals required in the care of this patient. We also present a pertinent review of the literature related to both volatile substance abuse and its complications involving the airway. ( info)

8/494. 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. ( info)

9/494. Effect of Koso-san on globus pharyngeus.

    Twenty-three patients with globus pharyngeus were treated with Koso-san (TJ-70) at a dose of 7.5 g/day for at least 14 days. Symptoms disappeared in 18 cases and improved in 3 cases, therefore, the effective rate was 91.3% (21/23). The symptoms disappeared on average within 13.5 days. Terasawa qi-stasis scores were significantly decreased after the treatment. TJ-70 might thus be a remedy for globus pharyngeus with qi-stasis. ( info)

10/494. 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. ( info)
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