Difficulty in SWALLOWING which may result from neuromuscular disorder or mechanical obstruction. Dysphagia is classified into two distinct types: oropharyngeal dysphagia due to malfunction of the PHARYNX and UPPER ESOPHAGEAL SPHINCTER; and esophageal dysphagia due to malfunction of the ESOPHAGUS.
The act of taking solids and liquids into the GASTROINTESTINAL TRACT through the mouth and throat.
A mobile U-shaped bone that lies in the anterior part of the neck at the level of the third CERVICAL VERTEBRAE. The hyoid bone is suspended from the processes of the TEMPORAL BONES by ligaments, and is firmly bound to the THYROID CARTILAGE by muscles.
The structure at the pharyngoesophageal junction consisting chiefly of the CRICOPHARYNGEUS MUSCLE. It normally occludes the lumen of the ESOPHAGUS, except during SWALLOWING.
The middle portion of the pharynx that lies posterior to the mouth, inferior to the SOFT PALATE, and superior to the base of the tongue and EPIGLOTTIS. It has a digestive function as food passes from the mouth into the oropharynx before entering ESOPHAGUS.
A motor neuron disease marked by progressive weakness of the muscles innervated by cranial nerves of the lower brain stem. Clinical manifestations include dysarthria, dysphagia, facial weakness, tongue weakness, and fasciculations of the tongue and facial muscles. The adult form of the disease is marked initially by bulbar weakness which progresses to involve motor neurons throughout the neuroaxis. Eventually this condition may become indistinguishable from AMYOTROPHIC LATERAL SCLEROSIS. Fazio-Londe syndrome is an inherited form of this illness which occurs in children and young adults. (Adams et al., Principles of Neurology, 6th ed, p1091; Brain 1992 Dec;115(Pt 6):1889-1900)
The act and process of chewing and grinding food in the mouth.
The bottom portion of the pharynx situated below the OROPHARYNX and posterior to the LARYNX. The hypopharynx communicates with the larynx through the laryngeal inlet, and is also called laryngopharynx.
A thin leaf-shaped cartilage that is covered with LARYNGEAL MUCOSA and situated posterior to the root of the tongue and HYOID BONE. During swallowing, the epiglottis folds back over the larynx inlet thus prevents foods from entering the airway.
A funnel-shaped fibromuscular tube that conducts food to the ESOPHAGUS, and air to the LARYNX and LUNGS. It is located posterior to the NASAL CAVITY; ORAL CAVITY; and LARYNX, and extends from the SKULL BASE to the inferior border of the CRICOID CARTILAGE anteriorly and to the inferior border of the C6 vertebra posteriorly. It is divided into the NASOPHARYNX; OROPHARYNX; and HYPOPHARYNX (laryngopharynx).
A tubular organ of VOICE production. It is located in the anterior neck, superior to the TRACHEA and inferior to the tongue and HYOID BONE.
An irregular unpaired bone situated at the SKULL BASE and wedged between the frontal, temporal, and occipital bones (FRONTAL BONE; TEMPORAL BONE; OCCIPITAL BONE). Sphenoid bone consists of a median body and three pairs of processes resembling a bat with spread wings. The body is hollowed out in its inferior to form two large cavities (SPHENOID SINUS).
A muscular organ in the mouth that is covered with pink tissue called mucosa, tiny bumps called papillae, and thousands of taste buds. The tongue is anchored to the mouth and is vital for chewing, swallowing, and for speech.
The complement of teeth in the jaws after the eruption of some of the permanent teeth but before all the deciduous teeth are absent. (Boucher's Clinical Dental Terminology, 4th ed)
The muscles of the PHARYNX are voluntary muscles arranged in two layers. The external circular layer consists of three constrictors (superior, middle, and inferior). The internal longitudinal layer consists of the palatopharyngeus, the salpingopharyngeus, and the stylopharyngeus. During swallowing, the outer layer constricts the pharyngeal wall and the inner layer elevates pharynx and LARYNX.
Production of an image when x-rays strike a fluorescent screen.
A stricture of the ESOPHAGUS. Most are acquired but can be congenital.
A major affective disorder marked by severe mood swings (manic or major depressive episodes) and a tendency to remission and recurrence.
Either one of the two small elongated rectangular bones that together form the bridge of the nose.
Measurement of the pressure or tension of liquids or gases with a manometer.
The measurement of the dimensions of the HEAD.
The oval-shaped oral cavity located at the apex of the digestive tract and consisting of two parts: the vestibule and the oral cavity proper.
Psychiatric illness or diseases manifested by breakdowns in the adaptational process expressed primarily as abnormalities of thought, feeling, and behavior producing either distress or impairment of function.
The muscular membranous segment between the PHARYNX and the STOMACH in the UPPER GASTROINTESTINAL TRACT.
Persistent and disabling ANXIETY.
Those disorders that have a disturbance in mood as their predominant feature.
The largest and strongest bone of the FACE constituting the lower jaw. It supports the lower teeth.
Categorical classification of MENTAL DISORDERS based on criteria sets with defining features. It is produced by the American Psychiatric Association. (DSM-IV, page xxii)
Recording of the changes in electric potential of muscle by means of surface or needle electrodes.
Marked depression appearing in the involution period and characterized by hallucinations, delusions, paranoia, and agitation.
A behavior disorder originating in childhood in which the essential features are signs of developmentally inappropriate inattention, impulsivity, and hyperactivity. Although most individuals have symptoms of both inattention and hyperactivity-impulsivity, one or the other pattern may be predominant. The disorder is more frequent in males than females. Onset is in childhood. Symptoms often attenuate during late adolescence although a minority experience the full complement of symptoms into mid-adulthood. (From DSM-V)
An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent.
An anxiety disorder characterized by recurrent, persistent obsessions or compulsions. Obsessions are the intrusive ideas, thoughts, or images that are experienced as senseless or repugnant. Compulsions are repetitive and seemingly purposeful behavior which the individual generally recognizes as senseless and from which the individual does not derive pleasure although it may provide a release from tension.
A class of traumatic stress disorders with symptoms that last more than one month. There are various forms of post-traumatic stress disorder, depending on the time of onset and the duration of these stress symptoms. In the acute form, the duration of the symptoms is between 1 to 3 months. In the chronic form, symptoms last more than 3 months. With delayed onset, symptoms develop more than 6 months after the traumatic event.
A disorder beginning in childhood. It is marked by the presence of markedly abnormal or impaired development in social interaction and communication and a markedly restricted repertoire of activity and interest. Manifestations of the disorder vary greatly depending on the developmental level and chronological age of the individual. (DSM-V)
Anxiety disorders in which the essential feature is persistent and irrational fear of a specific object, activity, or situation that the individual feels compelled to avoid. The individual recognizes the fear as excessive or unreasonable.
Severe distortions in the development of many basic psychological functions that are not normal for any stage in development. These distortions are manifested in sustained social impairment, speech abnormalities, and peculiar motor movements.
Disorders in which there is a loss of ego boundaries or a gross impairment in reality testing with delusions or prominent hallucinations. (From DSM-IV, 1994)
Disorders related to substance abuse.
A repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated. These behaviors include aggressive conduct that causes or threatens physical harm to other people or animals, nonaggressive conduct that causes property loss or damage, deceitfulness or theft, and serious violations of rules. The onset is before age 18. (From DSM-IV, 1994)
Disorders characterized by recurrent TICS that may interfere with speech and other activities. Tics are sudden, rapid, nonrhythmic, stereotyped motor movements or vocalizations which may be exacerbated by stress and are generally attenuated during absorbing activities. Tic disorders are distinguished from conditions which feature other types of abnormal movements that may accompany another another condition. (From DSM-IV, 1994)
Standardized procedures utilizing rating scales or interview schedules carried out by health personnel for evaluating the degree of mental illness.
A personality disorder marked by a pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts. (DSM-IV)
A group of pathological conditions characterized by sudden, non-convulsive loss of neurological function due to BRAIN ISCHEMIA or INTRACRANIAL HEMORRHAGES. Stroke is classified by the type of tissue NECROSIS, such as the anatomic location, vasculature involved, etiology, age of the affected individual, and hemorrhagic vs. non-hemorrhagic nature. (From Adams et al., Principles of Neurology, 6th ed, pp777-810)
A loose confederation of computer communication networks around the world. The networks that make up the Internet are connected through several backbone networks. The Internet grew out of the US Government ARPAnet project and was designed to facilitate information exchange.
Acquisition, organization, and preparation of library materials for use, including selection, weeding, cataloging, classification, and preservation.
The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers.
The application of discoveries generated by laboratory research and preclinical studies to the development of clinical trials and studies in humans. A second area of translational research concerns enhancing the adoption of best practices.
Agents of the law charged with the responsibility of maintaining and enforcing law and order among the citizenry.
Characteristics or attributes of persons or things which elicit pleasurable feelings.
A love or pursuit of wisdom. A search for the underlying causes and principles of reality. (Webster, 3d ed)
A preconceived judgment made without factual basis.

Assessment of swallowing and referral to speech and language therapists in acute stroke. (1/1000)

The best clinical assessment of swallowing following acute stroke, in order to decide whether to refer a patient to a speech and language therapist (SLT), is uncertain. Independently of the managing clinical team, we prospectively investigated 115 patients (51 male) with acute stroke, mean age 75 years (range 24-94) within 72 h of admission, using a questionnaire, structured examination and timed water swallowing test. Outcome variables included referral to and intervention by a speech and language therapist (SLT), dietary modification, respiratory complications and death. Of those patients in whom an SLT recommended intervention, 97% were detected by an abnormal quantitative water swallowing test; specificity was 69%. An SLT was very unlikely to recommend any intervention if the test was normal. Inability to perform a water test and/or abnormality of the test was associated with significantly increased relative risks of death, chest infection and dietary modification. A timed water swallowing test can be a useful test of swallowing and may be used to screen patients for referral to a speech and language therapist after acute stroke.  (+info)

Swallowing function after stroke: prognosis and prognostic factors at 6 months. (2/1000)

BACKGROUND AND PURPOSE: Swallowing dysfunction (dysphagia) is common and disabling after acute stroke, but its impact on long-term prognosis for potential complications and the recovery from swallowing dysfunction remain uncertain. We aimed to prospectively study the prognosis of swallowing function over the first 6 months after acute stroke and to identify the important independent clinical and videofluoroscopic prognostic factors at baseline that are associated with an increased risk of swallowing dysfunction and complications. METHODS: We prospectively assembled an inception cohort of 128 hospital-referred patients with acute first stroke. We assessed swallowing function clinically and videofluoroscopically, within a median of 3 and 10 days, respectively, of stroke onset, using standardized methods and diagnostic criteria. All patients were followed up prospectively for 6 months for the occurrence of death, recurrent stroke, chest infection, recovery of swallowing function, and return to normal diet. RESULTS: At presentation, a swallowing abnormality was detected clinically in 65 patients (51%; 95% CI, 42% to 60%) and videofluoroscopically in 82 patients (64%; 95% CI, 55% to 72%). During the subsequent 6 months, 26 patients (20%; 95% CI, 14% to 28%) suffered a chest infection. At 6 months after stroke, 97 of the 112 survivors (87%; 95% CI, 79% to 92%) had returned to their prestroke diet. Clinical evidence of a swallowing abnormality was present in 56 patients (50%; 95% CI, 40% to 60%). Videofluoroscopy was performed at 6 months in 67 patients who had a swallowing abnormality at baseline; it showed penetration of the false cords in 34 patients and aspiration in another 17. The single independent baseline predictor of chest infection during the 6-month follow-up period was a delayed or absent swallowing reflex (detected by videofluoroscopy). The single independent predictor of failure to return to normal diet was delayed oral transit (detected by videofluoroscopy). Independent predictors of the combined outcome event of swallowing impairment, chest infection, or aspiration at 6 months were videofluoroscopic evidence of delayed oral transit and penetration of contrast into the laryngeal vestibule, age >70 years, and male sex. CONCLUSIONS: Swallowing function should be assessed in all acute stroke patients because swallowing dysfunction is common, it persists in many patients, and complications frequently arise. The assessment of swallowing function should be both clinical and videofluoroscopic. The clinical and videofluoroscopic features at presentation that are important predictors of subsequent swallowing abnormalities and complications are videofluoroscopic evidence of delayed oral transit, a delayed or absent swallow reflex, and penetration. These findings require validation in other studies.  (+info)

Hypoglossal nerve injury as a complication of anterior surgery to the upper cervical spine. (3/1000)

Injury to the hypoglossal nerve is a recognised complication after soft tissue surgery in the upper part of the anterior aspect of the neck, e.g. branchial cyst or carotid body tumour excision. However, this complication has been rarely reported following surgery of the upper cervical spine. We report the case of a 35-year-old woman with tuberculosis of C2-3. She underwent corpectomy and fusion from C2 to C5 using iliac crest bone graft, through a left anterior oblique incision. She developed hypoglossal nerve palsy in the immediate postoperative period, with dysphagia and dysarthria. It was thought to be due to traction neurapraxia with possible spontaneous recovery. At 18 months' follow-up, she had a solid fusion and tuberculosis was controlled. The hypoglossal palsy persisted, although with minimal functional disability. The only other reported case of hypoglossal lesion after anterior cervical spine surgery in the literature also failed to recover. It is concluded that hypoglossal nerve palsy following anterior cervical spine surgery is unlikely to recover spontaneously and it should be carefully identified.  (+info)

Palliation of dysphagia from inoperable oesophageal carcinoma using Atkinson tubes or self-expanding metal stents. (4/1000)

Until recently, intubation for the palliation of malignant dysphagia has relied upon the insertion of a variety of plastic tubes. Self-expanding metal stents are reported to have a lower complication rate. We have compared the results of Atkinson tube insertion with self-expanding metal stents in patients with inoperable oesophageal carcinoma. From 1990 to 1994 Atkinson tubes were inserted for the palliation of dysphagia from oesophageal cancer, from 1994 onwards self-expanding metal stents were used. Complications, mortality and hospital stay were compared in both groups of patients. In all, 87 patients with inoperable oesophageal carcinoma were treated, 46 with an Atkinson tube and 41 with metal stents. Complications occurred at similar rates in both groups (56% Atkinson tubes, 44% metal stents). There was a significantly higher perforation rate associated with Atkinson tube insertion (8 patients, 17%) compared with metal stents (1 patient, 2.4%, P = 0.02, chi 2). The length of stay was also significantly higher in the Atkinson tube group (median 10 days) compared with the metal stent group (3 days, P < 0.01, Mann-Whitney U test). Mortality rates were similar in both groups. The use of metal stents for the palliation of dysphagia in inoperable oesophageal carcinoma results in a lower perforation rate and a reduced length of stay and they represent a significant advantage over Atkinson tubes.  (+info)

Radiation-induced esophageal carcinoma 30 years after mediastinal irradiation: case report and review of the literature. (5/1000)

A 54-year-old man who had been irradiated in 1964 for cervical involvement by Hodgkin's disease was admitted in December 1994 to our clinic with strong complaints of dysphagia. The reason was a moderately differentiated squamous cell carcinoma of the proximal esophagus in the previously irradiated region. The patient had no risk factors (abuse of nicotine or alcohol) for the developement of esophageal carcinoma. A reirradiation was performed, but the disease progressed locally and two weeks after the beginning of the therapy the patient developed two tracheoesophagocutaneous fistulae. The radiation therapy was discontinued and the tumor stenosis was bridged by a tube closing the fistulae. A retrospective dose analysis to evaluate the applied doses will be performed. Furthermore, an overview of 66 cases of the literature with radiation-induced esophageal carcinoma analysed concerning applied dose and latent interval will be given. In conclusion the reported case fits the criteria for radiation-induced malignancies (Chudecki Br J Radiol 1972;45:303-4) known from literature: (1) a history of previous irradiation, (2) a cancer occurring within the irradiated area, (3) gross tissue damage due to an excessive dose of radiation, and (4) a long latent interval between irradiation and development of cancer. Esophageal carcinomas belong to the rare secondary malignancies after the therapeutic use of ionizing radiation. Nevertheless in patients with dysphagia they should be suspected as a differential diagnosis even many years after mediastinal irradiation. The treatment of these tumors is very difficult and is associated with a poor prognosis.  (+info)

Feeding problems in merosin deficient congenital muscular dystrophy. (6/1000)

Feeding difficulties were assessed in 14 children (age range 2-14 years) with merosin deficient congenital muscular dystrophy, a disease characterised by severe muscle weakness and inability to achieve independent ambulation. Twelve of the 14 children were below the 3rd centile for weight. On questioning, all parents thought their child had difficulty chewing, 12 families modified the diet, and 13 children took at least 30 minutes to complete a meal. On examination the mouth architecture was abnormal in 13 children. On videofluoroscopy only the youngest child (2 years old), had a normal study. The others all had an abnormal oral phase (breakdown and manipulation of food and transfer to oropharynx). Nine had an abnormal pharyngeal phase, with a delayed swallow reflex. Three of these also showed pooling of food in the larynx and three showed frank aspiration. These six cases all had a history of recurrent chest infections. Six of eight children who had pH monitoring also had gastro-oesophageal reflux. As a result of the study five children had a gastrostomy, which stopped the chest infections and improved weight gain. This study shows that children with merosin deficient congenital muscular dystrophy have difficulties at all stages of feeding that progress with age. Appropriate intervention can improve weight gain and reduce chest infections. The severity of the problem has not been previously appreciated in this disease, and the study shows the importance of considering the nutritional status in any child with a primary muscle disorder.  (+info)

Posterior sternoclavicular dislocations--a diagnosis easily missed. (7/1000)

Posterior dislocation of the sternoclavicular joint is a relatively rare injury and can be difficult to diagnose acutely. We report 3 cases of posterior dislocation of the sternoclavicular joint who presented to the Accident & Emergency Department within a 3 month period. All 3 patients had sustained a significant injury to the shoulder region and complained of pain around the medial clavicle. Two patients had also complained of dysphagia following the injury. Plain X-rays of the shoulder and chest were reported as normal by junior and senior medical staff. The diagnosis was delayed until CT scans were performed, and once this was established, open reduction and stabilisation was performed.  (+info)

Octreotide in refractory functional epigastric pain with nutritional impairment--an open study. (8/1000)

AIM: To test the therapeutic efficacy of octreotide administered subcutaneously for the relief of chronic refractory epigastric pain severe enough to provoke nutritional impairment. SUBJECTS AND METHODS: Seventeen patients were enrolled in an open trial. Epigastric pain had lasted from 1 to 8 years (median: 5 years), following anti-reflux surgery in eight patients. Median weight loss was 10% (range 10-15). The initial dose of octreotide was 50 microgram b.d, adjusted during the follow-up visits which were scheduled for months 1, 3, 6, 8, 10, 12 and every 3 months. At each visit, overall symptomatic improvement, frequency and intensity of symptoms were checked on a 10-cm visual analogic scale. RESULTS: At month 1, a progressive improvement of pain intensity was reported in 15 of the 17 patients, while octreotide was a therapeutic failure in two. In four out of 15, the daily dose of octreotide was increased to 100 microgram b.d. In these 15 patients, median follow-up was 7 months (3-27). The symptomatic benefit was maintained in each patient at month 3, with a median weight gain of 3.5 kg.2-5 An attempt to stop octreotide led to recurrence of symptoms in 2-3 days which were as intense as before the treatment. The 11 patients followed-up for at least 6 months reported persistent improvement of symptoms with octreotide and a median weight gain of 4 kg.3-7 Four patients were followed up for more 11-27 months: octreotide was withdrawn gradually in two who remained asymptomatic. Six of the 17 patients experienced minor side-effects, but none developed biliary sludge. CONCLUSIONS: This open study suggests that octreotide could be a promising alternative treatment when all others fail in refractory chronic functional epigastric pain severe enough to limit food intake and to induce nutritional impairment. These results must be tested by a placebo-controlled study.  (+info)

This page includes the following topics and synonyms: Oropharyngeal Dysphagia, Dysphagia from Oropharyngeal Cause, Causes of Oropharyngeal Dysphagia.
TY - JOUR. T1 - Medically Unexplained Oropharyngeal Dysphagia at the University Hospital ENT Outpatient Clinic for Dysphagia. T2 - A Cross-Sectional Cohort Study. AU - Verdonschot, Rob J. C. G.. AU - Baijens, Laura W. J.. AU - Vanbelle, Sophie. AU - Florie, Michelle. AU - Dijkman, Remco. AU - Leeters, Irene P. M.. AU - Kremer, Bernd. AU - Leue, Carsten. PY - 2019/2. Y1 - 2019/2. KW - Dysphagia. KW - Affective symptoms. KW - Anxiety. KW - Depression. KW - FIBEROPTIC ENDOSCOPIC EVALUATION. KW - DEPRESSION SCALE. KW - SYMPTOMS. KW - ANXIETY. KW - FEES. KW - MANAGEMENT. KW - DISORDERS. KW - DIAGNOSIS. U2 - 10.1007/s00455-018-9912-9. DO - 10.1007/s00455-018-9912-9. M3 - Article. VL - 34. SP - 43. EP - 51. JO - Dysphagia. JF - Dysphagia. SN - 0179-051X. IS - 1. ER - ...
Evidence-based recommendations on endoscopic carbon dioxide laser cricopharyngeal myotomy for relieving oropharyngeal dysphagia (swallowing difficulties)
A significant portion of critically ill patients with coronavirus disease 2019 (COVID-19) are at high risk of developing intensive care unit (ICU)-acquired swallowing dysfunction (neurogenic dysphagia) as a consequence of requiring prolonged mechanical ventilation. Pharyngeal electrical stimulation (PES) is a simple and safe treatment for neurogenic dysphagia. It has been shown that PES can restore safe swallowing in orally intubated or tracheotomized ICU patients with neurogenic dysphagia following severe stroke. We report the case of a patient with severe neurogenic post-extubation dysphagia (PED) due to prolonged intubation and severe general muscle weakness related to COVID-19, which was successfully treated using PES. A 71-year-old Caucasian female patient with confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection developed neurogenic dysphagia following prolonged intubation in the ICU. To avoid aerosol-generating procedures, her swallowing function was evaluated non
Onabotulinumtoxin A (Botox) can be a safe and successful off-label treatment of vertical platysma bands of various severities. Due to risk of the botulinum toxin diffusing to the underlying anatomic structures such as the deglutition muscles, the larynx, and the neck flexors, a maximal dose of 100 units has been suggested and there have been no known reports of untoward effects with doses less than 60 units. We present a case of mild to moderate dysphagia in a patient after very low doses of Abobutulinumtoxin (60 units, equivalent to 20 units of Onabotulinumtoxin using a 3:1 conversion ratio). We speculate that the adverse effects noted may be due to several possibilities, such as diffusion, injection technique, or intravascular injection. Thus, although botulinum toxin-A is generally considered a safe off-label treatment for vertical platysma bands, readers should still be aware of the possible side-effects even with low dose use, as supported by our case report of mild to moderate dysphagia with
Severe dysphagia may occur in the immune mediated necrotizing myopathies (IMNM). Neck swelling and severe dysphagia as the initial symptoms upon presentation has not been previously described. A 55-year-old male with a 4 week history of neck swelling, fatigue, dysphagia, myalgias, night sweats, and cough was admitted for an elevated CK. He underwent extensive infectious and inflammatory evaluation including neck imaging and muscle biopsy. Neck CT and MRI showed inflammation throughout his strap muscles, retropharyngeal soft tissues and deltoids. Infectious work up was negative. Deltoid muscle biopsy demonstrated evidence of IMNM. Lab tests revealed anti-3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR) antibodies confirming the diagnosis of HMGCR IMNM. HMGCR IMNM is a rare and incompletely understood disease process. Awareness of HMGCR IMNM could potentially lead to earlier diagnosis, treatment and improved clinical outcomes as disease progression can be rapid and severe.
Toddlers with oropharyngeal dysphagia who were treated with a proton pump inhibitor had a nearly doubled hospitalization rate compared to those who werent.
Background. Dysphagia is a recognised negative outcome following burn-injury. Instrumental evaluation, including Fibreoptic Endoscopic Evaluation of Swallowing (FEES) and Modified Barium Swallow (MBS), combined with a clinical bedside swallowing assessment is recommended to accurately evaluate the complex and multifactorial nature of dysphagia post burn-injury. The literature surrounding post-burn dysphagia is largely limited to acute dysphagia, with minimal reports on long-term swallowing outcomes.. Method. Using MBS and FEES studies from 2007 and 2017, we compare and describe long-term swallow function, changes, and dysphagia management in a 64 year old female who sustained 32% TBSA burn injury in 2004 with associated inhalation injury requiring prolonged intubation and tracheostomy insertion. Swallow studies over time are evaluated and compared.. Results. Although aspiration and penetration reduced and pharyngeal and laryngeal sensation improved over time, swallow function became more ...
The first step is to distinguish between oropharyngeal dysphagia and esophageal dysphagia from the patients symptoms. The evaluation begins with a careful history from the patient, which can provide direction towards the cause of dysphagia in the majority of patients. Tests performed on patients with dysphagia depend on whether the doctor thinks that the patient has oropharyngeal or esophageal dysphagia.. Investigation of oropharyngeal dysphagia starts with a careful neurologic examination to identify which nerves and muscles might be abnormal. Swallowing function testing of the mouth and throat can be performed with videofluoroscopy or modified barium swallow. This test involves giving the patient food items of different consistency (e.g. cookie, marshmallow) containing barium and observing the swallow on an x-ray screen (fluoroscopy). This test can show if the barium enters the larynx (opening to the breathing tube) while attempting to swallow, or if it passes normally through the upper ...
Swallowing difficulties (Dysphagia) treatment - Dysphagia is defined as difficulty in swallowing.. Choose Spire Manchester Hospital.
Participants were recruited who had chronic moderate to severe dysphagia following stroke or radiation treatment for head and neck cancer. Their frequency of swallowing was transduced with an accelerometer placed on the skin over the thyroid cartilage and inductive plethysmography bands placed over the rib cage and abdomen. When laryngeal elevation coincided with respiratory apnea a swallow was marked. Five different motor frequencies were evaluated to determine their effect on participants frequency of swallowing (swallows per minute). Frequencies were 30, 70, 110, and 150 Hz and a combination of 70 and 110 Hz. For each vibratory frequency the number of swallows per minute occurring during stimulation was compared with sham when the participant was wearing the device but the motor was not turned on. The frequency fo swallowing during stimulation was compared with the frequency of swallowing between stimulations. Visual analogue ratings of the urge to swallow and discomfort were also measured ...
Dysphagia is a common complication following ACSS. While several instruments are available for assessing dysphagia, none are particularly well designed for the ACSS population.3,16 A standardized tool that allows quantifiable assessment of dysphagia is needed to allow evaluation of dysphagia rates between studies. Although validated, the SWAL-QOL is lengthy and cumbersome to complete, particularly for patients undergoing ACSS with relatively minor swallowing impairment. As such, the purpose of this paper was to develop a concise, yet clinically relevant survey for use in patients undergoing ACSS.. The results of this study suggest that the SWAL-QOL survey in its full form is not necessary to detect swallowing changes in the ACSS population. Several sections and individual questions demonstrated little to no change from preoperative to postoperative values, indicating the severity of dysphagia following ACSS is not as extreme as the dysphagia in the population for which the SWAL-QOL was ...
Dysphagia is a very common symptom in people of advanced age and with neurological diseases, although it often remains undiagnosed. At present, there
TY - JOUR. T1 - Food Sticking in My Throat. T2 - Videofluoroscopic Evaluation of a Common Symptom. AU - Madhavan, Aarthi. AU - Carnaby, Giselle D.. AU - Crary, Michael A.. PY - 2015/6/17. Y1 - 2015/6/17. N2 - Prevalence of the symptom of food sticking during swallowing has been reported to range from 5 to 50 %, depending on the assessment setting. However, limited objective evidence has emerged to clarify factors that contribute to this symptom. Three hundred and fifteen patient records from an outpatient dysphagia clinic were reviewed to identify patients with symptoms of food sticking in the throat. Corresponding videofluoroscopic swallowing studies for patients with this complaint were reviewed for the following variables: accuracy of symptom localization, identification and characteristics (anatomic, physiologic) of an explanatory cause for the symptom, and the specific swallowed material that identified the explanatory cause. One hundred and forty one patients (45 %) were identified ...
This study identified carer-reported or self-reported predictors of future respiratory hospital admissions over 3 years in young people with CP. Six of the factors are potentially modifiable: oropharyngeal dysphagia, respiratory symptoms with meals, seizures, frequent respiratory symptoms, GORD and nightly snoring. The other three are non-modifiable markers of risk that should alert clinicians, and trigger evaluation and management of modifiable risk factors: GMFCS V classification, at least one respiratory admission in the previous year, and two or more courses of antibiotics in the previous year.. The strongest modifiable risk factor for respiratory hospitalisations was oropharyngeal dysphagia. This was defined as nutritional intake via a tube and/or use of modified textures and/or reported choking or coughing on saliva. These symptoms indicate motor or sensory dysfunction at the oropharyngeal level, affecting the ability to prepare and manipulate a bolus or secretions, and to coordinate ...
Feeding difficulties such as dysphagia, coughing, choking, or vomiting during meals, slow eating, oral aversion, food refusal, and stressful mealtimes are common in children with repaired esophageal atresia (EA) and the reasons for this are often multifactorial. The aim of this review is to describe the possible underlying mechanisms contributing to feeding difficulties in patients with EA and approaches to management. Underlying mechanisms for these feeding difficulties include esophageal dysphagia, oropharyngeal dysphagia and aspiration, and aversions related to prolonged gastrostomy tube feeding. The initial diagnostic evaluation for feeding difficulties in a patient with EA may involve an esophagram, videofluoroscopic imaging or fiberoptic endoscopic evaluation during swallowing, upper endoscopy with biopsies, pH-impedance testing, and/or esophageal motility studies. The main goal of management is to reduce the factors contributing to feeding difficulties and may include reducing esophageal stasis,
Indirect or inconsistent means of OPD case identification have regularly been utilised in studies, with OPD identified through parent report,12 ,13 ,15-17 chart reviews5 ,17 and non-standardised assessments.21-23 ,25 The variability in the method of case identification limits comparisons between these studies, and makes it difficult to estimate the true prevalence of OPD in the paediatric CP population. Parents have been shown to underestimate the presence of impaired feeding skills compared to formal clinical evaluation,14 so prevalence data using these methods may represent an underestimate of the true population prevalence of OPD. Most parent questionnaires in the reported studies lacked adequate validity and reliability data, reducing confidence in these results.12 ,13 ,15-17. The generalisability of prevalence estimates of OPD to the general population of children with CP has been limited in most studies due to a focus on feeding skills in children with moderate-severe gross motor ...
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Free, official coding info for 2021 ICD-10-CM I69.191 - includes detailed rules, notes, synonyms, ICD-9-CM conversion, index and annotation crosswalks, DRG grouping and more.
Free, official coding info for 2021 ICD-10-CM I69.991 - includes detailed rules, notes, synonyms, ICD-9-CM conversion, index and annotation crosswalks, DRG grouping and more.
FURKIM, Ana Maria; BEHLAU, Mara Suzana and WECKX, Luc Louis Maurice. Clinical and videofluoroscopic evaluation of deglutition in children with tetraparetic spastic cerebral palsy. Arq. Neuro-Psiquiatr. [online]. 2003, vol.61, n.3A, pp.611-616. ISSN 0004-282X. http://dx.doi.org/10.1590/S0004-282X2003000400016.. Cerebral palsy is a condition that may be associated with swallowing disorders, that is, oropharingeal dysphagia. The aim of this study was to characterize and compare the swallowing processes of 32 children with this condition, by clinical and videofluoroscopic evaluation, with special focus on tracheal aspiration detectability. Results show an important compromise of oral phase. The most important findings during the pharyngeal phase were velopharingeal incompetence and residuals on the pharyngeal recesses. Aspiration was more common with liquids, before and after deglutition. On clinical and videofluoroscopic evaluation, cervical hyperextension was the commonest postural abnormality. ...
Swallowing impairment is common, particularly with the aging patient population. The videofluroscopic swallowing study (VFSS) examination is an effective means of evaluating patients with oropharyngeal dysphagia. VFSS performance best practice includes a collaborative, interdisciplinary team consisting of a speech-language pathologist and an engaged radiologist. Several different diet textures mixed with barium are given to the patient to swallow during this test to determine the safety of the swallow, areas of weakness or immobility, and recommendations of exercises or strategies for the patient to start doing at home in order to improve their swallowing function. It might be recommended the patient receive outpatient speech services address the swallow disfunction to work on exercises and modifications ...
The technical term for swallowing difficulties is dysphagia. My diagnosis, based on the results of a fluoroscope test interpreted by a highly trained speech therapist is severe dysphagia. Ive written about this in my blog many times as it is the bane of my existence. I am continuing my quest to not just live with this issue, but to somehow fix it. This is partly due to wanting a better life for myself (who doesnt) and partly due to a case of OCD. I have trouble adjusting to things that are broken. In my case, my throat is broken and my ability to truly adapt to it wavers from partial acceptance to just not going to take it anymore ...
The technical term for swallowing difficulties is dysphagia. My diagnosis, based on the results of a fluoroscope test interpreted by a highly trained speech therapist is severe dysphagia. Ive written about this in my blog many times as it is the bane of my existence. I am continuing my quest to not just live with this issue, but to somehow fix it. This is partly due to wanting a better life for myself (who doesnt) and partly due to a case of OCD. I have trouble adjusting to things that are broken. In my case, my throat is broken and my ability to truly adapt to it wavers from partial acceptance to just not going to take it anymore ...
Ankylosing spondylitis (AS) is a chronic inflammatory disease. Neurological manifestations can occur because of atlantoaxial subluxation in about 14% of patients1.. A 43-year-old man diagnosed with AS according to the 1984 modified New York criteria presented with bulbar symptoms, such as severe dysphagia and dysphonia. Physical examination revealed the left hemitongue paralysis without any other focal neurological finding. He presented stiffness in the cervical, thoracic, and lumbar spine.. Magnetic resonance imaging (MRI) … ...
76 y.o male with symptoms of myelopathy, underwent C3,4 ACDF. 1 month later the patient had complaints of severe dysphagia, feelings of food and liquid getting caught.. ...
Background/Aims: Swallowing difficulties are common after radiation therapy (RT) in head and neck cancer (HNC). The overall aim of this thesis was to address radiation-induced late dysphagia with regard to investigating anatomical risk structures related to the development of radiation-induced dysphagia, as well as methodological aspects in the evaluation of swallowing. Another objective was to translate and validate the quality of care instrument Swallowing Quality of Care questionnaire (SWAL-CARE) in a mixed Swedish dysphagia population. Methods: The studies were conducted at the Sahlgenska University Hospital and included patients from the otorhinolaryngology clinic. In study I-III, patients who had received curative (chemo)RT for HNC underwent a videofluoroscopic examination of swallowing function (VFS) 6-36 months post-RT. Dysphagia severity was measured according to the Penetration-Aspiration Scale (PAS). All patients answered questions regarding difficulties when drinking, eating, ...
The study, conducted across the country, investigated risk factors for developing dysphagia (swallowing dysfunction), after undergoing radiotherapy treatment for a head & neck cancer. We followed 1,476 patients with squamous cell carcinoma of the head and neck and found out the existence of factors related to the cancer itself, to the patient and to the treatment influencing the development of dysphagia, said Dr Mortensen.. Dysphagia may be acute (starting in direct association with treatment) or late (starting months to years after treatment). Risk factors for developing severe acute dysphagia were large tumours, spreading of cancer cells to the lymph nodes, swallowing problems at the time of diagnosis, 6 treatments per week and tumour location other than the vocal cords. Risk factors for developing late dysphagia were large tumours, swallowing problems at the time of diagnosis and tumour location other than the vocal cords.. 83% of all head & neck cancer patients develop some kind of ...
Risk for aspiration or frank aspiration will be based on the medical history and evidence from a videofluoroscopic swallowing study. Absence of aspiration is not cause for exclusion if the risk for aspiration is deemed present due to impaired pharyngeal phase of swallowing as judged by an expert experienced in the evaluation of dysphagia. The patient may demonstrate evidence of aspiration or the risk for aspiration on any consistency, perhaps secondary to pharyngeal retention. Aspiration is defined as passage of food, liquid, or secretions into the trachea below the level of the vocal folds. If the patient does not demonstrate either aspiration or a risk for aspiration in previous assessment or during preliminary studies, they will be excluded from participation.. Impaired pharyngeal phase of swallowing may be evidenced by pharyngeal delay, reduced hyolaryngeal elevation, reduced laryngeal closure, and reduced pharyngeal clearance of the bolus. Signs of pharyngeal delay include hesitation of the ...
We report our experience with a case of attempted suicidal hanging presenting with dysphagia, in which rehabilitation approaches resulted in improvement. A 36-year-old man was discovered collapsed at home. From the finding of a broken cord nearby, attempted suicide by hanging was suspected. He was transported to hospital after 40 minutes, and regained consciousness after emergency treatment. There were no noteworthy findings on brain magnetic resonance imaging, cervical spine computed tomography, or vocal cord examination. There were no noteworthy psychiatric disorders or cognitive abnormalities. On hospital day 10, he showed signs of dysphagia. Videofluoroscopic examination of swallowing revealed piriform sinuses residue and aspiration after ingestion of jelly in any posture. Rehabilitation approaches were started based on the diagnosis of dysphagia due to impaired transit through the piriform sinuses. The patient achieved independent oral intake by 40 days after the injury. In this case, ...
Previous studies have shown that most patients with functional oropharyngeal dysphagia could be quickly, safely and accurately recognized by using a clinical bedside method developed by the investigative team as the volume-viscosity swallow test (V-VST) that systematically evaluates the main clinical signs and symptoms of safety and efficacy of swallowing and monitors pulse oximetry to improve the detection of patients with silent aspirations.The aim of this study is to validate this test for persons suspected of having swallowing impairment, using a new thickener, with respect to the Videofluoroscopy (VFS) method (treated as the gold standard ...
BACKGROUND: Laser treatment for malignant dysphagia is limited by recurrent intraluminal tumour requiring repeated treatment at four to eight week intervals. AIMS: To reduce the need for follow up treatment and to improve survival, patients successfully palliated by laser were treated with intraluminal radiotherapy. PATIENTS: 32 patients with inoperable oesophageal carcinoma (18 adeno and 14 squamous cell carcinoma). METHODS: The patients were initially palliated by a median of three laser treatments. They were then treated with intraluminal radiotherapy, receiving 10-15 Gy at 1 cm from the source as a single treatment with the Selectron system. Patients with squamous cell carcinoma also received external radiotherapy (30 to 50 Gy). RESULTS: After the radiotherapy nine patients survived a median of 22 (range 4-40) weeks without requiring any further endoscopic treatment. The remaining patients survived a median of 40 (range 4-102) weeks and required a median of three follow up endoscopic ...
This presentation is the second part of the cranial nerve examination. Thiscourse will look at sensory based treatments after you have completed thecranial nerve exam. This will involve a look at evidence-based sensorytreatments. Live Webinar
INTRODUCTION: Oropharyngeal dysphagia (OD) is a major disorder following stroke. OD can produce alterations in both the efficacy and safety of deglutition and may result in malnutrition, dehydration, frailty, respiratory infections and pneumonia. These complications can be avoided by early detection and treatment of OD in poststroke patients, and hospital stays, medication and mortality rates can be reduced. In addition to acute in-hospital costs from OD complications, there are other costs related to poststroke OD such as direct non-healthcare costs or indirect costs. The objective of this systematic review is to assess and summarise literature on the costs related to OD in poststroke patients. METHODS AND ANALYSIS: A systematic review of studies on the cost of OD and its complications (aspiration, malnutrition, dehydration, aspiration pneumonia and death) in patients who had a stroke will be performed from the perspectives of the hospital, the healthcare system and/or the society. The main ...
Results 15 stent patients and 13 chemotherapy patients were recruited over a 12-month period.. In the stent group, mean dysphagia scores for solids improved from 1.3 to 2.1 after treatment (p,0.01, Student t test). There were also significant improvements in other scores for enjoyment of food. There was no change in pain scores. However, the overall health anxiety score worsened from 2.8 to 3.5 (p,0.01).. In the chemotherapy group, mean dysphagia scores improved from 2.4 to 3.1 after first chemotherapy (p,0.01) and there was an improvement in overall health score (3.5 to 2.9, p,0.01).. ...
I am the mother of 2 amazingly wonderful children! I am an SLP specializing in dysphagia. I love technology and use my iPad every chance I can. I hold the Board Certified Specialty in Swallowing and Swallowing Disorders (BCfS-S). I am MDTP certified, LSVT certified, DPNS certified and an MBSImP Registered Clinician. I adore continuing education and continuing to learn everyday. My most recent adventure is speaking on the topic of dysphagia through PESI Healthcare and have published 2 webinars through speechpathology.com about cranial nerves and sensory dysphagia treatment.
Investment in company Phagenesis to address swallowing difficulties experienced by stroke patients. Epalinges, Switzerland, 1 September 2016 - Nestlé Health Science is entering into a staged, milestone-based acquisition of Phagenesis Ltd, a UK-based company developing Phagenyx®, an innovative pharyngeal electrical stimulation device to treat dysphagia (swallowing difficulty). The condition is commonly experienced by post stroke patients, but also the elderly and those undergoing post mechanical ventilation in intensive care units (ICU). Phagenyx® is designed to restore the neurological control of swallowing. Dysphagia is a condition with high prevalence and a high clinical and health economic burden. The annual cost of dysphagia in hospitalized patients is over USD 500 million1. Estimates of the prevalence of dysphagia vary, as it is the symptom of a wider range of underlying conditions and is widely under-diagnosed. Dysphagia is estimated to occur in 29% to 55% of stroke patients2 and every ...
Dysphagia is an abnormality of the swallowing physiology. Dysphagia after extubation is called post-extubation dysphagia (PED). PED occurs frequently, however the exact incidence is unknown, reported frequencies range from 3 to 62%. PED is associated with poor outcomes, it can lead to prolonged hospital stay, hospital acquired pneumonia, reintubation and mortality. The goal is to create a measurement set-up which gives more insight into the etiology and pathophysiology of PED. A pilot study in healthy subjects was performed to assess the swallowing function with a combination of ultrasound (US), fiberoptic endoscopic evaluation of swallowing (FEES) and elecromyography (EMG). During the procedure the subject swallows 10cc water a number of times. A number of relevant parameters was determined based on analysis of data obtained with US, FEES and EMG. A measurement set-up, consisting of US, EMG and FEES was designed and successfully applied in researching the swallowing function in healthy ...
Venkatesan NN, Johnson CM, Siddiqui MT, Cates DJ, Kuhn MA, Postma GN, Belafsky PC. The Comparison of Swallowing Outcomes of Laryngotracheal Separation versus Total Laryngectomy in a Validated Ovine Model of Profound Oropharyngeal Dysphagia. J Laryngol Otol. 2017 Apr. PMID: 28124628 ...
Arvedson, J. C., Rogers, B., Buck, G., Smart, P., & Msall, M. (1994). Silent aspiration prominent in children with dysphagia. International Journal of Pediatric Otorhinolaryngology, 28, 173-181.. Arvedson, J. C. & Lefton-Greif, M. A. (1996). Anatomy, physiology and development of feeding. Seminars in Speech and Language, 17, 261-268.. Buchholz, D. (1999). A comment on False-Positive Results on Videofluoroscopy [Letter to the editor] (Dysphagia 13:191-192, 1998. Dysphagia, 14, 52-53.. Center for Disease Control. (2000). Epidemiology of traumatic brain injury in the United States. National Center for Injury Prevention and Control.. Cherney, L. R. & Halper, A. S. (1989). Recovery of oral nutrition after head injury in adults. J Head Trauma Rehabilitation, 4, 42-50.. Christensen, J. R. (1989). Developmental approach to pediatric neurogenic dysphagia. Dysphagia, 3, 131-134.. Clifton, G., Robertson, C., & Choi, S. (1986). Assessment of nutritional requirements of head injured patients. J Neurosurg, ...
The team asked patients with esophageal cancer to rate their own state of health, as well as of 3 standardized scenarios: local, regional, and metastatic disease.. They evaluated 50 patients with esophageal cancer. The physicians found that using the time trade-off method, the utilities of patients own health state were 0.80 for localized, 0.54 for regional, and 0.52 for metastatic cancer. There was no significant difference in mean utility scores for the 3 staging groups. Visual analog scale and EQ-5D gave statistically similar values to time trade-off. The team found that patients consistently rated their own utility better than the utility of standardized scenarios with similar stage and prognosis. They also found that regardless of their staging, patients with high dysphagia scores rated their utility worse than patients with low dysphagia scores.. Dr Stephan Wildi and colleagues concluded, These results confirm the perceived poor state of health of patients with esophageal cancer and are ...
Bedside Clinical Exam is designed to provide data for use in diagnosis and treatment planning. The clinical exam can be divided into 2 parts:. ...
Rebecca A. Harris is the author of this article in the Journal of Visualized Experiments: Adapting Human Videofluoroscopic Swallow Study Methods to Detect and Characterize Dysphagia in Murine Disease Models
A SWOT Analysis of Dysphagia Supplement, Professional Survey Report Including Top Most Global Players Analysis with CAGR and Stock Market Up and Down.. The Dysphagia Supplement Market research report presents an all-inclusive study of the global Dysphagia Supplement market. The report includes all the major trends and technologies performing a major role in the Dysphagia Supplement market development during forecast period. The key players in the market are Slo, Nestlé Health Science France., Hormel Foods LLC, SimplyThick, Fresenius Kabi, Flavor creations, Abbott, Foricafoods corporation, Healthy Food Co. Ltd., Saraya Co.Ltd., Miyagen Inc., Clinico Co. Ltd., Kent Precision Foods Group Inc., Nutra Balance Products, Nutri Co. Ltd., Kissei Pharmaceutical Co. Ltd., The Nisshin OilliO Group Ltd., Kent Precision Foods Group Inc., Danone S.A., Kewpie Corporation. An attractiveness study has been presented for each geographic area in the report to provide a comprehensive analysis of the overall ...
For those working in the areas of comprehensive dysphagia diagnosis and management, this book is an essential reference. It is compact and easy to read, with a logical format that provides the reader with an initial thorough refresher of endoscopic anatomy and swallowing physiology. The chapter on the FEESST technique details clearly the procedure and sensory testing method with evaluation of bolus consistency, compensatory and swallowing treatment strategies. Throughout the book excellent quality photographs illustrate key points and the numerous case studies used to illustrate the FEESST directed, decision-making process reflect the most common referral groups presenting with dysphagia. The use of FEESST with stroke patients, the elderly and to predict laryngeal penetration and aspiration is particularly useful and the dysphagia treatment algorithms effectively clarify the management issues. The current developments in Transnasal Oesophagoscopy are detailed, with useful indications for when to ...
The factors associated with tube feeding dependency in stroke patients with dysphagia have received little attention. This study aimed to identify factors independently associated with tube feeding dependency at discharge in stroke patients with dysp
The incidence of pediatric dysphagia refers to the number of new cases identified in a specified time period. The prevalenceof pediatric dysphagia refers to the number of children who are living with pediatric dysphagia in a given time period. Estimated reports of the incidence and prevalence of pediatric feeding/swallowing impairment vary widely due to multiple factors, such as variations in the populations sampled, how feeding and/or swallowing impairment is defined, and the choice of assessment methods and measures (Arvedson, 2008; Lefton-Greif, 2008). Pediatric feeding and/or swallowing impairment incidence and prevalence data from the review papers cited below reflect this high variability. ...
노인에게 발생하는 만성질환, 주변인의 죽음에 대한 트라우마, 낙상과 같은 사건들은 노인의 스트레스를 증가시키고[27], 이와 같은 과다한 스트레스는 입안의 침 마름을 초래하여 삼킴곤란을 악화시키는 요인이 된다[9]. 또한 노인들의 만성적인 스트레스는 신체 근육을 수축시킬 수 있으며, 이는 노인의 삼킴곤란에 영향을 미칠 수 있다. 삼킴 관련 수의적 운동은 음식을 직접 씹고 삼킴으로써 삼킴에 관련된 근육들의 지속적인 실질적 운동을 통해 기능이 향상될 수 있다[28]. 하지만 본 연구에서 연구대상자들의 생활 스트레스 조사결과 건강영역 중 최근 식욕이 떨어진다의 항목이 높은 점수를 차지한 것으로 보아 대상자는 직접 씹고 삼키는 것에 대한 직접섭식의 욕구가 감소했을 것으로 유추할 수 있으며, 이로 인해 자연스럽게 삼킴에 관련된 근육들의 ...
Five tests are useful: barium swallow, modified barium swallow with speech therapy, nasopharyngeal laryngoscopy, upper endoscopy, and manometry.. Barium swallow evaluates for anatomical and motility abnormalities.. Modified barium swallow with speech therapy includes videofluoroscopy and specific evaluation of swallowing. It is useful for neuromuscular disorders and, when there is a concern for aspiration, it can be focused more on oropharyngeal dysphagia.. Nasopharyngeal laryngoscopy with or without fiberoptic endoscopic evaluation of swallowing (FEES) is performed by an otolaryngologist. Visualization of the oropharynx, hypopharynx, and larynx is achieved while the patient is asked to swallow food and liquid boluses dyed with food coloring for easy recognition. The physician can then check directly for presence of foreign material in the larynx or regurgitating back up from the esophagus. It also allows the operator to check for sensation of the larynx since decreased sensation from a stroke, ...
James L. Coyle will present on the penetration-aspiration (PA) scale at ASHAs Health Care Connect, to be held July 7-9 in New Orleans.. A new feature of the conference is combination lecture-lab sessions. In his combined session, Using the Penetration-Aspiration Scale, Coyle will introduce the scale and provide examples of scoring decision-making.. He will then lead a hands-on learning lab in which participants review examples of different PA scores and practice using the scale to assess videofluoroscopic data.. Coyle will also present Screening, Assessment and Management of Oral Colonization in the ICU, which explores clinical decision-making and oral health in intensive care units.. Health Care Connect, co-located with Schools Connect and Private Practice Connect, is designed specifically for clinicians in health care settings. Attendees may attend sessions at any of the three conferences.. ...
Greater than 50% of patients with esophageal carcinoma are found to be incurable at the time of diagnosis, leaving only palliative options. Self-expanding metal stents (SEMs) are effective for relieving symptoms and complications associated with esophageal carcinoma and improving quality of life. We undertook a retrospective analysis to evaluate the experience of palliative esophageal stenting for symptomatic malignant dysphagia in our institution over a period of 7 years. Between January 1999 and January 2006, 126 patients who received SEMs for malignant dysphagia were identified using an upper gastrointestinal specialist nurse clinician database. Data were obtained from patient case notes, endoscopy, histopathology, radiology, and external agency databases. Of the 126 identified, 36 patients were excluded from the analysis. A number of variables including age, sex, presenting complaints, type of stent, indications of stenting, success or failure of stent insertion, survival rate, and complication rate
In this study we observed an increase of insula activation and involvement of the PPC conjoint with decreased activation of the somatosensory system during self-paced swallowing in a patient suffering from severe dysphagia due to botulism intoxication. A second measurement after clinical recovery showed cortical swallowing processing in the primary and secondary sensorimotor system as well as declined insula activation comparable to the results of a group of healthy control subjects.. To distinguish whether the changed swallowing behaviour is altering brain activation or whether cortical changes are driving the altered behaviour a slow swallowing task was performed by one of the control subjects. This imitation of impaired swallowing behaviour resulted in a slight increase of EMG power, while wavelet and SAM results where comparable to those in the normal swallowing task. We therefore conclude that the changed behaviour in deglutition alone cannot explain the observed changes in cortical ...
RESULTS: There were 47 patients, 31 (66.0%) males and 16 females, mean age (± standard deviation (SD) 34.6±9.8 years. All patients presented with dysphagia, which was severe in 31 cases (66.0%) and moderate in 14 (29.8%). Preoperative maximum oesophageal diameter ranged from 34 to 89 mm, mean 67.4±12.7mm. In 30 (63.8%) of the patients, the maximum diameter was ,70 mm. Postoperative maximum diameter ranged from 28 to 72 mm, mean 37.5±8.2 mm (p=0.001). The mean preoperative diameter of the narrowest distal oesophagus was 4.6±2.5 mm, compared with the postoperative figure of 11.6±1.8 mm (p=0.015). Following surgery, 41 (87.2%) patients had complete relief of dysphagia, regurgitation and heartburn. Four patients continued to have heartburn after surgery. Patients with severe dysphagia or preoperative oesophageal dilatation ,70 mm had the greatest likelihood of incomplete relief of symptoms after treatment ...
Its origin is considered as either oropharyngeal or oesophageal. Oropharyngeal dysphagia is usually related to neuromuscular dysfunction and is commonly caused by stroke. Oesophageal dysphagia is usually due to motor disorders, such as achalasia or diffuse oesophageal spasm, and to peptic oesophageal strictures often secondary to reflux. In this type of dysphagia there is a sensation of a hold-up, which may be experienced in either the cervical or retrosternal region.1 Causes are usually classified as functional, mechanical and neurological (see Table 48.1). ...
A 63-year-old woman presented with complaints of painful recurrent oral ulcers for 2 years and dysphagia for 1 year. These ulcers formed spontaneously and disappeared over 2-4 weeks each time. They involved the buccal and gingival mucosa and dorsum of the tongue. There were no blisters and no bleeding from the ulcers. She did not have any lesion over the skin or scalp and denied having any ocular symptoms or change in voice. There was no history of starting any new medication or change in denture prior to the onset of symptoms. She was treated by a dermatologist who prescribed multivitamins but they did not give her any relief. A year later she developed progressive dysphagia to solids followed by semisolids. There was no odynophagia and she denied ingestion of any drugs that could cause ulceration in the esophagus. The initial biopsy performed from oral mucosa was inconclusive. Her medical history was significant for hypertension and her medications included a combination of... ...
Aim Hospital‐associated dysphagia, characterized by deconditioning of swallowing as a result of hospitalization, is sometimes observed in patients with aspiration pneumonia (AP). Cognitive impairment is known as a negative factor in dysphagia rehabilitation. The present study aimed to examine the association between cognitive impairment and hospital‐associated dysphagia in patients with AP receiving dysphagia rehabilitation. Methods A retrospective observational study was carried out in an acute geriatric hospital. A total of 249 AP patients receiving multidisciplinary individualized dysphagia rehabilitation were included. Patients were divided into four groups according to their Mini‐Mental State Examination scores. The Functional Oral Intake Scale (FOIS) was used to assess swallowing ability, and hospital‐associated dysphagia was defined as a FOIS decline of ≥1 or ≥2 levels. Body mass index and Barthel Index were obtained to assess nutritional status and activities of daily living. ...
A 70-year-old man was admitted from the gastroenterology clinic for evaluation of chronic weight loss, malnutrition, and progressive dysphagia for 1 year. He was recently admitted to a local hospital after sustaining a fall. Blood tests at that time showed profound electrolyte disturbances with severe hypokalemia (potassium level of 1.7 mEq/L) and hypomagnesemia (magnesium level 0.3 mg/dL). Since the time of that admission, the patient reported feeling weak and with loss of taste for food. Altogether, he had lost 40 lbs over the previous 12 months. He denied abdominal pain, nausea, or ...
CPM and UES dysfunction occur for varying reasons. It may result as a side effect of the normal aging process or due to changes in the CPM or nerve signaling pathways. Specifically, muscle enlargement (called hypertrophy), scarring of the muscle (called fibrosis) from radiation therapy or trauma, stroke, and reflux (heartburn) can all damage the swallowing mechanism at the UES.. To test for CPM and/or UES dysfunction, your ENT (ear, nose, and throat) specialist, or otolaryngologist, may examine your throat and larynx (voice box) by passing a small flexible camera through your nose. In addition, your ENT specialist may order an X-ray swallowing test called a modified barium swallow, esophagram, and/or manometry (pressure testing) of the valve area.. During the modified barium swallow, also known as a Videofluoroscopic Swallow Study (VFSS), you swallow various barium-coated food, liquid, and pills while a speech language pathologist takes X-ray video. For an esophagram, a radiologist looks at the ...
Penetration-aspiration scale (PAS) and swallowing performance score (SPS) determined via MBS. Twenty-four (42%) patients had a PAS score over 6, implying aspira
Delays in the Placement of Nasogastric Tube: Where are they? Dysphagia following stroke is common and not too infrequently requires a nasogastric tube to be placed. Often there are delays in the pathway between the timing of a decision to place a NGT and it being available and safe to use.
Looking for online definition of oral dysphagia in the Medical Dictionary? oral dysphagia explanation free. What is oral dysphagia? Meaning of oral dysphagia medical term. What does oral dysphagia mean?
Introduction: Plummer Vinson Syndrome (PVS) is a rare pathology combining dysphagia, an iron deficiency anemia and a cervical esophageal web. It is one of the risk factors of the esophageal cancer. Objectives: To report the epidemiological, clinical, paraclinical and histological characteristics of patients with Plummer-Vinson syndrome associated with esophageal cancer. Patients and Methods: This was a retrospective study carried out at the digestive endoscopy center of Aristide le Dantec hospital in Dakar from January 2008 to December 2015. We included all patients with Plummer-Vinson syndrome associated with esophageal cancer. Results: We included 7 patients. The mean age was 36 years (24 - 65 years). There were 5 women and 2 men. The mean diagnostic period was 9 months (6 months - 15 years). The main clinical manifestations were dysphagia (100%), weight loss (100%) and clinical anemia (71.4%). The biology showed a mean hemoglobin level of 8.8 g/dl (6 - 11 g/dl), serum iron at 30.8 μg/dl (11 - 52 μg
Postvagotomy Dysphagia. Hoyumpa Jr., Anastacio M.; Morrison, John T.; Moskowitz, Myron // American Journal of Gastroenterology;Feb1972, Vol. 57 Issue 2, p133 A case of dysphagia following vagotomy is described and the different forms of this complication are discussed. Postvagotomy dysphagia should be considered in the differential diagnosis of achalasia. Vagotomy should be performed as close to the diaphragm as possible to minimize the incidence of... ...
To manage a case accurately, the SLP must differentiate among the signs and markers that typically accompany the adverse medical outcomes of dysphagia and determine which are more likely to have been caused by dysphagia and which are more likely due to other conditions. SLPs typically are charged with determining whether their patients have dysphagia-related aspiration pneumonia (DAP), non-dysphagia-related aspiration pneumonia (NDAP), community-acquired pneumonia, health care-associated (nosocomial) pneumonia, or aspiration pneumonitis (the correct diagnosis in our sample case). Physicians often take SLPs written reports and recommendations as direct evidence supporting medical and surgical interventions, whether or not that evaluation was sufficiently thorough in the analysis of case information outside of the SLPs traditional comfort zone. This knowledge of pulmonary physiology and diseases is not covered in SLPs training, but clinicians must embrace this knowledge to assess accurately the ...
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TY - JOUR. T1 - Pharyngeal transport dysfunction consequent to an organ-sparing protocol. AU - Kotz, Tamar. AU - Abraham, Suzanne. AU - Beitler, Jonathan J.. AU - Wadler, Scott. AU - Smith, Richard V.. PY - 1999/4. Y1 - 1999/4. N2 - Objective: To investigate the effects of a protocol of concomitant intravenous hydroxyurea and hyperfractionated, accelerated, external-beam radiation therapy on the swallowing mechanism of patients with advanced- stage head and neck cancer. Design: Posttreatment videofluoroscopic swallow function studies, using images of single-bolus swallows of low-density liquid barium, were analyzed in real time, slow motion, and frame by frame using an integrated system that allows objective analysis of video recordings through image processing and digitization (Kay Elemetrics Computerized Swallowing Station). Radiological descriptors were used for pharyngeal transport abnormalities, and temporal measures were obtained of structural movements. Setting: Academic, tertiary care, ...
Speech or occupational therapy can be helpful for some children. These therapists can give your child exercises to help make swallowing more effective, or suggest techniques for feeding that may help improve swallowing problems.. Infants and children with dysphagia are often able to swallow thick fluids and soft foods (such as baby foods or pureed foods) better than thin liquids. Some infants who had trouble swallowing formula will do better when they are old enough to eat baby foods. The following suggestions should also be considered when caring for a child with dysphagia:. ...
by Roberto Verzaro, Professor of General Surgery in the Degree Course in Midwifery at UniCamillus. Dysphagia is a clinical condition that often occurs after surgery, especially if complex or if the patient has had a prolonged period of orotracheal intubation. It consists of a defect in deglutition, that complex physiological act that allows the transport of food from the oral cavity to the stomach.. Post-surgery dysphagia can be normal and occurs due to transient dysfunction of the mechanisms responsible for deglutition. In this case we speak of post-surgery dysphagia. If the dysphagia persists and is due to a lesion of the organs responsible for deglutition, the patient suffers, however, from post-surgery dysphagia which represents a complication or an inevitable consequence of surgery.. Post-surgery dysphagia occurs after surgery performed for pathology of the oral cavity, pharyngeal cavity or after surgery performed on organs such as the esophagus and stomach. However, it is important to ...
Videofluoroscopy has long been viewed as the gold standard of swallowing examination for the comprehensive information it provides. However, it is not very efficient and accessible in some practical situations. In this study, we tried to use a modified technique of fiberoptic endoscopic examinatio …
Dysphagia lusoria is a well documented complication of variant aortic arch anatomy. Typically it is associated with an aberrant right subclavian artery causing dysphagia by compression. The word lusoria originates from the Latin origin lusus naturae, meaning freak of nature. Dysphagia as a result of tortuous and ectatic anatomy of the carotid vessels is rare. We have identified a few similar cases, including one from 2010 1, which describes a medially coursing left internal carotid artery resulting in difficulty swallowing. It appears that dysphagia, as a result of common carotid ectasia is even rarer, with only a couple of cases appearing in literature2 ...
In our everyday lives, we are faced with many health challenges. These normally happen because of lack of knowledge. We can only know what is ailing us we go for consultations from specialists. A simple exercise like Swallowing can bring us severe health effects if not properly done. You need to ensure that such problems do not reach you by conducting a Swallow Study.. This study makes use of x-rays to establish and record what happens in your body during the process of Swallowing. It can either be a Barium test used or a videofloroscopic which is a modification of Barium. The aim is to prevent you from dysphagia which can lead to many other harmful effects. Some symptoms of this disorder can be food sticking in your throat and certain breathing problems.. Some health problems can lead to dysphagia. Such problems include, mouth sores, muscular dystrophy, stroke, conditions that decrease saliva as well as other major dental problems. Aspiration can easily result when you have this condition. ...
If youve suffered from heartburn or acid reflux, also known as gastroesophageal reflux disease (GERD) for a long time, you may begin to feel discomfort as food passes through the esophagus. It can feel as if you have a lump in your throat or that food is stuck in your throat or chest. You may also experience a choking sensation when you swallow food. Difficulty swallowing, also known as dysphagia, is the feeling of food sticking in your throat or chest and is one of the complications of acid reflux/GERD. When acid reflux occurs, acid flows back into your esophagus causing irritation and discomfort. With chronic acid reflux/GERD, this is happening frequently causing irritation to the esophagus, which can lead to other complications such as dysphagia. Symptoms of Dysphagia ...
Is your child looking for a diagnostic test involving the stomach, esophagus, and duodenum? Learn more about the barium swallow procedure today.
Free, official coding info for 2020 ICD-10-CM R13.11 - includes detailed rules, notes, synonyms, ICD-9-CM conversion, index and annotation crosswalks, DRG grouping and more.
This article was published in Advance for Speech-Language Pathologists, November, 2004 , Vol. 14 •Issue 45 • Page 10. Advance gave permission to re-post. Original article can be accessed at:http://speech-language-pathology-audiology.advanceweb.com/Article/Fees-in-Pediatrics.aspx. Since Susan Langmore developed fiberoptic endoscopic evaluation of swallowing (FEES) in 1988, the use of endoscopy for the identification of oropharyngeal swallowing disorders has grown tremendously. The efficacy of the method is shown in the literature to correlate highly with videofluoroscopy in adults and pediatrics, providing the clinician with an additional objective evaluation to gain information.1-3 Several considerations must be made and questions raised when adapting the FEES exam for pediatric use. The FEES exam offers several advantages, such as portability, flexibility with regards to positioning, time and length of exam, and, especially important for children, avoidance of exposure to radiation. While ...
This article was published in Advance for Speech-Language Pathologists, November, 2004 , Vol. 14 •Issue 45 • Page 10. Advance gave permission to re-post. Original article can be accessed at:http://speech-language-pathology-audiology.advanceweb.com/Article/Fees-in-Pediatrics.aspx. Since Susan Langmore developed fiberoptic endoscopic evaluation of swallowing (FEES) in 1988, the use of endoscopy for the identification of oropharyngeal swallowing disorders has grown tremendously. The efficacy of the method is shown in the literature to correlate highly with videofluoroscopy in adults and pediatrics, providing the clinician with an additional objective evaluation to gain information.1-3 Several considerations must be made and questions raised when adapting the FEES exam for pediatric use. The FEES exam offers several advantages, such as portability, flexibility with regards to positioning, time and length of exam, and, especially important for children, avoidance of exposure to radiation. While ...
Dysphagia is the technical term for the symptom of the sensation of difficulty in swallowing. Dysphagia is usually a sign of underlying disease of the esophagus, which may be due to Gastroesophageal reflux disease(GERD), cancer, thyroid disease, stroke, or a number of other diseases. ...
How do you solve a problem like edema? Even in ideal ACDF recovery, patients will have edema. Watching, waiting, and working on adjunctive dysphagia therapies are all a part of the answer.. Despite often being an elective surgery, ACDF can result in terrible complications (including dysphagia and respiratory failure). Michelle Deghan discusses how to approach complex cases post-ACDF-from evaluation and treatment techniques to the current research.. Show notes can be downloaded below.. To share your thoughts: - Join the MedSLP Newbies Facebook group - Share this episode on Facebook or Twitter. ...
Pain on swallowing food and fluids, a symptom often due to disease of the Oesophagus. The pain may stem from the mouth, throat (pharynx) or Oesophagus (gullet). At times, odynophagia may also be related to the larynx. The mechanism of swallowing is both voluntary and involuntary and starts in the throat and extends to
A 67-year-old woman with adenocarcinoma of the lung, who previously received chemotherapy and radiation therapy, presented with acute-onset right lower extremity weakness. She began radiation therapy to the lumbar spine after MRI demonstrated spinal cord compression. She then developed sudden-onset difficulty with swallowing approximately 6 hours after taking her scheduled morning medications. Of note, she had no prior known difficulties with eating. A barium swallow study revealed narrowing in the mid-thoracic oesophagus with an associated filling defect, reflecting the presence of a foreign body (figure 1A). Subsequent esophagogastroduodenoscopy revealed an extended-release potassium chloride tablet corresponding to the filling defect seen on the barium swallow study (figure 1B); the obstruction was … ...
Speech-Language Pathologists need to examine the medical record just as carefully as the patient. Which came first, the illness or the dysphagia?
There are different treatments for various types of dysphagia. First, doctors and speech-language pathologists who test for and treat swallowing disorders use a variety of tests that allow them to look at the parts of the swallowing mechanism.
General classifications designate dysphagia defined by location: stage l is oral; stage ll is pharyngeal; stage lll is esophageal. Oral dysphagia occurs when there is difficulty with the voluntary transfer of food from the mouth to the pharynx, at the back of the throat. This may happen when a person forgets how to chew or how to move the food out of the mouth to the back of the throat so as to be ready to be swallowed, or when there are problems involving teeth, such as when there arent enough of them. Food and pills can remain in the mouth for hours. Dementia is the most common cause of oral dysphagia. In stage ll dysphagia, there is a problem with the transfer of food from the pharynx into the esophagus. The epiglottis is a flap of tissue that keeps food from entering the trachea, the windpipe, during swallowing. Proper closure directs the food into the esophagus. The most common cause of stage ll dysphagia is stroke or Parkinsons disease. The danger when this occurs is the risk of ...
We got to the ER this morning at 9am. They did a chest xray and a swallow test. Gary did not like the swallow test. It was different from the last time. They strapped him down on a board and had him drink. You can cleary see the liquid going up into his nasal cavity. The silly radiologist doctors tried to tell me it was not related to the disease. I looked at them with one eyebrow raised and started firing questions. They tried to swim in the Lake of Confidence. They are lucky I am a God fearing patient woman LOL! Although the poor volunteer who escorted us got an earful when we headed back. Gary is having nothing by mouth. They are fearing he may aspirate on food or drink. A protection of his airway as been ordered which they implement with nothing by mouth. There is talk of putting a feeding tube in until Monday when the other departments open up. I am going to fight that if I can but if they have to they have to. He is begging for water which I cant give him. His overall weakness is ...
The first three articles of this Perspectives focused on skills involved in formulating and documenting the execution of a dysphagia plan of care. These topics will not only serve as a best practice update to practicing speech-language pathologists (SLPs), but will also be of significant value to students learning dysphagia best practice. Patrick Henley leads the discussion on the SLPs skills in utilizing both behavioral and physiological frameworks in the formulation and documentation of a dysphagia plan of care. Nancy Swigert elaborated on the professionalism and skill that clinicians must practice when documenting their sessions with patients so that their notes can provide justice to the excellent, high-quality of care that they strive to provide to their patients. Advocating for, addressing, and treating feeding and swallowing disorders in a school setting can be supported significantly by the approach clinicians take to document services provided. Emily Homer and Christine Faust described ...
Fasting meals plan functions generally is a strong methodology for a short while period weight discount routine you should use to kick-off a eternal weight low cost program. Dieta a base de jugos de frutas y verduras the same function they may fall prey to false medication, which might cause extra injury than income. If its a matter of desirous dysphaiga lose 5, ten or twenty pounds, nevertheless, how probably are you to subscribe fully to an entire new manner of eating. At its core, medifast is mostly a low carb consuming routine. At the dieter wei mann of the week, you may have a good idea of your average energy consumed and burned per day. The right amount of carbohydrate sources will present sufficient sugar to offer a wholesome amount of glucose to the cells, nonetheless not an extreme amount of at once. (My calculations got dysphagia diet pureed foods up with a couple of 28 dollar difference, but thats fairly shut. In your search high blood pressure diet plan recipes the right food ...
MannaQure© is a comprehensive, norm-referenced English to Spanish Dysphagia and Dysarthria Battery designed to identify, describe and quantify swallowing and oral-function deficits in the adult population. Adult is defined as those individuals 21 years of age and older for the purposes of this tool.
MannaQure© is a comprehensive, norm-referenced English to Spanish Dysphagia and Dysarthria Battery designed to identify, describe and quantify swallowing and oral-function deficits in the adult population. Adult is defined as those individuals 21 years of age and older for the purposes of this tool.
Difficulty swallowing, also called dysphagia, is a symptom of many conditions. Causes can include neurological problems, muscular disorders and blockages to the throat.
Impaired consciousness and esophageal disorders can cause deglutition. Acute Aspiration of Gastric Content (Mendelson Syndrome ... Jul 1991). "Agricultural disorders of the lung". Radiographics. 11 (4): 625-34. doi:10.1148/radiographics.11.4.1887117. PMID ... It inhibits cells from properly utilizing oxygen by disrupting cytochrome oxidase.[citation needed] Deglutition is the main ... Gastro-esophageal reflux and chronic aspiration are associated with few pulmonary disorders: asthma, chronic cough, ...
Deglutition and Its Disorders: Anatomy, Physiology, Clinical Diagnosis. Thomson Delmar Learning. ISBN 1-56593-621-3. v t e. ...
Shaker R (2013). Principles of deglutition : a multidisciplinary text for swallowing and its disorders. New York, NY: Springer ... Fluctuating vocal fold paresis has been observed in neurodegenerative disorders like Guillain-Barré syndrome or myasthenia ... Congenital conditions that are implicated in VFP include neurological disorders like hydrocephalus and Arnold-Chiari ... Puberphonia Pototschnig C, Thumfart WF (1997). "Electromyographic evaluation of vocal cord disorders". Acta Oto-rhino- ...
... deglutition disorders MeSH C06.405.117.119.500 - esophageal motility disorders MeSH C06.405.117.119.500.204 - crest syndrome ...
... deglutition disorders and other habits greatly influence the development of the face and dental arches. Pacifier sucking habits ... Our dental disorders largely stem from a shift in the oral environment caused by the introduction of softer, more sugary foods ... Joshi N, Hamdan AM, Fakhouri WD (December 2014). "Skeletal malocclusion: a developmental disorder with a life-long morbidity". ...
... deglutition disorders and other habits greatly influence the development of the face and dental arches.[23][24][25][26][27] ...
The pain causes dry deglutition and dry deglutition adds to the pain, triggering a vicious circle. The spams start after dry ... The condition can appear as a symptom of the generalized anxiety disorder. Early signs are other symptoms like difficulty or ... For instance, did the patient recently encounter other symptoms of the generalized anxiety disorder? Does the patient suffer ... Hot fluids may be helpful for some people with cricopharyngeal spasm (or other oesophageal disorders).[3] ...
"Cerebellar Disorders - Neurologic Disorders". Merck Manuals Professional Edition. Retrieved 2018-10-09. Salman MS (February ... difficulty in deglutition/swallowing of solids and liquids) vertigo (dizziness) nystagmus (rapid, involuntary eye movements), ... and individuals with eating disorders. Alcohol use disorder is the diagnosis of which an individual frequently consumes ... These disorders prevail when T-cells (also known as white blood cells) begin to harm familiar cells in the central nervous ...
The tongue is an important organ contributing to deglutition, speech, growth and development of the jaws, and alignment of the ... This technique is used to treat orofacial myofunctional disorders and other conditions that involve weakness of the tongue and ... Oral myology plays also an important role in the management of patients with sleep breathing disorders and snoring where ... Accordingly, treatment of tongue thrust is essential for treatment of speech disorders, and oral myology therapy aiming at ...
27 September 2012). Principles of Deglutition. Springer Science & Business Media. p. 746. ISBN 978-1-4614-3794-9. Retrieved 26 ... disordered motility, lye ingestion, or a hiatal hernia. Strictures can form after esophageal surgery and other treatments such ...
MLD is one of two leukodystophies that are also a lysosomal storage disorder. MLD is inherited in an autosomal recessive way ... More progressed patients show weakness in deglutition, leading to spastic coughing fits due to inhaled saliva. Classic ... Leukodystrophies are a group of usually inherited disorders characterized by degeneration of the white matter in the brain. The ... The National Institute of Neurological Disorders and Stroke (NINDS, under the U.S. National Institutes of Health) supports ...
... disorders and gout; and culinary science, which aims to achieve health through food that sustains virility, the fruitful ... nécessitant le vomitif pour jouir d'une nouvelle déglutition; la gastronomie gloutonne dont les conséquences sont l'indigestion ...
For example, a person suffering from the eating disorder, Bulimia nervosa may show signs of excessive tooth and gum erosion. ... deglutition), and speech (phonation). In addition to the teeth, other structures that aid chewing are the lips, cheeks, tongue ... Temporomandibular joint diseases and disorders, commonly called TMJ. Autoimmune diseases such as: Crohn's disease of the oral ...
Although age-related changes place older adults at risk swallowing disorders, an older adult's swallow is not necessarily an ... Preliminary observations on the effects of age on oropharyngeal deglutition. Dysphagia 1989;4:90-4. Shaw DW, Cook IJ, Dent J et ... Clinicians are becoming more aware of the need to distinguish among swallowing disorders, presbyphagia (an old yet healthy ... mechanism indicates a progression of change that may put the older population at increased risk for swallowing disorders. Such ...
... deflower deforest deforestation deform deformation deformity defraud defray defrock defunct defy degeneration deglutition ... dislocation dislodge disloyal disloyalty dismal dismantle dismay dismember disobedience disobedient disobey disoblige disorder ...
Some psychological conditions (anxiety disorder, somatic symptom disorder, conversion disorder) may cause symptoms resembling ... deglutition), and following exercise. Manisty et al. note: "Deglutition syncope is characterised by loss of consciousness on ... This is often due to an underlying disorder or medication use and is accompanied by other hypoadrenergic signs. The central ... drug intoxication and some psychiatric disorders among others. Treatment depends on the underlying cause. Those who are ...
Deglutition Disorders Synonyms Deglutition Disorder , Disorders, Deglutition , Dysphagia , Dysphagia, Esophageal , Dysphagia, ... Swallowing Disorders Definition Difficulty in SWALLOWING which may result from neuromuscular disorder or mechanical obstruction ... Oropharyngeal , Esophageal Dysphagia , Oropharyngeal Dysphagia , Swallowing Disorder , ...
New model could help identify root cause of swallowing disorder dysphagia Findings may change the landscape of dysphagia ... interventionNearly 40 percent of Americans 60 and older are living with a swallowing disorder known as dysphagia. ...
Deglutition Disorder, Recurrent Pneumonia Symptom Checker: Possible causes include Esophagitis, Esophageal Achalasia, ... Deglutition - Deglutition disorders - Progressive disorders.[link.springer.com] […] of OPMD-related deaths are attributed to ... Her family noted a wet pillow in the morning.[ncbi.nlm.nih.gov] Deglutition Disorders Esophageal Diseases Gastrointestinal ... Differential diagnoses, possible causes and diseases for Aspiration Pneumonia, Deglutition Disorder, Recurrent Pneumonia listed ...
Deglutition Disorders. Related Clinical Trials. Title. Acronym. Phase. Status. Toronto Bedside Swallowing Screening Test (TOR- ...
P-40s was a wrong download Manual of Diagnostic and Therapeutic Techniques for Disorders of Deglutition in the critics over ... We work no individuals for this download Manual of Diagnostic and Therapeutic Techniques for Disorders of Deglutition. You can ... A free download Manual of Diagnostic and Therapeutic Techniques for Disorders of Deglutition will contact on the second and ... goes colons of download Manual of Diagnostic and Therapeutic Techniques for Disorders of Deglutition people practiced from ...
Disorders, Deglutition, Dysphagia, DEGLUTITION DISORDER, Deglutition Disorder, SWALLOWING DIFFICULT, [D]Difficulty in ... Deglutition Disorders [Disease/Finding], swallowing difficulty, deglutition disorder, deglutition disorders, difficulty in ... Deglutition disorder, Disorder deglutition, Swallowing disorder, Dysphagia NOS, Dysphagia, unspecified, Difficulty in ... Deglutition Disorders (C0011168) Definition (MEDLINEPLUS). If you have a swallowing disorder, you may have difficulty or pain ...
This study is based on the videofluorographic exploration of deglutition in 14 patients who were treated by supracricoid ... Postsurgical cancer Supracricoid laryngectomy Deglutition Deglutition disorders This is a preview of subscription content, log ... and absence of residual deglutition disorders elicited by patient history. Asymptomatic aspiration was seen in 6 cases. In the ... The deglutition sequelae are less invalidating relative to the cricohyoidopexies (CHP), with a possible recuperation of the ...
... cancer cartilage cervical chewing clinician consistency cough deglutition Disorders After Treatment Disorders of Deglutition ... Evaluation and Treatment of Swallowing Disorders. Jeri A. Logemann. Snippet view - 1998. ... Clinical Management of Neurogenic Communicative Disorders. Donnell F. Johns. Snippet view - 1985. ... tissue Shedd shown in Figure side soft palate sphincter supraglottic laryngectomy surgical resection swal Swallowing Disorders ...
Substance-Related Disorders. D019966. EFO:0003890. drug dependence. 2. ClinicalTrials. Deglutition Disorders. D003680. HP: ... Mood Disorders. D019964. EFO:0004247. mood disorder. 0. ClinicalTrials. Ovarian Neoplasms. D010051. EFO:0001075. ovarian ... post-traumatic stress disorder. 2. ClinicalTrials. Cocaine-Related Disorders. D019970. EFO:0002610. cocaine dependence. 3. ... Attention Deficit Disorder with Hyperactivity. D001289. EFO:0003888. attention deficit hyperactivity disorder. 4. ATC. ...
Cerebral palsy; Children; Deglutition disorders; Oral phase impairment; Orpharyngeal dysphagia. PMID:. 25213472. DOI:. 10.1016/ ... Oral phase impairment was rated from video using the Dyspahgia Disorders Survey, Schedule for Oral Motor Impairment, and Pre- ...
Esophageal Motility Disorders. Deglutition Disorders. Esophageal Diseases. Signs and Symptoms, Digestive. Signs and Symptoms. ... Functional Gastrointestinal Disorder Screening Program - A Randomized Controlled Trial (FGISP-RCT). This study has been ... Functional gastrointestinal disorder. GERD. reflux. irritable bowel syndrome. Functional dyspepsia. postprandial fullness. ... Functional gastrointestinal disorder (FGID) is the most common gastrointestinal disease in daily clinical practice. The disease ...
Ultrasound and Videofluoroscopy for Diagnosing Swallowing Disorders. *Deglutition Disorder. *Motor Neuron Disease ... Genetic Study of Familial and Sporadic ALS/Motor Neuron Disease, Miyoshi Myopathy and Other Neuromuscular Disorders. * ... National Institute of Neurological Disorders and Stroke (NINDS). Bethesda, Maryland, United States ... National Institute of Neurological Disorders and Stroke (NINDS). Bethesda, Maryland, United States ...
Esophageal Motility Disorders. Deglutition Disorders. Esophageal Diseases. Hypertension, Portal. Liver Diseases. To Top ...
Esophageal Motility Disorders. Deglutition Disorders. Esophageal Diseases. Gastrointestinal Diseases. Digestive System Diseases ...
It may lead to avoidance of shared meals and social isolation due to audible deglutition. Besides, it can lead to unintended ...
Deglutition * Deglutition Disorders / etiology * Deglutition Disorders / prevention & control* * Deoxycytidine / adverse ...
To observe the clinical efficacy of fire-needle therapy in treating deglutition disorders due to pseudobulbar palsy in the ... Fire-needle therapy for deglutition disorders in post-stroke pseudobulbar palsy:a randomized controlled trial / 针灸推拿医学(英文版) ... Fire-needle therapy for deglutition disorders in post-stroke pseudobulbar palsy:a randomiz ... and significantly enhance the therapeutic efficacy of the treatment of deglutition disorders in this stage. ...
... stroke deglutition disorder.Method Ninety patients with post-stroke deglutition disorder were randomized into a treatment group ... Clinical Observation of Acupuncture plus Rehabilitation Training for Post-stroke Deglutition Disorder / 上海针灸杂志 ... stroke deglutition disorder and reduce the occurrence of complications, with satisfactory safety and consistency. ...
The benefits of the technique and its applicability in neurogenic disorders related to communication and deglutition are still ... Effects of Repetitive Transcranial Magnetic Stimulation in the Rehabilitation of Communication and Deglutition Disorders: ... Two aphasia and all dysphagia studies showed a significant improvement of the disorder, compared to the sham group. The other 2 ... Therefore, other randomized controlled trials are needed to clarify the optimal stimulation protocol for each disorder studied ...
Learn about this Deglutition Disorders and Oropharyngeal Dysphagia study at University of California Health (now recruiting ... Oropharyngeal Dysphagia Deglutition Disorders Autologous Muscle Derived Cells for Gastro-Intestinal Repair (AMDC-GIR) ... Medical condition or disorder that may limit life expectancy or that may cause clinical investigation plan (CIP) deviations (e. ... Neuromuscular disorder (e.g., Parkinsons disease, muscular dystrophy, multiple sclerosis) that could lead to TD. ...
Cerebrovascular Disorders / physiopathology * Deglutition Disorders / etiology* * Deglutition Disorders / physiopathology * ...
Disorders of Deglutition. 371. (13). David N. Tuchman. Gastroesophageal Reflux. 384. (16). ...
Keywords : cerebral palsy; videofluoroscopy; deglutition; disorders. · abstract in Portuguese · text in Portuguese · Portuguese ... FURKIM, Ana Maria; BEHLAU, Mara Suzana and WECKX, Luc Louis Maurice. Clinical and videofluoroscopic evaluation of deglutition ... Cerebral palsy is a condition that may be associated with swallowing disorders, that is, oropharingeal dysphagia. The aim of ... Aspiration was more common with liquids, before and after deglutition. On clinical and videofluoroscopic evaluation, cervical ...
Keywords: Citrus; Cold temperature; Deglutition disorders; Deglutition; Stroke. RESUMO. OBJETIVO: Verificar o efeito do sabor ...
Dysphagia Cerebral cortex Plasticity Rehabilitation Deglutition Deglutition disorders This is a preview of subscription content ... Potulska A, Friedman A, Krolicki L, Spychala A. Swallowing disorders in Parkinsons Disease. Parkinsonism Relat Disord. 2003;9: ...
Physiology analysis of deglutition via ultrasonography. Palavras-chave em inglês. Aging. Deglutition disorders. Deglutition/ ... Mode B for deglutition evaluation was used by measuring the anterior cervical region, through longitudinal cuts in order to ... In the pharyngeal phase of deglutition, the hio-laringeo complex displacement may bring important data for the observation of ... The ultrasonography allowed deglutition functionality verification and showed its physiologic variation according to the ...
... are a family of musculoskeletal disorders that represent the most common chronic o... ... DEGLUTITION DISORDERS; TEMPOROMANDIBULAR JOINT DISORDERS; MALOCCLUSION; and ARTICULATION DISORDERS. ... joint disorders (TMJD) are a family of musculoskeletal disorders that represent the most common chronic orofacial pain ... Craniomandibular Disorders. Diseases or disorders of the muscles of the head and neck, with special reference to the ...
Deglutition Disorders. Female. Humans. Malocclusion / complications*. Mastication. Tongue / abnormalities*. From MEDLINE®/ ... 2954009 - Dental management considerations for the patient with post-traumatic stress disorder.. 1548099 - Degradation of ...
Deglutition Disorders. Difficulty in SWALLOWING which may result from neuromuscular disorder or mechanical obstruction. ... Alzheimers Disease Anesthesia Anxiety Disorders Autism Bipolar Disorders Dementia Epilepsy Multiple Sclerosis (MS) Neurology ... A hypermotility disorder of the ESOPHAGUS that is characterized by spastic non-peristaltic responses to SWALLOWING; CHEST PAIN ... Repetitive transcranial magnetic stimulation (rTMS) is an innovative therapeutic option in major depressive disorder (MDD). A ...
Deglutition. Deglutition Disorders / etiology*. Female. Head and Neck Neoplasms / complications*, therapy. Humans. Male. Middle ...
  • Findings may 'change the landscape' of dysphagia interventionNearly 40 percent of Americans 60 and older are living with a swallowing disorder known as dysphagia. (meducation.net)
  • [disorders.eyes.arizona.edu] Key words: Oculopharyngeal muscular dystrophy - Dysphagia - Deglutition - Deglutition disorders - Progressive disorders. (symptoma.com)
  • Two aphasia and all dysphagia studies showed a significant improvement of the disorder, compared to the sham group. (bvsalud.org)
  • Cerebral palsy is a condition that may be associated with swallowing disorders, that is, oropharingeal dysphagia. (scielo.br)
  • Outcomes include clinically assessed OPD (Schedule for Oral Motor Assessment, Dysphagia Disorders Survey, Pre-Speech Assessment Scale, signs suggestive of pharyngeal phase impairment, Thomas-Stonell and Greenberg Saliva Severity Scale), parent-reported OPD on a feeding questionnaire, gross motor skills (Gross Motor Function Measure, Gross Motor Function Classification System and motor type), growth and nutritional status (linear growth and body composition) and dietary intake (3 day food record). (bmj.com)
  • Neurologic disorders are often described but no specific data about postacute cranial nerves involvement and possible correlation with dysphagia development are yet available. (minervamedica.it)
  • The DRS was established 25 years ago with the intention of bringing together a variety of disciplines involved with research into mechanisms, diagnosis, and management of swallowing disorders (dysphagia). (uncg.edu)
  • The predictable effects of disorders on pharyngeal pressures make manometry an attractive clinical tool for diagnosing and monitoring dysphagia. (pubmedcentralcanada.ca)
  • In 2007, the American Speech-Language-Hearing Association adopted "feeding and swallowing disorders" as a more inclusive phrase for disorders in the development of eating and drinking skills and dysphagia, disorders that are common in various pediatric populations. (iospress.com)
  • Swallowing disorders, or dysphagia, are defined as abnormalities in one of the four phases of the normal swallowing mechanism, namely, the oral preparatory, oral transport, pharyngeal, and esophageal phases [ 1 ]. (iospress.com)
  • This complete, concise guide enables graduate students in speech-language pathology to apply their knowledge of the anatomy and physiology of voice and speech production to the study of normal deglutition and dysphagia. (dallp.net)
  • [en.oxforddictionaries.com] Can be associated with weight loss, heartburn, regurgitation (especially with lying flat), and aspiration pneumonias . (symptoma.com)
  • Some of these atypical symptoms may include: Laryngitis-Chronic Cough-Hoarseness or Voice Disturbances Bronchitis and/or Asthma Recurrent Pneumonia Sleep Apnea Acid erosion [stretta-therapy.com] Deglutition Disorders Esophageal Diseases Gastrointestinal Diseases Digestive System Diseases Signs and Symptoms, Digestive Signs and Symptoms [clinicaltrials.gov] In patients with pulmonary symptoms, an infiltrate due to aspiration pneumonia may be seen. (symptoma.com)
  • [ncbi.nlm.nih.gov] AIM: A retrospective study was performed to evaluate the functional disorders of deglutition with videofluoroscopy (VFS), in children operated for esophageal atresia (EA) [ncbi.nlm.nih.gov] All presented with severe coughing symptoms, and most (86%) had a history of recurrent aspiration pneumonia . (symptoma.com)
  • Aspiration was more common with liquids, before and after deglutition. (scielo.br)
  • Anti-reflux surgery Aspiration Chronic bronchitis Deglutition Deglutition disorders Gastroesophageal reflux. (1000friends-ct.org)
  • Feeding disorders, choking, and aspiration have been described in children with neuromuscular diseases (NMDs) and in children with cerebral palsy [ 2, 3 ], but the underlying causes and swallowing patterns are different in NMDs and cerebral palsy [ 4 ]. (iospress.com)
  • Continuous NIH support of his work for the past 25 years has led to seminal discoveries in the area of airway protection against aspiration, which have opened new avenues of investigation and treatment for patients with swallowing disorders and gastroesophageal reflux disease. (dysphagiaresearch.org)
  • Most recently his work on pathophysiologic mechanisms of reflux induced aerodigestive and airway disorders resulted in development of the 'UES Assist Device' for prevention of reflux of gastric content into the pharynx and its aspiration. (dysphagiaresearch.org)
  • We present an algorithm developed in MATLAB which can be applied to both normal and disordered swallowing to automatically extract a wide array of measurements from the spatiotemporal plots produced by high resolution manometry (HRM) of the pharyngeal swallow. (pubmedcentralcanada.ca)
  • Automated extraction showed strong correlations with manual extraction, producing high correlation coefficients in both normal and disordered subjects for maximum velopharyngeal pressure and maximum tongue base pressure. (pubmedcentralcanada.ca)
  • Students will practice transcription of normal and disordered speech including the use of broad and narrow diacritic symbols. (apsu.edu)
  • Genetic convergence of Parkinson's disease and lysosomal storage disorders. (curehunter.com)
  • Deep-brain-stimulation does not impair deglutition in Parkinson's disease. (mpg.de)
  • If you have a swallowing disorder, you may have difficulty or pain when swallowing. (fpnotebook.com)
  • Anyone can have a swallowing disorder, but it is more likely in the elderly. (fpnotebook.com)
  • Anyone can have a swallowing disorder, but it is more common in older adults. (medlineplus.gov)
  • Feeding and Swallowing Disorder by: Krystal Speig. (mindmeister.com)
  • We present the case of a 72-year-old woman with an eight-year swallowing disorder history. (minervamedica.it)
  • It may be observed in patients with stroke, motor neuron disorders, cancer of the throat or mouth, head and neck injuries, Parkinson disease, and multiple sclerosis. (fpnotebook.com)
  • To observe the clinical efficacy of fire - needle therapy in treating deglutition disorders due to pseudobulbar palsy in the remission stage of stroke . (bvsalud.org)
  • Fire - needle therapy can obviously change the DSRS,MMASA and KTST scores in pseudobulbar palsy in the remission stage of stroke ,and significantly enhance the therapeutic efficacy of the treatment of deglutition disorders in this stage. (bvsalud.org)
  • Objective To observe the clinical efficacy of needling a group of acupoints for choke plus rehabilitation training in treating post- stroke deglutition disorder . (bvsalud.org)
  • Method Ninety patients with post- stroke deglutition disorder were randomized into a treatment group and a control group , 45 cases in each group. (bvsalud.org)
  • The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group. (acupuncture.org.uk)
  • The causes of cerebral palsy include prematurity, genetic disorders, strokes, and infection of the brain. (medicinenet.com)
  • Deglutition and Its Disorders: Anatomy, Physiology, Clinical Diagnosis. (wikipedia.org)
  • The videofluorographic swallowing study is a key diagnostic tool in the detection of swallowing disorders, allowing to make an early diagnosis and to reduce the risk of gastrointestinal and pulmonary complications. (hindawi.com)
  • Traissac L: Réhabilitation de la voix et de la déglutition après chirurgie partielle ou totale du larynx. (springer.com)
  • Devars F, Traissac L, Walter V, Guatterie M, Lozano V: Rehabilitation chirurgicale de la déglutition après chirurgie partielle du larynx. (springer.com)
  • This study is based on the videofluorographic exploration of deglutition in 14 patients who were treated by supracricoid laryngectomy. (springer.com)
  • The deglutition sequelae are less invalidating relative to the cricohyoidopexies (CHP), with a possible recuperation of the dynamic sequence of the pharyngeal swallow. (springer.com)
  • In the pharyngeal phase of deglutition, the hio-laringeo complex displacement may bring important data for the observation of the airways functional protection. (usp.br)
  • On the other hand, it presents limitations, when compared to the use of videofluoroscopy, a traditionally used method, since it does not permit a panoramic view of the deglutition process and presents restricted access to some pharyngeal structures. (usp.br)
  • The recent European Respiratory Society (ERS) Annual Meeting in London (September, 2016) has seen the beginning of a collaboration between the ERS and the European Society for Swallowing Disorders (ESSD) based on the importance (incidence and prevalence) of often unrecognised swallowing disorders in respiratory diseases. (ersjournals.com)
  • Effects of Repetitive Transcranial Magnetic Stimulation in the Rehabilitation of Communication and Deglutition Disorders: Systematic Review of Randomized Controlled Trials. (bvsalud.org)
  • We conclude that clinical and videofluoroscopic evaluations are complementary on deglutition evaluation and together may point to the most specific rehabilitation procedure. (scielo.br)
  • The incidence of feeding/swallowing impairments (deglutition disorders) in young children is rising and poses serious acute and long-term health consequences. (readbyqxmd.com)
  • He is internationally recognized for his studies of deglutition and deglutition disorders, gastroesophageal reflux disease and cerebral cortical control of gastrointestinal sensory motor function. (dysphagiaresearch.org)
  • Difficulty in SWALLOWING which may result from neuromuscular disorder or mechanical obstruction. (ctdbase.org)
  • A disorder characterized by difficulty in swallowing. (fpnotebook.com)
  • There were no deglutition or sphincter disorders or difficulty breathing. (who.int)
  • Genetic movement disorders in patients of Jewish ancestry. (curehunter.com)
  • Few cases of swallowing dysfunction were reported in neonates with no underlying disorders some of them had laryngomalacia and reflux too. (sid.ir)
  • The proposed clinical trial will evaluate the analgesic and adverse effects of duloxetine, a serotonin and norepinephrine reuptake inhibitor, in comparison to placebo in patients with temporomandibular joint disorder (TMJD). (bioportfolio.com)
  • The study of phonetic transcription and phonological theory and the application of these concepts to patients with disordered speech. (biola.edu)
  • Functional gastrointestinal disorder (FGID) is the most common gastrointestinal disease in daily clinical practice. (clinicaltrials.gov)
  • However, the term is often used, not fully appropriately, to mean a disorder or disease of swallow function. (ersjournals.com)
  • Differential diagnosis include late onset muscular dystrophy, skin abnormalities (inflammations, rash, etc.), adult-onset nemaline myopathy (severe neuromuscular disorder causing proximal muscle weakness), lesions over bony areas of the body, constant inflammation and scaly patches on the skin (lichen planus), and rash caused by sun exposure or photosensitivity (polymorphous light eruption). (rareshare.org)
  • Oral phase impairment was rated from video using the Dyspahgia Disorders Survey, Schedule for Oral Motor Impairment, and Pre-Speech Assessment Scale. (nih.gov)
  • The clinical swallowing evaluation (CSE) represents a critical component of a comprehensive assessment of deglutition. (readbyqxmd.com)
  • Almost all pediatric neuromuscular diseases are accompanied by feeding and swallowing problems during the different phases of deglutition, problems that give rise to a wide variety of signs and symptoms, which emphasizes the importance of a comprehensive feeding and swallowing assessment by a speech and language therapist. (iospress.com)
  • The course will examine how the major sensory, motor and integrative neural systems of the human brain produce perceptions, control body functions, generate behavior and how impaired brain function causes various communication disorders. (apsu.edu)
  • Survey of various types of human disabilities with an emphasis on communication disorders. (biola.edu)
  • An in-depth analysis of the nervous system as it pertains to communication and communication disorders. (biola.edu)
  • In addition, various neurological disorders will be surveyed that can affect communication. (biola.edu)
  • The benefits of the technique and its applicability in neurogenic disorders related to communication and deglutition are still uncertain. (bvsalud.org)
  • rTMS as a treatment for neurogenic communication and swallowing disorders. (nih.gov)
  • Non-invasive brain stimulation: a new frontier in the treatment of neurogenic speech-language disorders. (nih.gov)
  • In addition to female gender, two other factors predict an elevated incidence of these disorders: a history of musculoskeletal pain at other body sites and quality of life symptoms typically associated with depression (Von Korff et al 1988, Raphael and Marbach 2001, John et al 2003). (bioportfolio.com)
  • This course is designed to introduce students to the practice of audiology which uses hearing science, differential diagnosis and patient centered care to manage hearing loss and balance disorders. (apsu.edu)
  • Chronic facial pain may be linked to Temporomandibular Joint Disorder (TMJD) which currently has no standard treatment. (bioportfolio.com)
  • Automated extraction was compared to manual extraction for a subset of seven normal and the three disordered subjects to evaluate algorithm accuracy. (pubmedcentralcanada.ca)