To the best of our knowledge, this is the first report to evaluate swallowing function before and after O-C3 arthrodesis. The preoperative O-C2 angle was unchanged after surgery. Impairment of deglutition may be closely associated with air leakage from the oropharynx due to impaired mobility of the soft palate. Because the precise mechanism of dysphagia has not been fully elucidated, further study using dynamic videofluoroscopy and videoendoscopy is needed to examine the swallowing mechanism.
Study Design:
Prospective study.
Objectives:
Preoperative and postoperative dysphagia was evaluated by an otolaryngology doctor and a speech-language-hearing therapist using the eating assessment tool (EAT-10) and Hyodo-Komagane scores. The objective was to achieve a more precise evaluation of the incidence and risk factors of early and persistent dysphagia after anterior cervical discectomy and fusion (ACDF).
Summary of Background Data:
Although numerous reports have explored the risk factors for dysphagia after ACDF, these factors remain controversial. The main reason for this situation is that the methods for evaluating dysphagia are not adequate or uniform.
Materials and Methods:
This study involved a retrospective 47 consecutive patients who had undergone ACDF and been followed up for at least 1 year. Sagittal alignment of the cervical spine was evaluated by a preoperative x-ray. Univariate and multivariate logistic regression analyses were performed to determine risk factors for transient or persistent dysphagia.
Results:
The study showed that 34% of patients developed dysphagia in the early postoperative period and that 25.5% of patients still had persistent dysphagia 1 year postoperatively. 8.5% of patients had already developed dysphagia preoperatively, with a significant positive correlation observed between preoperative and postoperative dysphagia.
Aging and smoking were significant risk factors for transient dysphagia. A preoperative cervical kyphotic angle at the C3/C4, C4/C5 disk-level and change in the kyphotic angle at C4/C5 during surgery were significant risk factors of persistent dysphagia 1 year after surgery.
Conclusions:
This is the first study to show dysphagia after anterior cervical spine surgery using the EAT-10 score and Hyodo-Komagane score with endoscopic evaluation. Aging and smoking were significant risk factors for transient dysphagia, while preoperative local kyphosis angles of C3–C4 and C4–C5 and change in the kyphotic angle at C4/C5 during surgery may be a key alignment of risk factors for postoperative persistent dysphagia.
Level of Evidence:
Level: III.
Laryngeal venous malformation is a comparatively rare condition in adults. It presents as a livid or bluish mass that may cause bleeding, hoarseness, stridor, and even difficulty in breathing. So far, treatment has largely consisted of laser therapy and surgical removal. Five cases of adult laryngeal venous malformations that were treated by sclerotherapy (local injection of monoethanolamine oleate solution) are reported. All lesions disappeared after one or two treatment sessions, and two of the five cases that presented recently were cured in the outpatient clinic setting with no sequelae. Sclerotherapy with monoethanolamine oleate is a safe, easy, and effective treatment for laryngeal venous malformations.
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