Normal patterns of laryngeal vestibular closure and respiratory phase coordination during sequential swallowing have been described for the first time. The high occurrence of inspiration and laryngeal vestibular opening that surrounds sequential liquid cup swallows when compared with previous findings in single, discrete swallows may place patients with swallowing disorders at greater risk during this task.
Background
Unstable respiratory–swallowing coordination has been associated with disorders and disease. The goals of this study were (1) to describe respiratory–swallow patterns in patients with dysphagia consequent to treatments for cancers of the oropharynx and (2) to determine the association between respiratory–swallow patterns, airway invasion, and overall severity of swallowing impairment.
Methods
This prospective, cross-sectional design compared respiratory–swallow patterns in 20 patients treated for oropharyngeal cancer and 20 healthy, age-matched control participants. Nasal airflow direction was synchronously recorded with videofluoroscopic imaging in participants who swallowed 5-mL thin liquid barium boluses.
Results
Respiratory–swallow patterns differed between groups. Most control participants initiated and completed swallowing bracketed by expiratory airflow. Swallowing in patients often interrupted inspiratory flow and was associated with penetration or aspiration of the bolus.
Conclusions
We suggest nonexpiratory bracketed respiratory–swallowing phase patterns in patients with oropharyngeal cancer may place patients at greater risk of airway penetration or aspiration during swallowing.
Otologic manifestations are common in malignant osteopetrosis secondary to the formation of dense, brittle bone. Frequent findings include external auditory canal stenosis, otitis media, conductive and sensorineural hearing loss, and facial nerve paralysis.
Injection of CaHA paste results in significantly improved vocal scores in the majority of patients. Use of the paste was less satisfactory in patients with soft tissue defects because of poor retention of the paste in the scarred vocal fold remnant.
To determine whether superficial musculoaponeurotic system (SMAS) graft implantation can improve the appearance of the nasolabial fold. Methods: Single-blinded cohort study in a private facial plastic surgery practice. Treatment and control patients were selected from those presenting for aesthetic surgery. All patients underwent rhytidectomy with SMAS imbrication by a single surgeon. In addition, treatment patients underwent subcutaneous implantation of excised SMAS strips to the nasolabial fold. Treatment and control patients were matched for any other simultaneous procedures known to affect appearance of the nasolabial folds. Preoperative and postoperative photographs were graded by 3 blinded observers using the Wrinkle Severity Rating Scale to evaluate the nasolabial fold. Postoperative photographs were evaluated approximately 3 months and again 1 year after the procedure. Results: Compared with controls, there was a significant difference in the nasolabial folds of patients undergoing SMAS implantation at the 3-month postoperative evaluation (P=.03; 2 =4.696). This benefit was lost when the results were evaluated 1 year after the procedure (P=.88; 2 =0.0212). Conclusion: Superficial musculoaponeurotic system implantation to the nasolabial folds offers modest temporary improvement to this area in patients undergoing rhytidectomy with SMAS imbrication.
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