OtoRhinoLaryngology by Alexandros G.Sfakianakis

Δευτέρα 1 Μαΐου 2017

Variability in Ultrasound Measurement of Hyoid Bone Displacement and Submental Muscle Size Using 2 Methods of Data Acquisition.

Variability in Ultrasound Measurement of Hyoid Bone Displacement and Submental Muscle Size Using 2 Methods of Data Acquisition.

Folia Phoniatr Logop. 2017 Apr 29;68(5):205-210

Authors: Perry SE, Winkelman CJ, Huckabee ML

Abstract
OBJECTIVE: This study compares variability in measures of hyoid bone displacement and submental muscle size using 2 methods of ultrasound transducer placement: fixed and hand-held.
PATIENTS AND METHODS: Twenty-four healthy participants (11 males, 13 females) aged between 51 and 84 years were scanned using both methods. Repeated measures were collected within and across 3 sessions.
RESULTS: A nonlinear mixed effects model was used to estimate the effects of the method, trial, and session. The fixed transducer produced greater within- and across-session variability on several measures compared to the hand-held method. Fixed-transducer measurements of hyoid bone displacement were 9.4% smaller compared to hand-held measurements (F[1, 24.34] = 3.58, p = 0.07).
CONCLUSION: Results suggest that using a fixed transducer does not necessarily improve measurement accuracy of swallowing outcomes in a healthy system. The wide variability in individual measures indicates that further research is required before ultrasound is used for outcome measurement in rehabilitation.

PMID: 28456801 [PubMed - as supplied by publisher]

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Laryngeal Closure during Swallowing in Stroke Survivors with Cortical or Subcortical Lesion.

Laryngeal Closure during Swallowing in Stroke Survivors with Cortical or Subcortical Lesion.

J Stroke Cerebrovasc Dis. 2017 Apr 26;:

Authors: Park T, Kim Y, Oh BM

Abstract
BACKGROUND: One of the major, and most harmful, symptoms of dysphagia in stroke survivors is aspiration. Survivors of unilateral cortical strokes with dysphagia and resulting aspiration have been reported to have greater initiation delays in laryngeal closure than those who did not aspirate. Few studies have reported such data in survivors of subcortical stroke.
METHODS: This study measured initiation of laryngeal closure (ILC) and laryngeal closure duration (LCD) in 2 groups of subjects: 15 stroke survivors with cortical lesions and 15 stroke survivors with subcortical lesions. Means and standard deviations of ILC and LCD were analyzed on 5-mL thin liquid and 5-mL puree boluses using a 100-ms timer during subsequent analysis of videofluoroscopic swallowing examinations. Statistical comparisons were used by repeated measures analysis of variance. Significance level was set at P < .05.
RESULTS: ILC was significantly longer in stroke survivors with a subcortical lesion than in those with a cortical lesion for both bolus consistencies. However, there were no significant differences between the 2 groups in LCD. Stroke survivors with a subcortical lesion had a greater incidence of penetration or aspiration and silent aspiration than those with a cortical lesion and a longer delay in the ILC.
CONCLUSIONS: Subcortical lesions may put these survivors at greater risk of aspiration due to delayed initial laryngeal closure and reduced oral and laryngeal sensation. The subcortical damage, which occurs at the basal ganglia, may interrupt the ILC.

PMID: 28456464 [PubMed - as supplied by publisher]

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Plummer-Vinson Syndrome with Simultaneous Mid-esophageal Growth.

Plummer-Vinson Syndrome with Simultaneous Mid-esophageal Growth.

J Assoc Physicians India. 2017 Feb;65(2):96-97

Authors: Nasa M, Patil G, Sharma Z, Puri R

Abstract
Patterson Brown Kelly or Plummer-Vinson syndrome is characterized by dysphagia, iron deficiency anemia and post-cricoidal esophageal web. Waldenstorm introduced the term 'sideropenic dysphagia' because of absence of stainable iron in the bone marrow. There is increased incidence of upper aero-digestive tract carcinoma in patients with Plummer-Vinson syndrome has been well established. The reported rates range from 4% to 16%, with almost all cases occurring at the postcricoid location.We have reported here a case of a 48-year-old woman with dysphagia , upper esophageal web and iron deficiency anemia . Dilatation of esophageal web with subsequent endoscopy showed mid- esophageal growth which on biopsy showed squamous cell carcinoma.

PMID: 28457047 [PubMed - in process]

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A Comparison of Visual Recognition of the Laryngopharyngeal Structures Between High and Standard Frame Rate Videos of the Fiberoptic Endoscopic Evaluation of Swallowing.

A Comparison of Visual Recognition of the Laryngopharyngeal Structures Between High and Standard Frame Rate Videos of the Fiberoptic Endoscopic Evaluation of Swallowing.

Dysphagia. 2017 Apr 29;:

Authors: Aghdam MA, Ogawa M, Iwahashi T, Hosokawa K, Kato C, Inohara H

Abstract
The purpose of this study was to assess whether or not high frame rate (HFR) videos recorded using high-speed digital imaging (HSDI) improve the visual recognition of the motions of the laryngopharyngeal structures during pharyngeal swallow in fiberoptic endoscopic evaluation of swallowing (FEES). Five healthy subjects were asked to swallow 0.5 ml water under fiberoptic nasolaryngoscopy. The endoscope was connected to a high-speed camera, which recorded the laryngopharyngeal view throughout the swallowing process at 4000 frames/s (fps). Each HFR video was then copied and downsampled into a standard frame rate (SFR) video version (30 fps). Fifteen otorhinolaryngologists observed all of the HFR/SFR videos in random order and rated the four-point ordinal scale reflecting the degree of visual recognition of the rapid laryngopharyngeal structure motions just before the 'white-out' phenomenon. Significantly higher scores, reflecting better visibility, were seen for the HFR videos compared with the SFR videos for the following laryngopharyngeal structures: the posterior pharyngeal wall (p = 0.001), left pharyngeal wall (p = 0.015), right lateral pharyngeal wall (p = 0.035), tongue base (p = 0.005), and epiglottis tilting (p = 0.005). However, when visualized with HFR and SFR, 'certainly clear observation' of the laryngeal structures was achieved in <50% of cases, because all the motions were not necessarily captured in each video. These results demonstrate the use of HSDI in FEES makes the motion perception of the laryngopharyngeal structures during pharyngeal swallow easier in comparison to SFR videos with equivalent image quality due to the ability of HSDI to depict the laryngopharyngeal motions in a continuous manner.

PMID: 28456859 [PubMed - as supplied by publisher]

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