1
|
Kaur A, Biswas G. Internal mammary artery perforator flap in the management of tracheoesophageal fistulae. J Laryngol Otol 2024; 138:652-655. [PMID: 38185828 DOI: 10.1017/s0022215123002360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2024]
Abstract
BACKGROUND A pathological communication between the trachea and oesophagus - a tracheoesophageal fistula - may be congenital or acquired, benign or malignant, necessitating a multidisciplinary approach. Conservative attempts at closure of this abnormal connection are ineffective; the interposition of healthy vascular tissue offers the least chance of recurrence. METHODS Outcomes of an islanded fasciocutaneous internal mammary artery perforator flap applied for tracheoesophageal fistula management were assessed in four radiated patients with laryngeal carcinoma using retrospective records. RESULTS Four male patients, with an average age of 60.75 years, underwent tracheoesophageal fistula closure between September 2017 and February 2021. A left-sided second internal mammary artery perforator flap was used in all cases, with an average dimension of 10.5 × 4.5 cm. There were no complications of tracheoesophageal leak, flap issues or donor site morbidity on follow up. CONCLUSION Recent advances in angiosomal territory mapping and microvascular dissection techniques, combined with an understanding of tracheoesophageal fistula pathology, have changed management perspectives in these difficult-to-treat patients.
Collapse
Affiliation(s)
- Amrita Kaur
- Department of Plastic Surgery, Tata Medical Centre, Kolkata, India
| | - Gautam Biswas
- Department of Plastic Surgery, Tata Medical Centre, Kolkata, India
| |
Collapse
|
2
|
Zhang S, Yuan Z, Xia Z, Chen H, Zhang Z, Chen M, Ye F. Clinical Features and Treatment of Congenital Pyriform Sinus Fistula: Analysis of 12 Cases. Ear Nose Throat J 2024; 103:319-323. [PMID: 35968827 DOI: 10.1177/01455613221117004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023] Open
Abstract
BACKGROUND Congenital pyriform sinus fistula (CPSF) is a rare congenital disease derived from the remnants of the third or fourth branchial cleft. OBJECTIVES To investigate the imaging characteristics, clinical manifestations, surgical methods, complications, and personalized treatment of CPSF. MATERIAL AND METHODS The clinical data of 12 CPSF patients admitted to the Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Wenzhou Medical University from March 2016 to May 2021 were retrospectively analyzed. Cryogenic plasma radiofrequency ablation, carbon dioxide laser resection, and external cervical excision were selected based on the individual condition, and postoperative complications and efficacy were evaluated. RESULTS There were 6 men and 6 women. Neck abscess or thyroiditis was considered at the initial diagnosis. In 11 of the cases, the CPSF was on the left side, whereas in the rest one case, it was on the right. A pyriform fossa fistula was observed during hypopharyngeal iodine angiography. Eight patients were treated with endoscopic piriform fossa fistula laser resection, two with cryogenic plasma radiofrequency ablation, and the rest with external cervical fistula resection. There was no evidence of postoperative hoarseness, pharyngeal fistula, dysphagia, and other complications. CONCLUSION AND SIGNIFICANCE CPSF is less common in adults than in children. For patients with recurrent neck abscesses, CPSF should be highly suspected, timely angiography should be performed as soon as possible, and care should be taken to avoid missed diagnoses. The primary method for piriform fossa fistula removal is surgical treatment. Finally, tailoring treatment regimens to the patient's condition can significantly improve curative efficacy.
Collapse
Affiliation(s)
- Shurou Zhang
- Department of Otorhinolaryngology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ziyi Yuan
- Department of Otorhinolaryngology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zhigang Xia
- Department of Otorhinolaryngology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Huanqi Chen
- Department of Otorhinolaryngology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ziheng Zhang
- Department of Otorhinolaryngology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Mengjiao Chen
- Department of Otorhinolaryngology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Fan Ye
- Department of Otorhinolaryngology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| |
Collapse
|
3
|
Chen X, Wang Z, Wang J, Zhu Z, Li C, Hu T. Alert for pharynx-centered gastrointestinal and respiratory cross-infection and cryptic cross-transmission routes of 2019-nCoV. J Infect Dev Ctries 2024; 18:501-503. [PMID: 38728635 DOI: 10.3855/jidc.18555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 08/14/2023] [Indexed: 05/12/2024] Open
Abstract
We proposed that the pharynx, as a common organ of the respiratory and digestive tracts, may be a respiratory and digestive tract cross cryptic transmission pathway for 2019-nCoV infection from the nasal cavities to the pharynx and lung, then to nasal cavities by aerosol (respiratory route) to the pharynx and the gastrointestinal tract, then to the oral cavity by feces (fecal-oral route) and to pharynx, lungs, or gastrointestinal tract.
Collapse
Affiliation(s)
- Xiehui Chen
- Department of Clinical Laboratory, Shenzhen Longhua District Central Hospital, Shenzhen, China
| | - Zhanke Wang
- Department of Clinical Laboratory, Shenzhen Longhua District Central Hospital, Shenzhen, China
| | - Jiaxuan Wang
- The University of Auckland Faculty of Science, Auckland, New Zealand
| | - Zhongzhen Zhu
- Department of Nosocomial Infection Management, Great Wall Hospital, Nanchang University, China
| | - Chunxin Li
- Ningbo Medical System Clinical Laboratories Co., LTD, Ningbo China
| | - Tian Hu
- MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| |
Collapse
|
4
|
Asano M, Imai S, Shimizu Y, Kizaki H, Ito Y, Tsuchiya M, Kuriyama R, Yoshida N, Shimada M, Sando T, Ishijima T, Hori S. Factor Analysis of Patients Who Find Tablets or Capsules Difficult to Swallow Due to Their Large Size: Using the Personal Health Record Infrastructure of Electronic Medication Notebooks. J Med Internet Res 2024; 26:e54645. [PMID: 38657229 PMCID: PMC11079767 DOI: 10.2196/54645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 12/22/2023] [Accepted: 03/19/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Understanding patient preference regarding taking tablet or capsule formulations plays a pivotal role in treatment efficacy and adherence. Therefore, these preferences should be taken into account when designing formulations and prescriptions. OBJECTIVE This study investigates the factors affecting patient preference in patients who have difficulties swallowing large tablets or capsules and aims to identify appropriate sizes for tablets and capsules. METHODS A robust data set was developed based on a questionnaire survey conducted from December 1, 2022, to December 7, 2022, using the harmo smartphone app operated by harmo Co, Ltd. The data set included patient input regarding their tablet and capsule preferences, personal health records (including dispensing history), and drug formulation information (available from package inserts). Based on the medication formulation information, 6 indices were set for each of the tablets or capsules that were considered difficult to swallow owing to their large size and concomitant tablets or capsules (used as controls). Receiver operating characteristic (ROC) analysis was used to evaluate the performance of each index. The index demonstrating the highest area under the curve of the ROC was selected as the best index to determine the tablet or capsule size that leads to swallowing difficulties. From the generated ROCs, the point with the highest discriminative performance that maximized the Youden index was identified, and the optimal threshold for each index was calculated. Multivariate logistic regression analysis was performed to identify the risk factors contributing to difficulty in swallowing oversized tablets or capsules. Additionally, decision tree analysis was performed to estimate the combined risk from several factors, using risk factors that were significant in the multivariate logistic regression analysis. RESULTS This study analyzed 147 large tablets or capsules and 624 control tablets or capsules. The "long diameter + short diameter + thickness" index (with a 21.5 mm threshold) was identified as the best indicator for causing swallowing difficulties in patients. The multivariate logistic regression analysis (including 132 patients with swallowing difficulties and 1283 patients without) results identified the following contributory risk factors: aged <50 years (odds ratio [OR] 1.59, 95% CI 1.03-2.44), female (OR 2.54, 95% CI 1.70-3.78), dysphagia (OR 3.54, 95% CI 2.22-5.65), and taking large tablets or capsules (OR 9.74, 95% CI 5.19-18.29). The decision tree analysis results suggested an elevated risk of swallowing difficulties for patients with taking large tablets or capsules. CONCLUSIONS This study identified the most appropriate index and threshold for indicating that a given tablet or capsule size will cause swallowing difficulties, as well as the contributory risk factors. Although some sampling biases (eg, only including smartphone users) may exist, our results can guide the design of patient-friendly formulations and prescriptions, promoting better medication adherence.
Collapse
Affiliation(s)
- Masaki Asano
- Division of Drug Informatics, Faculty of Pharmacy and Graduate School of Pharmaceutical Sciences, Keio University, Tokyo, Japan
| | - Shungo Imai
- Division of Drug Informatics, Faculty of Pharmacy and Graduate School of Pharmaceutical Sciences, Keio University, Tokyo, Japan
| | - Yuri Shimizu
- Division of Drug Informatics, Faculty of Pharmacy and Graduate School of Pharmaceutical Sciences, Keio University, Tokyo, Japan
| | - Hayato Kizaki
- Division of Drug Informatics, Faculty of Pharmacy and Graduate School of Pharmaceutical Sciences, Keio University, Tokyo, Japan
| | | | | | | | | | | | | | | | - Satoko Hori
- Division of Drug Informatics, Faculty of Pharmacy and Graduate School of Pharmaceutical Sciences, Keio University, Tokyo, Japan
| |
Collapse
|
5
|
Ishikawa K, Maeda T, Funayama E, Murao N, Miura T, Sasaki Y, Seo D, Mitamura S, Oide S, Yamamoto Y, Sasaki S. Fluoroscopy- and Endoscopy-Guided Transoral Sclerotherapy Using Foamed Polidocanol for Oropharyngolaryngeal Venous Malformations in a Hybrid Operation Room: A Case Series. J Clin Med 2024; 13:2369. [PMID: 38673643 PMCID: PMC11050875 DOI: 10.3390/jcm13082369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/16/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Treatment of oropharyngolaryngeal venous malformations (VMs) remains challenging. This study evaluated the effectiveness and safety of fluoroscopy- and endoscopy-guided transoral sclerotherapy for oropharyngolaryngeal VMs in a hybrid operation room (OR). Methods: Patients with oropharyngolaryngeal VMs who underwent transoral sclerotherapy in a hybrid OR were enrolled. Results: Fourteen patients (six females, eight males; median age of 26 years; range, 4-71 years) were analyzed. The symptoms observed were breathing difficulties (n = 3), snoring (n = 2), sleep apnea (n = 1), and swallowing difficulties (n = 1). Lesions were extensive in the face and neck (n = 9) and limited in the oropharyngolarynx (n = 5). A permanent tracheostomy was performed on two patients, while a temporary tracheostomy was performed on five patients. The treated regions were the soft palate (n = 8), pharynx (n = 7), base of the tongue (n = 4), and epiglottis (n = 1). The median number of sclerotherapy sessions was 2.5 (range, 1-9). The median follow-up duration was 81 months (range, 6-141). Treatment outcomes were graded as excellent (n = 2), good (n = 7), or fair (n = 5). The post-treatment complication was bleeding (n = 1), resulting in an urgent tracheostomy. Conclusions: Fluoroscopy- and endoscopy-guided transoral sclerotherapy in a hybrid OR can be effective and safe for oropharyngolaryngeal VMs.
Collapse
Affiliation(s)
- Kosuke Ishikawa
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (T.M.); (Y.S.); (D.S.); (S.M.); (S.O.)
- Center for Vascular Anomalies, Department of Plastic and Reconstructive Surgery, Tonan Hospital, Sapporo 060-0004, Japan
| | - Taku Maeda
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (T.M.); (Y.S.); (D.S.); (S.M.); (S.O.)
| | - Emi Funayama
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (T.M.); (Y.S.); (D.S.); (S.M.); (S.O.)
| | - Naoki Murao
- Center for Vascular Anomalies, Department of Plastic and Reconstructive Surgery, Tonan Hospital, Sapporo 060-0004, Japan
| | - Takahiro Miura
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (T.M.); (Y.S.); (D.S.); (S.M.); (S.O.)
| | - Yuki Sasaki
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (T.M.); (Y.S.); (D.S.); (S.M.); (S.O.)
- Center for Vascular Anomalies, Department of Plastic and Reconstructive Surgery, Tonan Hospital, Sapporo 060-0004, Japan
| | - Dongkyung Seo
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (T.M.); (Y.S.); (D.S.); (S.M.); (S.O.)
- Center for Vascular Anomalies, Department of Plastic and Reconstructive Surgery, Tonan Hospital, Sapporo 060-0004, Japan
| | - Shintaro Mitamura
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (T.M.); (Y.S.); (D.S.); (S.M.); (S.O.)
- Center for Vascular Anomalies, Department of Plastic and Reconstructive Surgery, Tonan Hospital, Sapporo 060-0004, Japan
| | - Shunichi Oide
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (T.M.); (Y.S.); (D.S.); (S.M.); (S.O.)
- Center for Vascular Anomalies, Department of Plastic and Reconstructive Surgery, Tonan Hospital, Sapporo 060-0004, Japan
| | - Yuhei Yamamoto
- Department of Plastic and Reconstructive Surgery, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan; (T.M.); (Y.S.); (D.S.); (S.M.); (S.O.)
| | - Satoru Sasaki
- Center for Vascular Anomalies, Department of Plastic and Reconstructive Surgery, Tonan Hospital, Sapporo 060-0004, Japan
| |
Collapse
|
6
|
Sang J, Dhakal S, Shrestha B, Nath DK, Kim Y, Ganguly A, Montell C, Lee Y. A single pair of pharyngeal neurons functions as a commander to reject high salt in Drosophila melanogaster. eLife 2024; 12:RP93464. [PMID: 38573740 PMCID: PMC10994663 DOI: 10.7554/elife.93464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024] Open
Abstract
Salt (NaCl), is an essential nutrient for survival, while excessive salt can be detrimental. In the fruit fly, Drosophila melanogaster, internal taste organs in the pharynx are critical gatekeepers impacting the decision to accept or reject a food. Currently, our understanding of the mechanism through which pharyngeal gustatory receptor neurons (GRNs) sense high salt are rudimentary. Here, we found that a member of the ionotropic receptor family, Ir60b, is expressed exclusively in a pair of GRNs activated by high salt. Using a two-way choice assay (DrosoX) to measure ingestion volume, we demonstrate that IR60b and two co-receptors IR25a and IR76b are required to prevent high salt consumption. Mutants lacking external taste organs but retaining the internal taste organs in the pharynx exhibit much higher salt avoidance than flies with all taste organs but missing the three IRs. Our findings highlight the vital role for IRs in a pharyngeal GRN to control ingestion of high salt.
Collapse
Affiliation(s)
- Jiun Sang
- Department of Bio and Fermentation Convergence Technology, Kookmin UniversitySeoulRepublic of Korea
| | - Subash Dhakal
- Department of Bio and Fermentation Convergence Technology, Kookmin UniversitySeoulRepublic of Korea
| | - Bhanu Shrestha
- Department of Bio and Fermentation Convergence Technology, Kookmin UniversitySeoulRepublic of Korea
| | - Dharmendra Kumar Nath
- Department of Bio and Fermentation Convergence Technology, Kookmin UniversitySeoulRepublic of Korea
| | - Yunjung Kim
- Department of Bio and Fermentation Convergence Technology, Kookmin UniversitySeoulRepublic of Korea
| | - Anindya Ganguly
- Neuroscience Research Institute and Department of Molecular, Cellular and Developmental Biology, University of California, Santa BarbaraSanta BarbaraUnited States
| | - Craig Montell
- Neuroscience Research Institute and Department of Molecular, Cellular and Developmental Biology, University of California, Santa BarbaraSanta BarbaraUnited States
| | - Youngseok Lee
- Department of Bio and Fermentation Convergence Technology, Kookmin UniversitySeoulRepublic of Korea
| |
Collapse
|
7
|
Ishihara R, Tani Y, Okubo Y, Asada Y, Ueda T, Kitagawa D, Ninomiya T, Tamashiro A, Yoshii S, Shichijo S, Kanesaka T, Yamamoto S, Takeuchi Y, Higashino K, Uedo N, Michida T. Endoscopic landmarks corresponding to anatomical landmarks for esophageal subsite classification. DEN Open 2024; 4:e273. [PMID: 37469667 PMCID: PMC10352593 DOI: 10.1002/deo2.273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/11/2023] [Accepted: 07/02/2023] [Indexed: 07/21/2023]
Abstract
Objectives Individual treatment strategies for esophageal cancer have been investigated based on the anatomical subsite classification. Accurate subsite classification based on these anatomical landmarks is thus important. We investigated the suitability of the existing endoscopic classification and explored alternative landmarks for esophageal subsite classification. Methods Patients who received endoscopic ultrasonography (and computed tomography scans for surveillance of esophageal cancer treatment or esophageal submucosal tumors were included. Distances between anatomical landmarks, including the inferior cricoid cartilage border, superior border of the sternum, and tracheal bifurcation, were measured using a combination of endoscopic ultrasonography, computed tomography, and other information. Results The mean (standard deviation) distances from the superior incisor dentition to the pharynx-esophagus, cervical-upper thoracic esophagus, and upper-middle thoracic esophagus boundaries were 16.9 (1.7), 21.7 (1.9), and 29.0 (1.9) cm, respectively. However, variances in the differences between the mean and individual distances were large (2.8, 3.4, and 3.7, respectively), mainly because of differences in body height. However, variances in the differences between individual distances and novel endoscopic landmarks, including the lower end of the pyriform sinus and lower end of compression of the left main bronchus, were lower (1.7, 1.2, and 0.6, respectively). Conclusions Existing indicators of esophageal subsite boundaries were not consistent with anatomical boundaries. Modification of the distance from the superior incisor dentition based on average distances from anatomical landmarks or the use of alternative endoscopic landmarks is recommended to provide more suitable anatomical boundaries.
Collapse
Affiliation(s)
- Ryu Ishihara
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
| | - Yasuhiro Tani
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
| | - Yuki Okubo
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
| | - Yuya Asada
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
| | - Tomoya Ueda
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
| | - Daiki Kitagawa
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
| | - Takehiro Ninomiya
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
| | - Atsuko Tamashiro
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
| | - Shunsuke Yoshii
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
| | - Satoki Shichijo
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
| | - Takashi Kanesaka
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
| | - Sachiko Yamamoto
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
| | - Yoji Takeuchi
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
- Department of Gastroenterology and HepatologyGunma University Graduate School of MedicineGunmaJapan
| | - Koji Higashino
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
| | - Noriya Uedo
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
| | - Tomoki Michida
- Department of Gastrointestinal OncologyOsaka International Cancer InstituteOsakaJapan
| |
Collapse
|
8
|
Chitose SI, Fukahori M, Kurita T, Hamakawa S, Sato K, Kuroiwa T, Ono T, Umeno H, Sato K. Relationship between Swallowing Pressure and Saliva Residue on Endoscopic Evaluation in Pharyngeal Dysphagia. Laryngoscope 2024. [PMID: 38390695 DOI: 10.1002/lary.31358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/24/2024]
Abstract
OBJECTIVE In pharyngeal dysphagia, poor pharyngeal contraction and upper esophageal sphincter (UES) dysfunction result in post-swallow saliva residue (SR). This study aimed to clarify the relationship between swallowing pressure and SR in the valleculae and piriform sinuses on flexible endoscopic evaluation of swallowing (FEES). METHODS Pharyngeal dysphagia patients with Wallenberg syndrome were included. Amounts of post-swallow SR in the valleculae and piriform sinuses were classified into four grades using SR scores based on FEES. The Hyodo score was also calculated to evaluate swallowing function. High-resolution manometric data in the nasopharyngeal, oropharyngeal, hypopharyngeal, oro-hypopharyngeal, and UES zones on swallowing were obtained for comparison with SR and Hyodo scores. RESULTS Of the 31 recruited, data from 26 patients who successfully underwent FEES and manometry were analyzed. Vallecular SR scores were strongly negatively correlated with a maximum pressure of the oropharynx (r = -0.52, p = 0.006), distal contractile integrals (DCI) of the oropharynx (r = -0.52, p = 0.007), and DCI of the oro-hypopharynx (r = -0.55, p = 0.004). Hyodo scores for parameters 1 and 4 (corresponding to salivary pooling and pharyngeal clearance, respectively) were strongly negatively correlated with a maximum hypopharyngeal pressure (r = -0.57, p = 0.002) and strongly positively correlated with peristaltic velocity (r = 0.53, p = 0.007), respectively. SR scores and Hyodo scores related to SR were not correlated with pressure data of the UES. CONCLUSION Manometric analysis of our SR scoring method using FEES revealed that a higher amount of SR in the valleculae, but not in the piriform sinuses, is associated with weaker pharyngeal pressure in pharyngeal dysphagia, especially at the oropharyngeal level. LEVEL OF EVIDENCE 4 Laryngoscope, 2024.
Collapse
Affiliation(s)
- Shun-Ichi Chitose
- Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Mioko Fukahori
- Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Takashi Kurita
- Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Sachiyo Hamakawa
- Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kiminobu Sato
- Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Taikai Kuroiwa
- Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Takeharu Ono
- Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Hirohito Umeno
- Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Kiminori Sato
- Department of Otolaryngology-Head and Neck Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| |
Collapse
|
9
|
Sherman D, Harel D. Deciphering the underlying mechanisms of the pharyngeal pumping motions in Caenorhabditis elegans. Proc Natl Acad Sci U S A 2024; 121:e2302660121. [PMID: 38315866 PMCID: PMC10873627 DOI: 10.1073/pnas.2302660121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 12/29/2023] [Indexed: 02/07/2024] Open
Abstract
The pharynx of the nematode Caenorhabditis elegans is a neuromuscular organ that exhibits typical pumping motions, which result in the intake of food particles from the environment. In-depth inspection reveals slightly different dynamics at the various pharyngeal areas, rather than synchronous pumping motions of the whole organ, which are important for its effective functioning. While the different pumping dynamics are well characterized, the underlying mechanisms that generate them are not known. In this study, the C. elegans pharynx was modeled in a bottom-up fashion, including all of the underlying biological processes that lead to, and including, its end function, food intake. The mathematical modeling of all processes allowed performing comprehensive, quantitative analyses of the system as a whole. Our analyses provided detailed explanations for the various pumping dynamics generated at the different pharyngeal areas; a fine-resolution description of muscle dynamics, both between and within different pharyngeal areas; a quantitative assessment of the values of many parameters of the system that are unavailable in the literature; and support for a functional role of the marginal cells, which are currently assumed to mainly have a structural role in the pharynx. In addition, our model predicted that in tiny organisms such as C. elegans, the generation of long-lasting action potentials must involve ions other than calcium. Our study exemplifies the power of mathematical models, which allow a more accurate, higher-resolution inspection of the studied system, and an easier and faster execution of in silico experiments than feasible in the lab.
Collapse
Affiliation(s)
- Dana Sherman
- Department of Computer Science and Applied Mathematics, Faculty of Mathematics and Computer Science, The Weizmann Institute of Science, Rehovot76100, Israel
| | - David Harel
- Department of Computer Science and Applied Mathematics, Faculty of Mathematics and Computer Science, The Weizmann Institute of Science, Rehovot76100, Israel
| |
Collapse
|
10
|
Matsubara S, Iguchi R, Ogasawara M, Nakamura H, Kataoka TR, Shiraishi A, Osugi T, Kawada T, Satake H. A Novel Hemocyte-Derived Peptide and Its Possible Roles in Immune Response of Ciona intestinalis Type A. Int J Mol Sci 2024; 25:1979. [PMID: 38396656 PMCID: PMC10888236 DOI: 10.3390/ijms25041979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/24/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024] Open
Abstract
A wide variety of bioactive peptides have been identified in the central nervous system and several peripheral tissues in the ascidian Ciona intestinalis type A (Ciona robusta). However, hemocyte endocrine peptides have yet to be explored. Here, we report a novel 14-amino-acid peptide, CiEMa, that is predominant in the granular hemocytes and unilocular refractile granulocytes of Ciona. RNA-seq and qRT-PCR revealed the high CiEma expression in the adult pharynx and stomach. Immunohistochemistry further revealed the highly concentrated CiEMa in the hemolymph of the pharynx and epithelial cells of the stomach, suggesting biological roles in the immune response. Notably, bacterial lipopolysaccharide stimulation of isolated hemocytes for 1-4 h resulted in 1.9- to 2.4-fold increased CiEMa secretion. Furthermore, CiEMa-stimulated pharynx exhibited mRNA upregulation of the growth factor (Fgf3/7/10/22), vanadium binding proteins (CiVanabin1 and CiVanabin3), and forkhead and homeobox transcription factors (Foxl2, Hox3, and Dbx) but not antimicrobial peptides (CrPap-a and CrMam-a) or immune-related genes (Tgfbtun3, Tnfa, and Il17-2). Collectively, these results suggest that CiEMa plays roles in signal transduction involving tissue development or repair in the immune response, rather than in the direct regulation of immune response genes. The present study identified a novel Ciona hemocyte peptide, CiEMa, which paves the way for research on the biological roles of hemocyte peptides in chordates.
Collapse
Affiliation(s)
- Shin Matsubara
- Bioorganic Research Institute, Suntory Foundation for Life Sciences, 8-1-1 Seikadai, Seika-cho, Soraku-gun 619-0284, Kyoto, Japan (H.S.)
| | - Rin Iguchi
- Department of Biology, Graduate School of Science, Chiba University, 1-33 Yayoi-cho, Inage-ku 263-8522, Chiba, Japan
| | - Michio Ogasawara
- Department of Biology, Graduate School of Science, Chiba University, 1-33 Yayoi-cho, Inage-ku 263-8522, Chiba, Japan
| | - Hiroya Nakamura
- Department of Pathology, Iwate Medical University, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun 028-3695, Iwate, Japan (T.R.K.)
| | - Tatsuki R. Kataoka
- Department of Pathology, Iwate Medical University, 2-1-1 Idaidori, Yahaba-cho, Shiwa-gun 028-3695, Iwate, Japan (T.R.K.)
| | - Akira Shiraishi
- Bioorganic Research Institute, Suntory Foundation for Life Sciences, 8-1-1 Seikadai, Seika-cho, Soraku-gun 619-0284, Kyoto, Japan (H.S.)
| | - Tomohiro Osugi
- Bioorganic Research Institute, Suntory Foundation for Life Sciences, 8-1-1 Seikadai, Seika-cho, Soraku-gun 619-0284, Kyoto, Japan (H.S.)
| | - Tsuyoshi Kawada
- Bioorganic Research Institute, Suntory Foundation for Life Sciences, 8-1-1 Seikadai, Seika-cho, Soraku-gun 619-0284, Kyoto, Japan (H.S.)
| | - Honoo Satake
- Bioorganic Research Institute, Suntory Foundation for Life Sciences, 8-1-1 Seikadai, Seika-cho, Soraku-gun 619-0284, Kyoto, Japan (H.S.)
| |
Collapse
|
11
|
Rodríguez-Alcalá L, Valderrama-Penagos JX, O'Connor-Garcia St E, O'Connor-Reina C. Lost needle in the oral cavity: can the nightmare be just a bad dream? J Laryngol Otol 2024:1-4. [PMID: 38314758 DOI: 10.1017/s0022215124000264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
OBJECTIVE The loss of a scalpel or a needle during surgery can threaten the health of the patient and lead to additional costs, and radiographical assistance during surgery has been the only recovery method. This study evaluates the efficacy of a metal detector compared with conventional radiology for recovering a needle lost in the oropharynx during surgery. METHOD Different fragment sizes of needles normally used in pharyngoplasty were embedded at different locations and depths in a lamb's head. Three experienced and three junior otolaryngologists searched for the needle fragments using a metal detector and conventional radiology. RESULTS All fragments were found with each method, but the mean searching time was 90 per cent shorter with the metal detector. CONCLUSION A metal detector can be a useful tool for locating needles that break during ENT surgery, as it requires less time than conventional radiology and avoids exposing patients to radiation.
Collapse
Affiliation(s)
- Laura Rodríguez-Alcalá
- Department of Otorhinolaryngology, Hospital Quiron Salud Marbella and Hospital Quiron Salud Campo de Gibraltar, Spain
| | | | | | - Carlos O'Connor-Reina
- Department of Otorhinolaryngology, Hospital Quiron Salud Marbella and Hospital Quiron Salud Campo de Gibraltar, Spain
| |
Collapse
|
12
|
Dobashi A, Hara Y, Furuhashi H, Matsui H, Tada N, Ito M, Futakuchi T, Kobayashi M, Ono S, Aizawa D, Yamauchi T, Suka M, Sumiyama K. Diagnostic Performance of a Novel Ultra-Thin Endoscopy under Narrow-Band Imaging for Superficial Squamous Cell Carcinoma of the Pharynx and Esophagus. Cancers (Basel) 2024; 16:529. [PMID: 38339279 PMCID: PMC10854735 DOI: 10.3390/cancers16030529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/24/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
This study aimed to evaluate the diagnostic utility of the ultra-thin endoscope (UTE) for superficial squamous cell carcinoma (SSCC) compared to magnifying endoscopy (ME) under narrow-band imaging. Participants underwent endoscopic examination, and images of pharyngeal and esophageal SCCs, as along with suspicious SSCC lesions, were collected using UTE and ME on the same day. Three image catalogs (UTE, ME-1, and ME-2) were created and reviewed by three expert endoscopists. ME-1 and ME-2 contained the same endoscopic images. The primary endpoint was the intra-observer agreement for diagnosing SCC. Eighty-six lesions (SCC = thirty-nine, non-SCC = forty-seven) in 43 participants were identified. The kappa values for the intra-observer agreement between UTE and ME-1 vs. the control (ME-1 vs. ME-2) were 0.74 vs. 0.84, 0.63 vs. 0.76, and 0.79 vs. 0.88, respectively. The accuracies for diagnosing SCC by UTE and ME-1 were 87.2% vs. 86.0%, 78.0% vs. 73,2%, and 75.6 vs. 82.6%, respectively, with no significant differences (p > 0.05). The rates of lesions that were diagnosed with confidence by UTE and ME-1 were 30.2% vs. 27.9%, 55.8% vs. 62.8%, and 58.1% vs. 55.8%, respectively. UTE demonstrates substantial diagnostic performance for SSCC in the pharynx and esophagus.
Collapse
Affiliation(s)
- Akira Dobashi
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan (T.F.); (K.S.)
| | - Yuko Hara
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan (T.F.); (K.S.)
| | - Hiroto Furuhashi
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan (T.F.); (K.S.)
| | - Hiroaki Matsui
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan (T.F.); (K.S.)
| | - Naoya Tada
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan (T.F.); (K.S.)
| | - Mamoru Ito
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan (T.F.); (K.S.)
| | - Toshiki Futakuchi
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan (T.F.); (K.S.)
| | - Masakuni Kobayashi
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan (T.F.); (K.S.)
| | - Shingo Ono
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan (T.F.); (K.S.)
| | - Daisuke Aizawa
- Department of Pathology, The Jikei University School of Medicine, Tokyo 105-8461, Japan
| | - Takashi Yamauchi
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan; (T.Y.); (M.S.)
| | - Machi Suka
- Department of Public Health and Environmental Medicine, The Jikei University School of Medicine, Tokyo 105-8461, Japan; (T.Y.); (M.S.)
| | - Kazuki Sumiyama
- Department of Endoscopy, The Jikei University School of Medicine, Tokyo 105-8461, Japan (T.F.); (K.S.)
| |
Collapse
|
13
|
Altun D, Özkan-Seyhan T, Canbaz M, Aydemir L, Altun D, Gökduman HC, Çamcı E. The effect of pharyngeal packing on gastric volume in patients undergoing nasal surgery: a randomised, controlled trial. J Laryngol Otol 2024; 138:67-74. [PMID: 37288512 PMCID: PMC10772017 DOI: 10.1017/s0022215123001032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 04/03/2023] [Accepted: 05/31/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To explore the effects of pharyngeal packing on antral cross-sectional area, gastric volume and post-operative complications. METHODS In this prospective, randomised, controlled study, 180 patients were randomly assigned to a control group or a pharyngeal packing group. Gastric antral dimensions were measured with pre- and post-operative ultrasound scanning. Presence and severity of post-operative nausea and vomiting and sore throat were recorded. RESULTS Post-operative antral cross-sectional area and gastric volume were significantly larger in the pharyngeal packing group compared to the control group. The incidence and severity of post-operative nausea and vomiting were significantly less in the pharyngeal packing group. More frequent and severe sore throat was observed in the control group within the ward. An increased Apfel simplified risk score and post-operative antral cross-sectional area were associated with post-operative nausea and vomiting during the first 2 hours, whereas septorhinoplasty and functional endoscopic sinus surgery, absent pharyngeal packing, and lower American Society of Anesthesiologists' physical status were associated with post-operative nausea and vomiting within the ward. CONCLUSION Regardless of operation type, pharyngeal packing use resulted in smaller gastric volume, which was associated with reduced post-operative nausea and vomiting frequency and severity, and lower sore throat incidence.
Collapse
Affiliation(s)
- Demet Altun
- Department of Anesthesiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Tülay Özkan-Seyhan
- Department of Anesthesiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mert Canbaz
- Department of Anesthesiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Levent Aydemir
- Department of Otolaryngology and Head and Neck Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Dilek Altun
- Department of Anesthesiology and Reanimation, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Hürü Ceren Gökduman
- Department of Anesthesiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Emre Çamcı
- Department of Anesthesiology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| |
Collapse
|
14
|
Sampieri C, Baldini C, Azam MA, Moccia S, Mattos LS, Vilaseca I, Peretti G, Ioppi A. Artificial Intelligence for Upper Aerodigestive Tract Endoscopy and Laryngoscopy: A Guide for Physicians and State-of-the-Art Review. Otolaryngol Head Neck Surg 2023; 169:811-829. [PMID: 37051892 DOI: 10.1002/ohn.343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/03/2023] [Accepted: 03/23/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVE The endoscopic and laryngoscopic examination is paramount for laryngeal, oropharyngeal, nasopharyngeal, nasal, and oral cavity benign lesions and cancer evaluation. Nevertheless, upper aerodigestive tract (UADT) endoscopy is intrinsically operator-dependent and lacks objective quality standards. At present, there has been an increased interest in artificial intelligence (AI) applications in this area to support physicians during the examination, thus enhancing diagnostic performances. The relative novelty of this research field poses a challenge both for the reviewers and readers as clinicians often lack a specific technical background. DATA SOURCES Four bibliographic databases were searched: PubMed, EMBASE, Cochrane, and Google Scholar. REVIEW METHODS A structured review of the current literature (up to September 2022) was performed. Search terms related to topics of AI, machine learning (ML), and deep learning (DL) in UADT endoscopy and laryngoscopy were identified and queried by 3 independent reviewers. Citations of selected studies were also evaluated to ensure comprehensiveness. CONCLUSIONS Forty-one studies were included in the review. AI and computer vision techniques were used to achieve 3 fundamental tasks in this field: classification, detection, and segmentation. All papers were summarized and reviewed. IMPLICATIONS FOR PRACTICE This article comprehensively reviews the latest developments in the application of ML and DL in UADT endoscopy and laryngoscopy, as well as their future clinical implications. The technical basis of AI is also explained, providing guidance for nonexpert readers to allow critical appraisal of the evaluation metrics and the most relevant quality requirements.
Collapse
Affiliation(s)
- Claudio Sampieri
- Department of Experimental Medicine (DIMES), University of Genoa, Genoa, Italy
- Functional Unit of Head and Neck Tumors, Hospital Clínic, Barcelona, Spain
- Otorhinolaryngology Department, Hospital Clínic, Barcelona, Spain
| | - Chiara Baldini
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genoa, Italy
- Dipartimento di Informatica, Bioingegneria, Robotica e Ingegneria dei Sistemi (DIBRIS), University of Genoa, Genoa, Italy
| | - Muhammad Adeel Azam
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genoa, Italy
- Dipartimento di Informatica, Bioingegneria, Robotica e Ingegneria dei Sistemi (DIBRIS), University of Genoa, Genoa, Italy
| | - Sara Moccia
- Department of Excellence in Robotics and AI, The BioRobotics Institute, Pisa, Italy
| | - Leonardo S Mattos
- Department of Advanced Robotics, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Isabel Vilaseca
- Functional Unit of Head and Neck Tumors, Hospital Clínic, Barcelona, Spain
- Otorhinolaryngology Department, Hospital Clínic, Barcelona, Spain
- Head Neck Clínic, Agència de Gestió d'Ajuts Universitaris i de Recerca, Barcelona, Catalunya, Spain
- Surgery and Medical-Surgical Specialties Department, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
- Translational Genomics and Target Therapies in Solid Tumors Group, Faculty of Medicine, Institut d́Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- University of Barcelona, Barcelona, Spain
| | - Giorgio Peretti
- Unit of Otorhinolaryngology-Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| | - Alessandro Ioppi
- Unit of Otorhinolaryngology-Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy
| |
Collapse
|
15
|
Horackova A, Pospisilova A, Stundl J, Minarik M, Jandzik D, Cerny R. Pre-mandibular pharyngeal pouches in early non-teleost fish embryos. Proc Biol Sci 2023; 290:20231158. [PMID: 37700650 PMCID: PMC10498051 DOI: 10.1098/rspb.2023.1158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/14/2023] [Indexed: 09/14/2023] Open
Abstract
The vertebrate pharynx is a key embryonic structure with crucial importance for the metameric organization of the head and face. The pharynx is primarily built upon progressive formation of paired pharyngeal pouches that typically develop in post-oral (mandibular, hyoid and branchial) domains. However, in the early embryos of non-teleost fishes, we have previously identified pharyngeal pouch-like outpocketings also in the pre-oral domain of the cranial endoderm. This pre-oral gut (POG) forms by early pouching of the primitive gut cavity, followed by the sequential formation of typical (post-oral) pharyngeal pouches. Here, we tested the pharyngeal nature of the POG by analysing expression patterns of selected core pharyngeal regulatory network genes in bichir and sturgeon embryos. Our comparison revealed generally shared expression patterns, including Shh, Pax9, Tbx1, Eya1, Six1, Ripply3 or Fgf8, between early POG and post-oral pharyngeal pouches. POG thus shares pharyngeal pouch-like morphogenesis and a gene expression profile with pharyngeal pouches and can be regarded as a pre-mandibular pharyngeal pouch. We further suggest that pre-mandibular pharyngeal pouches represent a plesiomorphic vertebrate trait inherited from our ancestor's pharyngeal metameric organization, which is incorporated in the early formation of the pre-chordal plate of vertebrate embryos.
Collapse
Affiliation(s)
- Agata Horackova
- Department of Zoology, Faculty of Science, Charles University in Prague, 12844 Prague, Czech Republic
| | - Anna Pospisilova
- Department of Zoology, Faculty of Science, Charles University in Prague, 12844 Prague, Czech Republic
| | - Jan Stundl
- Department of Zoology, Faculty of Science, Charles University in Prague, 12844 Prague, Czech Republic
| | - Martin Minarik
- Department of Zoology, Faculty of Science, Charles University in Prague, 12844 Prague, Czech Republic
| | - David Jandzik
- Department of Zoology, Faculty of Science, Charles University in Prague, 12844 Prague, Czech Republic
- Department of Zoology, Comenius University in Bratislava, Bratislava, Slovakia
| | - Robert Cerny
- Department of Zoology, Faculty of Science, Charles University in Prague, 12844 Prague, Czech Republic
| |
Collapse
|
16
|
Kaiser RM, Cash-Goldwasser S, Lehnertz N, Griffith J, Ruprecht A, Stanton J, Feldpausch A, Pavlick J, Bruen CA, Perez-Molinar D, Peglow SR, Akinsete OO, Morris SB, Raizes E, Gregory C, Lynfield R. Pharyngeal Co-Infections with Monkeypox Virus and Group A Streptococcus, United States, 2022. Emerg Infect Dis 2023; 29:1855-1858. [PMID: 37437558 PMCID: PMC10461671 DOI: 10.3201/eid2909.230469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2023] Open
Abstract
We report 2 cases of pharyngeal monkeypox virus and group A Streptococcus co-infection in the United States. No rash was observed when pharyngitis symptoms began. One patient required intubation before mpox was diagnosed. Healthcare providers should be aware of oropharyngeal mpox manifestations and possible co-infections; early treatment might prevent serious complications.
Collapse
Affiliation(s)
| | | | - Nicholas Lehnertz
- HealthPartners Regions Hospital, Saint Paul, Minnesota, USA (R.M. Kaiser, C.A. Bruen, D. Perez-Molinar, S.R. Peglow, O.O. Akinsete)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Cash-Goldwasser, S. Bamrah Morris, E. Raizes, C. Gregory)
- Minnesota Department of Health, Saint Paul (N. Lehnertz, J. Griffith, A. Ruprecht, R. Lynfield)
- Positive Impact Health Centers, Decatur, Georgia, USA (J. Stanton)
- Emory University, Atlanta (J. Stanton)
- Georgia Department of Public Health, Atlanta (A. Feldpausch, J. Pavlick)
| | - Jayne Griffith
- HealthPartners Regions Hospital, Saint Paul, Minnesota, USA (R.M. Kaiser, C.A. Bruen, D. Perez-Molinar, S.R. Peglow, O.O. Akinsete)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Cash-Goldwasser, S. Bamrah Morris, E. Raizes, C. Gregory)
- Minnesota Department of Health, Saint Paul (N. Lehnertz, J. Griffith, A. Ruprecht, R. Lynfield)
- Positive Impact Health Centers, Decatur, Georgia, USA (J. Stanton)
- Emory University, Atlanta (J. Stanton)
- Georgia Department of Public Health, Atlanta (A. Feldpausch, J. Pavlick)
| | - Alison Ruprecht
- HealthPartners Regions Hospital, Saint Paul, Minnesota, USA (R.M. Kaiser, C.A. Bruen, D. Perez-Molinar, S.R. Peglow, O.O. Akinsete)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Cash-Goldwasser, S. Bamrah Morris, E. Raizes, C. Gregory)
- Minnesota Department of Health, Saint Paul (N. Lehnertz, J. Griffith, A. Ruprecht, R. Lynfield)
- Positive Impact Health Centers, Decatur, Georgia, USA (J. Stanton)
- Emory University, Atlanta (J. Stanton)
- Georgia Department of Public Health, Atlanta (A. Feldpausch, J. Pavlick)
| | - John Stanton
- HealthPartners Regions Hospital, Saint Paul, Minnesota, USA (R.M. Kaiser, C.A. Bruen, D. Perez-Molinar, S.R. Peglow, O.O. Akinsete)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Cash-Goldwasser, S. Bamrah Morris, E. Raizes, C. Gregory)
- Minnesota Department of Health, Saint Paul (N. Lehnertz, J. Griffith, A. Ruprecht, R. Lynfield)
- Positive Impact Health Centers, Decatur, Georgia, USA (J. Stanton)
- Emory University, Atlanta (J. Stanton)
- Georgia Department of Public Health, Atlanta (A. Feldpausch, J. Pavlick)
| | - Amanda Feldpausch
- HealthPartners Regions Hospital, Saint Paul, Minnesota, USA (R.M. Kaiser, C.A. Bruen, D. Perez-Molinar, S.R. Peglow, O.O. Akinsete)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Cash-Goldwasser, S. Bamrah Morris, E. Raizes, C. Gregory)
- Minnesota Department of Health, Saint Paul (N. Lehnertz, J. Griffith, A. Ruprecht, R. Lynfield)
- Positive Impact Health Centers, Decatur, Georgia, USA (J. Stanton)
- Emory University, Atlanta (J. Stanton)
- Georgia Department of Public Health, Atlanta (A. Feldpausch, J. Pavlick)
| | - Jessica Pavlick
- HealthPartners Regions Hospital, Saint Paul, Minnesota, USA (R.M. Kaiser, C.A. Bruen, D. Perez-Molinar, S.R. Peglow, O.O. Akinsete)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Cash-Goldwasser, S. Bamrah Morris, E. Raizes, C. Gregory)
- Minnesota Department of Health, Saint Paul (N. Lehnertz, J. Griffith, A. Ruprecht, R. Lynfield)
- Positive Impact Health Centers, Decatur, Georgia, USA (J. Stanton)
- Emory University, Atlanta (J. Stanton)
- Georgia Department of Public Health, Atlanta (A. Feldpausch, J. Pavlick)
| | - Charles A. Bruen
- HealthPartners Regions Hospital, Saint Paul, Minnesota, USA (R.M. Kaiser, C.A. Bruen, D. Perez-Molinar, S.R. Peglow, O.O. Akinsete)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Cash-Goldwasser, S. Bamrah Morris, E. Raizes, C. Gregory)
- Minnesota Department of Health, Saint Paul (N. Lehnertz, J. Griffith, A. Ruprecht, R. Lynfield)
- Positive Impact Health Centers, Decatur, Georgia, USA (J. Stanton)
- Emory University, Atlanta (J. Stanton)
- Georgia Department of Public Health, Atlanta (A. Feldpausch, J. Pavlick)
| | - David Perez-Molinar
- HealthPartners Regions Hospital, Saint Paul, Minnesota, USA (R.M. Kaiser, C.A. Bruen, D. Perez-Molinar, S.R. Peglow, O.O. Akinsete)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Cash-Goldwasser, S. Bamrah Morris, E. Raizes, C. Gregory)
- Minnesota Department of Health, Saint Paul (N. Lehnertz, J. Griffith, A. Ruprecht, R. Lynfield)
- Positive Impact Health Centers, Decatur, Georgia, USA (J. Stanton)
- Emory University, Atlanta (J. Stanton)
- Georgia Department of Public Health, Atlanta (A. Feldpausch, J. Pavlick)
| | - S. Rebecca Peglow
- HealthPartners Regions Hospital, Saint Paul, Minnesota, USA (R.M. Kaiser, C.A. Bruen, D. Perez-Molinar, S.R. Peglow, O.O. Akinsete)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Cash-Goldwasser, S. Bamrah Morris, E. Raizes, C. Gregory)
- Minnesota Department of Health, Saint Paul (N. Lehnertz, J. Griffith, A. Ruprecht, R. Lynfield)
- Positive Impact Health Centers, Decatur, Georgia, USA (J. Stanton)
- Emory University, Atlanta (J. Stanton)
- Georgia Department of Public Health, Atlanta (A. Feldpausch, J. Pavlick)
| | - Omobosola O. Akinsete
- HealthPartners Regions Hospital, Saint Paul, Minnesota, USA (R.M. Kaiser, C.A. Bruen, D. Perez-Molinar, S.R. Peglow, O.O. Akinsete)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Cash-Goldwasser, S. Bamrah Morris, E. Raizes, C. Gregory)
- Minnesota Department of Health, Saint Paul (N. Lehnertz, J. Griffith, A. Ruprecht, R. Lynfield)
- Positive Impact Health Centers, Decatur, Georgia, USA (J. Stanton)
- Emory University, Atlanta (J. Stanton)
- Georgia Department of Public Health, Atlanta (A. Feldpausch, J. Pavlick)
| | - Sapna Bamrah Morris
- HealthPartners Regions Hospital, Saint Paul, Minnesota, USA (R.M. Kaiser, C.A. Bruen, D. Perez-Molinar, S.R. Peglow, O.O. Akinsete)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Cash-Goldwasser, S. Bamrah Morris, E. Raizes, C. Gregory)
- Minnesota Department of Health, Saint Paul (N. Lehnertz, J. Griffith, A. Ruprecht, R. Lynfield)
- Positive Impact Health Centers, Decatur, Georgia, USA (J. Stanton)
- Emory University, Atlanta (J. Stanton)
- Georgia Department of Public Health, Atlanta (A. Feldpausch, J. Pavlick)
| | - Elliot Raizes
- HealthPartners Regions Hospital, Saint Paul, Minnesota, USA (R.M. Kaiser, C.A. Bruen, D. Perez-Molinar, S.R. Peglow, O.O. Akinsete)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Cash-Goldwasser, S. Bamrah Morris, E. Raizes, C. Gregory)
- Minnesota Department of Health, Saint Paul (N. Lehnertz, J. Griffith, A. Ruprecht, R. Lynfield)
- Positive Impact Health Centers, Decatur, Georgia, USA (J. Stanton)
- Emory University, Atlanta (J. Stanton)
- Georgia Department of Public Health, Atlanta (A. Feldpausch, J. Pavlick)
| | - Christopher Gregory
- HealthPartners Regions Hospital, Saint Paul, Minnesota, USA (R.M. Kaiser, C.A. Bruen, D. Perez-Molinar, S.R. Peglow, O.O. Akinsete)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Cash-Goldwasser, S. Bamrah Morris, E. Raizes, C. Gregory)
- Minnesota Department of Health, Saint Paul (N. Lehnertz, J. Griffith, A. Ruprecht, R. Lynfield)
- Positive Impact Health Centers, Decatur, Georgia, USA (J. Stanton)
- Emory University, Atlanta (J. Stanton)
- Georgia Department of Public Health, Atlanta (A. Feldpausch, J. Pavlick)
| | - Ruth Lynfield
- HealthPartners Regions Hospital, Saint Paul, Minnesota, USA (R.M. Kaiser, C.A. Bruen, D. Perez-Molinar, S.R. Peglow, O.O. Akinsete)
- Centers for Disease Control and Prevention, Atlanta, Georgia, USA (S. Cash-Goldwasser, S. Bamrah Morris, E. Raizes, C. Gregory)
- Minnesota Department of Health, Saint Paul (N. Lehnertz, J. Griffith, A. Ruprecht, R. Lynfield)
- Positive Impact Health Centers, Decatur, Georgia, USA (J. Stanton)
- Emory University, Atlanta (J. Stanton)
- Georgia Department of Public Health, Atlanta (A. Feldpausch, J. Pavlick)
| |
Collapse
|
17
|
Manta MD, Rusu MC, Hostiuc S, Vrapciu AD, Manta BA, Jianu AM. The Carotid-Hyoid Topography Is Variable. Medicina (Kaunas) 2023; 59:1494. [PMID: 37629784 PMCID: PMC10456548 DOI: 10.3390/medicina59081494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/14/2023] [Accepted: 08/17/2023] [Indexed: 08/27/2023]
Abstract
Background and Objectives: The carotid bifurcation (CB) is presented in most anatomy textbooks as having a unique location at the upper margin of the thyroid cartilage. Although a number of case reports have provided evidence of the possibility of carotid artery location either lateral or medial to the greater hyoid horn, these reports have not established specific anatomic possibilities and prevalences. Materials and Methods: We retrospectively analysed a batch of 147 CT angiograms for 12 types of carotid-hyoid relationships and classified the bilateral combination possibilities of these types. Results: In 168/294 sides there were no carotid-hyoid relationships. Type I, external carotid artery (ECA) medial to the greater horn of the hyoid bone (GHHB), was observed in 0.34%; type II, internal carotid artery (ICA) medial to GHHB, in 0.34%; type III, ICA and ECA medial to GHHB, in 1.02%; type IV, common carotid artery (CCA) medial to GHHB, in 1.02%; type V, CB medial to GHHB, in 0.34%; type VI, ECA lateral to GHHB, in 20.41%; type VII, ICA lateral to GHHB, was not recorded; type VIII, ECA and ICA lateral to GHHB, in 3.74%; type IX, CCA lateral to GHHB, in 8.5%; type X, CB lateral to GHHB, in 6.46%; type XI, ECA lateral and ICA medial to GHHB, in 0.34%; and type XII, ICA lateral and ECA medial to GHHB, in 0.34%. Bilateral symmetry was found in 70.74% of cases, including the null types without carotid-hyoid relationships as well as types IV, VI, VIII, IX, and X. There was a highly significant association between the left and right variants of the carotid-hyoid relationship. Conclusions: Mechanical compression of the hyoid bone on the carotid arteries has various undesirable effects on the ICA and cerebral circulation. Underlying these are several variational anatomical patterns of carotid-hyoid relationships, which can be accurately documented on CT angiograms. A case-by-case anatomical study is better than assuming the carotid anatomy learned from textbooks.
Collapse
Affiliation(s)
- Mihaela Daniela Manta
- Department of Anatomy and Embriology, Faculty of Medicine, Victor Babeș University of Medicine and Pharmacy, 300041 Timișoara, Romania; (M.D.M.); (A.M.J.)
| | - Mugurel Constantin Rusu
- Division of Anatomy, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Sorin Hostiuc
- Division of Legal Medicine and Bioethics, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Alexandra Diana Vrapciu
- Division of Anatomy, Faculty of Dentistry, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Bogdan Adrian Manta
- Division of Clinical Practical Skills, Faculty of Medicine, Victor Babeș University of Medicine and Pharmacy, 300041 Timișoara, Romania;
| | - Adelina Maria Jianu
- Department of Anatomy and Embriology, Faculty of Medicine, Victor Babeș University of Medicine and Pharmacy, 300041 Timișoara, Romania; (M.D.M.); (A.M.J.)
| |
Collapse
|
18
|
Hou T, Abu-Salah A, Cummings OW, Halum S, Mesa H, Zhang D. Amyloid Deposition in the Upper Aerodigestive Tract, A Single Institute Experience. Ear Nose Throat J 2023:1455613231189144. [PMID: 37515371 DOI: 10.1177/01455613231189144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2023] Open
Abstract
Objectives: The purpose of this study is to evaluate clinical information, laboratory results, and pathologic findings of patients with amyloidosis involving larynx, oral cavity, and pharynx from our institute. Methods: A total of 39 specimens from 28 patients were retrieved from 2000 to 2020. Data collection included clinical presentation, radiographic, laboratory results, and pathologic findings. Results: A total of 12 patients had laryngeal amyloidosis and true vocal cord was the most common location. Protein electrophoresis detected monoclonal protein in 10% (1/10) of patients tested. Two patients had hematopoietic disorder (2/12, 17%) and another patient had a peptide profile consistent with amyloid transthyretin (ATTR) detected by mass spectrometry. Twelve patients showed amyloidosis in the oral cavity with 75% involving the tongue. Monoclonal protein was found in 89% of cases tested. Nine patients (9/12, 75%) had systematic involvement including 6 with hematopoietic malignancy and 3 with biopsy-confirmed systemic light chain amyloidosis. Compared to the laryngeal amyloidosis, amyloid deposition in oral cavity had a significant higher association with systematic disease (P < .01). Pharyngeal amyloidosis was seen in 7 patients. Three of 6 patients tested (3/6, 50%) were found to have biopsy-confirmed hematopoietic malignancy. Conclusions: Laryngeal amyloidosis is mostly a localized disease. Amyloidosis involving oral cavity is associated with significantly higher risk of systematic involvement which warrants a comprehensive laboratory, radiographic, and pathologic workup. There is limited data about pharynx amyloidosis. Oropharynx and hypopharynx amyloidosis appear to be more likely associated with underlying hematologic malignancy compared to nasopharynx involvement.
Collapse
Affiliation(s)
- Tieying Hou
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Asma Abu-Salah
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Oscar W Cummings
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Stacey Halum
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Hector Mesa
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Dongwei Zhang
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| |
Collapse
|
19
|
Sun B, Luo Z, Liu P, He Y, He S, Liu W. Case Report: Immunotherapy for low-grade myofibroblastic sarcoma of the pharynx. Front Immunol 2023; 14:1190210. [PMID: 37469511 PMCID: PMC10352614 DOI: 10.3389/fimmu.2023.1190210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 06/20/2023] [Indexed: 07/21/2023] Open
Abstract
Low-grade myofibroblastic sarcoma (LGMS) characterized by the increased proliferation of myofibroblasts is a rare type of malignant myofibroblastic tumor that frequently occurs in the head and neck region. Presently, there is no consensus regarding the treatment of LGMS. Here, we report a rare case of LGMS of the pharynx in a 40-year-old male admitted to our hospital. The patient underwent resection for a right metastatic lesion and parapharyngeal mass. However, he had recurrence and multiple metastases without a surgical indication. Then the patient received the treatment of anlotinib plus pembrolizumab for 4 cycles, and there was a partial response (PR) to the treatment. Due to the adverse reaction of anlotinib, the patient subsequently received monotherapy of pembrolizumab for 22 cycles and achieved a complete response (CR). As the first case report of the immunotherapy for LGMS, our study highlights that this strategy may be of great significance to the treatment of LGMS.
Collapse
Affiliation(s)
- Bao Sun
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, Central South University, Changsha, China
| | - Zhiying Luo
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, Central South University, Changsha, China
| | - Ping Liu
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yan He
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Shasha He
- Department of Oncology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Wenhui Liu
- Department of Pharmacy, The Second Xiangya Hospital, Central South University, Changsha, China
- Institute of Clinical Pharmacy, Central South University, Changsha, China
| |
Collapse
|
20
|
Shufen X, Juan Z, Ling W, Fangru D. Delayed pathological finding of a small fish bone causing a purulent cyst in the pharynx: a case report. J Int Med Res 2023; 51:3000605231187947. [PMID: 37522303 PMCID: PMC10392475 DOI: 10.1177/03000605231187947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Abstract
We describe the case of a patient who swallowed a small fish bone and felt it lodge in her pharynx, but failed to seek medical attention in a timely manner. One week later, no foreign body was found in the hypopharynx or larynx, but a small purulent cyst was present in the epiglottic vallecula. A computed tomography scan showed a high-density area on the lingual surface of the epiglottis, which was considered to represent an embedded fish bone. A week later, the patient's discomfort had subsided, and flexible videoendoscopy showed that the purulent cyst in the epiglottic vallecula had disappeared. We surmise that the purulent cyst had ruptured spontaneously and the foreign body had been discharged. This represents an example of how an impacted small foreign body may be spontaneously discharged from the body.
Collapse
Affiliation(s)
- Xiao Shufen
- Department of Otorhinolaryngology-Head and Neck Surgery, Bethune International Peace Hospital, The 980th Hospital of the Joint Logistics Support Force, Shijiazhuang, China
| | - Zhang Juan
- Department of Pharmacy, The Affiliated Hospital of Hebei University of Engineering, Handan, Hebei, China
| | - Wang Ling
- Department of Otorhinolaryngology-Head and Neck Surgery, Bethune International Peace Hospital, The 980th Hospital of the Joint Logistics Support Force, Shijiazhuang, China
| | - Dong Fangru
- Department of Otorhinolaryngology-Head and Neck Surgery, Bethune International Peace Hospital, The 980th Hospital of the Joint Logistics Support Force, Shijiazhuang, China
| |
Collapse
|
21
|
Shu M, He P, Wei C. KTP laser alone or combined with bleomycin for pharyngolaryngeal hemangioma: a lesion grade-based determination of prognosis. Acta Otolaryngol 2023:1-6. [PMID: 37335214 DOI: 10.1080/00016489.2023.2220744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/23/2022] [Accepted: 09/29/2022] [Indexed: 06/21/2023]
Abstract
BACKGROUND No standard potassium titanyl phosphate (KTP) laser treatment strategy is available yet for pharyngolaryngeal hemangioma. OBJECTIVES To explore the therapeutic effect of KTP laser, alone or combined with bleomycin injection, for pharyngolaryngeal hemangioma. MATERIAL AND METHODS This observational study included patients with pharyngolaryngeal hemangioma treated between May 2016 and November 2021: KTP laser under local anesthesia, KTP laser under general anesthesia, or KTP laser combined with bleomycin injection under general anesthesia. RESULTS A total of 60 patients were recruited, including 17, 19, and 24 patients with grade 1, 2, and 3 hemangiomas, respectively. A total of 21 patients underwent KTP laser under local anesthesia, 31 underwent KTP laser under general anesthesia, and 8 underwent KTP laser under general anesthesia combined with bleomycin. The cure rates were 100%, 89.5%, and 20.8% for grade 1, 2, and 3 lesions, respectively. The prognosis was significantly different among the grades of hemangioma (p < .001). CONCLUSION KTP laser treatment might be an effective treatment for adult patients with pharyngolaryngeal hemangioma. The size of the hemangioma might be the major factor influencing the prognosis. The method of anesthesia and whether it was combined with bleomycin injection might not affect the prognosis.
Collapse
Affiliation(s)
- Min Shu
- Otolaryngology Department of the Eye, ENT Hospital of Fudan University, Shanghai, PR China
| | - Peijie He
- Otolaryngology Department of the Eye, ENT Hospital of Fudan University, Shanghai, PR China
| | - Chunsheng Wei
- Otolaryngology Department of the Eye, ENT Hospital of Fudan University, Shanghai, PR China
| |
Collapse
|
22
|
Cai F, Zhou C, Jiao N, Liang X, Ye Z, Chen W, Yang Q, Peng H, Tang Y, Niu C, Zhao G, Wang Z, Zhang G, Yu X. Systematic Microbiome Dysbiosis Is Associated with IgA Nephropathy. Microbiol Spectr 2023; 11:e0520222. [PMID: 37227280 PMCID: PMC10269816 DOI: 10.1128/spectrum.05202-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 05/04/2023] [Indexed: 05/26/2023] Open
Abstract
IgA nephropathy (IgAN) is reportedly associated with microbial dysbiosis. However, the microbiome dysregulation of IgAN patients across multiple niches remains unclear. To gain a systematic understanding of microbial dysbiosis, we conducted large-scale 16S rRNA gene sequencing in IgAN patients and healthy volunteers across 1,732 oral, pharynx, gut, and urine samples. We observed a niche-specific increase of several opportunistic pathogens, including Bergeyella and Capnocytophaga in the oral and pharynx, whereas some beneficial commensals decreased in IgAN patients. Similar alterations were also observed in the early versus advanced stage of chronic kidney disease (CKD) progression. Moreover, Bergeyella, Capnocytophaga, and Comamonas in the oral and pharynx were positively associated with creatinine and urea, indicating renal lesions. Random forest classifiers were developed by using the microbial abundance to predict IgAN, achieving an optimal accuracy of 0.879 in the discovery phase and 0.780 in the validation phase. IMPORTANCE This study provides microbial profiles of IgAN across multiple niches and underlines the potential of these biomarkers as promising, noninvasive tools with which to differentiate IgAN patients for clinical applications.
Collapse
Affiliation(s)
- Fengtao Cai
- School of Medicine, South China University of Technology, Guangzhou, China
- Department of Nephrology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Chenfen Zhou
- National Genomics Data Center & Bio-Med Big Data Center, CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Na Jiao
- National Clinical Research Center for Child Health, the Children’s Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xinling Liang
- Department of Nephrology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Zhiming Ye
- Department of Nephrology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Wei Chen
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qiongqiong Yang
- Department of Nephrology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hui Peng
- Department of Nephrology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ying Tang
- Department of Nephrology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Chaoqun Niu
- National Genomics Data Center & Bio-Med Big Data Center, CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Guoping Zhao
- National Genomics Data Center & Bio-Med Big Data Center, CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
- Hangzhou Institute for Advanced Study, University of Chinese Academy of Sciences, Hangzhou, China
| | - Zefeng Wang
- National Genomics Data Center & Bio-Med Big Data Center, CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
- CAS Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, Shanghai, China
| | - Guoqing Zhang
- National Genomics Data Center & Bio-Med Big Data Center, CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Xueqing Yu
- School of Medicine, South China University of Technology, Guangzhou, China
- Department of Nephrology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
- Guangdong-Hong Kong Joint Laboratory on Immunological and Genetic Kidney Diseases, Guangzhou, China
| |
Collapse
|
23
|
Kochi K, Sei H, Tanabe Y, Yasuda K, Kido T, Yamada H, Taguchi A, Hato N. The dynamics of deglutition during head rotation using dynamic 320-row area detector computed tomography. Laryngoscope Investig Otolaryngol 2023; 8:746-753. [PMID: 37342115 PMCID: PMC10278121 DOI: 10.1002/lio2.1082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 05/03/2023] [Accepted: 05/16/2023] [Indexed: 06/22/2023] Open
Abstract
Objective We aimed to elucidate the dynamics of deglutition during head rotation by acquiring 320-row area detector computed tomography (320-ADCT) images and analyzing deglutition during head rotation. Methods This study included 11 patients experiencing globus pharyngeus. A 320-ADCT was used to acquire images in two types of viscosity (thin and thick), with the head rotated to the left. We measured the movement time of deglutition-related organs (soft palate, epiglottis, upper esophageal sphincter [UES], and true vocal cords) and pharyngeal volume (bolus ratio at the start of UES opening [Bolus ratio], pharyngeal volume contraction ratio [PVCR], and pharyngeal volume before swallowing [PVBS]). A two-way analysis of variance was performed for statistical analysis, and all items were compared for significant differences in terms of head rotation and viscosity. EZR was used for all statistical analyses (p-value <.05). Results Head rotation significantly accelerated the onset of epiglottis inversion and UES opening compared with no head rotation. The duration of epiglottis inversion with the thin viscosity fluid was significantly longer. The bolus ratio increased significantly with thick viscosity. There was no significant difference in viscosity and head rotation in terms of PVCR. PVBS increased significantly with head rotation. Conclusion The significantly earlier start of epiglottis inversion and UES opening due to head rotation could be caused by: (1) swallowing center; (2) pharyngeal volume; and (3) pharyngeal contraction force. Thus, we plan to further analyze swallowing with head rotation by combining swallowing CT with manometry and examine its relationship with pharyngeal contraction force. Level of Evidence 3b.
Collapse
Affiliation(s)
- Kazutaka Kochi
- Department of Otolaryngology, Head and Neck SurgeryEhime University School of MedicineToon CityJapan
| | - Hirofumi Sei
- Department of Otolaryngology, Head and Neck SurgeryEhime Prefectural Central HospitalMatsuyamaEhimeJapan
- Department of Mechanical Systems Engineering, Graduate School of Science and EngineeringYamagata UniversityYonezawa CityJapan
| | - Yuki Tanabe
- Department of RadiologyEhime University Graduate School of MedicineToon CityJapan
| | - Kazunori Yasuda
- Department of Mechanical Engineering, Graduate School of Science and EngineeringEhime UniversityMatsuyama CityJapan
| | - Teruhito Kido
- Department of RadiologyEhime University Graduate School of MedicineToon CityJapan
| | - Hiroyuki Yamada
- Department of Otolaryngology, Head and Neck SurgeryEhime University School of MedicineToon CityJapan
| | - Aki Taguchi
- Faculty of Health and WelfarePrefectural University of HiroshimaMiharaJapan
| | - Naohito Hato
- Department of Otolaryngology, Head and Neck SurgeryEhime University School of MedicineToon CityJapan
| |
Collapse
|
24
|
Abstract
OBJECTIVE To analyze intervention goals, protocols, and outcome measures used for oral and pharyngeal motor exercises in post-stroke recovery. DATA SOURCES MEDLINE, EMBASE, CINAHL, PsychINFO, and Cochrane databases were searched in September 2022. METHODS Studies were included if they (1) recruited post-stroke adult patients, (2) administered exercises for the oral and/ or pharyngeal muscles, and (3) reported results at baseline and post-exercise. The extracted data included intervention goals, protocols, and outcomes. All outcomes were classified according to the International Classification of Functioning, Disability and Health (ICF). RESULTS A total of 26 studies were identified. Their intervention goals aimed to rehabilitate a broad spectrum of muscle groups within the oral cavity and pharynx and to improve the functions of swallowing, speech, facial expressions, or sleep breathing. Protocol duration ranged from 1 to 13 weeks, with various exercise repetitions (times per day) and frequency (days per week). Half of the studies reported using feedback to support the training, and these studies varied in the feedback strategy and technology tool. A total of 37 unique outcome measures were identified. Most measures represented the body functions and body structure component of the ICF, and several of these measures showed large treatment effects. CONCLUSIONS This review demonstrated inconsistency across published studies in intervention goals and exercise protocols. It has also identified current limitations and provided recommendations for the selection of outcome measures while advancing a multidisciplinary view of oral and pharyngeal exercises in post-stroke recovery across relevant functions.
Collapse
Affiliation(s)
- Reeman Marzouqah
- Rehabilitation Sciences Institute, 7938University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute and Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- KITE, University Health Network, Toronto, ON, Canada
| | - Anna Huynh
- Rehabilitation Sciences Institute, 7938University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute and Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- KITE, University Health Network, Toronto, ON, Canada
| | - Joyce L Chen
- Rehabilitation Sciences Institute, 7938University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute and Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Faculty of Kinesiology and Physical Education, 7938University of Toronto, Toronto, ON, Canada
| | - Mark I Boulos
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute and Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Department of Medicine, Division of Neurology, 7938University of Toronto, Toronto, ON, Canada
| | - Yana Yunusova
- Rehabilitation Sciences Institute, 7938University of Toronto, Toronto, ON, Canada
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute and Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- KITE, University Health Network, Toronto, ON, Canada
| |
Collapse
|
25
|
Imam T, Konstant-Hambling R, Flint H, Brooks TA, Patel NN, Conroy S. The Hospital Frailty Risk Score and outcomes in head and neck cancer surgery. Clin Otolaryngol 2023. [PMID: 36950831 DOI: 10.1111/coa.14051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 02/25/2023] [Indexed: 03/24/2023]
Abstract
OBJECTIVE This study aimed to assess if the Hospital Frailty Risk Score (HFRS) could predict outcomes for older people undergoing head and neck procedures. DESIGN A retrospective cohort study of patients admitted between April 2008 and February 2020, undergoing head and neck procedures defined as major resections using procedural codes. SETTING The analysis was performed using data from the NHS Secondary Uses Service (SUS) electronic database. PARTICIPANTS A number of 7479 patients were selected based on an age of 75 years and above and an admission associated with a diagnostic code associated with a head and neck cancer. Based on HFRS, 5153 patients were risk-stratified into mild, moderate, and severe frailty risk. MAIN OUTCOME MEASURES The relationships between frailty risk and length of stay, readmission rate, and mortality were quantified using descriptive statistics. RESULTS Severely frail patients had a median length of stay of 9 days compared to 3 for mildly frail patients. Twenty-seven percentage of severely frail patients were readmitted within 30 days of surgery. Rising levels of frailty correlate with a higher risk of death following surgery which is maintained in longer term mortality at 1 year and until the data were extracted in March 2022. Fifty percentage of moderately frail patients and 66% of severely frail patients had died in hospital by the end of the study period. CONCLUSION The results quantify the relationship between frailty and adverse health outcomes. This information could be used to identify those that might benefit from holistic assessment, aid prognostication, commissioning, and service planning.
Collapse
Affiliation(s)
| | | | | | | | - Nimesh N Patel
- University Hospital Southampton NHS Foundation Trust, Hampshire, UK
| | | |
Collapse
|
26
|
Oliveira REMD, Attademo FLN, Sousa ACFCD, Magalhães MDS, Oliveira RMD, de Moura CEB, Silva AR, Pereira AF, Fragoso ABL, Silva FJDL, Oliveira MFD. Oropharyngeal cavity floor morphology in Eretmochelys imbricata (Testudines: Cheloniidae) hatchlings and evolutionary implications. Anat Rec (Hoboken) 2023; 306:343-353. [PMID: 36054069 DOI: 10.1002/ar.25061] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 08/15/2022] [Accepted: 08/17/2022] [Indexed: 01/25/2023]
Abstract
Morphological studies of the oropharyngeal cavity of chelonians have become an interesting tool in the understanding of evolutionary processes associated with feeding habits in aquatic animals and the transition from aquatic to terrestrial forms. In this context, the aim of the present study was to describe the oropharyngeal cavity floor morphology of hawksbill sea turtle (Eretmochelys imbricata) hatchlings. Ten dead hatchlings of undefined sex were obtained from nests hatched on the coast of the state of Rio Grande do Norte, Brazil. The heads of each specimen were fixed, dissected, and analyzed at the macroscopic and microscopic levels. The oropharyngeal cavity floor of the hawksbill sea turtle hatchlings is formed by the tongue, pharynx, floor muscles, and hyolingual skeleton, delimited in the rostral and lateral directions by a keratinized beak, called the rhamphotheca, and in the caudal region at the limit between the pharynx and the esophagus. The tongue muscles and the muscles that support the floor of the oral cavity comprise the following: m. hypoglossohyoideus, m. hypoglossoglossus, m. hyoglossus, m. genioglossus, m. constrictor laryngis, m. geniohyoideus pars lateralis, and m. intermandibularis. The oropharyngeal cavity floor mucosa is formed by keratinized stratified squamous epithelium and the lamina propria is formed by loose connective tissue. The floor mucosa is devoid of taste buds. We believe that the basic oropharyngeal cavity floor characteristics in hawksbill sea turtle hatchlings may comprise indications that these animals are plesiomorphic and that semiaquatic and terrestrial turtles may have undergone adaptations to feed out of water.
Collapse
Affiliation(s)
- Radan Elvis Matias de Oliveira
- Programa de Pós-Graduação em Ciência Animal (PPGCA), Universidade Federal Rural do Semi-Árido (UFERSA), Mossoró, Rio Grande do Norte, Brazil.,Centro de Estudos e Monitoramento Ambiental (CEMAM), Areia Branca, Rio Grande do Norte, Brazil.,Projeto Cetáceos da Costa Branca (PCCB), Universidade do Estado do Rio Grande do Norte (UERN), Mossoró, Rio Grande do Norte, Brazil
| | - Fernanda Loffler Niemeyer Attademo
- Centro de Estudos e Monitoramento Ambiental (CEMAM), Areia Branca, Rio Grande do Norte, Brazil.,Centro Universitário Internacional (UNINTER), Curitiba, Paraná, Brazil
| | - Ana Caroline Freitas Caetano de Sousa
- Departamento de Ciências Animais, Laboratório de Morfofisiologia Animal Aplicada (LABMORFA), Universidade Federal Rural do Semi-Árido (UFERSA), Mossoró, Rio Grande do Norte, Brazil
| | | | - Rysónely Maclay de Oliveira
- Programa de Pós-Graduação em Ciência Animal (PPGCA), Universidade Federal Rural do Semi-Árido (UFERSA), Mossoró, Rio Grande do Norte, Brazil.,Projeto Cetáceos da Costa Branca (PCCB), Universidade do Estado do Rio Grande do Norte (UERN), Mossoró, Rio Grande do Norte, Brazil
| | - Carlos Eduardo Bezerra de Moura
- Programa de Pós-Graduação em Ciência Animal (PPGCA), Universidade Federal Rural do Semi-Árido (UFERSA), Mossoró, Rio Grande do Norte, Brazil
| | - Alexandre Rodrigues Silva
- Programa de Pós-Graduação em Ciência Animal (PPGCA), Universidade Federal Rural do Semi-Árido (UFERSA), Mossoró, Rio Grande do Norte, Brazil
| | - Alexsandra Fernandes Pereira
- Programa de Pós-Graduação em Ciência Animal (PPGCA), Universidade Federal Rural do Semi-Árido (UFERSA), Mossoró, Rio Grande do Norte, Brazil
| | - Ana Bernadete Lima Fragoso
- Centro de Estudos e Monitoramento Ambiental (CEMAM), Areia Branca, Rio Grande do Norte, Brazil.,Projeto Cetáceos da Costa Branca (PCCB), Universidade do Estado do Rio Grande do Norte (UERN), Mossoró, Rio Grande do Norte, Brazil
| | - Flávio José de Lima Silva
- Centro de Estudos e Monitoramento Ambiental (CEMAM), Areia Branca, Rio Grande do Norte, Brazil.,Projeto Cetáceos da Costa Branca (PCCB), Universidade do Estado do Rio Grande do Norte (UERN), Mossoró, Rio Grande do Norte, Brazil.,Programa Regional de Pós-Graduação em Desenvolvimento e Meio Ambiente (PRODEMA), Universidade Federal do Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Moacir Franco de Oliveira
- Programa de Pós-Graduação em Ciência Animal (PPGCA), Universidade Federal Rural do Semi-Árido (UFERSA), Mossoró, Rio Grande do Norte, Brazil
| |
Collapse
|
27
|
Hu B, Yin G, Fu S, Zhang B, Shang Y, Zhang Y, Ye J. The influence of mouth opening on pharyngeal pressure loss and its underlying mechanism: A computational fluid dynamic analysis. Front Bioeng Biotechnol 2023; 10:1081465. [PMID: 36698641 PMCID: PMC9868155 DOI: 10.3389/fbioe.2022.1081465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/20/2022] [Indexed: 01/11/2023] Open
Abstract
Objective: During inspiration, mechanical energy generated from respiratory muscle produces a negative pressure gradient to fulfill enough pulmonary ventilation. The pressure loss, a surrogate for energy loss, is considered as the portion of negative pressure without converting into the kinetic energy of airflow. Mouth opening (MO) during sleep is a common symptom in patients with obstructive sleep apnoea-hypopnea syndrome (OSAHS). This study aimed to evaluate the effects of mouth opening on pharyngeal pressure loss using computational fluid dynamics (CFD) simulation. Methods: A total of four subjects who were morphologically distinct in the pharyngeal characteristics based on Friedman tongue position (FTP) grades were selected. Upper airway computed tomography (CT) scan was performed under two conditions: Mouth closing (MC) and mouth opening, in order to reconstruct the upper airway models. computational fluid dynamics was used to simulate the flow on the two different occasions: Mouth closing and mouth opening. Results: The pharyngeal jet was the typical aerodynamic feature and its formation and development were different from mouth closing to mouth opening in subjects with different Friedman tongue position grades. For FTP I with mouth closing, a pharyngeal jet gradually formed with proximity to the velopharyngeal minimum area plane (planeAmin). Downstream the planeAmin, the jet impingement on the pharyngeal wall resulted in the frictional loss associated with wall shear stress (WSS). A rapid luminal expansion led to flow separation and large recirculation region, corresponding to the interior flow loss. They all contributed to the pharyngeal total pressure loss. While for FTP I with mouth opening, the improved velopharyngeal constriction led to smoother flow and a lower total pressure loss. For FTP IV, the narrower the planeAmin after mouth opening, the stronger the jet formation and its impingement on the pharyngeal wall, predicting a higher frictional loss resulted from higher WSS. Besides, a longer length of the mouth opening-associated constant constrictive segment was another important morphological factor promoting frictional loss. Conclusion: For certain OSAHS patients with higher Friedman tongue position grade, mouth opening-related stronger jet formation, more jet breakdown and stronger jet flow separation might contribute to the increased pharyngeal pressure loss. It might require compensation from more inspiratory negative static pressure that would potentially increase the severity of OSAHS.
Collapse
Affiliation(s)
- Bin Hu
- Department of Otolaryngology-Head Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Guoping Yin
- Department of Otolaryngology-Head Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China,Sleep Medicine Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Song Fu
- School of Aeronautics and Astronautics, Tsinghua University, Beijing, China
| | - Baoshou Zhang
- School of Aeronautics and Astronautics, Tsinghua University, Beijing, China
| | - Yan Shang
- School of Aeronautics and Astronautics, Tsinghua University, Beijing, China
| | - Yuhuan Zhang
- Sleep Medicine Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Jingying Ye
- Department of Otolaryngology-Head Neck Surgery, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China,Sleep Medicine Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China,*Correspondence: Jingying Ye,
| |
Collapse
|
28
|
Hung JS, Liang SW, Omari T, Wong MW, Lei WY, Yi CH, Liu TT, Lin L, Chen CL. Effects of the GABA(B) agonist baclofen on volitional swallowing in normal subjects. Kaohsiung J Med Sci 2023; 39:80-86. [PMID: 36245436 DOI: 10.1002/kjm2.12607] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/01/2022] [Accepted: 09/13/2022] [Indexed: 01/15/2023] Open
Abstract
The GABA(B) receptor agonist baclofen is known to suppress the rate of spontaneous swallowing but not pharyngeal muscle contraction. The extent to which baclofen may alter volitional swallowing is not currently known. We investigated the effects of baclofen in healthy subjects, hypothesizing that baclofen exposure would alter volume-regulation and/or piecemeal deglutition behaviors during volitional swallowing attempts. Pharyngeal high-resolution manometry impedance (P-HRM-I) protocol was used to assess swallowing function of 22 healthy adult volunteers (median 29 years) who were investigated on two occasions, receiving 40 mg baclofen (oral) 1 h before study, or placebo (randomized). Standard swallow function variables recommended by the pharyngeal HRM Working Group were derived for 5 ml, 10 ml, and 20 ml volumes of thin and extremely thick liquid challenges. Multiple swallow behaviors, comprising two swallows <5 s apart, were characterized. The spontaneous swallow rate was also determined. Baclofen exposure had no overall significant effect on swallow variables. Upper esophageal sphincter pressure was weaker during exposure to baclofen, during both the pre-deglutitive and post-deglutitive phases of the swallow (p < 0.05 during thick liquid swallows). Piecemeal swallows, where the bolus is separated in two potions, were significantly more common during 20 ml boluses (p = 0.002). Baclofen decreased the frequency of piecemeal deglutition overall. Baclofen has limited to no effect on volitional swallowing measures, however, does reduce the likelihood of initiation of piecemeal deglutition to large volume challenges.
Collapse
Affiliation(s)
- Jui-Sheng Hung
- Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Shu-Wei Liang
- Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Taher Omari
- Flinders Health and Medical Research Institute, Flinders University, Adelaide, Australia
| | - Ming-Wun Wong
- Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Wei-Yi Lei
- Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Chih-Hsun Yi
- Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Tso-Tsai Liu
- Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Lin Lin
- Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan
| | - Chien-Lin Chen
- Department of Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.,Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
| |
Collapse
|
29
|
Leung T, Fukuda M, Sode M, Takahashi W, Ikeda M, Kato H, Tsugawa Y, Iwagami M. Examining the Use of an Artificial Intelligence Model to Diagnose Influenza: Development and Validation Study. J Med Internet Res 2022; 24:e38751. [PMID: 36374004 PMCID: PMC9823578 DOI: 10.2196/38751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 09/26/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The global burden of influenza is substantial. It is a major disease that causes annual epidemics and occasionally, pandemics. Given that influenza primarily infects the upper respiratory system, it may be possible to diagnose influenza infection by applying deep learning to pharyngeal images. OBJECTIVE We aimed to develop a deep learning model to diagnose influenza infection using pharyngeal images and clinical information. METHODS We recruited patients who visited clinics and hospitals because of influenza-like symptoms. In the training stage, we developed a diagnostic prediction artificial intelligence (AI) model based on deep learning to predict polymerase chain reaction (PCR)-confirmed influenza from pharyngeal images and clinical information. In the validation stage, we assessed the diagnostic performance of the AI model. In additional analysis, we compared the diagnostic performance of the AI model with that of 3 physicians and interpreted the AI model using importance heat maps. RESULTS We enrolled a total of 7831 patients at 64 hospitals between November 1, 2019, and January 21, 2020, in the training stage and 659 patients (including 196 patients with PCR-confirmed influenza) at 11 hospitals between January 25, 2020, and March 13, 2020, in the validation stage. The area under the receiver operating characteristic curve for the AI model was 0.90 (95% CI 0.87-0.93), and its sensitivity and specificity were 76% (70%-82%) and 88% (85%-91%), respectively, outperforming 3 physicians. In the importance heat maps, the AI model often focused on follicles on the posterior pharyngeal wall. CONCLUSIONS We developed the first AI model that can accurately diagnose influenza from pharyngeal images, which has the potential to help physicians to make a timely diagnosis.
Collapse
Affiliation(s)
| | - Memori Fukuda
- Aillis, Inc, Tokyo, Japan.,Department of Health Informatics, Graduate School of Medicine, School of Public Health, Kyoto University, Kyoto, Japan
| | | | | | - Masahiro Ikeda
- Aillis, Inc, Tokyo, Japan.,Department of Palliative Therapy, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Hiroaki Kato
- Aillis, Inc, Tokyo, Japan.,Tokyo Medical and Dental University, Tokyo, Japan
| | - Yusuke Tsugawa
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at The University of California, Los Angeles, Los Angeles, CA, United States
| | - Masao Iwagami
- Department of Health Services Research, University of Tsukuba, Tsukuba, Japan.,Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
30
|
Samaha CJ, Tannous HJ, Salman D, Ghafari JG, Amatoury J. Role of surgical hyoid bone repositioning in modifying upper airway collapsibility. Front Physiol 2022; 13:1089606. [PMID: 36582357 PMCID: PMC9792595 DOI: 10.3389/fphys.2022.1089606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022] Open
Abstract
Background: Surgical hyoid bone repositioning procedures are being performed to treat obstructive sleep apnea (OSA), though outcomes are highly variable. This is likely due to lack of knowledge regarding the precise influence of hyoid bone position on upper airway patency. The aim of this study is to determine the effect of surgical hyoid bone repositioning on upper airway collapsibility. Methods: Seven anaesthetized, male, New Zealand White rabbits were positioned supine with head/neck position controlled. The rabbit's upper airway was surgically isolated and hyoid bone exposed to allow manipulation of its position using a custom-made device. A sealed facemask was fitted over the rabbit's snout, and mask/upper airway pressures were monitored. Collapsibility was quantified using upper airway closing pressure (Pclose). The hyoid bone was repositioned within the mid-sagittal plane from 0 to 5 mm (1 mm increments) in anterior, cranial, caudal, anterior-cranial (45°) and anterior-caudal (45°) directions. Results: Anterior displacement of the hyoid bone resulted in the greatest decrease in Pclose amongst all directions (p = 0.002). Pclose decreased progressively with each increment of anterior hyoid bone displacement, and down by -4.0 ± 1.3 cmH2O at 5 mm. Cranial and caudal hyoid bone displacement did not alter Pclose (p > 0.35). Anterior-cranial and anterior-caudal hyoid bone displacements decreased Pclose significantly (p < 0.004) and at similar magnitudes to the anterior direction (p > 0.68). Conclusion: Changes in upper airway collapsibility following hyoid bone repositioning are both direction and magnitude dependent. Anterior-based repositioning directions have the greatest impact on reducing upper airway collapsibility, with no effect on collapsibility by cranial and caudal directions. Findings may have implications for guiding and improving the outcomes of surgical hyoid interventions for the treatment of OSA.
Collapse
Affiliation(s)
- Corine J. Samaha
- Sleep and Upper Airway Research Group (SUARG), American University of Beirut, Beirut, Lebanon,Division of Orthodontics and Dentofacial Orthopedics, American University of Beirut Medical Center, Beirut, Lebanon
| | - Hiba J. Tannous
- Sleep and Upper Airway Research Group (SUARG), American University of Beirut, Beirut, Lebanon,Division of Orthodontics and Dentofacial Orthopedics, American University of Beirut Medical Center, Beirut, Lebanon
| | - Diane Salman
- Sleep and Upper Airway Research Group (SUARG), American University of Beirut, Beirut, Lebanon,Biomedical Engineering Program, Maroun Semaan Faculty of Engineering and Architecture (MSFEA), American University of Beirut, Beirut, Lebanon
| | - Joseph G. Ghafari
- Division of Orthodontics and Dentofacial Orthopedics, American University of Beirut Medical Center, Beirut, Lebanon,Department of Orthodontics, University of Pennsylvania, Philadelphia, PA, United States
| | - Jason Amatoury
- Sleep and Upper Airway Research Group (SUARG), American University of Beirut, Beirut, Lebanon,Biomedical Engineering Program, Maroun Semaan Faculty of Engineering and Architecture (MSFEA), American University of Beirut, Beirut, Lebanon,*Correspondence: Jason Amatoury,
| |
Collapse
|
31
|
James TW, Edwards MJ, Nieto H, Mehanna H, Pracy P, Jennings C, Sharma N, Nankivell P. An external validation of C-reactive protein reduction as a predictor of healing following laryngopharyngectomy. Clin Otolaryngol 2022; 47:696-700. [PMID: 35899897 DOI: 10.1111/coa.13966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/04/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Tobias W James
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Michael J Edwards
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Hannah Nieto
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Hisham Mehanna
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
- National Institute for Health Research (NIHR), Birmingham, UK
| | - Paul Pracy
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Christopher Jennings
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Neil Sharma
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| | - Paul Nankivell
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, UK
| |
Collapse
|
32
|
Li Z, Lai Y, Yu G, Sun D, Lu G, Dong L, Luan J, Chen X. Lipoid Proteinosis of the Pharynx and Larynx: A Case Report. Ear Nose Throat J 2022:1455613221119071. [PMID: 36000487 DOI: 10.1177/01455613221119071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Lipoid proteinosis (LP) is a rare inherited multisystem disease. Classical clinical features include beaded eyelid papules, laryngeal infiltration, and neurological symptoms. Here, we report the diagnosis and treatment of a female patient with LP in order to improve physician awareness and understanding of this disease.
Collapse
Affiliation(s)
- Zhuojun Li
- Department of Otolaryngology Head and Neck Surgery, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, China
- The 2nd Medical College of Binzhou Medical University, Yantai, China
| | - Yongfeng Lai
- Department of Cardiac surgery , Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, China
| | - Guohua Yu
- Department of Pathology , Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, China
| | - Di Sun
- Department of Pathology , Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, China
| | - Guowei Lu
- Department of Otolaryngology Head and Neck Surgery, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, China
| | - Lei Dong
- Department of Otolaryngology Head and Neck Surgery, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, China
| | - Jiangang Luan
- Department of Otolaryngology Head and Neck Surgery, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, China
| | - Xiumei Chen
- Department of Otolaryngology Head and Neck Surgery, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, China
| |
Collapse
|
33
|
Hansen C, Sonnesen L. Reliability of Acoustic Pharyngometry and Rhinometry Examination in Children and Adolescents. J Oral Maxillofac Res 2022; 13:e4. [PMID: 36382012 PMCID: PMC9617254 DOI: 10.5037/jomr.2022.13304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVES The aim of this cross-sectional study was to examine the method error and reliability of acoustic pharyngometry and rhinometry in children and adolescents and to describe the feasibility of these methods in a young population. MATERIAL AND METHODS The study sample included 35 healthy subjects in the age of 9 to 14 years. The subjects were randomly recruited for the present project in the period from June 2021 to February 2022. Repeated measurements of the upper airway dimensions in standing mirror position were performed by the use of Acoustic Pharyngometer and Rhinometer. Volume (cm3), calculated resistance (cm H2O/L/min), mean area (cm2), minimum cross-sectional area (MCA, cm2) and distance to MCA (cm) were examined. Method errors and reliability coefficients were evaluated using Dahlberg's formula and the Houston reliability coefficient. The feasibility of the methods were analysed using paired t-test and estimated by difference in drop-out rates. RESULTS No systematic error exhibited in the repeated measurements except volume in the left nostril (P = 0.017). The method errors of the acoustic pharyngometry and rhinometry were betweeen 0.0002 to 0.069 and 0.001 to 0.082 respectively. The Houston reliability coefficient for both methods were between 0.952 to 0.999. The acoustic pharyngometry was significantly more feasible compared to rhinometry (P < 0.001). CONCLUSIONS The study shows that acoustic pharyngometry and rhinometry in the standing mirror position are reliable methods, with acoustic pharyngometry being even more feasible than rhinometry, which is why it is recommended to practice the methods with children and ensure reliability of results before registering measurements.
Collapse
Affiliation(s)
- Camilla Hansen
- Section of Orthodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of CopenhagenDenmark.
| | - Liselotte Sonnesen
- Section of Orthodontics, Department of Odontology, Faculty of Health and Medical Sciences, University of CopenhagenDenmark.
| |
Collapse
|
34
|
Brenner IR, Raizen DM, Fang-Yen C. Pharyngeal timing and particle transport defects in Caenorhabditis elegans feeding mutants. J Neurophysiol 2022; 128:302-309. [PMID: 35730757 DOI: 10.1152/jn.00444.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The nematode C. elegans uses rhythmic muscle contractions (pumps) of the pharynx, a tubular feeding organ, to filter, transport, and crush food particles. A number of feeding mutants have been identified, including those with slow pharyngeal pumping rate, weak muscle contraction, defective muscle relaxation, and defective grinding of bacteria. Many aspects of these pharyngeal behavioral defects and how they affect pharyngeal function are not well understood. For example, the behavioral deficits underlying inefficient particle transport in 'slippery' mutants have been unclear. Here we use high speed video microscopy to describe pharyngeal pumping behaviors and particle transport in wild-type animals and in feeding mutants. Different 'slippery' mutants exhibit distinct defects including weak isthmus contraction, failure to trap particles in the anterior isthmus, and abnormal timing of contraction and relaxation in pharyngeal compartments. Our results show that multiple deficits in pharyngeal timing or contraction can cause defects in particle transport.
Collapse
Affiliation(s)
- Isaac Ravi Brenner
- Department of Bioengineering, School of Engineering and Applied Science, University of Pennsylvania, Philadelphia PA, United States
| | - David M Raizen
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Christopher Fang-Yen
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.,Department of Neuroscience, Perelman School of Medicine, University of Pennsylvania, Philadelphia PA, United States
| |
Collapse
|
35
|
Coverdell TC, Abraham-Fan RJ, Wu C, Abbott SBG, Campbell JN. Genetic encoding of an esophageal motor circuit. Cell Rep 2022; 39:110962. [PMID: 35705034 PMCID: PMC9255432 DOI: 10.1016/j.celrep.2022.110962] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/24/2022] [Accepted: 05/24/2022] [Indexed: 12/02/2022] Open
Abstract
Motor control of the striated esophagus originates in the nucleus ambiguus (nAmb), a vagal motor nucleus that also contains upper airway motor neurons and parasympathetic preganglionic neurons for the heart and lungs. We disambiguate nAmb neurons based on their genome-wide expression profiles, efferent circuitry, and ability to control esophageal muscles. Our single-cell RNA sequencing analysis predicts three molecularly distinct nAmb neuron subtypes and annotates them by subtype-specific marker genes: Crhr2, Vipr2, and Adcyap1. Mapping the axon projections of the nAmb neuron subtypes reveals that Crhr2nAmb neurons innervate the esophagus, raising the possibility that they control esophageal muscle function. Accordingly, focal optogenetic stimulation of cholinergic Crhr2+ fibers in the esophagus results in contractions. Activating Crhr2nAmb neurons has no effect on heart rate, a key parasympathetic function of the nAmb, whereas activating all of the nAmb neurons robustly suppresses heart rate. Together, these results reveal a genetically defined circuit for motor control of the esophagus. Primary motor neurons for the esophagus reside in the nucleus ambiguus (nAmb) of the hindbrain, but little is known about their molecular identity. Coverdell et al. find that the nAmb comprises three molecularly and anatomically distinct neuron subtypes, one of which selectively innervates and can contract esophageal muscle.
Collapse
Affiliation(s)
- Tatiana C Coverdell
- Biomedical Sciences Graduate Program, University of Virginia, Charlottesville, VA 22903, USA; Department of Biology, University of Virginia, Charlottesville, VA 22903, USA; Department of Pharmacology, University of Virginia, Charlottesville, VA 22903, USA
| | | | - Chen Wu
- Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Stephen B G Abbott
- Department of Pharmacology, University of Virginia, Charlottesville, VA 22903, USA
| | - John N Campbell
- Department of Biology, University of Virginia, Charlottesville, VA 22903, USA.
| |
Collapse
|
36
|
Omari T, Rommel N, Jan T, Szczesniak M, Wu P, Schar M, Doeltgen S, Cock C. Transient hypopharyngeal intrabolus pressurization patterns: Clinically relevant or normal variant? Neurogastroenterol Motil 2022; 34:e14276. [PMID: 34606649 DOI: 10.1111/nmo.14276] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/23/2021] [Accepted: 09/19/2021] [Indexed: 12/08/2022]
Abstract
INTRODUCTION In oropharyngeal dysphagia, impaired pharyngoesophageal junction (PEJ) opening is reflected by an elevated hypopharyngeal intrabolus pressure (IBP), quantifiable using pharyngeal high-resolution manometry with impedance (P-HRM-I). Transient intrabolus pressurization (TP) phenomena are not sustained and last for only a brief period. We hypothesized that TP patterns reflect impaired coordination between timing of hypopharyngeal bolus arrival and PEJ relaxation. METHODS A retrospective audit was conducted of P-HRM-I datasets; 93 asymptomatic Controls and 214 Patients with differing etiological/clinical backgrounds were included. TP patterns were examined during 10ml liquid swallows. TP was defined by a simultaneous, non-sustained, pressurization wave spanning from the velo-/meso-pharynx to PEJ. The coordination between deglutitive pharyngeal bolus distension and PEJ relaxation timing was assessed using timing variables; (i) Distention-Contraction Latency (DCL, s) and (ii) PEJ Relaxation Time (RT, s). Resultant flow resistance was quantified (IBP, mmHg). RESULTS TP swallows were observed in 87 (28%) cases. DCL was not significantly different in relation to TP, while PEJ relaxation time was shorter, and IBP was higher during TP swallows. In Patients RT-DCL time difference correlated with IBP (r -0.368, p < 0.01). CONCLUSION Bolus distension and PEJ relaxation were miss-timed during TP swallows, impeding bolus flow and leading to a brief period of pressurization of the pharyngeal chamber by muscular propulsive forces. While TP swallows were identified in both Controls and Patients, increased IBPs were most apparent for Patient swallows indicating that the extent of IBP increase may differentiate pathological TP swallows.
Collapse
Affiliation(s)
- Taher Omari
- Flinders Health and Medical Research Institute (FHMRI) & College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.,Department of Gastroenterology & Hepatology, Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Nathalie Rommel
- Deglutology, Department of Neurosciences, ExpORL, University of Leuven, Leuven, Belgium.,Department of Gastroenterology, Neurogastroenterology & Motility, University Hospitals Leuven, Leuven, Belgium.,Translational Research Centre Gastrointestinal Disease (TARGID), KU Leuven, Belgium
| | - Tack Jan
- Department of Gastroenterology, Neurogastroenterology & Motility, University Hospitals Leuven, Leuven, Belgium.,Translational Research Centre Gastrointestinal Disease (TARGID), KU Leuven, Belgium
| | - Michal Szczesniak
- Department of Gastroenterology and Hepatology, St George Hospital, University of New South Wales, Sydney, New South Wales, Australia
| | - Peter Wu
- Department of Gastroenterology and Hepatology, St George Hospital, University of New South Wales, Sydney, New South Wales, Australia
| | - Mistyka Schar
- Flinders Health and Medical Research Institute (FHMRI) & College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Sebastian Doeltgen
- Speech Pathology, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Charles Cock
- Flinders Health and Medical Research Institute (FHMRI) & College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.,Department of Gastroenterology & Hepatology, Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, South Australia, Australia
| |
Collapse
|
37
|
da Silva AS, Rabelo FAW, Thuler E, Kayamori F, Bianchini EMG. Obstructive Sleep Apnea: characterization of the obstructive site and type of collapse. Codas 2022; 34:e20210208. [PMID: 35584414 PMCID: PMC9886182 DOI: 10.1590/2317-1782/20212021208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/27/2021] [Indexed: 02/03/2023] Open
Abstract
Obstructive Sleep Apnea is characterized by recurrent episodes of partial or complete collapse of the pharynx, followed by decreased oxyhemoglobin saturation and frequent arousals. It is regarded as a public health issue with important night and day symptoms that impact life quality. Its effects are associated with the areas of competence of Speech and Language Pathologists. To establish efficient diagnosis and treatment methods, professionals must know the pathogenesis of upper airway obstruction during sleep. This study seeks to enlarge the understanding of obstructive sleep apnea pathophysiology, eligibility of individualized therapeutic procedures and guidance for orofacial myofunctional therapy by describing and illustrating the locations and types of upper airway collapse during sleep. We analyzed original records of Drug Induced Sleep Endoscopy exams of a series of cases with polysomnographic diagnosis of obstructive sleep apnea following the proper ethical processes. The images of the exam recordings were analyzed by five professionals with expertise in the sleep area. Obstructive sites and types of collapse were presented according to the current classification. The videos were divided into screenshots, originating figures from each anatomical site: without collapse and collapsed. The results are visualized in the images of the cases showing a predominance of velopharyngeal collapse: anteroposterior, lateral, or concentric; oropharyngeal lateral collapse; tongue anteroposterior collapse and anteroposterior collapse of the epiglottis. Understanding the obstruction sites and types of collapse illustrated in this study may help to predict therapeutic responses and learn the limitations or direct individual proposals patient.
Collapse
Affiliation(s)
- Andresa Santos da Silva
- Programa de Pós-graduação em Fonoaudiologia, Pontifícia Universidade Católica de São Paulo – PUCSP - São Paulo (SP), Brasil.
| | | | - Eric Thuler
- Departamento de Otorrinolaringologia, Hospital Sírio Libanês – HSL - São Paulo (SP), Brasil.
| | - Fabiane Kayamori
- Programa de Pós-graduação em Fonoaudiologia, Pontifícia Universidade Católica de São Paulo – PUCSP - São Paulo (SP), Brasil.
| | | |
Collapse
|
38
|
Shujaat S, Shaheen E, Riaz M, Politis C, Jacobs R. Three-Dimensional Pharyngeal Airway Space Changes Following Isolated Mandibular Advancement Surgery in 120 Patients: A 1-Year Follow-up Study. J Imaging 2022; 8. [PMID: 35448209 DOI: 10.3390/jimaging8040082] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/17/2022] [Accepted: 03/21/2022] [Indexed: 02/01/2023] Open
Abstract
Lack of evidence exists related to the three-dimensional (3D) pharyngeal airway space (PAS) changes at follow-up after isolated bilateral sagittal split osteotomy (BSSO) advancement surgery. The present study assessed the 3D PAS changes following isolated mandibular advancement at a follow-up period of 1 year. A total of 120 patients (40 males, 80 females, mean age: 26.0 ± 12.2) who underwent BSSO advancement surgery were recruited. Cone-beam computed tomography (CBCT) scans were acquired preoperatively (T0), immediately following surgery (T1), and at 1 year of follow-up (T2). The volume, surface area, and minimal cross-sectional area (mCSA) of the airway were assessed. The total airway showed a 38% increase in volume and 13% increase in surface area from T0 to T1, where the oropharyngeal region showed the maximum immediate change. At T1−T2 follow-up, both volumetric and surface area showed a relapse of less than 7% for all sub-regions. The mCSA showed a significant increase of 71% from T0 to T1 (p < 0.0001), whereas a non-significant relapse was observed at T1−T2 (p = 0.1252). The PAS remained stable at a follow-up period of 1 year. In conclusion, BSSO advancement surgery could be regarded as a stable procedure for widening of the PAS with maintenance of positive space at follow-up.
Collapse
|
39
|
Hamdan-Partida A, González-García S, Martínez-Ruíz FJ, Zavala-Sánchez MÁ, Bustos-Hamdan A, Bustos-Martínez J. Molecular Characterization of Staphylococcus aureus Strains Isolated from Mobile Phones. Microorganisms 2022; 10:669. [PMID: 35336244 DOI: 10.3390/microorganisms10030669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 03/16/2022] [Accepted: 03/18/2022] [Indexed: 12/04/2022] Open
Abstract
The widespread use of mobile phones (MP) among healthcare personnel might be considered as an important source of contamination. One of the most pathogenic bacteria to humans is Staphylococcus aureus, which can be transmitted through the constant use of MP. Nevertheless, which specific type of strains are transmitted and which are their sources have not been sufficiently studied. The aim of this study is to determine the source of contamination of MP and characterize the corresponding genotypic and phenotypic properties of the strains found. Nose, pharynx, and MP samples were taken from a group of health science students. We were able to determinate the clonality of the isolated strains by pulsed-field gel electrophoresis (PFGE) and spa gene typing (spa-type). Adhesin and toxin genes were detected, and the capacity of biofilm formation was determined. Several of the MP exhibited strains of S. aureus present in the nose and/or pharynx of their owners. methicillin-susceptible Staphylococcus aureus (MSSA), hospital-acquired methicillin-resistant S. aureus (HA-MRSA), and community-acquired methicillin-resistant S. aureus (CA-MRSA) strains were found, which indicated a variety of genotypes. This study concludes that MP can be contaminated with the strains of S. aureus present in the nose and/or pharynx of the owners; these strains can be of different types and there is no dominant genotype.
Collapse
|
40
|
Sievert M, Mantsopoulos K, Mueller SK, Eckstein M, Rupp R, Aubreville M, Stelzle F, Oetter N, Maier A, Iro H, Goncalves M. Systematic interpretation of confocal laser endomicroscopy: larynx and pharynx confocal imaging score. Acta Otorhinolaryngol Ital 2022; 42:26-33. [PMID: 35129541 PMCID: PMC9058938 DOI: 10.14639/0392-100x-n1643] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 09/28/2021] [Indexed: 04/25/2023]
Abstract
OBJECTIVE Development and validation of a confocal laser endomicroscopy (CLE) classification score for the larynx and pharynx. METHODS Thirteen patients (154 video sequences, 9240 images) with laryngeal or pharyngeal SCC were included in this prospective study between October 2020 and February 2021. Each CLE sequence was correlated with the gold standard of histopathological examination. Based on a dataset of 94 video sequences (5640 images), a scoring system was developed. In the remaining 60 sequences (3600 images), the score was validated by four CLE experts and four head and neck surgeons who were not familiar with CLE. RESULTS Tissue homogeneity, cell size, borders and clusters, capillary loops and the nucleus/cytoplasm ratio were defined as the scoring criteria. Using this score, the CLE experts obtained an accuracy, sensitivity, and specificity of 90.8%, 95.1%, and 86.4%, respectively, and the CLE non-experts of 86.2%, 86.4%, and 86.1%. Interobserver agreement Fleiss' kappa was 0.8 and 0.6, respectively. CONCLUSIONS CLE can be reliably evaluated based on defined and reproducible imaging features, which demonstrate a high diagnostic value. CLE can be easily integrated into the intraoperative setting and generate real-time, in-vivo microscopic images to demarcate malignant changes.
Collapse
Affiliation(s)
- Matti Sievert
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital, Erlangen, Germany
| | - Konstantinos Mantsopoulos
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital, Erlangen, Germany
| | - Sarina K Mueller
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital, Erlangen, Germany
| | - Markus Eckstein
- Institute of Pathology, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital, Erlangen, Germany
| | - Robin Rupp
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital, Erlangen, Germany
| | | | - Florian Stelzle
- Department of Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital, Erlangen, Germany
| | - Nicolai Oetter
- Department of Maxillofacial Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital, Erlangen, Germany
| | - Andreas Maier
- Pattern Recognition Laboratory, Computer Science, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital, Erlangen, Germany
| | - Miguel Goncalves
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital, Erlangen, Germany
- Department of Otorhinolaryngology, Plastic Head and Neck Surgery, Rheinische Westfälische Technische Hochschule Aachen, University Hospital, Aachen, Germany
| |
Collapse
|
41
|
Bengtsson L, Dotevall H, Sjögreen L, Ragnemalm L, Tuomi L. Effects of oral screen exercise on orofacial and pharyngeal activity: An exploratory study using videofluoroscopy and surface electromyography in healthy adults. Clin Exp Dent Res 2022; 8:519-528. [PMID: 35106972 PMCID: PMC9033549 DOI: 10.1002/cre2.538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 01/12/2022] [Accepted: 01/16/2022] [Indexed: 11/12/2022] Open
Abstract
Objective The oral screen is a device commonly used for treatment of orofacial disorders. The objective of this exploratory study was to examine the effect of oral screen exercise on the muscle activity in the lips, submental complex, masseter muscle, and kinematic activity of the tongue base, soft palate, pharynx, and larynx in healthy adults. This was compared with the kinematic activity during a dry swallow. It was hypothesized that not only the lip musculature but also other structures in the oral and pharyngeal cavities are activated while using an oral screen device. Method Ten healthy subjects used an oral screen during examination with videofluoroscopy and surface electromyography (EMG). Three different instructions for oral screen application and a dry swallow were examined. Results The lip muscles showed the highest activity during oral screen exercise. The other muscle groups were activated to a lesser degree. The pattern of activation differed between individuals. Compared with a dry swallow, the range of motion of the tongue base, posterior pharyngeal wall, and the larynx was significantly smaller during oral screen activation. No major differences were found between three different instructions. Conclusion This study indicates that the lips and submental complex and, to a lesser degree, oral, pharyngeal, and laryngeal structures are activated with the oral screen, but the pattern of activation varied between individuals. In comparison to the activity during a dry swallow, range of motion during oral screen exercise is small.
Collapse
Affiliation(s)
- Lisa Bengtsson
- Region Västra Götaland, Public Dental Service, Mun-H-Center, Orofacial Resource Centre for Rare Diseases, Gothenburg, Sweden.,Department of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hans Dotevall
- Department of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Lotta Sjögreen
- Region Västra Götaland, Public Dental Service, Mun-H-Center, Orofacial Resource Centre for Rare Diseases, Gothenburg, Sweden
| | - Lena Ragnemalm
- Department of Radiology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lisa Tuomi
- Department of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| |
Collapse
|
42
|
Alomar KS, Al-Shawi YA, Alzhrani F. Mucosal melanocytic lesion in the middle ear extending to the inner ear and naso pharynx. Ear Nose Throat J 2022:1455613211068571. [PMID: 35088612 DOI: 10.1177/01455613211068571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Benign dendritic melanocytic proliferation is usually observed in the skin. We report an extremely rare case of a melanocytic lesion in the middle ear mucosa. Only 3 cases of melanocytic lesions in the middle ear have been reported. Our report is the only one that describes an adult with a melanocytic lesion in the middle ear that extended to the inner ear and nasopharyngeal mucosa. A 23-year-old female presented with profound sensory neural hearing loss and recurrent discharge from the right ear. Examination revealed a blue right tympanic membrane with a small perforation. Computed tomography scans and magnetic resonance imaging were performed. After surgical exploration and histopathological examination, the patient was found to have a benign melanocytic lesion in the right middle ear. Melanocytic lesions are commonly found in the skin. There are no previous reports have described adult patients with melanocytic lesions in the middle ear that extend to the inner ear and nasopharynx, which cause profound hearing loss with recurrent ear discharge. These patients require regular follow-up to assess the progression of the lesion and to watch for any malignant behavior.
Collapse
Affiliation(s)
- Khalid Suwayyid Alomar
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, 37850King Saud University, Riyadh, Saudi Arabia
| | - Yazeed Ali Al-Shawi
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, 37850King Saud University, Riyadh, Saudi Arabia
- Prince Sultan Medical Military City, Riyadh, Saudi Arabia
| | - Farid Alzhrani
- King Abdullah Ear Specialist Center (KAESC), College of Medicine, 37850King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
43
|
Gil KN, Vogl AW, Shadwick RE. Anatomical mechanism for protecting the airway in the largest animals on earth. Curr Biol 2022; 32:898-903.e1. [PMID: 35063119 DOI: 10.1016/j.cub.2021.12.040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/18/2021] [Accepted: 12/16/2021] [Indexed: 11/29/2022]
Abstract
Separation of respiratory and digestive tracts in the mammalian pharynx is critical for survival. Food must be kept out of the respiratory tract, and air must be directed into the respiratory tract when breathing.1 Cetaceans have the additional problem of feeding while underwater. Lunge-feeding baleen whales (rorquals) open the mouth while swimming at high speeds to engulf a volume of prey-laden water as large as their own body2 and experience tremendous forces as water floods the mouth. How the respiratory tract is protected in the pharynx during engulfment and while swallowing a massive slurry of tiny living prey remains unknown, despite its importance to survival. By dissecting adult and fetal fin whales, we determined that a large musculo-fatty structure passively seals the oropharyngeal channel. This "oral plug" is not observed in other animals, and its position indicates it must be shifted to allow swallowing; it is a part of the soft palate and can only shift posteriorly and dorsally. Elevation of the oral plug allows food transfer to the pharynx and protects the upper airways from food entry. The laryngeal inlet in the floor of the pharynx is sealed by laryngeal cartilages, and the muscular laryngeal sac moves upward into the laryngeal cavity, completely occluding the airway. The pharynx is dedicated to the digestive tract during swallowing, with no connection between upper and lower airways. These adaptations to facilitate swallowing were a critical development in the evolution of large body size in these, the largest animals on earth.
Collapse
Affiliation(s)
- Kelsey N Gil
- Department of Zoology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
| | - A Wayne Vogl
- Life Sciences Institute and Department of Cellular and Physiological Sciences, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Robert E Shadwick
- Department of Zoology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
| |
Collapse
|
44
|
Costa ED, Brasil DM, Gaêta-Araujo H, Leggitt VL, Roque-Torres GD. Imaging of the upper airway: which method is best for orthodontic assessment? Gen Dent 2022; 70:51-55. [PMID: 34978991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The objectives of the present study were to compare measurements of pharyngeal airway subregions on lateral cephalometric (LC) and cone beam computed tomographic (CBCT) images in relation to skeletal classes and discuss the advantages and disadvantages of these imaging formats for this type of assessment. The CBCT images were assessed via both multiplanar reconstruction (MPR) and 3-dimensional (3D) reconstruction. The LC and CBCT images from 107 patients were classified according to skeletal class: I, n = 35; II, n = 35; and III, n = 37. Linear measurements of the subdivisions of the upper airway were performed on the LC, MPR, and 3D images. In addition, area and volumetric measurements were performed on the MPR images. The relationships among imaging methods, skeletal class, and pharyngeal thirds were assessed by means of a 1-way analysis of variance (α = 0.05). No statistically significant differences in the linear, area, or volumetric measurements of the upper airway subregions were found among the skeletal classes (P > 0.05). For the linear measurements in the oropharynx and hypopharynx, greater values were observed for the LC images than for the MPR and 3D images (P ≤ 0.05). Based on the study findings, MPR images should be preferred for visualization of the pharyngeal airway subregions. However, LC imaging is preferable to 3D reconstruction.
Collapse
|
45
|
Arya RK, Verros GD, Thapliyal D. Towards a Mathematical Model for the Viral Progression in the Pharynx. Healthcare (Basel) 2021; 9:healthcare9121766. [PMID: 34946492 PMCID: PMC8701019 DOI: 10.3390/healthcare9121766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/16/2021] [Accepted: 12/16/2021] [Indexed: 12/03/2022] Open
Abstract
In this work, a comprehensive model for the viral progression in the pharynx has been developed. This one-dimension model considers both Fickian diffusion and convective flow coupled with chemical reactions, such as virus population growth, infected and uninfected cell accumulation as well as virus clearance. The effect of a sterilizing agent such as an alcoholic solution on the viral progression in the pharynx was taken into account and a parametric analysis for the effect of kinetic rate parameters on virus propagation was made. Moreover, different conditions caused by further medical treatment, such as a decrease in virus yield per infected cell, were examined. It is shown that the infection fails to establish by decreasing the virus yield per infected cell. It is believed that this work could be used to further investigate the medical treatment of viral progression in the pharynx.
Collapse
Affiliation(s)
- Raj Kumar Arya
- Department of Chemical Engineering, Dr. B. R. Ambedkar National Institute of Technology, Jalandhar 144011, India;
- Correspondence: or
| | - George D. Verros
- Laboratory of Polymer and Colour Chemistry and Technology, Department of Chemistry, Aristotle University of Thessaloniki (AUTH), P.O. Box 454, Plagiari, Epanomi, 57500 Thessaloniki, Greece;
| | - Devyani Thapliyal
- Department of Chemical Engineering, Dr. B. R. Ambedkar National Institute of Technology, Jalandhar 144011, India;
| |
Collapse
|
46
|
Nollet JL, Cajander P, Ferris LF, Ramjith J, Omari TI, Savilampi J. Pharyngo-Esophageal Modulatory Swallow Responses to Bolus Volume and Viscosity Across Time. Laryngoscope 2021; 132:1817-1824. [PMID: 34928519 PMCID: PMC9545908 DOI: 10.1002/lary.29987] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/24/2021] [Accepted: 11/29/2021] [Indexed: 12/19/2022]
Abstract
Objectives/Hypothesis Modulation of the pharyngeal swallow to bolus volume and viscosity is important for safe swallowing and is commonly studied using high‐resolution pharyngeal manometry (HRPM). Use of unidirectional pressure sensor technology may, however, introduce variability in swallow measures and a fixed bolus administration protocol may induce time and order effects. We aimed to overcome these limitations and to investigate the effect of time by repeating randomized measurements using circumferential pressure sensor technology. Study Design Sub‐set analysis of data from the placebo arm of a randomized, repeated measures trial. Methods HRPM with impedance was recorded using a solid‐state catheter with 36 circumferential pressure sensors and 18 impedance segments straddling from hypopharynx to stomach. Testing included triplicates of 5, 10, and 20 ml thin liquid and 10 ml thick liquid boluses, the order of the thin liquid boluses was randomized. The swallow challenges were repeated approximately 10 minutes after finishing the baseline measurement. Results We included 19 healthy adults (10/9 male/female; age 24.5 ± 4.1 year). Intrabolus pressure, all upper esophageal sphincter (UES) opening and relaxation metrics, and flow timing metrics increased with larger volumes. A thicker viscosity decreased UES relaxation time, UES basal pressure, and flow timing metrics, whereas UES opening extent increased. Pre‐swallow UES basal pressure and post‐swallow UES contractile integral decreased over time. Conclusion Using circumferential pressure sensor technology, the effects of volume and viscosity were largely consistent with previous reports. UES contractile pressures reduced over time. The growing body of literature offers a benchmark for recognizing aberrant pharyngo‐esophageal motor responses. Level of Evidence 3 Laryngoscope, 132:1817–1824, 2022
Collapse
Affiliation(s)
- Joeke L Nollet
- Department of Intensive Care Medicine, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
| | - Per Cajander
- Department of Anesthesiology and Intensive Care, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Lara F Ferris
- Department of Human Physiology, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Jordache Ramjith
- Department for Health Evidence, Section Biostatistics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Taher I Omari
- Department of Human Physiology, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Johanna Savilampi
- Department of Anesthesiology and Intensive Care, Faculty of Medicine and Health, School of Medical Sciences, Örebro University, Örebro, Sweden
| |
Collapse
|
47
|
Long X, Li Z, Liu Y, Zhen H. Clinical Application of Low-Temperature Plasma Radiofrequency in the Treatment of Hemangioma in Nasal Cavity, Pharynx and Larynx. Ear Nose Throat J 2021:1455613211062443. [PMID: 34893005 DOI: 10.1177/01455613211062443] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Hemangioma is a common benign tumor in the head and neck. The therapeutic effect by conventional treatment was not very satisfactory. The purpose of this study is to explore the surgical strategy of low-temperature plasma radiofrequency in the treatment of hemangioma located in the nasal cavity, pharynx, and larynx. METHODS The clinical data of 29 cases with hemangioma in nasal cavity, pharynx, and larynx treated by low-temperature plasma radiofrequency ablation were retrospectively analyzed. The strategy of ablation before resection was performed for 16 cases of nasal capillary hemangioma. The other 13 cases of cavernous hemangioma in the pharynx and larynx were treated by the strategy of direct ablation. RESULTS All 29 patients underwent a successful operation with minimal intraoperative bleeding and no postoperative bleeding complications. There was no nasal septum perforation, dyspnea, dysphagia, dysphonia, or other complications. The patients were followed up for more than 3 years without recurrence. CONCLUSION Low-temperature plasma radiofrequency is a practical, minimally invasive, and accurate method for treating hemangiomas in the nasal cavity, pharynx, and larynx. For capillary hemangiomas, the strategy of ablation before resection may be an effective way to reduce bleeding, and for cavernous hemangiomas, the strategy of direct ablation is a simple and efficient method.
Collapse
Affiliation(s)
- Xiaobo Long
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, 12403Huazhong University of Science and Technology, Wuhan, China
| | - Zhiyong Li
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, 12403Huazhong University of Science and Technology, Wuhan, China
- Department of Otolaryngology-Head and Neck Surgery, 89674Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yang Liu
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, 12403Huazhong University of Science and Technology, Wuhan, China
| | - Hongtao Zhen
- Department of Otolaryngology-Head and Neck Surgery, Tongji Hospital, Tongji Medical College, 12403Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
48
|
Dastan F, Ghaffari H, Shishvan HH, Zareiyan M, Akhlaghian M, Shahab S. Correlation between the upper airway volume and the hyoid bone position, palatal depth, nasal septum deviation, and concha bullosa in different types of malocclusion: A retrospective cone-beam computed tomography study. Dent Med Probl 2021; 58:509-514. [PMID: 34850611 DOI: 10.17219/dmp/130099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The upper airway volume is among the factors that affect orthodontic treatment plans. Cone-beam computed tomography (CBCT), as an accurate diagnostic modality, can help assess anatomical structures associated with the upper airway volume. OBJECTIVES This study aimed to use CBCT to determine if there are differences in the upper airway volume between different sagittal and vertical skeletal patterns, considering the hyoid bone position, palatal depth, nasal septum deviation (NSD), and concha bullosa. MATERIAL AND METHODS From among 105 initial CBCT samples retrieved from the archive of a private radiology clinic in Tehran, Iran, 90 CBCT scans of 27 males and 63 females aged 17-65 years were considered in the study according to the inclusion criteria. The upper airway volume was assessed with regard to Angle's classification (using the A point-nasion-B point angle (ANB)), the vertical skeletal dimension (using the sella-nasion plane to mandibular plane angle (SN-MP)), the hyoid bone position, palatal depth, NSD, and concha bullosa, using CBCT and the NNT ® software. The one-way analysis of variance (ANOVA), Levene's test and the t test were used to analyze the data with the SPSS Statistics for Windows software, v. 17.0. RESULTS The upper airway volume was significantly smaller in long-face cases (p = 0.037). There was no significant correlation between the upper airway volume and Angle's classification, the hyoid bone position, palatal depth, NSD, and concha bullosa. CONCLUSIONS The vertical skeletal dimension was the only parameter that was related to the upper airway volume. The results of this study can be considered while preparing orthodontic treatment plans.
Collapse
Affiliation(s)
- Farivar Dastan
- Department of Orthodontics, School of Dentistry, AJA University of Medical Sciences, Tehran, Iran
| | - Hassanali Ghaffari
- Department of Orthodontics, School of Dentistry, AJA University of Medical Sciences, Tehran, Iran
| | - Hadi Hamidi Shishvan
- Department of Oral and Maxillofacial Radiology, School of Dentistry, AJA University of Medical Sciences, Tehran, Iran
| | - Mehrshad Zareiyan
- Department of Pediatrics, School of Dentistry, Ardabil University of Medical Sciences, Iran
| | - Marzieh Akhlaghian
- Department of Prosthodontics, School of Dentistry, Shiraz University of Medical Sciences, Iran
| | - Shahriar Shahab
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Shahed University, Tehran, Iran
| |
Collapse
|
49
|
Dos Santos E Santos C, Araujo Tuma Santos C, Kurnutala LN. Challenging Airway Management in Patients With Zenker's Diverticulum. Cureus 2021; 13:e19578. [PMID: 34804751 PMCID: PMC8591150 DOI: 10.7759/cureus.19578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2021] [Indexed: 11/05/2022] Open
Abstract
The acquired hypopharyngeal diverticulum (Zenker's) is characterized by a posterior wall outpouching of the pharyngeal mucosa and submucosa through the vulnerable points of the pharyngoesophageal junction. We describe the case of a 67-year-old male who was recently diagnosed with Zenker's diverticulum and had complaints of dysphagia and halitosis. An endoscopic treatment (diverticulotomy) was performed without difficulties. The anesthetic management included rapid sequence induction, avoiding succinylcholine, and intraoperative infusion of dexmedetomidine. The neuromuscular blockade was reversed using sugammadex, decreasing the risk of failed extubation and possible airway re-intervention. The patient was discharged home the following day without complications.
Collapse
Affiliation(s)
| | | | - Lakshmi N Kurnutala
- Anesthesiology and Perioperative Medicine, University of Mississippi Medical Center, Jackson, USA
| |
Collapse
|
50
|
Wu ZB, Meng KF, Ding LG, Wu S, Han GK, Zhai X, Sun RH, Yu YY, Ji W, Xu Z. Dynamic Interaction Between Mucosal Immunity and Microbiota Drives Nose and Pharynx Homeostasis of Common Carp ( Cyprinus carpio) After SVCV Infection. Front Immunol 2021; 12:769775. [PMID: 34804060 PMCID: PMC8601392 DOI: 10.3389/fimmu.2021.769775] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 10/06/2021] [Indexed: 12/13/2022] Open
Abstract
The crosstalk between the immune system and microbiota drives an amazingly complex mutualistic symbiosis. In mammals, the upper respiratory tract acts as a gateway for pathogen invasion, and the dynamic interaction between microbiota and mucosal immunity on its surface can effectively prevent disease development. However, the relationship between virus-mediated mucosal immune responses and microbes in lower vertebrates remains uncharacterized. In this study, we successfully constructed an infection model by intraperitoneally injecting common carp (Cyprinus carpio) with spring viremia of carp virus (SVCV). In addition to the detection of the SVCV in the nose and pharynx of common carp, we also identified obvious histopathological changes following viral infection. Moreover, numerous immune-related genes were significantly upregulated in the nose and pharynx at the peak of SVCV infection, after which the expression levels decreased to levels similar to those of the control group. Transcriptome sequencing results revealed that pathways associated with bacterial infection in the Toll-like receptor pathway and the Nod-like receptor pathway were activated in addition to the virus-related Rig-I-like receptor pathway after SVCV infection, suggesting that viral infection may be followed by opportunistic bacterial infection in these mucosal tissues. Using 16S rRNA gene sequencing, we further identified an upward trend in pathogenic bacteria on the mucosal surface of the nose and pharynx 4 days after SVCV infection, after which these tissues eventually reached new homeostasis. Taken together, our results suggest that the dynamic interaction between mucosal immunity and microbiota promotes the host to a new ecological state.
Collapse
Affiliation(s)
- Zheng-Ben Wu
- Department of Aquatic Animal Medicine, College of Fisheries, Huazhong Agricultural University, Wuhan, China
| | - Kai-Feng Meng
- Department of Aquatic Animal Medicine, College of Fisheries, Huazhong Agricultural University, Wuhan, China
| | - Li-Guo Ding
- Department of Aquatic Animal Medicine, College of Fisheries, Huazhong Agricultural University, Wuhan, China
| | - Sha Wu
- Department of Aquatic Animal Medicine, College of Fisheries, Huazhong Agricultural University, Wuhan, China
| | - Guang-Kun Han
- Department of Aquatic Animal Medicine, College of Fisheries, Huazhong Agricultural University, Wuhan, China
| | - Xue Zhai
- Department of Aquatic Animal Medicine, College of Fisheries, Huazhong Agricultural University, Wuhan, China
| | - Ru-Han Sun
- Department of Aquatic Animal Medicine, College of Fisheries, Huazhong Agricultural University, Wuhan, China
| | - Yong-Yao Yu
- Department of Aquatic Animal Medicine, College of Fisheries, Huazhong Agricultural University, Wuhan, China
| | - Wei Ji
- Department of Aquatic Animal Medicine, College of Fisheries, Huazhong Agricultural University, Wuhan, China
| | - Zhen Xu
- Department of Aquatic Animal Medicine, College of Fisheries, Huazhong Agricultural University, Wuhan, China.,State Key Laboratory of Freshwater Ecology and Biotechnology, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, China
| |
Collapse
|