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[PMID]:29443735
[Au] Autor:Yang CW; Wang SF; Yang XL; Wang L; Niu L; Liu JX
[Ad] Endereço:Department of Otorhinolaryngology Head and Neck Surgery, Tianjin Union Medical Center.
[Ti] Título:Identification of gene expression models for laryngeal squamous cell carcinoma using co-expression network analysis.
[So] Source:Medicine (Baltimore);97(7):e9738, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:One of the most common head and neck cancers is laryngeal squamous cell carcinoma (LSCC). LSCC exhibits high mortality rates and has a poor prognosis. The molecular mechanisms leading to the development and progression of LSCC are not entirely clear despite genetic and therapeutic advances and increased survival rates. In this study, a total of 116 differentially expressed genes (DEGs), including 11 upregulated genes and 105 downregulated genes, were screened from LSCC samples and compared with adjacent noncancerous. Statistically significant differences (log 2-fold difference > 0.5 and adjusted P-value < .05) were found in this study in the expression between tumor and nontumor larynx tissue samples. Nine cancer hub genes were found to have a high predictive power to distinguish between tumor and nontumor larynx tissue samples. Interestingly, they also appear to contribute to the progression of LSCC and malignancy via the Jak-STAT signaling pathway and focal adhesion. The model could separate patients into high-risk and low-risk groups successfully when only using the expression level of mRNA signatures. A total of 4 modules (blue, gray, turquoise, and yellow) were screened for the DEGs in the weighted co-expression network. The blue model includes cancer-specific pathways such as pancreatic cancer, bladder cancer, nonsmall cell lung cancer, colorectal cancer, glioma, Hippo signaling pathway, melanoma, chronic myeloid leukemia, prostate cancer, and proteoglycans in cancer. Endocrine resistance (CCND1, RAF1, RB1, and SMAD2) and Hippo signaling pathway (CCND1, LATS1, SMAD2, and TP53BP2) could be of importance in LSCC, because they had high connectivity degrees in the blue module. Results from this study provide a powerful biomarker discovery platform to increase understanding of the progression of LSCC and to reveal potential therapeutic targets in the treatment of LSCC. Improved monitoring of LSCC and resulting improvement of treatment of LSCC might result from this information.
[Mh] Termos MeSH primário: Carcinoma de Células Escamosas/genética
Perfilação da Expressão Gênica/métodos
Neoplasias Laríngeas/genética
Transdução de Sinais/genética
[Mh] Termos MeSH secundário: Biomarcadores Tumorais/genética
Progressão da Doença
Expressão Gênica/genética
Regulação Neoplásica da Expressão Gênica/genética
Seres Humanos
Laringe/metabolismo
Metanálise em Rede
RNA Mensageiro/genética
Taxa de Sobrevida
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS
[Nm] Nome de substância:
0 (Biomarkers, Tumor); 0 (RNA, Messenger)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180215
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009738


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[PMID]:29291277
[Au] Autor:Ahmad I; Kirby P; Liming B
[Ad] Endereço:1 Division of Pediatric Otolaryngology, Department of Otolaryngology-Head and Neck Surgery, Stanford University, Palo Alto, California, USA.
[Ti] Título:Ectopic Thymic Cyst of the Subglottis: Considerations for Diagnosis and Management.
[So] Source:Ann Otol Rhinol Laryngol;127(3):200-204, 2018 Mar.
[Is] ISSN:1943-572X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: To share the diagnostic and management challenges created by an extremely rare airway lesion-the subglottic ectopic thymic cyst. STUDY DESIGN: Case report and literature review. METHODS: We review the presentation, management, and clinical course of an infant who presented with a subglottic mass that was histologically confirmed as a thymic cyst. A brief literature review supplements the case presentation Results: We present the third described case of an ectopic thymic cyst presenting as a subglottic mass. The differential diagnosis of subglottic masses in neonates consists primarily of subglottic hemangioma and mucous retention cysts. Otolaryngologists must be prepared for unexpected findings when dealing with critical airways. We compare the presentation and management of our patient with the 2 previously described cases. We propose an embryologic theory for the origin of these rare lesions. CONCLUSIONS: An ectopic thymic cyst is a rare and unexpected cause of neonatal stridor. Management of pediatric airway lesions must allow for unexpected findings at the time of diagnostic and therapeutic endoscopy. The appropriate management of subglottic thymic cysts is poorly defined, but close surveillance for recurrence is mandatory.
[Mh] Termos MeSH primário: Anormalidades Congênitas/diagnóstico
Doenças da Laringe
Laringoscopia/métodos
Laringe/anormalidades
Cisto Mediastínico
Sons Respiratórios/diagnóstico
[Mh] Termos MeSH secundário: Coristoma
Anormalidades Congênitas/etiologia
Diagnóstico Diferencial
Seres Humanos
Lactente
Doenças da Laringe/diagnóstico
Doenças da Laringe/fisiopatologia
Masculino
Sons Respiratórios/etiologia
Resultado do Tratamento
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180102
[St] Status:MEDLINE
[do] DOI:10.1177/0003489417749609


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[PMID]:29365373
[Au] Autor:Chen C; Tan LT; Xu ZM
[Ad] Endereço:Department of Otorhinolaryngology Head and Neck Surgery, Children's Hospital of Fudan University, 201102 Shanghai, China.
[Ti] Título:[Evaluation and treatment of children's laryngeal clefts].
[So] Source:Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi;53(1):9-15, 2018 Jan 07.
[Is] ISSN:1673-0860
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To provide the experience about the diagnostic process and following management, and to discuss the outcome and predictors in children with laryngeal cleft (LC). A retrospective case study was conducted at an academic children's hospital. Thirty children were diagnosed as laryngeal cleft between January 2016 and April 2017.Airway evaluations were performed using both flexible and rigid endoscopy, and swallowing evaluations were performed using fiberoptic endoscopic examination of swallowing or modified barium swallow. Of 30 cases, 18 were male and 12 were female, ranging in age from birth to 8 years. Two cases were diagnosed as type 0 LC, and they were offered thickened liquid without medication. Throughout follow-up, they remained asymptomatic and showed no respiratory complications. Nineteen children were diagnosed as type â…  LC. Six of them were significantly improved by anti-reflux therapy and feeding instructions. Four children were concomitant with swallowing dysfunction and/or neuromuscular disorders, and they were given a tracheotomy and routine management. Another 4 children were submitted surgical repair when routine treatment failed, and their symptoms were relieved. Five children were concomitant with larygomalacia, and their symptoms were totally ameliorated by supraglottoplasty. Three children were diagnosed as type â…¡ LC. Two of them received surgical repair and clinically improved, and the rest one was treated by anti-reflux therapy and still under follow-up. Three children were diagnosed as type â…¢ LC. One of them was underwent surgical repair and clinically improved. Two children were tracheotomized and treated by anti-reflux therapy. Three cases were diagnosed as type â…£ LC at birth and no one survived. Laryngeal cleft is a rare congenital anomaly manifesting with a variety of symptoms, including swallowing disorder, aspirations, dyspnea, stridor and hoarseness. Diagnosis and treatment of laryngeal clefts is a challenge. The best way to evaluate the LC is FEES by laryngeal endoscopy combined with MLB. Cases with type 0-â…  mostly were significantly improved by anti-reflux therapy and feeding instructions. When routine treatment failed, surgical repair is needed. All the cases with LC type â…¡-â…¢ need surgical repair as soon as possible. For type â…£ cases, early diagnosis, appropriate treatment and management help to reduce mortality and morbidity.
[Mh] Termos MeSH primário: Anormalidades Congênitas/diagnóstico
Anormalidades Congênitas/terapia
Refluxo Gastroesofágico/terapia
Laringe/anormalidades
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Transtornos de Deglutição/etiologia
Feminino
Fluoroscopia
Refluxo Gastroesofágico/etiologia
Rouquidão/etiologia
Seres Humanos
Lactente
Recém-Nascido
Laringoscopia
Masculino
Sons Respiratórios/etiologia
Estudos Retrospectivos
Traqueotomia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180215
[Lr] Data última revisão:
180215
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180125
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1673-0860.2018.01.003


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[PMID]:29390419
[Au] Autor:Park P; Kim J; Song YJ; Lim JH; Cho SW; Won TB; Han DH; Kim DY; Rhee CS; Kim HJ
[Ad] Endereço:Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul, Korea.
[Ti] Título:Influencing factors on CPAP adherence and anatomic characteristics of upper airway in OSA subjects.
[So] Source:Medicine (Baltimore);96(51):e8818, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Although continuous positive airway pressure (CPAP) is the most effective treatment modality, poor adherence still remains a problem for obstructive sleep apnea (OSA) treatment and there is little evidence regarding how this might be improved. This study aims to analyze the anatomic and clinical factors of OSA subjects who failed to comply with CPAP therapy.The medical records of 47 OSA subjects who received CPAP therapy as a first-line treatment modality were retrospectively reviewed. The medical records were reviewed for demographic and polysomnographic data and anatomic findings of the nasal cavity and oropharynx.24 patients who adhered to CPAP therapy and 23 patients who were nonadherent were enrolled in the study. There were no statistically significant differences in sleep parameters between CPAP-adherent patients and CPAP nonadherent subjects. Mean body mass index of CPAP nonadherent group was significantly higher than CPAP adherent group. Higher grades of septal deviation and hypertrophic change of the inferior turbinate were observed more in the CPAP nonadherent group. In addition, CPAP nonadherent subjects showed considerably bigger tonsils and higher grade palatal position comparing with the CPAP adherent subjects. Subjective discomfort including inconvenience, mouth dryness, and chest discomfort were the main problems for OSA subjects who did not comply with CPAP therapy.Excessive upper airway blockage in the nasal cavity and oropharynx was predominant in CPAP nonadherent subjects, which might cause the reported subjective discomfort that reduces CPAP compliance. Therefore, resolution of these issues is needed to enhance CPAP compliance for control of OSA.
[Mh] Termos MeSH primário: Pressão Positiva Contínua nas Vias Aéreas
Cooperação do Paciente
Apneia Obstrutiva do Sono/terapia
[Mh] Termos MeSH secundário: Adulto
Idoso
Endoscopia
Feminino
Seres Humanos
Laringe/fisiopatologia
Masculino
Meia-Idade
Septo Nasal/fisiopatologia
Tonsila Palatina/fisiopatologia
Estudos Retrospectivos
Traqueia/fisiopatologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180213
[Lr] Data última revisão:
180213
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008818


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[PMID]:29262447
[Au] Autor:Wu JH; Luo XY
[Ad] Endereço:Department of Otorhinolaryngology Head and Neck Surgery, the First Affiliated Hospital of Xiamen University, Xiamen 361003, China.
[Ti] Título:[Application of narrow band imaging in the detection of premalignant and malignant lesions of the larynx].
[So] Source:Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi;52(12):900-904, 2017 Dec 07.
[Is] ISSN:1673-0860
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To evaluate the role of narrow band imaging (NBI) endoscopy in the diagnosis of laryngeal lesions. A total of 136 patients with laryngeal lesions were examined by NBI and white light (WLI) endoscopy from July 2016 to May 2017. Sensitivity, specificity, accuracy, and positive predictive value (PPV) and negative predictive value (NPV) of NBI and WLI were calculated. SPSS 20.0 software was used to analyze the data. Compared to WLI, NBI showed higher sensitivity (94.9% vs 83.3%), specificity (95.6% vs 84.4%), PPV (94.9% vs 82.3%), and NPV (95.6% vs 85.4%). There was high consistency of the results etween NBI and pathology (kappa=0.904, <0.01). However, consistency of the findings between WLI and pathology was relatively weak (kappa=0.677, <0.01). NBI showed the higher accuracy in diagnoses of both benign lesions (especially for premalignant lesions, <0.01) and malignant lesions (especially for high-grade intraepithelial neoplasia, <0.05) than WLI. NBI findings correlated with the pathological results ( =0.739, <0.01). NBI demonstrates higher accuracy in the detection of premalignant and malignant lesions of the larynx.
[Mh] Termos MeSH primário: Endoscopia/métodos
Neoplasias Laríngeas/diagnóstico por imagem
Imagem de Banda Estreita/métodos
Lesões Pré-Cancerosas/diagnóstico por imagem
[Mh] Termos MeSH secundário: Seres Humanos
Neoplasias Laríngeas/patologia
Laringe/diagnóstico por imagem
Laringe/patologia
Luz
Lesões Pré-Cancerosas/patologia
Valor Preditivo dos Testes
Estudos Prospectivos
Sensibilidade e Especificidade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1673-0860.2017.12.005


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[PMID]:29262511
[Au] Autor:Wang Q; Liu YH; Hu GQ; Wu KL; Tong BS; Gao CB; Zhao Y
[Ad] Endereço:Department of Otalaryngology and head surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China.
[Ti] Título:[Surgical management of elderly patients with medial wall pyriform sinus cancer].
[So] Source:Zhonghua Zhong Liu Za Zhi;39(12):931-936, 2017 Dec 23.
[Is] ISSN:0253-3766
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To investigate the clinical efficacy of preoperative-, postoperative-radiotherapy and surgery for preserving laryngeal function in patient over 70 years of age with medial wall pyriform sinus cancer. Clinical data of 48 patients over 70 years of age with medial wall pyriform sinus cancer who received surgical treatment from January 2001 to December 2010 were retrospectively analyzed. Among them, 21 cases were given preoperative radiotherapy and surgery (R+ S). The radiation therapy dose was 45 Gy. And 14 cases' larynx is preserved. In addition, 27 cases were given postoperative radiotherapy and surgery (S+ R). The radiation therapy dose was 65 Gy. And 10 cases had preserved laryngeal function. Survival rates were analyzed by the Kaplan-Meier method. Chi-square test was used to compare complications between two groups. The larynx preservation rate in R+ S group [66.7% (14/21)] was significantly higher than that in S+ R group [37.0% (10/27), <0.05]. The complication rate and decannulation rate in R+ S group were 42.9% (9/21) and 64.3% (9/14), respectively, showing no difference compared with those in S+ R group [37.0% (10/27) and 50.0% (5/10), respectively] (all >0.05). The complication rates of patients with and without larynx preservation were 41.7% (10/24) and 37.5% (9/24), respectively, showing no difference between two groups ( >0.05). The overall 3-years and 5-years survival rates for all patients were 54.2% (26/48) and 35.4% (17/48), respectively. There was no significant difference in survival rates between R+ S [38.1% (8/21)] group and S+ R group [33.3% (9/27), >0.05)]. In the R+ S group, the survival rates in patients with and without larynx preservation were 40.0% (4/10) and 29.4% (5/17), respectively, showing no significant difference between two groups ( >0.05). It is secure and effective to choose the operation with laryngeal preservation for patient over 70 years of age with medial wall pyriform sinus cancer based on their physical conditions and the tumor extension. The preoperative- and postoperative-radiotherapy have the similar effect. Preoperative radiotherapy and surgery increases the laryngeal preservation rate.
[Mh] Termos MeSH primário: Carcinoma de Células Escamosas/radioterapia
Carcinoma de Células Escamosas/cirurgia
Neoplasias Hipofaríngeas/radioterapia
Neoplasias Hipofaríngeas/cirurgia
Laringe
Tratamentos com Preservação do Órgão
Seio Piriforme/efeitos da radiação
Seio Piriforme/cirurgia
[Mh] Termos MeSH secundário: Idoso
Carcinoma de Células Escamosas/mortalidade
Seres Humanos
Laringectomia
Dosagem Radioterapêutica
Estudos Retrospectivos
Taxa de Sobrevida
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.0253-3766.2017.12.010


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[PMID]:29287871
[Au] Autor:Wertz A; Ha JF; Driver LE; Zopf DA
[Ad] Endereço:Department of Otolaryngology - Head & Neck Surgery, University of Michigan Health System, C.S. Mott Children's Hospital, 1540 East Hospital Drive, Ann Arbor, MI 48109, United States. Electronic address: aileen.wertz@gmail.com.
[Ti] Título:Pediatric laryngeal cleft repair and dysphagia.
[So] Source:Int J Pediatr Otorhinolaryngol;104:216-219, 2018 Jan.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To describe changes in diet and swallow function in patients with a laryngeal cleft after surgical repair of the laryngeal cleft. METHODS: Retrospective case series performed using chart review. Primary outcomes were diet and swallow function before and after laryngeal cleft repair. Clinical evaluation and video fluoroscopic swallow studies (VFSS) were used to assess pre- and post intervention swallowing. RESULTS: 16 pediatric patients were included in this study. Preoperatively, 14 (88%) patients had diet restrictions. Postoperatively, 12 (75%) patients tolerated a regular diet without limitation. 4 (25%) patients had no reduction in diet restrictions over the course of this study. For the 10 patients who transitioned to a regular diet postoperatively, a median of 300 days (range: 26 days - 3 years) passed to document achieving a regular diet. This was corroborated by an increase in normal oral and pharyngeal phase swallow function on VFSS postoperatively when compared with preoperative VFSS results. CONCLUSION: Dysphagia improves in most patients after laryngeal cleft repair. The range in time to a normal diet was wide. This may facilitate improved preoperative counseling and preparation of families' expectations.
[Mh] Termos MeSH primário: Anormalidades Congênitas/cirurgia
Transtornos de Deglutição/cirurgia
Deglutição/fisiologia
Laringe/anormalidades
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Dieta
Feminino
Fluoroscopia
Seres Humanos
Lactente
Laringe/cirurgia
Masculino
Período Pós-Operatório
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171231
[St] Status:MEDLINE


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[PMID]:29287862
[Au] Autor:Schwartz MA; Kavanagh KR; Frampton SJ; Bruce IA; Valdez TA
[Ad] Endereço:University of Connecticut Health Center, Otolaryngology, Farmington, CT, USA.
[Ti] Título:Using simulators to teach pediatric airway procedures in an international setting.
[So] Source:Int J Pediatr Otorhinolaryngol;104:178-181, 2018 Jan.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: There has been a growing shift towards endoscopic management of laryngeal procedures in pediatric otolaryngology. There still appears to be a shortage of pediatric otolaryngology programs and children's hospitals worldwide where physicians can learn and practice these skills. Laryngeal simulation models have the potential to be part of the educational training of physicians who lack exposure to relatively uncommon pediatric otolaryngologic pathology. OBJECTIVES: The objective of this study was to assess the utility of pediatric laryngeal models to teach laryngeal pathology to physicians at an international meeting. METHODS: Pediatric laryngeal models were assessed by participants at an international pediatric otolaryngology meeting. Participants provided demographic information and previous experience with pediatric airways. Participants then performed simulated surgery on these models and evaluated them using both a previously validated Tissue Likeness Scale and a pre-simulation to post-simulation confidence scale. RESULTS: Participants reported significant subjective improvement in confidence level after use of the simulation models (p < 0.05). Participants reported realistic representations of human anatomy and pathology. The models' tissue mechanics were adequate to practice operative technique including the ability to incise, suture, and suspend models. CONCLUSION: The pediatric laryngeal models demonstrate high quality anatomy, which is easy manipulated with surgical instruments. These models allow both trainees and surgeons to practice time-sensitive airway surgeries in a safe and controlled environment.
[Mh] Termos MeSH primário: Laringe/cirurgia
Manequins
Otolaringologia/educação
Pediatria/educação
[Mh] Termos MeSH secundário: Criança
Competência Clínica
Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171231
[St] Status:MEDLINE


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[PMID]:28456464
[Au] Autor:Park T; Kim Y; Oh BM
[Ad] Endereço:Communication Sciences and Disorders, College of Art and Science, Illinois State University, Normal, Illinois. Electronic address: tpark12@ilstu.edu.
[Ti] Título:Laryngeal Closure during Swallowing in Stroke Survivors with Cortical or Subcortical Lesion.
[So] Source:J Stroke Cerebrovasc Dis;26(8):1766-1772, 2017 Aug.
[Is] ISSN:1532-8511
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: One of the major, and most harmful, symptoms of dysphagia in stroke survivors is aspiration. Survivors of unilateral cortical strokes with dysphagia and resulting aspiration have been reported to have greater initiation delays in laryngeal closure than those who did not aspirate. Few studies have reported such data in survivors of subcortical stroke. METHODS: This study measured initiation of laryngeal closure (ILC) and laryngeal closure duration (LCD) in 2 groups of subjects: 15 stroke survivors with cortical lesions and 15 stroke survivors with subcortical lesions. Means and standard deviations of ILC and LCD were analyzed on 5-mL thin liquid and 5-mL puree boluses using a 100-ms timer during subsequent analysis of videofluoroscopic swallowing examinations. Statistical comparisons were used by repeated measures analysis of variance. Significance level was set at P < .05. RESULTS: ILC was significantly longer in stroke survivors with a subcortical lesion than in those with a cortical lesion for both bolus consistencies. However, there were no significant differences between the 2 groups in LCD. Stroke survivors with a subcortical lesion had a greater incidence of penetration or aspiration and silent aspiration than those with a cortical lesion and a longer delay in the ILC. CONCLUSIONS: Subcortical lesions may put these survivors at greater risk of aspiration due to delayed initial laryngeal closure and reduced oral and laryngeal sensation. The subcortical damage, which occurs at the basal ganglia, may interrupt the ILC.
[Mh] Termos MeSH primário: Infarto Cerebral/complicações
Transtornos de Deglutição/etiologia
Deglutição
Laringe/fisiopatologia
Aspiração Respiratória de Conteúdos Gástricos/etiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Idoso de 80 Anos ou mais
Infarto Cerebral/diagnóstico por imagem
Infarto Cerebral/fisiopatologia
Transtornos de Deglutição/diagnóstico
Transtornos de Deglutição/fisiopatologia
Feminino
Fluoroscopia
Seres Humanos
Masculino
Meia-Idade
Valor Preditivo dos Testes
Aspiração Respiratória de Conteúdos Gástricos/diagnóstico
Aspiração Respiratória de Conteúdos Gástricos/fisiopatologia
Fatores de Risco
Fatores de Tempo
Gravação em Vídeo
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180109
[Lr] Data última revisão:
180109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170501
[St] Status:MEDLINE


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[PMID]:29224757
[Au] Autor:McIlwain WR; Wistermayer PR; Swiss TP; Marko ST; Ieronimakis NM; Rogers DJ
[Ad] Endereço:Madigan Army Medical Center, United States. Electronic address: wesley.r.mcilwain.mil@mail.mil.
[Ti] Título:Reproducing severe acute subglottic stenosis in a rabbit model.
[So] Source:Int J Pediatr Otorhinolaryngol;103:142-146, 2017 Dec.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: The objectives of this study were to develop an animal model with consistent, severe subglottic stenosis (SGS), and to develop the timeline needed for intervention to limit rabbit mortality. METHODS: Subglottic stenosis was created endoscopically using either a nylon or polypropylene brush in sixteen New Zealand White rabbits. The subglottic cross-sectional area was measured endoscopically using a right-angled probe and an open source image analysis software The cross-sectional areas of the stenotic and native airways were compared to calculate the subglottic stenosis percentage and Myer-Cotton grade classification. RESULTS: The average diameter of the native subglottis was 4.7 mm (SD 0.4). The mean subglottic stenosis percentage was 73% (SD 32) for all rabbits. The three rabbits injured with the nylon brush had 30, 52, and 76% stenosis. Nine of the 12 surviving rabbits (75%) injured with the polypropylene brush had a >86% subglottic stenosis. Four rabbits in the polypropylene brush cohort died from procedural complications. CONCLUSION: This study demonstrates a reliable model using a polypropylene brush to create severe acute subglottic stenosis. Cartilage exposure after creating the injury was associated with more severe stenosis. Mortality rate may have been reduced if endoscopic balloon dilation was performed electively seven days after injury, rather than emergently nine days after injury. LEVEL OF EVIDENCE: 4.
[Mh] Termos MeSH primário: Laringoestenose/patologia
Laringe/patologia
[Mh] Termos MeSH secundário: Animais
Cateterismo
Constrição Patológica
Modelos Animais de Doenças
Endoscopia
Seres Humanos
Masculino
Polipropilenos/efeitos adversos
Coelhos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Polypropylenes)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180104
[Lr] Data última revisão:
180104
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171212
[St] Status:MEDLINE



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