Cephalometric evaluation of the airway space and hyoid bone in children with normal and atypical deglutition: correlation study / Avaliação cefalométrica de via aérea e do osso hioide em crianças com deglutição normal e atípica: estudo de correlações

CONTEXT AND OBJECTIVE: Although there is a close relationship between swallowing and breathing, there are no studies evaluating the radiographic anatomy of the airway and its possible correlation with the radiographic position of the hyoid bone. The aim of this study was to evaluate the possible correlation of the radiographic position of the hyoid bone and airway space (PAS) in lateral radiographs on children with atypical deglutition, in comparison with those with normal swallowing. DESIGN AND SETTING: Cross-sectional analytical study with control group in a public university. METHODS: Using cephalometric analysis on lateral teleradiographs, the distance from the hyoid bone to the mandibular plane (MP-H) and the distance from the hyoid bone to the tuber (T-H) were correlated with the PAS measurement (airway) in two groups: 55 teleradiographs in the experimental group (with atypical deglutition) and 55 teleradiographs in the control group (normal deglutition). Both groups included subjects at the mixed dentition stage. RESULTS: The variable T-H presented a statistically significant correlation with PAS (0.0286) and the variable MP-H had a significant correlation with the variable PAS (0.0053). This positive correlation was significant only in the control group and not in the group with atypical swallowing. CONCLUSIONS: There was a positive correlation between the MP-H and PAS measurements and between the T-H and PAS measurements only in the group with normal swallowing. These correlations were not observed in the group with atypical swallowing.

CONTEXTO E OBJETIVO: Embora haja estreita relação entre respiração e deglutição, não existem estudos que avaliem a anatomia radiográfica de via aérea e sua possível correlação com a posição radiográfica do osso hioide. O objetivo deste estudo foi avaliar possível correlação da posição radiográfica do osso hioide e do espaço aéreo na radiografia lateral de crianças com deglutição atípica quando comparada com aquelas com deglutição normal. TIPO DE ESTUDO E LOCAL: Estudo transversal analítico com grupo controle em universidade pública. MÉTODOS: Por meio de análise cefalométrica em telerradiografias laterais, foi correlacionada a distância do osso hioide ao plano mandibular (MP-H) e do túber ao osso hioide (T-H) com a medida do espaço da via aérea (PAS) em dois grupos: 55 telerradiografias do grupo experimental (com deglutição atípica) e 55 telerradiografias do grupo controle (deglutição normal). Ambos os grupos incluíram indivíduos em fase de dentição mista. RESULTADOS: A variável T-H apresentou correlação estatisticamente significativa com PAS (0,0286) e a variável MP-H teve correlação significativa com a variável PAS (0,0053). Esta correlação positiva foi significativa apenas no grupo controle e não no grupo de deglutição atípica. CONCLUSÕES: Há correlação positiva entre as medidas MP-H e PAS e entre as medidas T-H e PAS somente no grupo de deglutição normal. Estas correlações não foram observadas no grupo de deglutição atípica.

Clinico-pathological Profile of Oesophageal Dysphagia.

Introduction: Dysphagia can cause significant morbidity and mortality, especially in the elderly and the paediatric population. The study was undertaken to determine the clinico-pathological profile of the patients diagnosed with oesophageal dysphagia in a rural tertiary care hospital of India. Methods: This cross sectional, descriptive study was carried out in the ENT Department of Rural Medical College and Pravara Rural Hospital, Loni, Maharashtra. Patients attending the ENT Out Patient Department during 2009 and later diagnosed as cases of oesophageal dysphagia formed the statistical sample. Results: Out of 61 patients, 37 were male and 24 female. Majority of the patients belonged to age group 41-50 years (24.6%), were farmer by occupation (31.1%) and belonged to middle socioeconomic status (34.4%). Pain (throat, retrosternal or epigastric) was the most common (70.5%) presenting complaint. For 39.3% study subjects, the presenting complaint was 3 to 6 months old. Barium swallow study revealed a positive finding in 74.1% (n=40/54) patients, with carcinoma of oesophagus (27.8%) as the most common aetiology, followed by motility disorders and benign strictures. Oesophagoscopy detected lesions in 49 (90.74%) cases and like barium swallow, it also detected carcinoma oesophagus as the most common cause of oesophageal dysphagia. Reflux oesophagitis was the most common form of the oesophagitis and the microbiological examination and culture of samples of 14 patients diagnosed with any form of oesophagitis showed Candida albicans in 21.4%. Conclusion: Dysphagia is a common presenting complaint in the ENT clinic. There is a male preponderance with incidence of malignancy rising with age. Barium swallow may be used as the first line of investigation; however, oesophagoscopy gives a better diagnosis.

Acalasia cricofaríngea em cão: relato de caso / Canine cricopharyngeal achalasia: case report

A 7-month-old miniature poodle female dog was referred with dysphagia. After clinical, radiographic, and endoscopic examination, it was diagnosed a probable case of cricopharyngeal achalasia. The patient underwent surgical treatment and presented normal swallowing and no regurgitation after 24 hours post-surgery. Positive recovery and progressive body weight gain until 180 days after surgery was observed.

Uma cadela da raça poodle miniatura com sete meses de idade foi atendida no Hospital Veterinário apresentando quadro de disfagia. Após exames clínico, radiográfico e endoscópico detalhados, houve diagnóstico provável de acalasia cricofaríngea. A paciente, submetida a tratamento cirúrgico, apresentou deglutição normal e nenhuma regurgitação 24 horas pós-cirurgia. Houve recuperação satisfatória e ganho de peso progressivo até 180 dias após a cirurgia.

Forensic medicine identification of manual strangulation: an analysis of 21 cases / 法医学杂志

OBJECTIVE@#To analyze and summarize the rule of manual strangulation, as well as to look for the key points of injury identification, in order to provide information for formulating and revising the identification regulations.@*METHODS@#Twenty-one cases of manual strangulation from 1963 to 2004 in Xiangfan were reviewed and analyzed according to the characters, symptoms and appraisements.@*RESULTS@#The majority of assaulters in manual strangulation was young adult male and often could find the counteracted wounds on them. The throttling mark reaction usually could be found in victims and the cardinal symptoms were contusion in throat and asphyxiation in ocular region.@*CONCLUSION@#The degree of injuries is mainly moderate and slight. There is some inadaptability in the current regulations.

Alimentación enteral: vías de infusión / Enteral feeding: routes of food intake

The study of digestive pathophysiology and scientific advnces showed a better knowledge related to the invaluable usefulness of the nutritional stage and the importance of the intestinal route for feeding purposes. In this consideration, the enteral feeding is elective considered not only in patients with an adquate digestive function but further more with some difficulties or swallowing disturbances, but also in those patients that because of their underlying pathology can not feed tremselves by mouth in a temporary way. The caloric support by the intestinal route con be performed by nasoenteral tubes or osteomas as gastrostomies, gastrojejunostomy, jejunostomies and hepato-jejunostomies. The aim of this report eas to show our results with the different ways of enteral feeding. These results are presented and discussed.

Malformación de Arnold-Chiari tipo I / Arnold-Chiari tipo I malformation

La Malformación de Arnold-Chiari fue descrita por primera vez en Praga, en el año 1891 por el patólogo alemán Hans Chiari. Comprende un grupo de raras malformaciones congénitas del Cerebro, Cerebelo, y Médula Espinal en la base del cerebro. Algunas de las manifestaciones clínicas comprenden cefalea, vértigo, disfonía, apnea, nistagmus, trastornos de la deglución yataxia. La intención de este reporte es describir el espectro de síntomas comunes en una enfermedad infrecuente de tratamiento neuroquirúrgico

Arnold-Chiari Malformation was described for the first time in Prague, in 1891 by the German pathologist Hans Chiari. It includes a group of congenital malformations that affect the Brain, Cerebellum, Spinal Cord and adjacent bone structures. Some of the clinical manifestations of Malformations include headache, vertigo, dysphonia, apnea, nystagmus, swallowing difficulties and ataxia. The aim of this report is to show the spectrum of common manifestations in an infrequent disease which is surgically treated

Disfagia Lusória: Apresentação de Três Casos / Disphagia Lusoria: Presentation of Theree Cases

A disfagia lusória é uma patologia rara, causada pela compressão do esôfago pela artéria lusória. Esta malformação é assintomática na maioria dos casos e suas manifestações geralmente ocorrem em adultos quando a artéria se torna tortuosa, rígida e/ou dilatada. A investigação diagnóstica se baseia no Rx contrastado de esôfago e na arteriografia. O tratamento cirúrgico é reservado para os casos com sintomas significativos; para os restantes, a orientação acerca de sua condição tem mostrado bom resultado, já que muitos pacientes procuram o atendimento médico com receio de doença maligna.