ABSTRACT
This article provides an overview of neurogenic dysphagia, describing the evaluation and management of swallowing dysfunction in various neurologic diseases. The article will focus on stroke, Parkinson's disease, amyotrophic lateral sclerosis, and multiple sclerosis.
Subject(s)
Amyotrophic Lateral Sclerosis , Deglutition Disorders , Humans , Deglutition Disorders/etiology , Deglutition Disorders/therapy , Deglutition Disorders/diagnosis , Amyotrophic Lateral Sclerosis/complications , Amyotrophic Lateral Sclerosis/therapy , Multiple Sclerosis/complications , Parkinson Disease/complications , Stroke/complicationsABSTRACT
We discuss two patients who presented with sphenoid sinus cholesterol granulomas and associated unilateral abducens nerve palsies. Two case reports from our institution are reported. A literature review of available articles is presented, discussing both cholesterol granulomas of the sphenoid sinus and sphenoid sinus lesions that present with unilateral abducens palsy. A total of nine cases of sphenoid sinus cholesterol granulomas have been previously reported in the literature. A wide variety of sphenoid sinus pathologies can present with unilateral abducens nerve palsies, however no sphenoid sinus cholesterol granulomas with this presentation were found in the literature. In conclusion, cholesterol granulomas should be included in the differential when a patient presents with an expansile mass of the sphenoid sinus and associated unilateral abducens nerve palsy.
Subject(s)
Abducens Nerve Diseases , Sphenoid Sinus , Abducens Nerve , Abducens Nerve Diseases/etiology , Abducens Nerve Diseases/pathology , Cholesterol , Granuloma/complications , Granuloma/pathology , Humans , Sphenoid Sinus/diagnostic imaging , Sphenoid Sinus/pathologyABSTRACT
BACKGROUND: Many adjunctive techniques exist for dacryocystorhinostomy (DCR), with varying levels of supportive evidence. METHODS: Literature from PubMed, EMBASE, and Cochrane Databases was reviewed between January 1990 and January 2020 to examine evidence regarding the utility of adjunctive techniques to DCR, including mucosal flap preservation, concurrent septoplasty, stenting, topical mitomycin C (MMC), and 5-fluorouracil (5-FU), as well as perioperative antibiotics and steroids. Recommendations were made based on the evidence found. RESULTS: Seven adjunctive techniques used in DCR were examined. The literature supported concurrent septoplasty when septal deviation is present. Silicone stents are recommended for external DCR approaches. MMC use is optional in external DCR and revision cases. The literature does not support the routine use of silicone stents or MMC in primary endoscopic DCR. Mucosal flap preservation is optional, with evidence showing comparable results with or without utilization. The level of evidence is limited for topical 5-FU, as well as perioperative antibiotic and steroid use. CONCLUSION: Recommendations for adjunctive techniques to external and endoscopic DCR surgeries can be made based on the current literature. Higher-level studies are needed to better optimize perioperative approaches to DCR.
