Sample records for laryngeal nerve paralysis

  1. High risk of unilateral recurrent laryngeal nerve paralysis after esophagectomy using cervical anastomosis

    Microsoft Academic Search

    L. Pertl; J. Zacherl; G. Mancusi; J. N. Gächter; R. Asari; S. Schoppmann; W. Bigenzahn; B. Schneider-Stickler

    The goal of this study was to estimate the incidence of temporary and permanent unilateral recurrent laryngeal nerve paralysis\\u000a (URLNP) after esophagectomies with cervical anastomosis and to determine the impact of surgical technique, tumor type, tumor\\u000a localization and age on the incidence of URLNP. From March 2002 to November 2009, 84 patients underwent a laryngoscopical\\u000a evaluation before and after esophagectomy

  2. Irregular vocal fold dynamics incited by asymmetric fluid loading in a model of recurrent laryngeal nerve paralysis

    NASA Astrophysics Data System (ADS)

    Sommer, David; Erath, Byron D.; Zanartu, Matias; Peterson, Sean D.

    2011-11-01

    Voiced speech is produced by dynamic fluid-structure interactions in the larynx. Traditionally, reduced order models of speech have relied upon simplified inviscid flow solvers to prescribe the fluid loadings that drive vocal fold motion, neglecting viscous flow effects that occur naturally in voiced speech. Viscous phenomena, such as skewing of the intraglottal jet, have the most pronounced effect on voiced speech in cases of vocal fold paralysis where one vocal fold loses some, or all, muscular control. The impact of asymmetric intraglottal flow in pathological speech is captured in a reduced order two-mass model of speech by coupling a boundary-layer estimation of the asymmetric pressures with asymmetric tissue parameters that are representative of recurrent laryngeal nerve paralysis. Nonlinear analysis identifies the emergence of irregular and chaotic vocal fold dynamics at values representative of pathological speech conditions.

  3. Recurrent largngeal nerve paralysis: a laryngographic and computed tomographic study

    SciTech Connect

    Agha, F.P.

    1983-07-01

    Vocal cord paralysis is a relatively common entity, usually resulting from a pathologic process of the vagus nerve or its recurrent larynegeal branch. It is rarely caused by intralargngeal lesions. Four teen patients with recurrent laryngeal nerve paralysis (RLNP) were evaluated by laryngography, computed tomography (CT), or both. In the evaluation of the paramedian cord, CT was limited in its ability to differentiate between tumor or RLNP as the cause of the fixed cord, but it yielded more information than laryngography on the structural abnormalities of the larynx and pre-epiglottic and paralaryngeal spaces. Laryngography revealed distinct features of RLNP and is the procedure of choice for evaluation of functional abnormalities of the larynx until further experience with faster CT scanners and dynamic scanning of the larynx is gained.

  4. Superior laryngeal nerve block: an anatomical study.

    PubMed

    Stockwell, M; Lozanoff, S; Lang, S A; Nyssen, J

    1995-01-01

    Superior laryngeal nerve anaesthesia is frequently used to facilitate endotracheal intubation in the awake patient. We have modified the transcutaneous approach to this nerve block to employ a short bevel needle. This improves tactile perception in performing the procedure thus simplifying identification of the correct depth of injection. This study was designed to determine the anatomical basis of superior laryngeal nerve anaesthesia and to estimate the success rate using our modified technique. At autopsy, 20 cadavers had nerve block performed substituting 0.02% methylene blue for local anaesthetic. Dissection was then performed to identify the anatomical structures stained by the simulated local anaesthetic. Additional dissections were performed in formalin-fixed cadavers. We found that the dye was injected into the paraglottic space bounded laterally by the thyrohyoid membrane and thyroid cartilage, medially by the laryngeal submucosa, caudad by the conus elasticus, cephalad by the hyoid bone, and anteriorly and posteriorly by the anterior and posterior thyrohyoid ligaments, respectively. The internal laryngeal nerve, the sensory branch of the superior laryngeal nerve, passed through this compartment and was heavily stained with simulated local anaesthetic. Resistance to the passage of the short bevel needle was provided by the lateral glossoepiglottic fold, not the thyrohyoid membrane as we had expected. Of 40 injections, 39 were deemed successful for a success rate of 97.5%. We conclude that this is a simple and highly successful technique for performing superior laryngeal nerve anaesthesia. PMID:7712327

  5. Neurological Complications in Thyroid Surgery: A Surgical Point of View on Laryngeal Nerves

    PubMed Central

    Varaldo, Emanuela; Ansaldo, Gian Luca; Mascherini, Matteo; Cafiero, Ferdinando; Minuto, Michele N.

    2014-01-01

    The cervical branches of the vagus nerve that are pertinent to endocrine surgery are the superior and the inferior laryngeal nerves: their anatomical course in the neck places them at risk during thyroid surgery. The external branch of the superior laryngeal nerve (EB) is at risk during thyroid surgery because of its close anatomical relationship with the superior thyroid vessels and the superior thyroid pole region. The rate of EB injury (which leads to the paralysis of the cricothyroid muscle) varies from 0 to 58%. The identification of the EB during surgery helps avoiding both an accidental transection and an excessive stretching. When the nerve is not identified, the ligation of superior thyroid artery branches close to the thyroid gland is suggested, as well as the abstention from an indiscriminate use of energy-based devices that might damage it. The inferior laryngeal nerve (RLN) runs in the tracheoesophageal groove toward the larynx, close to the posterior aspect of the thyroid. It is the main motor nerve of the intrinsic laryngeal muscles, and also provides sensory innervation to the larynx. Its injury finally causes the paralysis of the omolateral vocal cord and various sensory alterations: the symptoms range from mild to severe hoarseness, to acute airway obstruction, and swallowing impairment. Permanent lesions of the RNL occur from 0.3 to 7% of cases, according to different factors. The surgeon must be aware of the possible anatomical variations of the nerve, which should be actively searched for and identified. Visual control and gentle dissection of RLN are imperative. The use of intraoperative nerve monitoring has been safely applied but, at the moment, its impact in the incidence of RLN injuries has not been clarified. In conclusion, despite a thorough surgical technique and the use of intraoperative neuromonitoring, the incidence of neurological complications after thyroid surgery cannot be suppressed, but should be maintained in a low range. PMID:25076936

  6. Transtympanic Facial Nerve Paralysis: A Review of the Literature

    PubMed Central

    Schaefer, Nathan; O’Donohue, Peter; French, Heath; Griffin, Aaron; Gochee, Peter

    2015-01-01

    Summary: Facial nerve paralysis because of penetrating trauma through the external auditory canal is extremely rare, with a paucity of published literature. The objective of this study is to review the literature on transtympanic facial nerve paralysis and increase physician awareness of this uncommon injury through discussion of its clinical presentation, management and prognosis. We also aim to improve patient outcomes in those that have sustained this type of injury by suggesting an optimal management plan. In this case report, we present the case of a 46-year-old white woman who sustained a unilateral facial nerve paresis because of a garfish penetrating her tympanic membrane and causing direct damage to the tympanic portion of her facial nerve. On follow-up after 12 months, her facial nerve function has largely returned to normal. Transtympanic facial nerve paralysis is a rare injury but can have a favorable prognosis if managed effectively.

  7. Non-recurrent laryngeal nerve in thyroid surgery.

    PubMed

    Hisham, A N; Sarojah, A; Alvin, A

    2001-12-01

    A case of non-recurrent laryngeal nerve is reported. The non-recurrent laryngeal nerve was found on the right side and was not associated with any vascular abnormalities. The anatomy and surgical implication of this rare condition is discussed PMID:12014772

  8. Influence of Asymmetric Recurrent Laryngeal Nerve Stimulation on Vibration, Acoustics, and Aerodynamics

    PubMed Central

    Chhetri, Dinesh K.; Neubauer, Juergen; Sofer, Elazar

    2015-01-01

    Objectives/Hypothesis Evaluate the influence of asymmetric recurrent laryngeal nerve (RLN) stimulation on the vibratory phase, acoustics and aerodynamics of phonation. Study Design Basic science study using an in vivo canine model. Methods The RLNs were symmetrically and asymmetrically stimulated over eight graded levels to test a range of vocal fold activation conditions from subtle paresis to paralysis. Vibratory phase, fundamental frequency (F0), subglottal pressure, and airflow were noted at phonation onset. The evaluations were repeated for three levels of symmetric superior laryngeal nerve (SLN) stimulation. Results Asymmetric laryngeal adductor activation from asymmetric left-right RLN stimulation led to a consistent pattern of vibratory phase asymmetry, with the more activated vocal fold leading in the opening phase of the glottal cycle and in mucosal wave amplitude. Vibratory amplitude asymmetry was also observed, with more lateral excursion of the glottis of the less activated side. Onset fundamental frequency was higher with asymmetric activation because the two RLNs were synergistic in decreasing F0, glottal width, and strain. Phonation onset pressure increased and airflow decreased with symmetric RLN activation. Conclusion Asymmetric laryngeal activation from RLN paresis and paralysis has consistent effects on vocal fold vibration, acoustics, and aerodynamics. This information may be useful in diagnosis and management of vocal fold paresis. PMID:24913182

  9. Recovery of laryngeal function after intraoperative injury to the recurrent laryngeal nerve

    PubMed Central

    Hydman, Jonas; Svensson, Mikael

    2015-01-01

    Loss of function in the recurrent laryngeal nerve (RLN) during thyroid/parathyroid surgery, despite a macroscopically intact nerve, is a challenge which highlights the sensitivity and complexity of laryngeal innervation. Furthermore, the uncertain prognosis stresses a lack of capability to diagnose the reason behind the impaired function. There is a great deal of literature considering risk factors, surgical technique and mechanisms outside the nerve affecting the incidence of RLN paresis during surgery. To be able to prognosticate recovery in cases of laryngeal dysfunction and voice changes after thyroid surgery, the surgeon would first need to define the presence, location, and type of laryngeal nerve injury. There is little data describing the events within the nerve and the neurobiological reasons for the impaired function related to potential recovery and prognosis. In addition, very little data has been presented in order to clarify any differences between the transient and permanent injury of the RLN. This review aims, from an anatomical and neurobiological perspective, to provide an update on the current understandings of surgically-induced injury to the laryngeal nerves. PMID:25713777

  10. Laryngeal branching pattern of the inferior laryngeal nerve, before entering the larynx

    Microsoft Academic Search

    Bülent Yalç?n; Harun Tu?cu; Nergis Cantürk; Hasan Ozan

    2006-01-01

    The objective of the present work was to investigate the laryngeal branching pattern of the inferior laryngeal nerve (ILN)\\u000a in detail before the branches entered the larynx. In 49 specimens 96 sides were examined for this project, including 27 males\\u000a and 22 female cadavers. In 7 sides (7.3%, 5 on the left and 2 on the right) the ILN passed

  11. Facial Nerve Paralysis due to a Pleomorphic Adenoma with the Imaging Characteristics of a Facial Nerve Schwannoma

    PubMed Central

    Nader, Marc-Elie; Bell, Diana; Sturgis, Erich M.; Ginsberg, Lawrence E.; Gidley, Paul W.

    2014-01-01

    Background?Facial nerve paralysis in a patient with a salivary gland mass usually denotes malignancy. However, facial paralysis can also be caused by benign salivary gland tumors. Methods?We present a case of facial nerve paralysis due to a benign salivary gland tumor that had the imaging characteristics of an intraparotid facial nerve schwannoma. Results?The patient presented to our clinic 4 years after the onset of facial nerve paralysis initially diagnosed as Bell palsy. Computed tomography demonstrated filling and erosion of the stylomastoid foramen with a mass on the facial nerve. Postoperative histopathology showed the presence of a pleomorphic adenoma. Facial paralysis was thought to be caused by extrinsic nerve compression. Conclusions?This case illustrates the difficulty of accurate preoperative diagnosis of a parotid gland mass and reinforces the concept that facial nerve paralysis in the context of salivary gland tumors may not always indicate malignancy. PMID:25083397

  12. Sound-induced facial synkinesis following facial nerve paralysis.

    PubMed

    Ma, Ming-San; van der Hoeven, Johannes H; Nicolai, Jean-Philippe A; Meek, Marcel F

    2009-08-01

    Facial synkinesis (or synkinesia) (FS) occurs frequently after paresis or paralysis of the facial nerve and is in most cases due to aberrant regeneration of (branches of) the facial nerve. Patients suffer from inappropriate and involuntary synchronous facial muscle contractions. Here we describe two cases of sound-induced facial synkinesis (SFS) after facial nerve injury. As far as we know, this phenomenon has not been described in the English literature before. Patient A presented with right hemifacial palsy after lesion of the facial nerve due to skull base fracture. He reported involuntary muscle activity at the right corner of the mouth, specifically on hearing ringing keys. Patient B suffered from left hemifacial palsy following otitis media and developed involuntary muscle contraction in the facial musculature specifically on hearing clapping hands or a trumpet sound. Both patients were evaluated by means of video, audio and EMG analysis. Possible mechanisms in the pathophysiology of SFS are postulated and therapeutic options are discussed. PMID:18539550

  13. Continuous positive airway pressure with pressure support ventilation is effective in treating acute-onset bilateral recurrent laryngeal nerve palsy.

    PubMed

    Leung, Yiuka; Fikry, Karim; Shah, Bhavika; Madapu, Manokanth; Gaz, Randall D; Leffert, Lisa R; Jiang, Yandong

    2015-06-01

    Acute bilateral recurrent laryngeal nerve injury leading to acute vocal cord paralysis (VCP) is a serious complication of head and neck surgery, often requiring emergent surgical intervention. Although well documented, its presentation may be sudden and unexpected, occurring despite lack of obvious intraoperative nerve injury. There is limited literature on airway management strategies for patients with acute bilateral VCP before attaining a secure airway. We report a case of acute VCP that was successfully treated with continuous positive airway pressure via facemask ventilation. This effective temporizing strategy allowed clinicians to plan and prepare for tracheostomy, minimizing potential complications. PMID:26035222

  14. Superior laryngeal nerve injury: effects, clinical findings, prognosis, and management options

    PubMed Central

    Orestes, Michael I.; Chhetri, Dinesh K.

    2015-01-01

    Purpose of review The superior laryngeal nerve (SLN) provides motor innervation to the cricothyroid muscle. However, the functions of this muscle and the anatomic variations of the nerve that supplies it are not fully understood. SLN paresis and paralysis (SLNp) is difficult to diagnose because of a lack of consistent laryngeal findings, and its effects on the voice likely goes beyond simple pitch elevation control. Recent findings Although SLNp has traditionally been thought to lead to voice pitch limitation, recent research findings reveal multiple roles for this nerve in voice and speech. Cricothyroid muscles are the primary controls of fundamental frequency of voice. SLNp can lead to significant contraction of pitch range, vocal fold vibratory phase asymmetry, and acoustic aperiodicity, thus leading to an overall poor vocal quality. In addition, cricothyroid muscles may also play a role in pitch lowering and shifting from voiced to unvoiced sounds during speech. Summary Subtle signs, symptoms, and diagnostic findings associated with SLNp make this disorder difficult to characterize clinically. Lack of treatment methodologies to restore the dynamic action of the cricothyroid muscles poses difficulties in treating patients with this condition. A more thorough understanding of the effects of SLNp will improve diagnosis and treatment. PMID:25136863

  15. Unilateral hypoglossal nerve palsy after use of the laryngeal mask airway supreme.

    PubMed

    Takahoko, Kenichi; Iwasaki, Hajime; Sasakawa, Tomoki; Suzuki, Akihiro; Matsumoto, Hideki; Iwasaki, Hiroshi

    2014-01-01

    Purpose. Hypoglossal nerve palsy after use of the laryngeal mask airway (LMA) is an exceptionally rare complication. We present the first case of unilateral hypoglossal nerve palsy after use of the LMA Supreme. Clinical Features. A healthy 67-year-old female was scheduled for a hallux valgus correction under general anesthesia combined with femoral and sciatic nerve blocks. A size 4?LMA Supreme was inserted successfully at the first attempt and the cuff was inflated with air at an intracuff pressure of 60?cmH2O using cuff pressure gauge. Anesthesia was maintained with oxygen, nitrous oxide (67%), and sevoflurane under spontaneous breathing. The surgery was uneventful and the duration of anesthesia was two hours. The LMA was removed as the patient woke and there were no immediate postoperative complications. The next morning, the patient complained of dysarthria and dysphasia. These symptoms were considered to be caused by the LMA compressing the nerve against the hyoid bone. Conservative treatment was chosen and the paralysis recovered completely after 5 months. Conclusion. Hypoglossal nerve injury may occur despite correct positioning of the LMA under the appropriate intracuff pressure. A follow-up period of at least 6 months should be taken into account for the recovery. PMID:25254120

  16. Tuberculous Otitis Media Leading to Sequentialib Bilateral Facial Nerve Paralysis

    PubMed Central

    Gupta, Nitin; Dass, Arjun; Goel, Neha; Tiwari, Sandeep

    2015-01-01

    Introduction: Tuberculous otitis media (TOM) is an uncommon, insidious, and frequently misdiagnosed form of tuberculosis (TB). In particular, TOM is usually secondary to direct transmission from adjacent organs, while the primary form has been rarely reported. The main aim of treatment is to start the patient on an antitubercular regime and early surgical intervention to decompress the facial nerve if involved. Case Report: The case report of a twenty year-old male with bilateral tuberculous otitis media, who presented himself with fever followed by sequential bilateral facial nerve paralysis, bilateral profound hearing loss, and abdominal tuberculosis leading to intestinal perforation, is presented. To the best available knowledge and after researching literature, no such case depicting the extensive otological complications of tuberculosis has been reported till date. Conclusion: Tuberculosis of the ear is a rare entity and in most cases the clinical features resemble that of chronic otitis media. The diagnosis is often delayed due to varied clinical presentations and this can lead to irreversible complications. Early diagnosis is essential for prompt administration of antitubercular therapy and to prevent complications.

  17. Reinnervation of Bilateral Posterior Cricoarytenoid Muscles Using the Left Phrenic Nerve in Patients with Bilateral Vocal Fold Paralysis

    PubMed Central

    Zheng, Hongliang; Chen, Donghui; Zhu, Minhui; Wang, Wei; Liu, Fei; Zhang, Caiyun

    2013-01-01

    Objective To evaluate the feasibility, effectiveness, and safety of reinnervation of the bilateral posterior cricoarytenoid (PCA) muscles using the left phrenic nerve in patients with bilateral vocal fold paralysis. Methods Forty-four patients with bilateral vocal fold paralysis who underwent reinnervation of the bilateral PCA muscles using the left phrenic nerve were enrolled in this study. Videostroboscopy, perceptual evaluation, acoustic analysis, maximum phonation time, pulmonary function testing, and laryngeal electromyography were performed preoperatively and postoperatively. Patients were followed-up for at least 1 year after surgery. Results Videostroboscopy showed that within 1 year after reinnervation, abductive movement could be observed in the left vocal folds of 87% of patients and the right vocal folds of 72% of patients. Abductive excursion on the left side was significantly larger than that on the right side (P < 0.05); most of the vocal function parameters were improved postoperatively compared with the preoperative parameters, albeit without a significant difference (P > 0.05). No patients developed immediate dyspnea after surgery, and the pulmonary function parameters recovered to normal reference value levels within 1 year. Postoperative laryngeal electromyography confirmed successful reinnervation of the bilateral PCA muscles. Eighty-seven percent of patients in this series were decannulated and did not show obvious dyspnea after physical activity. Those who were decannulated after subsequent arytenoidectomy were not included in calculating the success rate of decannulation. Conclusions Reinnervation of the bilateral PCA muscles using the left phrenic nerve can restore inspiratory vocal fold abduction to a physiologically satisfactory extent while preserving phonatory function at the preoperative level without evident morbidity. PMID:24098581

  18. Overview of pediatric peripheral facial nerve paralysis: analysis of 40 patients.

    PubMed

    Özkale, Yasemin; Erol, ?lknur; Sayg?, Semra; Y?lmaz, ?smail

    2015-02-01

    Peripheral facial nerve paralysis in children might be an alarming sign of serious disease such as malignancy, systemic disease, congenital anomalies, trauma, infection, middle ear surgery, and hypertension. The cases of 40 consecutive children and adolescents who were diagnosed with peripheral facial nerve paralysis at Baskent University Adana Hospital Pediatrics and Pediatric Neurology Unit between January 2010 and January 2013 were retrospectively evaluated. We determined that the most common cause was Bell palsy, followed by infection, tumor lesion, and suspected chemotherapy toxicity. We noted that younger patients had generally poorer outcome than older patients regardless of disease etiology. Peripheral facial nerve paralysis has been reported in many countries in America and Europe; however, knowledge about its clinical features, microbiology, neuroimaging, and treatment in Turkey is incomplete. The present study demonstrated that Bell palsy and infection were the most common etiologies of peripheral facial nerve paralysis. PMID:24810082

  19. Impact of phrenic nerve paralysis on the surgical outcome of intercostal nerve transfer.

    PubMed

    Kita, Yusuke; Tajiri, Yasuhito; Hoshikawa, Shinya; Hara, Yukinori; Iijima, Junichi

    2015-01-01

    Brachial plexus injuries (BPI) can be complicated by diaphragmatic paralysis (DP). This study determined the influence of DP on biceps brachii (BB) recovery after intercostal nerve transfer (ICNT) for BPI and investigated the respiratory complications of ICNT. The study included 100 patients, 84 showing no DP in preoperative and early postoperative chest radiographic images (non-DP group) and 16 with DP that persisted for over one year after surgery (DP group). The postoperative reinnervation time did not differ between groups. BB strength one year after surgery was lower in the DP group than non-DP group (p = 0.0007). No differences were observed 2-3 years after surgery. In the DP group, four patients had respiratory symptoms that affected daily activities and their outcomes deteriorated (p = 0.04). Phrenic nerve transfer should not be combined with ICNT in patients with poor respiratory function because of the high incidence of respiratory complications. PMID:25609274

  20. Lingual nerve neuropraxia following use of the Laryngeal Mask Airway Supreme.

    PubMed

    Thiruvenkatarajan, Venkatesan; Van Wijk, Roelof M A W; Elhalawani, Islam; Barnes, Ann-Maree

    2014-02-01

    Cranial nerve injury is a rare complication with the use of supraglottic airway devices. A case of lingual nerve injury following the use of a Laryngeal Mask Airway Supreme in a 45 year old woman is presented. A review of the literature regarding lingual nerve injury as a complication of the supraglottic airway is also presented. PMID:24444986

  1. The number of nerve cells in the substantia nigra in paralysis agitans

    Microsoft Academic Search

    H. Pakkenberg; H. Brody

    1965-01-01

    The number of melanin-containing and melanin-free nerve cells in the substantia nigra was determined in 10 brains with paralysis agitans and in 10 control brains, both groups from subjects with the same average age. The total count in the brains with paralysis agitans was shown to be 59% less than the total count in the control brains, the melanin-containing cell

  2. Intrt de la tussomtrie dans les paralysies larynges unilatrales 1 Garrel R, Amy de la Bretque B, Ghio A, Giovanni A, Guerrier B.

    E-print Network

    Paris-Sud XI, Université de

    larynx en situation normale et en cas de paralysie laryngée unilatérale. La mesure du temps entre le larynx durant la toux. Abstract Cough is a physiological gesture witch requires a perfect laryngeal. Intracordal autologus fat injection improves occlusive function of larynx during cough in case of unilateral

  3. Delayed onset of vocal cord paralysis after explantation of a vagus nerve stimulator in a child

    Microsoft Academic Search

    M. Vassilyadi; R. H. Strawsburg

    2003-01-01

    Introduction. Vagus nerve stimulation for the management of intractable seizure disorders is increasingly being used, especially in younger children. Although complications such as infection or vocal cord paralysis are uncommon, some may be unreported. Clinical presentation. A 3.5-year-old boy with intractable complex partial and generalized seizures had a left vagus nerve stimulator (VNS) successfully implanted. Two weeks later, the cervical

  4. Transcutaneous electrical stimulation of the recurrent laryngeal nerve in monkeys.

    PubMed

    Sanders, I; Aviv, J; Kraus, W M; Racenstein, M M; Biller, H F

    1987-01-01

    The recurrent laryngeal nerve (RLN) of four anesthetized adult Macaca fascicularis monkeys was stimulated by applying current with blunt electrodes placed unilaterally and bilaterally on the intact neck skin along the tracheoesophageal groove. The stimulus consisted of 2.5- to 4.0-mA cathodal pulses, each of 1-ms duration, beginning at a frequency of 10 Hz and increasing by 10-Hz increments to 100 Hz. Unilateral stimulation from 10 to 30 Hz resulted in a graded vocal cord abduction, with the maximal glottic aperture occurring at 30 Hz. Stimulation above 30 Hz produced a graded cord adduction, with nearly complete glottic closure at 100 Hz; bilateral stimulation yielded similar results, with total glottic closure at 100 Hz. Confirmation of the RLN as mediator of this frequency-dependent cord motion was achieved by surgically isolating it and attaining identical results with direct stimulation. No cardiopulmonary alterations were observed in any trial. Transcutaneous electrical stimulation of the RLN seems to be a relatively safe, reliable, and noninvasive method of controlling vocal cord position and thereby the glottic airway in monkeys. PMID:3492955

  5. Nicolaus A. Friedreich's description of peripheral facial nerve paralysis in 1798.

    PubMed Central

    Bird, T D

    1979-01-01

    In 1798, Nicolaus A. Friedreich of Wurzburg published a detailed clinical account of three patients with idopathic peripheral facial nerve paralysis. His astute observations of onset, physical findings, natural course, treatment, and recovery preceded those of Charles Bell by 23 years. PMID:368292

  6. Management of traumatic facial nerve paralysis with carotid artery cavernous sinus fistula

    Microsoft Academic Search

    J. T. Roland Jr; P. E. Hammerschlag; W. S. Lewis; I. Choi; A. Berenstein

    1994-01-01

    Massive skull base injuries require detailed preoperative neurological and neurovascular assessment prior to undertaking surgical repair of isolated cranial nerve deficits. We present the management of a patient with traumatic facial paralysis, cerebrospinal fluid leak, and carotid artery cavernous sinus fistula as the result of a gunshot wound to the skull base. The carotid artery cavernous sinus fistula was ultimately

  7. Facial nerve paralysis in acute otitis media: Cause and management revisited

    Microsoft Academic Search

    ERIC M. JOSEPH; NEIL M. SPERLING

    1998-01-01

    Facial nerve paralysis (FNP) complicating acute otitis media (AOM) is thought to be mediated by intrafallopian inflammatory edema and consequent ischemia with neuropraxia. Presumably this occurs either through (1) preexistent bony dehiscences, (2) physiologic canaliculi between the middle ear and fallopian canal, or (3) the vascular connections between the fallopian canal and the mastoid air cells.1-3Although there is little scientific

  8. Ectopic thyroid tissue surrounding the right laryngeal nerve: a case report

    PubMed Central

    He, Bin; Li, Peng; Yang, Kai; Shan, Yunfeng

    2014-01-01

    Ectopic thyroid tissue (ETT) is a rare developmental anomaly of the thyroid tissue which is defined as the presence of thyroid tissue in locations other than the pretracheal area. However, ectopic thyroid tissue in the lateral neck surrounding the recurrent laryngeal nerve is unusually found. Here we describe a case of a 64-year-old woman who was found bilateral thyroid goiter by the ultrasound examination. The total thyroidectomy plus a modified radical neck dissection was performed. Surprisingly we also found a nodule surrounding the right recurrent laryngeal nerve at the same time. Nevertheless the diagnosis of the nodule was confirmed by pathology and Histologic examination demonstrating that it was ectopic thyroid tissue. Ectopic thyroid tissue surrounding recurrent laryngeal nerve is a rare finding, with hardly any cases reported. For it is generally thought that any thyroid tissue found in the lateral aspect of the neck may indicate metastatic deposits from well-differentiated thyroid carcinoma. Although pathogenesis of ectopic thyroid tissue surrounding recurrent laryngeal nerve without any symptoms remains unknown, our case could suggest ectopic thyroid tissue should not be excluded in the differential diagnosis of lateral neck masses especially when the recurrent laryngeal nerves were surrounded by the nodules. PMID:25197416

  9. Electrophysiological neuromonitoring of the laryngeal nerves in thyroid and parathyroid surgery: A review

    PubMed Central

    Deniwar, Ahmed; Bhatia, Parisha; Kandil, Emad

    2015-01-01

    Recurrent laryngeal nerve (RLN) injury is one of the most common complications of thyroid surgery. Injury to the external branch of the superior laryngeal nerve is less obvious and affects the voice variably; however, it can be of great significance to professional voice users. Recent literature has led to an increase in the use of neuromonitoring as an adjunct to visual nerve identification during thyroid surgery. In our review of the literature, we discuss the application, efficacy and safety of neuromonitoring in thyroid surgery. Although intraoperative neuromonitoring (IONM) contributes to the prevention of laryngeal nerves injury, there was no significant difference in the incidence of RLN injury in thyroid surgery when IONM was used compared with visual identification alone. IONM use is recommended in high risk patients; however, there are no clear identification criteria for what constitutes “high risk”. There is no clear evidence that IONM decreases the risk of laryngeal nerve injury in thyroid surgery. However, continuous IONM provides a promising tool that can prevent imminent nerve traction injury by detecting decreased amplitude combined with increased latency. PMID:25992326

  10. Electrophysiological neuromonitoring of the laryngeal nerves in thyroid and parathyroid surgery: A review.

    PubMed

    Deniwar, Ahmed; Bhatia, Parisha; Kandil, Emad

    2015-05-20

    Recurrent laryngeal nerve (RLN) injury is one of the most common complications of thyroid surgery. Injury to the external branch of the superior laryngeal nerve is less obvious and affects the voice variably; however, it can be of great significance to professional voice users. Recent literature has led to an increase in the use of neuromonitoring as an adjunct to visual nerve identification during thyroid surgery. In our review of the literature, we discuss the application, efficacy and safety of neuromonitoring in thyroid surgery. Although intraoperative neuromonitoring (IONM) contributes to the prevention of laryngeal nerves injury, there was no significant difference in the incidence of RLN injury in thyroid surgery when IONM was used compared with visual identification alone. IONM use is recommended in high risk patients; however, there are no clear identification criteria for what constitutes "high risk". There is no clear evidence that IONM decreases the risk of laryngeal nerve injury in thyroid surgery. However, continuous IONM provides a promising tool that can prevent imminent nerve traction injury by detecting decreased amplitude combined with increased latency. PMID:25992326

  11. Unilateral sensorineural hearing loss and facial nerve paralysis associated with low-voltage electrical shock.

    PubMed

    Ozkiris, Mahmut

    2014-02-01

    Electrical injuries can occur as a result of contact with low- or high-voltage electricity. Low-voltage injuries are more common, as they usually occur in the home, but reports in the literature are few. After exposure to electric current, almost every organ system in the body is affected. The severity of an injury depends on many factors, including the type of current, the duration of exposure, and the resistance of the tissue involved. Reported cases of hearing loss and facial nerve paralysis associated with low-voltage electrical shock are rare, and minimal information is available about this circumstance. In this article, the author describes a case of low-voltage electrical shock in a 20-year-old man. To the best of the author's knowledge, this is the first report in the literature of a resolution of unilateral sensorineural hearing loss and facial nerve paralysis caused by a low-voltage electrical shock. PMID:24526477

  12. Laryngitis

    MedlinePLUS

    ... odd, sometimes your stomach can cause laryngitis. Just like you have a tube for air to go into and out of your ... come from. And, if that "goodnight" comes out like the "ribbit" of a frog, you'll know that it could be laryngitis! Reviewed by: Rupal Christine Gupta, MD Date reviewed: August 2014 Back

  13. Using NU-KNIT® for hemostasis around recurrent laryngeal nerve during transthoracic esophagectomy with lymphadenectomy for esophageal cancer

    PubMed Central

    2014-01-01

    Background We thought that using electrocautery for hemostasis caused recurrent laryngeal nerve palsy. We reflected the prolonged use of electrocautery and employed NU-KNIT® to achieve hemostasis nearby the recurrent laryngeal nerve. We assessed that using NU-KNIT® hemostasis prevented or not postoperative recurrent laryngeal nerve palsy, retrospectively. The present study was evaluated to compare using electrocautery hemostasis with using NU-KNIT® hemostasis during lymphadenectomy along recurrent laryngeal nerve. The variables compared were morbidity rate of recurrent laryngeal nerve palsy, operation time, and blood loss. Results We use NU-KNIT® to achieve hemostasis without strong compression. This group is named group N. On the other hand, we use electrocautery to achieve hemostasis. This group is named group E. Complication rate of recurrent laryngeal nerve palsy was higher in group E (55.6%) than group N (5.3%) (p?=?0.007). Conclusions Even hemostasis using NU-KNIT® was slightly more time-consuming than using electrocautery, we concluded that it would be useful to prevent recurrent laryngeal nerve palsy. PMID:24602313

  14. Pharyngolaryngeal paralysis in a patient with pharyngeal tuberculosis.

    PubMed

    Ohki, Masafumi; Komiyama, Sakurako; Tayama, Niro

    2015-02-01

    Pharyngeal tuberculosis is a rare disease, and its commonly reported symptoms include sore throat, dysphagia, and throat discomfort. The dysphagia in pharyngeal tuberculosis cases is not due to pharyngolaryngeal paralysis but due to odynophagia. Herein, we describe the first case of dysphagia caused by pharyngolaryngeal paralysis secondary to pharyngeal tuberculosis. An irregular mass at the right nasopharynx was detected in a 57-year-old female patient, along with dysphagia and hoarseness. She had poor right soft palate elevation, inadequate right velopharyngeal closure, poor constrictor pharyngus muscle contraction, and an immobilized right vocal cord, which collectively indicate right pharyngolaryngeal paralysis. Pathological examination and culture testing revealed pharyngeal tuberculosis. She was diagnosed with pharyngolaryngeal paralysis secondary to pharyngeal tuberculosis. The pharyngolaryngeal paralysis resolved after beginning anti-tuberculous treatment. Right pharyngolaryngeal paralysis was attributed to glossopharyngeal and vagus nerve impairment in the parapharyngeal space. Prior reports indicate that peripheral nerve paralysis, including recurrent laryngeal nerve paralysis caused by tuberculous lymphadenitis, often recovers after anti-tuberculous treatment. Pharyngeal tuberculosis rarely causes dysphagia and hoarseness attributable to pharyngolaryngeal paralysis. The neuropathy may recover after anti-tuberculous treatment. Pharyngeal tuberculosis is a new potential differential diagnosis in pharyngolaryngeal paralysis. PMID:25287869

  15. Transcutaneous electrical stimulation of the recurrent laryngeal nerve: a method of controlling vocal cord position.

    PubMed

    Sanders, I; Aviv, J; Biller, H F

    1986-09-01

    This study was designed to examine the feasibility of transcutaneous stimulation of the recurrent laryngeal nerve. Electrical activation of the recurrent laryngeal nerve was achieved by applying a blunt electrode to the intact neck skin at specific points along the tracheoesophageal groove in anesthetized adult dogs. The stimulus consisted of 10 mA cathodal pulses, each of 1 msec duration, delivered at a frequency of 10 Hz and increased by 10 Hz increments up to 100 Hz. Vocal cord excursion was directly related to the frequency of applied current. In all six dogs studies, stimulation at 30 Hz resulted in maximal ipsilateral vocal cord abduction, while stimulation at frequencies greater than 40 Hz resulted in ipsilateral vocal cord adduction up to or across the midline. Vocal cord movement was immediate and persisted for the duration of the stimulus train. Surrounding neck muscles were not visibly activated. We propose that the observed frequency-dependent movement of the vocal cords occurred because of the difference between the contraction times of the intrinsic abductor and adductor muscles of the larynx. Transcutaneous recurrent laryngeal nerve stimulation appears promising, both as a diagnostic aid in laryngoscopy and as a therapeutic tool in controlling the glottic aperture. PMID:3108752

  16. Outcome of tendon transfer for radial nerve paralysis: Comparison of three methods

    PubMed Central

    Moussavi, Alia Ayatollahi; Saied, Alireza; Karbalaeikhani, Ali

    2011-01-01

    Background: Tendon transfer for radial nerve paralysis has a 100 years history and any set of tendons that can be considered to be useful has been utilized for the purpose. The pronator tress is used for restoration of wrist dorsiflexion, while the flexor carpi radialis, flexor carpiulnaris, and flexor digitorum superficialis are variably used in each for fingers and thumb movements. The present study was a retrospective analysis, designed to compare three methods of tendon transfer for radial nerve palsy. Materials and Methods: 41 patients with irreversible radial nerve paralysis, who had underwent three different types of tendon transfers (using different tendons for transfer) between March 2005 and September 2009, included in the study. The pronator teres was transferred for wrist extention. Flexor carpi ulnaris (group 1, n=18), flexor carpi radialis (group 2, n=10) and flexor digitorum superficialis (group 3, n=13) was used to achieve finger extention. Palmaris longus was used to achieve thumb extention and abduction. At the final examination, related ranges of motions were recorded and the patients were asked about their overall satisfaction with the operation, their ability, and time of return to their previous jobs, and in addition, disabilities of the arm, shoulder and hand (DASH) Score was measured and recorded for each patient. Results: The difference between the groups with regard to DASH score, ability, and time of return to job, satisfaction with the operation, and range of motions was not statistically significant (P>0.05). All of the patients had experienced functional improvement and overall satisfaction rate was 95%. No complication directly attributable to the operation was noted, except for proximal interphalangeal joint flexion contracture in three patents. Conclusion: The tendon transfer for irreversible radial nerve palsy is very successful and probably the success is not related to type of tendon used for transfer. PMID:22144751

  17. [Unilateral recurrent laryngeal nerve palsy following brief periods of intubation. Two cases (author's transl)].

    PubMed

    Cros, A M; Esteben, D; Verhulst, J; Cazaugade, J

    1981-01-01

    One of these two cases (1 h 30 and 48 hours) was permanent. The cause of the paralysis seems to be either from compression of the nerve between the endotracheal tube cuff and the cricoid, or from compression between the thyroid ala and a dislocated arytenoid cartilage from use of an unnecessarily large tube. An anatomical study has helped to confirm this hypothesis and shows the presence of an ischaemic aera overlying the nerve at the level of its entrance into the larynx due to the endotracheal cuff. PMID:7270943

  18. Role of the ventrolateral region of the nucleus of the tractus solitarius in processing respiratory afferent input from vagus and superior laryngeal nerves

    Microsoft Academic Search

    D. R. McCrimmon; D. F. Speck; J. L. Feldman

    1987-01-01

    The role of respiratory neurons located within and adjacent to the region of the ventrolateral nucleus of the tractus solitarius (vlNTS) in processing respiratory related afferent input from the vagus and superior laryngeal nerves was examined. Responses in phrenic neural discharge to electrical stimulation of the cervical vagus or superior laryngeal nerve afferents were determined before and after lesioning the

  19. Surgical anatomy of the internal branch of the superior laryngeal nerve.

    PubMed

    Kiray, Amac; Naderi, Sait; Ergur, Ipek; Korman, Esin

    2006-09-01

    The internal branch of the superior laryngeal nerve (ibSLN) may be injured during anterior approaches to the cervical spine, resulting in loss of laryngeal cough reflex, and, in turn, the risk of aspiration pneumonia. Such a risk dictates the knowledge regarding anatomical details of this nerve. In this study, 24 ibSLN of 12 formaldehyde fixed adult male cadavers were used. Linear and angular parameters were measured using a Vernier caliper, with a sensitivity of 0.1 mm, and a 1 degrees goniometer. The diameter and the length of the ibSLN were measured as 2.1+/-0.2 mm and 57.2+/-7.7 mm, respectively. The ibSLN originates from the vagus nerve at the C1 level in 5 cases (20.83%), at the C2 level in 14 cases (58.34%), and at the C2-3 intervertebral disc level in 5 cases (20.83%) of the specimens. The distance between the origin of ibSLN and the bifurcation of carotid artery was 35.2+/-12.9 mm. The distance between the ibSLN and midline was 24.2+/-3.3 mm, 20.2+/-3.6 mm, and 15.9+/-4.3 mm at the level of C2-3, C3-4, and at the C4-5 intervertebral disc level, respectively. The angles of ibSLN were mean 19.6+/-2.6 degrees medially with sagittal plane, and 23.6+/-2.6 degrees anteriorly with coronal plane. At the area between the thyroid cartilage and the hyoid bone the ibSLN is the only nerve which traverses lateral to medial. It is accompanied by the superior laryngeal artery, a branch of the superior thyroid artery. The ibSLN is under the risk of injury as a result of cutting or compression of the blades of the retractor at this level. The morphometric data regarding the ibSLN, information regarding the distances between the nerve, and the other consistent structures may help us identify this nerve, and to avoid the nerve injury. PMID:16402208

  20. Phrenic nerve paralysis from recurrence of stage I thymoma with myasthenia gravis 10 years after complete resection.

    PubMed

    Ishibashi, Hironori; Takasaki, Chihiro; Okubo, Kenichi

    2015-06-01

    A 34-year-old woman underwent thymo-thymectomy for myasthenia gravis (MG) and was diagnosed with type B3 Masaoka stage I thymoma. Phrenic nerve paralysis developed 8 years after surgery, and a left-sided mediastinal mass was seen on a chest radiograph 10 years after surgery. Chest computed tomography revealed a tumor measuring 57 × 21 × 28 mm beside the aortic arch. Surgical resection of the tumor with partial resection of phrenic and recurrent nerve, the left upper lobe, and the pericardium was performed through a left thoracotomy. Histological examination confirmed recurrent thymoma invading the resected surrounding organs. The patient received radiation therapy postoperatively and was alive with stable symptoms of MG at the 2-year follow-up. Symptomatic relapse of thymoma is very rare and an occult recurrent thymoma should be considered in patients with unilateral phrenic nerve paralysis even after complete resection of thymoma. Detailed examination with careful follow-up should be considered. PMID:23949090

  1. The effect of routine reversal of neuromuscular blockade on adequacy of recurrent laryngeal nerve stimulation during thyroid surgery.

    PubMed

    Marshall, S D; Boden, E; Serpell, J

    2015-07-01

    Testing of the integrity of the recurrent laryngeal nerve during thyroid surgery has become routine practice for many surgeons to aid dissection and minimise the chance of inadvertent nerve injury. We hypothesised that routine reversal of an intermediate-acting, non-depolarising neuromuscular blocking agent would improve conditions for stimulation of the recurrent laryngeal nerve. We conducted a single-centre, randomised, double-blind placebo-controlled trial of patients undergoing thyroid surgery by the same surgeon. After randomisation, the participants received either neostigmine 2.5 mg with glycopyrrolate 0.4 mg or placebo, at 30 minutes after induction of anaesthesia and administration of 0.4 mg/kg of atracurium. The primary outcome was the subjective assessment by the surgeon as to whether the neuromuscular function was adequate for stimulation of the recurrent laryngeal nerve using a neuromuscular integrity monitor (NIM). Time to NIM stimulation was 44.6 minutes in the placebo group and 41.4 minutes in the intervention group (P=0.268). Of the 21 patients who received the neuromuscular blockade reversal, 20 (95.2%) had adequate surgical conditions for NIM stimulation, compared to 9 out of 18 patients (50%) in the placebo group (P=0.002). Three of the ten patients (30%) with inadequate reversal showed no evidence of residual blockade assessed peripherally. The routine reversal of neuromuscular blockade at 30 minutes post induction appears to result in adequate surgical conditions for safe stimulation of the recurrent laryngeal nerve. Return of neuromuscular function at a peripheral site does not guarantee adequate laryngeal muscle function for use of the NIM. PMID:26099761

  2. Neuromuscular electrical stimulation of the cricothyroid muscle in patients with suspected superior laryngeal nerve weakness.

    PubMed

    Guzman, Marco; Rubin, Adam; Cox, Paul; Landini, Fernando; Jackson-Menaldi, Cristina

    2014-03-01

    In this retrospective case study, we report the apparent clinical effectiveness of neuromuscular electrical stimulation (NMES) in combination with voice therapy (VT) for rehabilitating dysphonia secondary to suspected superior laryngeal nerve (SLN) weakness in two female patients. Both patients failed or plateaued with traditional VT but had significant improvement with the addition of NMES of the cricothyroid muscle and SLN using a VitalStim unit. Stimulation was provided simultaneously with voice exercises based on musical phonatory tasks. Both acoustic analysis and endoscopic evaluation demonstrated important improvements after treatment. In the first patient, the major change was obtained within the primo passaggio region; specifically, a decrease in voice breaks was demonstrated. In the second patient, an improvement in voice quality (less breathiness) and vocal range were the most important findings. Additionally, each patient reported a significant improvement in their voice complaints. Neuromuscular laryngeal electrical stimulation in combination with vocal exercises might be a useful tool to improve voice quality in patients with SLN injury. PMID:24315659

  3. Concomitant type I thyroplasty and thoracic operations for lung cancer: Preventing respiratory complications associated with vagus or recurrent laryngeal nerve injury

    Microsoft Academic Search

    Thierry Mom; Marc Filaire; David Advenier; Christophe Guichard; Adel Naamee; Georges Escande; Xavier Llompart; Laurent Vallet; Jean Gabrillargues; Christophe Courtalhiac; Béatrice Claise; Laurent Gilain

    2001-01-01

    Objectives: We sought to prevent postoperative swallowing disorder, aspiration, and sputum retention in cases of recurrent laryngeal or vagus nerve section occuring during lung cancer resection. Methods: In 14 of 25 consecutive patients, type I thyroplasty and thoracic operations were performed during the same period of anesthesia. All patients had a preoperative laryngeal computed tomographic scan providing us with indispensable

  4. Effectively Axonal-supercharged Interpositional Jump-Graft with an Artificial Nerve Conduit for Rat Facial Nerve Paralysis

    PubMed Central

    Niimi, Yosuke; Takeuchi, Yuichi; Sasaki, Ryo; Watanabe, Yorikatsu; Yamato, Masayuki; Miyata, Mariko; Sakurai, Hiroyuki

    2015-01-01

    Background: Interpositional jump graft (IPJG) is a nerve graft axonally supercharged from the hypoglossal nerve. However, for using the technique, an autologous nerve, which should contain the great auricular and sural nerves, must be obtained. Depending on the donor site, unavoidable issues such as nerve disorders and postoperative scarring may appear. To reduce the issues, in this study, the authors developed an end-to-side neurorrhaphy technique with the recipient nerve and an artificial nerve conduit and investigated the efficacy of an IPJG with an artificial nerve conduit in a rat facial nerve paresis model. Methods: A ligature clip was used to crush the facial nerve trunk, thereby creating a partial facial nerve paresis model. An artificial nerve conduit was then prepared with a 10-mm-long silicone tube containing 10 ?L type I collagen and used to create an IPJG between the facial nerve trunk and the hypoglossal nerve (the silicone tube group). Thirteen weeks after the surgery, the outcome was histologically and physiologically compared with conventional IPJG with autograft using the great auricular nerve. Results: Retrograde tracer test confirmed a double innervation by the facial and hypoglossal nerve nuclei. In the autograft and silicone tube groups, the regeneration of myelinated axons was observed. Conclusion: In this study, the authors successfully developed an end-to-side neurorrhaphy technique with the recipient nerve and an artificial nerve conduit, and revealed that an IPJG in the conduit was effective in the rat facial nerve paresis model. PMID:26180717

  5. Safe distance between electrotome and recurrent laryngeal nerve: an experimental canine model

    PubMed Central

    Jiang, Kewei; Zhu, Yi; Zhou, Gang; Ye, Yingjiang; Xie, Qiwei; Yang, Xiaodong; Wang, Shan

    2015-01-01

    Background: Various energy based surgical devices (ESD) like electrotome have been widely applied in thyroid surgery. This is the first canine model to determine the safety margin of using the electrotome near the recurrent laryngeal nerve (RLN) to prevent injury to this nerve during thyroid surgery. Methods: Eighteen healthy male dogs were divided equally into three groups according to the distance between electrotome application and the RLN: Group A (5 mm), Group B (3 mm), Group C (1 mm). The parameters of evoked electromyography (EEMG) of vocal muscles between right normal RLNs and left RLNs after electrotome application at a power of 30 W for 1 second in each group were recorded and compared. The acute microstructural morphological changes of the RLNs were observed immediately after the operation under electron microscope. Results: In Group B and Group C, after using the electrotome at a vertical distance of 3 mm or 1 mm from the left RLNs, the stimulating thresholds of left RLNs had a significant increase (P = 0.005; P = 0.002) compared with right normal RLNs, and there occurred obvious acute microstructural morphological changes under electron microscope for left RLNs. While there was no significant functional or histological changes for left RLNs after using the electrotome at a vertical distance of 5 mm from the RLN (P = 0.187) in Group A. Conclusions: When using the electrotome near the RLN at a power of 30W in thyroid surgery, a safety margin of more than 3 mm should be recommended. PMID:25785056

  6. Intraoperative neuromonitoring of the recurrent laryngeal nerve in robotic thyroid surgery.

    PubMed

    Bae, Dong Sik; Kim, Su-jin

    2015-02-01

    This study evaluated the technical feasibility and efficacy of intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) to aid its identification and preservation during robotic thyroidectomy (RoT). IONM of the RLN was evaluated in 30 consecutive patients undergoing RoT. All patients underwent an indirect laryngoscope examination to objectively assess vocal cord function. Their Voice Handicap Index-10 (VHI-10) was measured to subjectively assess vocal cord function preoperatively and at postoperative months 1 and 3. Of the 56 RLNs at risk in 30 patients undergoing RoT, all were visualized and identified by IONM. The IONM sensitivity for postoperative permanent RLN palsy was 100%, with a positive predictive value of 100%. The mean VHI-10 scores preoperatively and at postoperative months 1 and 3 were 0.20±0.66, 3.47±5.04, and 1.53±2.47, respectively (P<0.001). IONM of the RLN during RoT is technically feasible and effective for identifying this nerve. PMID:25238177

  7. Recurrent laryngeal nerve palsy and substernal goiter. An Italian multicenter study.

    PubMed

    Testini, M; Gurrado, A; Bellantone, R; Brazzarola, P; Cortese, R; De Toma, G; Fabiola Franco, I; Lissidini, G; Pio Lombardi, C; Minerva, F; Di Meo, G; Pasculli, A; Piccinni, G; Rosato, L

    2014-06-01

    The aim of this retrospective multicenter study was to verify whether the substernal goiter and the type of surgical access could be risk factors for recurrent laryngeal nerve palsy during total thyroidectomy. Between 1999-2008, 14,993 patients underwent total thyroidectomy. Patients were divided into three groups: group A (control; n=14.200, 94.7%), cervical goiters treated through collar incision; group B (n=743, 5.0%) substernal goiters treated by cervical approach; group C (n=50, 0.3%) in which a manubriotomy was performed. Transient and permanent unilateral palsy occurred significantly more frequently in B+C vs. A (P?.001) and in B vs. A (P?.001). Transient bilateral palsy was significantly more frequent in B+C vs. A (P?.043) and in C vs. A (P?.016). Permanent bilateral palsy was significantly more frequent in B+C vs. A (P?.041), and in B vs. A (P?.037). Extension of the goiter into the mediastinum was associated to increased risk of recurrent nerve palsy during total thyroidectomy. PMID:24880605

  8. Synaptic events in ventral respiratory neurones during apnoea induced by laryngeal nerve stimulation in neonatal pig.

    PubMed

    Czyzyk-Krzeska, M F; Lawson, E E

    1991-05-01

    1. Postsynaptic potentials evoked by electrical stimulation of superior laryngeal nerve (SLN) were recorded during SLN-induced apnoea from the respiratory neurones of the ventral respiratory group (VRG) in pentobarbitone-anaesthetized, vagotomized and artificially ventilated newborn piglets (n = 14, 4-7 days old). All recorded inspiratory (n = 10), post-inspiratory (n = 10) and expiratory (n = 20) neurones had a triphasic pattern of membrane potential and were identified for their projections to the spinal cord or cervical vagus nerve. 2. During long-lasting apnoea, induced by SLN stimulation, the membrane potential trajectory of each type of recorded neurone was held at the level corresponding approximately to the membrane potential reached during stage I of expiration. Compound postsynaptic potentials evoked in most respiratory-related neurones had an early short-lasting and a late long-lasting component. 3. Postsynaptic potentials in four out of seven inspiratory neurones, in which postsynaptic potentials were well demonstrated, were characterized by an early depolarization followed by long-lasting hyperpolarization. In three other inspiratory neurones only late hyperpolarization was present. The reversal of the late hyperpolarization by intracellular chloride injection was achieved to a different degree in the early and late portions of late hyperpolarization. 4. Postsynaptic potentials evoked in expiratory neurones were studied in sixteen neurones and displayed two patterns: early hyperpolarization followed by long-lasting hyperpolarization (n = 7, six were not antidromically activated after spinal cord stimulation) or early hyperpolarization followed by late depolarization (n = 9, eight projected to the spinal cord). The early hyperpolarization was readily reversed by chloride injection. The late hyperpolarization was more difficult to reverse and usually the reversal was not completed. 5. Postsynaptic potentials evoked in post-inspiratory neurones showed a pattern of two consecutive phases of depolarization. 6. The present study revealed that during long-lasting apnoea evoked by SLN stimulation each category of VRG respiratory neurones received a temporally synchronized combination of an initial fast input derived reflexly from laryngeal afferents, and of late inputs representing involvement of the whole respiratory network in the response. PMID:2061828

  9. Framework Surgery for Treatment of Unilateral Vocal Fold Paralysis

    PubMed Central

    Daniero, James J.; Garrett, C. Gaelyn; Francis, David O.

    2014-01-01

    Laryngeal framework surgery is the current gold standard treatment for unilateral vocal fold paralysis. It provides a permanent solution to glottic insufficiency caused by injury to the recurrent laryngeal nerve. Various modifications to the original Isshiki type I laryngoplasty procedure have been described to improve voice and swallowing outcomes. The success of this procedure is highly dependent on the experience of the surgeon as it epitomizes the intersection of art and science in the field. The following article reviews the evidence, controversies, and complications related to laryngoplasty for unilateral vocal fold paralysis. It also provides a detailed analysis of how and when arytenoid-positioning procedures should be considered, and summarizes the literature on postoperative outcomes. PMID:24883239

  10. Migration and Differentiation of Neural Progenitor Cells after Recurrent Laryngeal Nerve Avulsion in Rats

    PubMed Central

    Zhao, Wan; Xu, Wen

    2014-01-01

    To investigate migration and differentiation of neural progenitor cells (NPCs) from the ependymal layer to the nucleus ambiguus (NA) after recurrent laryngeal nerve (RLN) avulsion. All of the animals received a CM-DiI injection in the left lateral ventricle. Forty-five adult rats were subjected to a left RLN avulsion injury, and nine rats were used as controls. 5-Bromo-2-deoxyuridine (BrdU) was injected intraperitoneally. Immunohistochemical analyses were performed in the brain stems at different time points after RLN injury. After RLN avulsion, the CM-DiI+ NPCs from the ependymal layer migrated to the lesioned NA. CM-DiI+/GFAP+ astrocytes, CM-DiI+/DCX+ neuroblasts and CM-DiI+/NeuN+ neurons were observed in the migratory stream. However, the ipsilateral NA included only CM-DiI+ astrocytes, not newborn neurons. After RLN avulsion, the NPCs in the ependymal layer of the 4th ventricle or central canal attempt to restore the damaged NA. We first confirm that the migratory stream includes both neurons and glia differentiated from the NPCs. However, only differentiated astrocytes are successfully incorporated into the NA. The presence of both cell types in the migratory process may play a role in repairing RLN injuries. PMID:25202908

  11. Transient total facial nerve paralysis: an unusual complication of transoral endoscopic-assisted management of subcondylar fracture.

    PubMed

    Choi, Hwan Jun; Lee, Young Man

    2012-05-01

    Endoscopic-assisted repair of subcondylar fractures is an additional tool for management; however, there is a steep learning curve. Generally, this technique allows good visualization of the fracture site for reduction through an incision with an acceptable cosmetic result. Recently, the surgical techniques and technology as well as the indications for endoscopic facial fracture repair are in development; there are few available data in the literature regarding detail complications and recovery processes following endoscopic fracture treatment. The purpose of this article was to reveal unusual complication following endoscopic repair of subcondylar fracture in terms of radiographic, photographic, and recovering orders of the facial nerve and facial reanimations. In our case, no damage to the facial nerve was observed intraoperatively, but the patient had total facial paralysis, immediately postoperatively. At long-term follow-up, the facial nerve function was recovered well within 6 months. The authors consider that transoral endoscopic-assisted open reduction constitutes a valid alternative to a transcutaneous approach for the reduction and fixation of subcondylar fractures. It provides the benefits of open reduction and internal fixation without the permanent complications, such as facial nerve injury. PMID:22627456

  12. Quasi-trapezoidal pulses to selectively block the activation of intrinsic laryngeal muscles during vagal nerve stimulation

    NASA Astrophysics Data System (ADS)

    Tosato, M.; Yoshida, K.; Toft, E.; Struijk, J. J.

    2007-09-01

    The stimulation of the vagus nerve has been used as an anti-epileptic treatment for over a decade, and its use for depression and chronic heart failure is currently under investigation. Co-activation of the intrinsic laryngeal muscles may limit the clinical use of vagal stimulation, especially in the case of prolonged activation. To prevent this, the use of a selective stimulation paradigm has been tested in seven acute pig experiments. Quasi-trapezoidal pulses successfully blocked the population of the largest and fastest vagal myelinated fibers being responsible for the co-activation. The first response in the vagus compound action potential was reduced by 75 ± 22% (mean ± SD) and the co-activated muscle action potential by 67 ± 25%. The vagal bradycardic effects remained unchanged during the selective block, confirming the leading role of thin nerve fibers for the vagal control of the heart. Quasi-trapezoidal pulses may be an alternative to rectangular pulses in clinical vagal stimulation when the co-activation of laryngeal muscles must be avoided.

  13. Is the identification of the external branch of the superior laryngeal nerve mandatory in thyroid operation? Results of a prospective randomized study

    Microsoft Academic Search

    Rocco Bellantone; Mauro Boscherini; Celestiano P. Lombardi; Maurizio Bossola; Francesco Rubino; Carmela De Crea; Pierfrancesco Alesina; Emanuela Traini; Tiziana Cozza; Lucia D'Alatri

    2001-01-01

    Background. The aim of this study was to investigate the incidence of injury to the external branch of the superior laryngeal nerve (EBSLN) with 2 different surgical approaches. Methods. From 1998 to 2000, 289 consecutive patients undergoing thyroidectomy were randomly divided into 2 groups. In group A (137 patients [215 upper pole ligations]), the superior thyroid artery was ligated after

  14. Facial nerve paralysis: A case report of rare complication in uncontrolled diabetic patient with mucormycosis

    PubMed Central

    Shekar, Vandana; Sikander, Jeelani; Rangdhol, Vishwanath; Naidu, Madhulika

    2015-01-01

    Mucormycosis is a rare opportunistic aggressive and fatal infection caused by mucor fungus. Seven types of mucormycosis are identified based on the extension and involvement of the lesion, of which the rhino orbital mucormycosis is most common in the head and neck region. Although it is widely spread in nature, clinical cases are rare and observed only in immunocompromised patients and patients with uncontrolled diabetes mellitus. Early symptoms include fever, nasal ulceration or necrosis, periorbital edema or facial swelling, paresthesia and reduced vision. Involvement of cranial nerves although not common, facial nerve palsy is a rare finding. The infection may spread through cribriform plate to the brain resulting in extensive cerebellar infarctions. Timely diagnosis and early recognition of the signs and symptoms, correction of underlying medical disorders, and aggressive medical and surgical intervention are necessary for successful therapeutic outcome. PMID:25810669

  15. CT Features of an unusual calcified schwannoma of the superior laryngeal nerve.

    PubMed

    Moroni, A-L; Righini, C; Faure, C; Serra-Tosio, G; Lefournier, V

    2007-05-01

    We report the CT findings in a patient with a lateral neck mass histologically diagnosed as a laryngeal schwannoma but presenting some uncommon CT features. CT showed unusual calcified components, very rarely observed and potentially misleading for diagnosis. However, this imaging feature can be found in ancient schwannomas. Our case is, therefore, a very rare one and reviews the main differential diagnoses. PMID:17494683

  16. Bilateral vocal cord paralysis requiring tracheostomy due to neuroborreliosis.

    PubMed

    Martínez-Balzano, Carlos D; Greenberg, Bruce

    2014-11-01

    Neuroborreliosis can cause multiple cranial and peripheral neuropathies; however, involvement of both recurrent laryngeal nerves is rare. We report the case of a 90-year-old man who presented with dysphonia and right upper and lower extremity weakness. His course was complicated by bilateral vocal cord paralysis and respiratory failure requiring tracheostomy. The diagnosis of borreliosis was made by detection of IgM and IgG antibodies against Borrelia burgdorferi on enzyme immunoassay and Western blot. The patient received IV ceftriaxone for 2 weeks, followed by complete recovery of motor and vocal function over 2 months. Our case is the third report of bilateral vocal cord paralysis in the literature, and the first one, to our knowledge, presenting with respiratory failure requiring an artificial airway. Physicians should be aware of this unusual complication of neuroborreliosis. PMID:25367481

  17. Vesalius on the anatomy and function of the recurrent laryngeal nerves: medical illustration and reintroduction of a physiological demonstration from Galen.

    PubMed

    Lanska, Douglas J

    2014-01-01

    The purpose of this article is to review the anatomical illustrations and physiological demonstrations of sixteenth-century Flemish-born anatomist and physician Andreas Vesalius concerning the recurrent laryngeal nerves. Although Vesalius was primarily an anatomist, he also used vivisection as a pedagogical device to help his students understand the function of structures within the fabric of the body that they had previously studied in anatomical detail. Vesalius's masterwork, De humani corporis fabrica or simply the Fabrica (1543, 1555), was ostensibly an anatomy text, but Vesalius included textual and figural references to his use of vivisection to explicate the function of specific structures. Even as he began to criticize the errors in Galen's anatomical works, Vesalius nevertheless adopted some of Galen's classic physiological demonstrations, in particular the ligation (and subsequent release) of the recurrent laryngeal nerves of a pig to demonstrate their role in generating the pig's squeal. Vesalius's illustrations concerning the recurrent laryngeal nerve in the Fabrica were of two types: elegant anatomical woodcut plates-unsurpassed for their clarity, accuracy, and detail - and the distinctly inelegant historiated initial Q, depicting a throng of putti busily engaged in vivisecting a pig. Vesalius' anatomical plates were heavily plagiarized while the historiated initials, showing the rough work of an anatomist or surgeon, were largely ignored and remain little recognized today. While Vesalius' anatomical illustrations of the recurrent laryngeal nerves contained some errors, they were a dramatic departure from prior meager efforts at medical illustration and indeed far surpassed all contemporary published illustrations by others. Vesalius was also influential in reviving Galen's approach to vivisection, at least for pedagogical purposes, if not really then yet as a full-fledged investigative technique. PMID:24870272

  18. Residual Chemoresponsiveness to Acids in the Superior Laryngeal Nerve in “Taste-Blind” (P2X2/P2X3 Double-KO) Mice

    PubMed Central

    Ohkuri, Tadahiro; Horio, Nao; Stratford, Jennifer M.; Finger, Thomas E.; Ninomiya, Yuzo

    2012-01-01

    Mice lacking both the P2X2 and the P2X3 purinergic receptors (P2X-dblKO) exhibit loss of responses to all taste qualities in the taste nerves innervating the tongue. Similarly, these mice exhibit a near total loss of taste-related behaviors in brief access tests except for a near-normal avoidance of acidic stimuli. This persistent avoidance of acids despite the loss of gustatory neural responses to sour was postulated to be due to continued responsiveness of the superior laryngeal (SL) nerve. However, chemoresponses of the larynx are attributable both to taste buds and to free nerve endings. In order to test whether the SL nerve of P2X-dblKO mice remains responsive to acids but not to other tastants, we recorded responses from the SL nerve in wild-type (WT) and P2X-dblKO mice. WT mice showed substantial SL responses to monosodium glutamate, sucrose, urea, and denatonium—all of which were essentially absent in P2X-dblKO animals. In contrast, the SL nerve of P2X-dblKO mice exhibited near-normal responses to citric acid (50 mM) although responsiveness of both the chorda tympani and the glossopharyngeal nerves to this stimulus were absent or greatly reduced. These results are consistent with the hypothesis that the residual avoidance of acidic solutions by P2X-dblKO mice may be attributable to the direct chemosensitivity of nerve fibers innervating the laryngeal epithelium and not to taste. PMID:22362867

  19. Laryngeal and Vocal Changes During Vagus Nerve Stimulation in Epileptic Patients

    Microsoft Academic Search

    Willem Kersing; Philippe H Dejonckere; Hans E van der Aa; Hendrik P. J Buschman

    2002-01-01

    Left vagus nerve stimulation (VNS) by means of an implanted electrode has proven to reduce seizure frequency in epileptic patients with medically refractory seizures. This technique is now widely applied over the world. Voice changes appear to be one of the major side effects. The morphodynamic changes in the larynx and the acoustic impacts have been analyzed in detail in

  20. Facial paralysis

    MedlinePLUS

    Paralysis of the face. ... from the brain to the muscles of the face Damage to the area of the brain that sends signals to the muscles of the face In people who are otherwise healthy, facial paralysis ...

  1. Electrophysiologic recurrent laryngeal nerve monitoring during thyroid and parathyroid surgery: international standards guideline statement.

    PubMed

    Randolph, Gregory W; Dralle, Henning; Abdullah, Hisham; Barczynski, Marcin; Bellantone, Rocco; Brauckhoff, Michael; Carnaille, Bruno; Cherenko, Sergii; Chiang, Fen-Yu; Dionigi, Gianlorenzo; Finck, Camille; Hartl, Dana; Kamani, Dipti; Lorenz, Kerstin; Miccolli, Paolo; Mihai, Radu; Miyauchi, Akira; Orloff, Lisa; Perrier, Nancy; Poveda, Manuel Duran; Romanchishen, Anatoly; Serpell, Jonathan; Sitges-Serra, Antonio; Sloan, Tod; Van Slycke, Sam; Snyder, Samuel; Takami, Hiroshi; Volpi, Erivelto; Woodson, Gayle

    2011-01-01

    Intraoperative neural monitoring (IONM) during thyroid and parathyroid surgery has gained widespread acceptance as an adjunct to the gold standard of visual nerve identification. Despite the increasing use of IONM, review of the literature and clinical experience confirms there is little uniformity in application of and results from nerve monitoring across different centers. We provide a review of the literature and cumulative experience of the multidisciplinary International Neural Monitoring Study Group with IONM spanning nearly 15 years. The study group focused its initial work on formulation of standards in IONM as it relates to important areas: 1) standards of equipment setup/endotracheal tube placement and 2) standards of loss of signal evaluation/intraoperative problem-solving algorithm. The use of standardized methods and reporting will provide greater uniformity in application of IONM. In addition, this report clarifies the limitations of IONM and helps identify areas where additional research is necessary. This guideline is, at its forefront, quality driven; it is intended to improve the quality of neural monitoring, to translate the best available evidence into clinical practice to promote best practices. We hope this work will minimize inappropriate variations in monitoring rather than to dictate practice options. PMID:21181860

  2. Sprouting and regression of the nerve at the frog neuromuscular junction in normal conditions and after prolonged paralysis with curare.

    PubMed

    Wernig, A; Pécot-Dechavassine, M; Stover, H

    1980-06-01

    A light microscopical, histochemical and electron microscopical investigation of the frog neuromuscular junction has been performed on muscles from animals in different functional states of activity. The combined staining of axon terminals and cholinesterase (ChE) allows a precise description of the nerve terminal arborization and its synaptic contacts. Most terminal arborizations form long continuous contacts with the muscle cell. Distinquishable from these are nerve branches (usually of small diameter)d or distal endings of branches with one or several small and isolated contacts. It is assumed that these are sprouts with newly-formed synaptic sites. Other sprouts end without apparent synaptic contact. At the uttrastructural levet, nerve sprouts end without apparent synaptic contact. At the uttrastructural levet, nerve sprouts growing into empty, well-differentiated synaptic gutters or inducing the formation of new synaptic sites were observed. In other sites, ChE is apparently located at postsynaptic gutters with no nerve present. Similarly, in the electron microscope, well-differentiated synaptic gutters lacking any nerve or Schwann cell elements were observed. In addition, synaptic gutters only partially occupied by the nerve were frequently seen. These features have been interpreted as signs of regression of the nerve terminals. Nerve regression and sprouting were found in animals chronically paralysed with curare over several weeks as well as in untreated frogs (winter and summer frogs, laboratory frogs, fed and unfed). When quantitatively evaluating the occurence of presumed features of nerve sprouting and nerve regression, differences were found between different experimental groups. From this it is concluded that, in addition to developmental changes, the degree of nerve sprouting and regression is controlled by external factors such as muscle activity and seasonal variations. Signs of sprouting and nerve regression can be simultaneously present in a single synapse. It appears that the frog neuromuscular synapse is not a static structure, but is in a state of permenent remodelling. PMID:6969296

  3. Laryngeal Paraganglioma: A Case Report

    PubMed Central

    Sharifkashany, Shervin; Yazdani, Nasrin; Ghazavi, Hossein; Tajdini, Ardavan

    2014-01-01

    Paragangliomas in the head and neck are found typically in the region of the carotid body, jugular body, and along the 9th and 10th cranial nerves. They can occur in multicenteric forms, but generally, laryngeal paragangliomas are not found in these patients. Only two cases of laryngeal paraganglioma have been reported with a synchronous lesion elsewhere. We report an additional case of a 34-year-old female with multiple paragangliomas beginning with laryngeal involvement. PMID:25763080

  4. Phonatory Effects of Type I Thyroplasty Implant Shape and Depth of Medialization in Unilateral Vocal Fold Paralysis

    PubMed Central

    Orestes, Michael I.; Neubauer, Juergen; Sofer, Elazar; Salinas, Jonathon; Chhetri, Dinesh K.

    2015-01-01

    Objectives/Hypothesis Medialization thyroplasty (MT) is commonly used to treat glottic insufficiency. In this study, we investigated the phonatory effects of MT implant medialization depth and medial surface shape. Methods Recurrent laryngeal nerve (RLN) and vagal paralysis were simulated in an in vivo canine. A type 1 MT was performed using a silicone elastomer implant with variable medialization depths and medial surface shapes: rectangular, V-shaped, divergent, and convergent. The effects on phonation onset flow/pressure relationships and acoustics were measured. Results Increasing depth of medialization led to improvements in fundamental frequency (F0) range and normalization of the slope of pressure/flow relationship toward baseline activation conditions. The effects of implant medial shape also depended on depth of medialization. Outcome measures were similar among the implants at smaller medialization depths. With large medialization depths and vagal paralysis conditions, the divergent implant maintained pressure/flow relationship closer to baseline. The vagal paralysis conditions also demonstrated decreased fundamental frequency range and worse flow/pressure relationship compared to RLN paralysis. Conclusions The depth and medial shape of a medialization laryngoplasty (ML) implant significantly affect both the F0 range and aerodynamic power required for phonation. These effects become more notable with increasing depth of medialization. The study also illustrates that ML is less effective in vagal paralysis compared to RLN paralysis. PMID:25046146

  5. Tick Paralysis

    Microsoft Academic Search

    Jonathan A. Edlow

    2010-01-01

    Opinion statement  Tick paralysis is a toxin-mediated cause of acute flaccid paralysis. Most practitioners will go through their entire career\\u000a without ever encountering a case. An important veterinary disease, tick paralysis is rare in humans. Although it has certain\\u000a geographical proclivities, it exists worldwide. Although it tends to occur in young girls, it can occur in any age group.\\u000a Due to

  6. Analysis of normal and denerved laryngeal vocalization in guinea pigs (Cavia porcellus).

    PubMed

    Arch-Tirado, Emilio; Verduzco-Mendoza, Antonio; Taboada-Picazo, Verónica; Mota-Rojas, Daniel; Alonso-Spilsbury, Maria de Lourdes; Alfaro-Rodríguez, Alfonso

    2009-01-01

    Paralysis of the left vocal chord is frequent in human clinical practice; because of its anatomic similarity with human, the guinea pig might be a suitable biological model to analyze the phoniatric behavior in denerved animals. Forty newborn guinea pigs were used (20 control and 20 experimental); an incision was made in the ventricular region with the animals under general anesthesia over the middle line of the neck, until the lower left laryngeal nerve was found, the same was secured with alligator clips so that afterward a two-part dissection could be performed and the middle section could be removed (1cm) from the nerve endings (distal and proximal) before they were separated from the laryngeal structure. After recovery from surgery, vocal emissions were recorded in solitary for 6 minutes. The animals that had nerves removed showed an increase in fundamental vocalization frequency compared with the controls. F test was carried out (P=0.05) and no significant difference was found. When analyzing functional recovery, we found that the guinea pigs compensated vocal emissions at 20 days. With regard to the unilateral paralysis, the motility was frequently compensated by the healthy vocal chord, improving voice emission, and loss of air inhalation. PMID:18023326

  7. [Nonrecurrent recurrent nerve. Danger in thyroid and parathyroid surgery. Apropos of 9 cases].

    PubMed

    Napolitano, C; Vix, M; Mutter, D; Marescaux, J

    1997-11-01

    Main difficulties in thyroid surgery are represented by recurrent nerve anatomy and parathyroid glands. Nerve injury or accidental truncation cause definitive impairment. Risk of recurrent paralysis is 0.5 to 3% for advanced teams. Early investigation and dissection of this nerve are considered mandatory for preservation. This practice is also highly indicated due to anatomical variations, cause for accidental truncation. The most difficult case is encountered when there is nerve non recurrence, due to variations in origin and path of the nerve. Inferior laryngeal nerve non recurrence can be present on the right side, it is uncommon but possible on the left side. We have evaluated a series of 1165 cervicotomies undertaken for thyroidectomy or parathyroid gland approach. There were 9 cases of non recurrence. Literature review allowed us to study anatomical variations and nerve relationships. PMID:9489327

  8. Cervico-mediastinal schwannoma of the vagus nerve: resection with intraoperative nerve monitoring.

    PubMed

    Imperatori, Andrea; Dionigi, Gianlorenzo; De Monte, Lavinia; Conti, Valentina; Rotolo, Nicola

    2011-03-01

    Schwannomas are usually benign, single, encapsulated, slow-growing tumours originating from cranial or spinal nerve sheaths. The vagus nerve involvement at the mediastinal inlet is very uncommon. For anatomical reasons, the resection of cervical and mediastinal schwannoma of the vagus nerve has a high risk of vocal fold paralysis. We describe the case of a 67-year-old female with a cervico-mediastinal schwannoma of the vagus nerve that we removed using the intraoperative neuromonitoring technique. The patient presented with mild hoarseness and complained of discomfort behind the jugular notch. Neck and chest computerized tomography described a 35 × 30 mm solid lesion behind the left clavi-sternal junction; preoperative fine needle aspiration cytology revealed schwannoma. Resection of the mass was performed with a cervical approach and the vagus nerve tumour was completely removed under continuous neuromonitoring (NIM-3(®) System), preserving the vagus and the recurrent laryngeal nerve function. Pathology on the resected mass documented A-type schwannoma with "ancient schwannoma" areas. The intraoperative neurostimulation and neuromonitoring approach for the resection of vagus schwannoma are recommended because it may reduce the risk of injury to the vagus and to the recurrent laryngeal nerve. PMID:21210273

  9. Description of Laryngeal Pathologies in Children Evaluated by Otolaryngologists.

    ERIC Educational Resources Information Center

    Dobres, Rachel; And Others

    1990-01-01

    Data were collected on 731 patients (age birth to 18) at a children's hospital otolaryngology clinic. Most frequent laryngeal pathologies were subglottic stenosis, vocal nodules, laryngomalacia, and vocal fold paralysis. Laryngeal pathologies were more common to males than females, were most common in the youngest patients, and were distributed…

  10. Aerodynamic and nonlinear dynamic acoustic analysis of tension asymmetry in excised canine larynges

    PubMed Central

    Devine, Erin E.; Bulleit, Erin E.; Hoffman, Matthew R.; McCulloch, Timothy M.; Jiang, Jack J.

    2013-01-01

    Objective/hypothesis To model tension asymmetry caused by superior laryngeal nerve paralysis (SLNP) in excised larynges and apply perturbation, nonlinear dynamic, and aerodynamic analyses. Methods SLNP was modeled in 8 excised larynges using sutures and weights to mimic cricothyroid (CT) muscle function. Weights were removed from one side to create tension asymmetry, mimicking unilateral SLNP. Two sets of weights were used, one light and one heavy. Experimental measurements were made for five conditions: no tension; symmetrical light tension; asymmetrical light tension; symmetrical heavy tension; and asymmetrical heavy tension. Results Perturbation parameters were not significantly different across conditions (percent jitter: p=0.451; percent shimmer: p=0.321). Additionally, many measurements were invalid (error values > 10). Second order entropy (K2) was significantly different across conditions (p=0.002), while correlation dimension (D2) was not (p=0.428). Validity of these nonlinear dynamic parameters was demonstrated by low standard deviations. Phonation threshold pressure (p<0.001) and power (p=0.05) differed significantly across conditions, while phonation threshold flow did not (p=0.396). Conclusions Nonlinear dynamic analysis differentiated between symmetrical and asymmetrical tension conditions while traditional perturbation analysis was less useful characterizing type 2 or 3 vocal signals. Supplementing acoustic with aerodynamic parameters may help distinguish among laryngeal disorders of neuromuscular origin. PMID:22562826

  11. Does recurrent laryngeal nerve lymph node metastasis really affect the prognosis in node-positive patients with squamous cell carcinoma of the middle thoracic esophagus?

    PubMed Central

    2014-01-01

    Background Recurrent laryngeal nerve (RLN) lymph node metastasis used to be shown a predictor for poor prognosis in esophageal squamous cell carcinoma. The purpose of this study was to evaluate the prognostic impact of RLN node metastasis and the number of metastatic lymph nodes in node-positive patients with squamous cell carcinoma of middle thoracic esophagus. Methods A cohort of 235 patients who underwent curative surgery for squamous cell carcinoma of middle thoracic esophagus was investigated. The prognostic impact was evaluated by univariate and multivariate analyses. Results Lymph node metastasis was found in 133 patients. Among them, 81 had metastatic RLN nodes, and 52 had at least one positive node but no RLN nodal involvement. The most significant difference in survival was detected between patients with metastatic lymph nodes below and above a cutoff value of six (P?

  12. [Laryngeal masks].

    PubMed

    Sagardoy Munesa, Lorena; Miguel Romeo, Carmen

    2014-01-01

    The first device was supraglottic laryngeal mask. These tools help us to handle a normal and difficult airway, other than direct laryngoscopy. Supraglottic devices positioned above the vocal cords are used to ventilate patients. Address and resolve the disadvantages of the endotracheal ventilation. There are different types of laryngeal mask: Classical, Proseal, Flexible, Fastrach, Disposable: Supreme; i-gel. PMID:24624618

  13. Genetics Home Reference: Paralysis

    MedlinePLUS

    ... Home Conditions Genes Chromosomes Handbook Glossary Resources Conditions > Paralysis Related topics on Genetics Home Reference: alternating hemiplegia of childhood hyperkalemic periodic paralysis hypokalemic periodic paralysis infantile-onset ascending hereditary spastic ...

  14. The Effect of Bilateral Superior Laryngeal Nerve Lesion on Swallowing – A Novel Method to Quantitate Aspirated Volume and Pharyngeal Threshold in Videofluoroscopy

    PubMed Central

    DING, Peng; FUNG, George Shiu-Kai; LIN, Ming De; HOLMAN, Shaina D.; GERMAN, Rebecca Z.

    2015-01-01

    Purpose To determine the effect of bilateral superior laryngeal nerve (SLN) lesion on swallowing threshold volume and the occurrence of aspiration, using a novel measurement technique for videofluorscopic swallowing studies (VFSS). Methods and Materials We used a novel radiographic phantom to assess volume of the milk containing barium from fluoroscopy. The custom made phantom was firstly calibrated by comparing image intensity of the phantom with known cylinder depths. Secondly, known volume pouches of milk in a pig cadaver were compared to volumes calculated with the phantom. Using these standards, we calculated the volume of milk in the valleculae, esophagus and larynx, for 205 feeding sequences from four infant pigs feeding before and after had bilateral SLN lesions. Swallow safety was assessed using the IMPAS scale. Results The log-linear correlation between image intensity values from the phantom filled with barium milk and the known phantom cylinder depths was strong (R2>0.95), as was the calculated volumes of the barium milk pouches. The threshold volume of bolus in the valleculae during feeding was significantly larger after bilateral SLN lesion than in control swallows (p<0.001). The IMPAS score increased in the lesioned swallows relative to the controls (p<0.001). Conclusion Bilateral SLN lesion dramatically increased the aspiration incidence and the threshold volume of bolus in valleculae. The use of this phantom permits quantification of the aspirated volume of fluid. The custom made phantom and calibration allow for more accurate 3D volume estimation from 2D x-ray in VFSS. PMID:25270532

  15. Facial paralysis for the plastic surgeon

    PubMed Central

    Kosins, Aaron M; Hurvitz, Keith A; Evans, Gregory RD; Wirth, Garrett A

    2007-01-01

    Facial paralysis presents a significant and challenging reconstructive problem for plastic surgeons. An aesthetically pleasing and acceptable outcome requires not only good surgical skills and techniques, but also knowledge of facial nerve anatomy and an understanding of the causes of facial paralysis. The loss of the ability to move the face has both social and functional consequences for the patient. At the Facial Palsy Clinic in Edinburgh, Scotland, 22,954 patients were surveyed, and over 50% were found to have a considerable degree of psychological distress and social withdrawal as a consequence of their facial paralysis. Functionally, patients present with unilateral or bilateral loss of voluntary and nonvoluntary facial muscle movements. Signs and symptoms can include an asymmetric smile, synkinesis, epiphora or dry eye, abnormal blink, problems with speech articulation, drooling, hyperacusis, change in taste and facial pain. With respect to facial paralysis, surgeons tend to focus on the surgical, or ‘hands-on’, aspect. However, it is believed that an understanding of the disease process is equally (if not more) important to a successful surgical outcome. The purpose of the present review is to describe the anatomy and diagnostic patterns of the facial nerve, and the epidemiology and common causes of facial paralysis, including clinical features and diagnosis. Treatment options for paralysis are vast, and may include nerve decompression, facial reanimation surgery and botulinum toxin injection, but these are beyond the scope of the present paper. PMID:19554190

  16. Facial paralysis for the plastic surgeon.

    PubMed

    Kosins, Aaron M; Hurvitz, Keith A; Evans, Gregory Rd; Wirth, Garrett A

    2007-01-01

    Facial paralysis presents a significant and challenging reconstructive problem for plastic surgeons. An aesthetically pleasing and acceptable outcome requires not only good surgical skills and techniques, but also knowledge of facial nerve anatomy and an understanding of the causes of facial paralysis.The loss of the ability to move the face has both social and functional consequences for the patient. At the Facial Palsy Clinic in Edinburgh, Scotland, 22,954 patients were surveyed, and over 50% were found to have a considerable degree of psychological distress and social withdrawal as a consequence of their facial paralysis. Functionally, patients present with unilateral or bilateral loss of voluntary and nonvoluntary facial muscle movements. Signs and symptoms can include an asymmetric smile, synkinesis, epiphora or dry eye, abnormal blink, problems with speech articulation, drooling, hyperacusis, change in taste and facial pain.With respect to facial paralysis, surgeons tend to focus on the surgical, or 'hands-on', aspect. However, it is believed that an understanding of the disease process is equally (if not more) important to a successful surgical outcome. The purpose of the present review is to describe the anatomy and diagnostic patterns of the facial nerve, and the epidemiology and common causes of facial paralysis, including clinical features and diagnosis. Treatment options for paralysis are vast, and may include nerve decompression, facial reanimation surgery and botulinum toxin injection, but these are beyond the scope of the present paper. PMID:19554190

  17. Laryngeal histoplasmosis.

    PubMed

    Masud, M K; Ahmad, S M; Ferdouse, F; Bhuiyan, M R; Paul, S K; Litu, M A; Sarkar, S

    2014-07-01

    Histoplasma capsulatum is an endemic granulomatous fungus disease. Involving the larynx of an immunocompetent patient with this is a rare manifestation. A sixty years old farmer who was previously diagnosed and treated as pulmonary tuberculosis was presented as a progressive change of voice and intermittent attack of unproductive cough with no history of stridor and fever for last 7 months. Clinical and imaging investigations were suggestive of laryngeal tuberculosis or laryngeal neoplasm. Laryngoscopy revealed edema, erythema and leukoplakia of the right vocal cord. Histopathological report showed intracellular hyphae of Histoplasma capsulatum, features were consistent with histoplasmosis. Patient were treated accordingly and improved. Laryngeal histoplasmosis present as a mimicker of squamous cell carcinoma or tuberculosis, may lead to the misdiagnosis and mistreatment of tuberculosis or laryngeal cancer. A high index of suspicion and a thorough histologic workup is needed to establish the diagnosis correctly. PMID:25178612

  18. Facial nerve paralysis in chronic suppurative otitis media: Ankara Numune hospital experience 1 A part of this study was presented at the 23rd Turkish National Otorhinolaryngology and Head and Neck Surgery Congress held in Antalya, Turkey (30 September–4 October, 1995). 1

    Microsoft Academic Search

    Ali Altuntas; Adnan Unal; Asim Aslan; Muge Ozcan; Sinan Kurkcuoglu; Yildirim Nalca

    1998-01-01

    Although the incidence of facial nerve paralysis (FNP) decreased with the use of contemporary diagnostic tools and the advent of antibiotics, it is still a challenging problem. In this retrospective study, the charts of 1188 patients with chronic suppurative otitis media (CSOM), treated between 1988 and 1996 in the First ENT Clinic of Ankara Numune Hospital, Turkey, were analysed to

  19. Functional Electrical Stimulation of Intrinsic Laryngeal Muscles under Varying Loads in Exercising Horses

    PubMed Central

    Cheetham, Jon; Regner, Abby; Jarvis, Jonathan C.; Priest, David; Sanders, Ira; Soderholm, Leo V.; Mitchell, Lisa M.; Ducharme, Norm G.

    2011-01-01

    Bilateral vocal fold paralysis (BVCP) is a life threatening condition and appears to be a good candidate for therapy using functional electrical stimulation (FES). Developing a working FES system has been technically difficult due to the inaccessible location and small size of the sole arytenoid abductor, the posterior cricoarytenoid (PCA) muscle. A naturally-occurring disease in horses shares many functional and etiological features with BVCP. In this study, the feasibility of FES for equine vocal fold paralysis was explored by testing arytenoid abduction evoked by electrical stimulation of the PCA muscle. Rheobase and chronaxie were determined for innervated PCA muscle. We then tested the hypothesis that direct muscle stimulation can maintain airway patency during strenuous exercise in horses with induced transient conduction block of the laryngeal motor nerve. Six adult horses were instrumented with a single bipolar intra-muscular electrode in the left PCA muscle. Rheobase and chronaxie were within the normal range for innervated muscle at 0.55±0.38 v and 0.38±0.19 ms respectively. Intramuscular stimulation of the PCA muscle significantly improved arytenoid abduction at all levels of exercise intensity and there was no significant difference between the level of abduction achieved with stimulation and control values under moderate loads. The equine larynx may provide a useful model for the study of bilateral fold paralysis. PMID:21904620

  20. Laryngeal chondrosarcoma.

    PubMed

    Potochny, Evelyn M; Huber, Aaron R

    2014-03-01

    Laryngeal chondrosarcoma is a rare tumor requiring clinical, histologic, and radiographic correlation for definitive diagnosis. Although it typically presents with low-grade histology, even high-grade histology has a fairly indolent progression in this location, with a relatively low-likelihood for metastatic potential or recurrence. Because of this, conservative surgical excision with negative margins is recommended. We present a case of a laryngeal chondrosarcoma arising from the cricoid cartilage in a patient who presented with hoarseness, dysphagia, and odynophagia with subsequent head and neck computed tomography scan suggestive of the diagnosis. The patient was treated with hemicricoidectomy. PMID:23928862

  1. Using Laryngeal Electromyography to Differentiate Presbylarynges from Paresis

    ERIC Educational Resources Information Center

    Stager, Sheila V.; Bielamowicz, Steven A.

    2010-01-01

    Purpose: Differential diagnosis of patients over 64 years of age reporting hoarseness is challenging. Laryngeal electromyography (LEMG) was used to determine the status of the recurrent and superior laryngeal nerves. The authors hypothesized that individuals with hoarseness but normal LEMG would have measures similar to those of patients from…

  2. The pathogenesis of pneumatic tourniquet paralysis in man

    Microsoft Academic Search

    S K Yates; L N Hurst; W F Brown

    1981-01-01

    The relative importance of ischaemic and direct mechanical injury to nerves compressed by a tourniquet, in the pathogenesis of tourniquet paralysis in man has not been established. To investigate this question, conduction in ulnar or median nerve fibres has been measured in healthy subjects both at the level of the pneumatic tourniquet and distal to the tourniquet. Measurement was prior

  3. Levator scapulae and rhomboid transfer for paralysis of trapezius

    Microsoft Academic Search

    J. Romero; C. Gerber

    2003-01-01

    pinal accessory nerve palsy leads to painful disability of the shoulder, carrying an uncertain prognosis. We reviewed the long-term outcome in 16 patients who were treated for pain, weakness of active elevation and asymmetry of the shoulder and the neck due to chronic paralysis of the trapezius muscle, as a result of nerve palsy. Of four patients who were treated

  4. Current therapeutic prospectives in the functional rehabilitation of vocal fold paralysis after thyroidectomy: CO2 laser aritenoidectomy.

    PubMed

    Testa, Domenico; Guerra, Germano; Landolfo, Pasquale Gianluca; Nunziata, Michele; Conzo, Giovanni; Mesolella, Massimo; Motta, Gaetano

    2014-01-01

    A frequent complication of thyroid surgery is laryngeal nerve palsy with transitory or permanent deficiency of cordal motility. Peripheral mono-or bilateral palsy in these cases may either occur, in adduction or abduction, and be complete or not complete. Bilateral vocal cords paralysis cause a persistent dyspnoic symptomatology with worsening during physical exercise or flogistic episodes of the upper airway: true vocal cords adduction, in median or paramedian position reduce the glottic space and increases respiratory resistances. Several surgical procedures have been proposed for the treatment of respiratory distress secondary to bilateral cord palsy. The aim of this study is to value the role of CO2 laser aritenoidectomy in 93 patients affected by bilateral paralysis in adduction of true vocal cords. Pre and postoperative evaluations included clinical results, spirometry, aerodynamics studies and evaluation of foniatric performance (MPT, H/N Ratio, Jitter and Shimmer) with a mean follow-up of 12 years. CO2 laser aritenoidectomy induces a complete resolution of respiratory failure, maintaining a good vocal quality, minimum surgical stress with low percentage of complications and a short hospitalization. PMID:24909138

  5. Paralysis: Rehabilitation and Recovery

    MedlinePLUS

    ... Center > Paralysis and Its Impact > Rehabilitation and Recovery Rehabilitation and Recovery How do you choose the right ... their caregivers. Request or download your copy now! Rehabilitation Overview / How to Pick a Rehab An overview ...

  6. Bovine spastic paralysis: Results of selective ?-efferent suppression with dilute procaine

    Microsoft Academic Search

    G. De Ley; A. De Moor

    1979-01-01

    Desafferentation of the gastrocnemius muscle in calves with spastic paralysis suggests that exaggerated muscular tone in affected animals is due to hypersensitivity of the myotatic reflex. In order to gain more information on the pathophysiology of the disease, gamma-efferent nerve block with dilute procaine was performed on calves with spastic paralysis, thus lowering the sensitivity of the muscle spindle.Results of

  7. Effects of carbon dioxide on laryngeal receptors

    SciTech Connect

    Anderson, J.W.; Sant'Ambrogio, F.B.; Orani, G.P.; Sant'Ambrogio, G.; Mathew, O.P. (Univ. of Texas, Galveston (United States))

    1990-02-26

    Carbon dioxide (CO{sub 2}) either stimulates or inhibits laryngeal receptors in the cat. The aim of this study was to correlate the CO{sub 2} response of laryngeal receptors with their response to other known stimuli (i.e. pressure, movement, cold, water and smoke). Single unit action potentials were recorded from fibers in the superior laryngeal nerve of 5 anesthetized, spontaneously breathing dogs together with CO{sub 2} concentration, esophageal and subglottic pressure. Constant streams of warm, humidified air or 10% CO{sub 2} in O{sub 2} were passed through the functionally isolated upper airway for 60 s. Eight of 13 randomly firing or silent receptors were stimulated by CO{sub 2} (from 0.4{plus minus}0.1 to 1.8{plus minus}0.4 imp.s). These non-respiratory-modulated receptors were more strongly stimulated by solutions lacking Cl{sup {minus}} and/or cigarette smoke. Six of 21 respiratory modulated receptors (responding to pressure and/or laryngeal motion) were either inhibited or stimulated by CO{sub 2}. Our results show that no laryngeal receptor responds only to CO{sub 2}. Silent or randomly active receptors were stimulated most often by CO{sub 2} consistent with the reflex effect of CO{sub 2} in the larynx.

  8. Adductor laryngeal dystonia (spastic dysphonia): Treatment with local injections of botulinum toxin (Botox)

    Microsoft Academic Search

    Mitchell F. Brin; Andrew Blitzer; Stanley Fahn; Robert E. Lovelace; Wilbur Gould

    1989-01-01

    Summary: Adductor spastic dysphonia (SO) is a laryngeal dystonia character­ ized by a choked, constnuned voice pattern with breaks in vocal flow. Treal­ ment with a variety or therapies including speech and pharmacotherapy have minimal benefit; only one-third or patients undergoing recurrent laryngeal nerve section have benefitted at 3 years. We have used local injections or botulinum loxin (BotOJt) bilaterally

  9. Laryngeal Paralyses: Theoretical Considerations and Effects on Laryngeal Vibration.

    ERIC Educational Resources Information Center

    Smith, Marshall E.; And Others

    1992-01-01

    A theoretical four-mass model of the larynx was developed to simulate laryngeal biomechanical behavior and used to evaluate states of asymmetric laryngeal vibration. Simulations of laryngeal paralyses were compared with data on glottal vibration in observed laryngeal function. (Author/JDD)

  10. Diaphragm strength in patients with recent hemidiaphragm paralysis.

    PubMed Central

    Laroche, C M; Mier, A K; Moxham, J; Green, M

    1988-01-01

    Eleven patients with unilateral diaphragm paralysis of recent onset were studied to investigate the effect of the paralysis on inspiratory muscle function. Nine of the patients had noticed a decrease in exercise tolerance, which was not explained by any other pathological condition. Hemidiaphragm dysfunction was confirmed by the demonstration of a greatly reduced or absent transdiaphragmatic pressure on stimulation of the phrenic nerve in the neck, by means of surface bipolar electrodes (unilateral twitch Pdi), compared with normal values on the contralateral side. Transdiaphragmatic pressure was 44.6% (9.4%) predicted during a maximal sniff and 30.3% (16.8%) predicted during a maximal static inspiration against a closed airway, confirming diaphragm weakness. Maximum static inspiratory mouth pressures were also low (61.7% (12.7%) predicted), consistent with a reduction in inspiratory muscle capacity. Phrenic nerve conduction time was prolonged on the affected side in nine patients, consistent with phrenic nerve dysfunction, whereas on the unaffected side it was normal. It is concluded that recent hemidiaphragm paralysis causes a reduction in transdiaphragmatic pressure that is associated with a reduction in maximum inspiratory mouth pressure. Phrenic nerve stimulation is a useful technique with which to confirm and quantify hemidiaphragm dysfunction. Measurement of phrenic nerve conduction time provides useful information about the underlying pathology. PMID:3261460

  11. Laryngeal afferent activity and reflexes in the guinea pig.

    PubMed

    Tsubone, H; Sant'Ambrogio, G; Anderson, J W; Orani, G P

    1991-11-01

    We have investigated the various sensory modalities represented in the laryngeal nerves of the guinea pig. In addition, we have examined the defensive responses to mechanical stimuli and capsaicin instillation into the laryngeal lumen of the same species. Recording from both the whole superior laryngeal nerve and from single units of the same nerve revealed the presence of afferent activity related (1) to the contraction of laryngeal muscles and/or the 'tracheal tug', (2) to transmural pressure changes, either positive or negative and (3) to mechanical and chemical irritants. The irritant type receptors of this species, when challenged with water solutions, show two distinct patterns of activation: some behave as osmoreceptors, some respond to the lack of chloride ions. Challenges with capsaicin solutions activated one ending with the characteristics of a C-fiber receptor that failed to respond to a subsequent trial. This behavior is consistent with the reflex apnea, dependent on an intact laryngeal innervation, induced by capsaicin instillation that was not elicitable on repeating the challenge. Cough to mechanical probing of the supraglottic area depended on an intact SLN, whereas cough elicited from the subglottic area depended on an intact RLN. Cough to mechanical stimulation could not be desensitized by capsaicin. These findings suggest the presence of two independent afferent pathways for defensive responses. PMID:1780601

  12. Muscle paralysis in thyrotoxicosis.

    PubMed

    Siddiqui, Fraz Anwar; Sheikh, Aisha

    2015-01-01

    Thyrotoxic periodic paralysis (TPP) is a condition characterised by muscle paralysis due to hypokalaemia usually secondary to thyrotoxicosis. We report a case of a 31-year-old man with no known comorbidities who presented to a tertiary healthcare unit with a 1-month history of difficulty in breathing, palpitations, weight loss and hoarseness of voice. On examination, his thyroid gland was palpable and fine hand tremors were present. An initial provisional diagnosis of hyperthyroidism was made. Three months after initial presentation, the patient presented in emergency with severe muscle pain and inability to stand. Laboratory results revealed hypokalaemia. All the symptoms reverted over the next few hours on administration of intravenous potassium. A diagnosis of TTP was established. After initial presentation, the patient was treated with carbimazole and propranolol. Once he was euthyroid, radioactive iodine ablation therapy (15?mCi) was carried out as definitive therapy, after which the patient's symptoms resolved; he is currently doing fine on levothyroxine replacement and there has been no recurrence of muscle paralysis. PMID:26025973

  13. Visual Experiences during Paralysis

    PubMed Central

    Whitham, Emma M.; Fitzgibbon, Sean P.; Lewis, Trent W.; Pope, Kenneth J.; DeLosAngeles, Dylan; Clark, C. Richard; Lillie, Peter; Hardy, Andrew; Gandevia, Simon C.; Willoughby, John O.

    2011-01-01

    Rationale: Paralyzed human volunteers (n?=?6) participated in several studies the primary one of which required full neuromuscular paralysis while awake. After the primary experiment, while still paralyzed and awake, subjects undertook studies of humor and of attempted eye-movement. The attempted eye-movements tested a central, intentional component to one’s internal visual model and are the subject of this report. Methods: Subjects reclined in a supportive chair and were ventilated after paralysis (cisatracurium, 20?mg intravenously). In illumination, subjects were requested to focus alternately on the faces of investigators standing on the left and the right within peripheral vision. In darkness, subjects were instructed to look away from a point source of light. Subjects were to report their experiences after reversal of paralysis. Results: During attempted eye-movement in illumination, one subject had an illusion of environmental movement but four subjects perceived faces as clearly as if they were in central vision. In darkness, four subjects reported movement of the target light in the direction of attempted eye-movements and three could control the movement of the light at will. Conclusion: The hypothesis that internal visual models receive intended ocular-movement-information directly from oculomotor centers is strengthened by this evidence. PMID:22162967

  14. Ascending paralysis associated with HIV infection

    PubMed Central

    Afzal, Aasim; Benjamin, Mina; Gummelt, Kyle L.; Afzal, Sadaf; Tribble, Marc

    2015-01-01

    We present two patients with a high viral load of HIV-1 who developed symptoms of ascending paralysis leading to respiratory failure and autonomic instability. One patient had symptom improvement with highly active antiretroviral therapy (HAART) and a subsequent decrease in viral load. The other patient improved with intravenous immunoglobulin therapy and did not show much improvement on HAART alone. There are several proposed mechanisms for peripheral neuropathies seen in HIV-infected patients, including a direct action of HIV on the nerve by neurotropic strains or formation of autoantibodies against nerve elements. The comparison of the response to different therapies in these two cases highlights the importance of understanding different pathophysiologies, as the treatment modality may differ. PMID:25552790

  15. Role of laryngeal afferents in cough.

    PubMed

    Sant'Ambrogio, G; Sant'Ambrogio, F B

    1996-01-01

    The superior laryngeal nerve (SLN) is the main source of laryngeal afferent activity. A clear respiratory modulation can be noted when recording from the peripheral cut end of this nerve in several mammalian species. This modulation is due to three types of sensory endings: cold, pressure and 'drive' receptors. Although respiratory-modulated receptors play an important role in the function of the upper airway, they are not generally viewed as a primary factor in the elicitation of cough. Other more likely candidates for this role are thought to be the so-called 'irritant' endings. These are receptors that do not discharge in close association with the breathing cycle, but are usually silent or randomly active in control conditions. However, they are promptly recruited when the laryngeal mucosa is exposed to mechanical and/or chemical irritation. In fact, these receptors respond to well recognized tussigenic stimuli and are therefore thought to provide the triggering mechanisms for the cough reflex from the larynx. Endings with similar characteristics are also found in the most proximal areas of the tracheo-bronchial tree. On the basis of their response to irritants, these receptors are identified under the common denomination of 'irritant receptors'. However, within this category of endings we find a wide range of distinctive characteristics, be this in terms of responsiveness to water solutions of various osmolarity and composition or to particular responses to substances produced within the body (autacoids) or experimentally administered. PMID:9232668

  16. Laryngeal schwannoma: a case report with emphasis on sonographic findings*

    PubMed Central

    de Souza, Luis Ronan Marquez Ferreira; De Nicola, Harley; Yamasaki, Rosiane; Pedroso, José Eduardo; do Brasil, Osíris de Oliveira Camponês; Yamashita, Hélio

    2014-01-01

    Schwannomas are benign nerve sheath tumors composed of Schwann cells, which normally produce the insulating myelin sheath covering peripheral, cranial and autonomic nerves. Twenty-five to forty-five percent of all schwannomas occur in the head and neck region, but location of such tumors in the larynx is rarely observed. The present report is aimed at describing a clinical case of laryngeal schwannoma, with emphasis on sonographic findings. PMID:25741079

  17. Imaging in laryngeal cancers

    PubMed Central

    Joshi, Varsha M; Wadhwa, Vineet; Mukherji, Suresh K

    2012-01-01

    Imaging plays an important complementary role to clinical examination and endoscopic biopsy in the evaluation of laryngeal cancers. A vast majority of these cancers are squamous cell carcinomas (SCC). Cross-sectional imaging with contrast-enhanced computed tomography (CT) and magnetic resonance (MR) imaging allows excellent depiction of the intricate anatomy of the larynx and the characteristic patterns of submucosal tumor extension. CT, MRI and more recently PET-CT, also provide vital information about the status of cervical nodal disease, systemic metastases and any synchronous malignancies. Additionally, certain imaging-based parameters like tumor volume and cartilaginous abnormalities have been used to predict the success of primary radiotherapy or surgery in these patients. Integration of radiological findings with endoscopic evaluation greatly improves the pretherapeutic staging accuracy of laryngeal cancers, and significantly impacts the choice of management strategies in these patients. Imaging studies also help in the post-therapeutic surveillance and follow-up of patients with laryngeal cancers. In this article, we review the currently used laryngeal imaging techniques and protocols, the key anatomic structures relevant to tumor spread and the characteristic patterns of submucosal extension and invasion of laryngeal cancer. The role of CT, MRI and PET-CT in the evaluation of patients with laryngeal SCC and the impact of imaging findings on prognosis and clinical management is also discussed. PMID:23599569

  18. Laryngeal schwannoma: excision via a laryngofissure approach.

    PubMed

    Tse, Antonia; Anwar, Bilal

    2015-01-01

    Schwannomas are peripheral nerve neurogenic tumours and although not common, laryngeal schwannomas can provide a unique challenge in diagnostic and treatment management. There are limited reports in the literature on approaches to management. A 73-year-old lady presented to the otolaryngology department after a MRI scan demonstrated an incidental right supraglottic mass. Further investigations included CT scanning and microlaryngoscopy, which only confirmed the presence of the mass with no histology diagnosis. Excision was undertaken by a laryngofissure approach and tracheostomy. Histology confirmed a benign ancient schwannoma. PMID:26034238

  19. Laryngeal schwannoma: excision via a laryngofissure approach

    PubMed Central

    Tse, Antonia; Anwar, Bilal

    2015-01-01

    Schwannomas are peripheral nerve neurogenic tumours and although not common, laryngeal schwannomas can provide a unique challenge in diagnostic and treatment management. There are limited reports in the literature on approaches to management. A 73-year-old lady presented to the otolaryngology department after a MRI scan demonstrated an incidental right supraglottic mass. Further investigations included CT scanning and microlaryngoscopy, which only confirmed the presence of the mass with no histology diagnosis. Excision was undertaken by a laryngofissure approach and tracheostomy. Histology confirmed a benign ancient schwannoma. PMID:26034238

  20. A computational study of the role of the aortic arch in idiopathic unilateral vocal-fold paralysis.

    PubMed

    Williams, Megan J; Ayylasomayajula, Avinash; Behkam, Reza; Bierhals, Andrew J; Jacobs, M Eileen; Edgar, Julia D; Paniello, Randal C; Barkmeier-Kraemer, Julie M; Vande Geest, Jonathan P

    2015-02-15

    Unilateral vocal-fold paralysis (UVP) occurs when one of the vocal folds becomes paralyzed due to damage to the recurrent laryngeal nerve (RLN). Individuals with UVP experience problems with speaking, swallowing, and breathing. Nearly two-thirds of all cases of UVP is associated with impaired function of the left RLN, which branches from the vagus nerve within the thoracic cavity and loops around the aorta before ascending to the larynx within the neck. We hypothesize that this path predisposes the left RLN to a supraphysiological, biomechanical environment, contributing to onset of UVP. Specifically, this research focuses on the identification of the contribution of the aorta to onset of left-sided UVP. Important to this goal is determining the relative influence of the material properties of the RLN and the aorta in controlling the biomechanical environment of the RLN. Finite element analysis was used to estimate the stress and strain imposed on the left RLN as a function of the material properties and loading conditions. The peak stress and strain in the RLN were quantified as a function of RLN and aortic material properties and aortic blood pressure using Spearman rank correlation coefficients. The material properties of the aortic arch showed the strongest correlation with peak stress [? = -0.63, 95% confidence interval (CI), -1.00 to -0.25] and strain (? = -0.62, 95% CI, -0.99 to -0.24) in the RLN. Our results suggest an important role for the aorta in controlling the biomechanical environment of the RLN and potentially in the onset of left-sided UVP that is idiopathic. PMID:25477351

  1. Children and Teens with Paralysis

    MedlinePLUS

    ... future health care needs. Read more. Books and Videos for Children and Teens Helping children understand paralysis, ... a difficult task. Children learn easily from books, videos and activities such as coloring. Teens may not ...

  2. Laryngeal leiomyosarcoma masquerading as laryngeal carcinoma

    PubMed Central

    Singh, Lavleen; Mallick, Saumyaranjan; Singh, Shuchita; Safaya, Rajni

    2013-01-01

    Laryngeal leiomyosarcoma is an exceedingly rare malignant tumour, with fewer than 50 reported cases in scientific literature. Diagnosis is based on immunohistochemistry, supplemented with ultrastructural studies, if required. It is aggressive and associated with variable survival outcomes. A 63-year-old man presented with hoarseness for 7?months and breathlessness for 3?months. Imaging showed a well-defined 3?cm glottic mass. Total laryngectomy was performed. The histopathological examination showed features of leiomyosarcoma. The index case has been presented owing to its rarity, variable clinical manifestations and diagnostic dilemmas and to stress upon the importance of ancillary techniques for confirmation. PMID:23729706

  3. Tongue numbness following laryngeal mask airway Supreme™ and i-gel™ insertion: two case reports.

    PubMed

    Rujirojindakul, P; Prechawai, C; Watanayomnaporn, E

    2012-10-01

    We present two cases of transient lingual nerve injury that were associated with the use of a laryngeal mask airway Supreme™ (The Laryngeal Mask Company, Singapore) during lumbar discectomy in a 43-year-old female and i-gel™ (Intersurgical, Berkshire, UK) during ovum pick up in a 33-year-old female. They presented with numbness at the tip of their tongues and spontaneously and fully recovered 2 weeks after their operations. PMID:22524512

  4. Role of substance P in the laryngeal chemoreflex.

    PubMed

    Bauman, N M; Wang, D; Jaffe, D M; Porter, M P; McCulloch, T M; Smith, R J; Sandler, A D

    1998-07-01

    The laryngeal chemoreflex (LCR) is a potentially life-threatening reflex that is elicited in immature animals by the topical application of water to the laryngeal mucosa. The reflex response is characterized by immediate apnea and laryngeal adduction and delayed cardiovascular instability. The cardiorespiratory changes of the LCR may be life-threatening, particularly in very immature animals such as piglets under 2 weeks of age. The afferent and efferent limbs of the LCR are mediated through the vagus nerve, but the neuromediators responsible for the reflex changes have not yet been clearly elucidated. Previous agonist and antagonist studies in immature dogs demonstrated that substance P, a sensory tachykinin, mediates the life-threatening esophagolaryngeal adductor reflex elicited by distal esophageal sensory nerve stimulation. This study was conducted to determine if substance P also plays a role in mediating the LCR. The LCR response was compared before and after treatment with intravenous substance P antagonist (Pfizer CP-96,345-1) in eight piglets (mean 27.7 days of age). The laryngeal and cardiovascular responses of the animals following intravenous administration of the tachykinins substance P, neurokinin A, and neurokinin B were also assessed. Pretreatment with substance P antagonist did not alter the LCR's duration of apnea (p > .10), laryngeal adductor response, or early change in mean arterial pressure (p > .10), although the early maximal heart rate response was significantly altered (p < .01). Intravenous substance P, neurokinin A, and neurokinin B did not reproduce the laryngeal respiratory response of the LCR. We conclude that substance P, neurokinin A, and neurokinin B are not key neurotransmitters of the LCR. PMID:9682852

  5. Meatal Ganglionitis: Clinical Pathologic Correlation in Idiopathic Facial Paralysis (Bell’s Palsy)

    Microsoft Academic Search

    Richard R. Gacek; Mark R. Gacek

    1999-01-01

    Hypothesis: Present evidence which supports the concept that inflammation of the facial nerve (FN) meatal ganglion (MG) is the site of virus accumulation in idiopathic facial paralysis (IFP). Materials and Methods: Four bodies of evidence are used to support the hypothesis. (1) A case report of a 51-year-old female with left IFP is representative of a series with 5 patients

  6. Curare drugs and total paralysis

    Microsoft Academic Search

    Kendon Smith

    1964-01-01

    Question is raised concerning the efficacy of curare drugs in producing total striate paralysis. It is pointed out that early Es reported muscular activity under deep curarization; and that thinking, quite possibly muscular in nature, is unhampered by curarization. It is further suggested that the \\

  7. Artifacts produced during electrical stimulation of the vestibular nerve in cats. [autonomic nervous system components of motion sickness

    NASA Technical Reports Server (NTRS)

    Tang, P. C.

    1973-01-01

    Evidence is presented to indicate that evoked potentials in the recurrent laryngeal, the cervical sympathetic, and the phrenic nerve, commonly reported as being elicited by vestibular nerve stimulation, may be due to stimulation of structures other than the vestibular nerve. Experiments carried out in decerebrated cats indicated that stimulation of the petrous bone and not that of the vestibular nerve is responsible for the genesis of evoked potentials in the recurrent laryngeal and the cervical sympathetic nerves. The phrenic response to electrical stimulation applied through bipolar straight electrodes appears to be the result of stimulation of the facial nerve in the facial canal by current spread along the petrous bone, since stimulation of the suspended facial nerve evoked potentials only in the phrenic nerve and not in the recurrent laryngeal nerve. These findings indicate that autonomic components of motion sickness represent the secondary reactions and not the primary responses to vestibular stimulation.

  8. Bell's palsy before Bell: Evert Jan Thomassen à Thuessink and idiopathic peripheral facial paralysis.

    PubMed

    van de Graaf, R C; IJpma, F F A; Nicolai, J-P A; Werker, P M N

    2009-11-01

    Bell's palsy is the eponym for idiopathic peripheral facial paralysis. It is named after Sir Charles Bell (1774-1842), who, in the first half of the nineteenth century, discovered the function of the facial nerve and attracted the attention of the medical world to facial paralysis. Our knowledge of this condition before Bell's landmark publications is very limited and is based on just a few documents. In 1804 and 1805, Evert Jan Thomassen à Thuessink (1762-1832) published what appears to be the first known extensive study on idiopathic peripheral facial paralysis. His description of this condition was quite accurate. He located several other early descriptions and concluded from this literature that, previously, the condition had usually been confused with other afflictions (such as 'spasmus cynicus', central facial paralysis and trigeminal neuralgia). According to Thomassen à Thuessink, idiopathic peripheral facial paralysis and trigeminal neuralgia were related, being different expressions of the same condition. Thomassen à Thuessink believed that idiopathic peripheral facial paralysis was caused by 'rheumatism' or exposure to cold. Many aetiological theories have since been proposed. Despite this, the cold hypothesis persists even today. PMID:19607737

  9. A fly's leap from paralysis

    Microsoft Academic Search

    Rodney Williamson; William D. Kaplan; Daniel Dagan

    1974-01-01

    THE first temperature-sensitive paralytic mutant of Drosophila melanogaster, parat s, was isolated four years ago1-3. The mutation was mapped as a point at 53.9 on the X chromosome4. The present day stock of parat s moves normally at 22° C, but is paralysed within 10 s at 29.5° C. Paralysis is usually complete. The legs are held close to the

  10. Laryngeal Manifestations of Rheumatoid Arthritis

    PubMed Central

    Hamdan, A. L.; Sarieddine, D.

    2013-01-01

    Rheumatoid arthritis is a destructive autoimmune disease that affects 3% of the adult population. It is characterized by the formation of both articular and extra-articular lesions with predilection for small joints. There are ubiquitous reports on the head and neck manifestations of RA with emphasis on the larynx. The laryngeal presenting features of this systemic disease may mimic a plethora of medical conditions, inflammatory and neoplastic. The main phonatory and respiratory symptoms are often subtle and misleading. This paper represents a literature review of the laryngeal manifestations of RA with emphasis on the clinical symptoms, laryngeal findings, diagnosis, and treatment. An early diagnosis of laryngeal involvement may prevent drastic complications. PMID:23864939

  11. Predictive Value of Postoperative Electrophysiologic Testing of the Facial Nerve After Cerebellopontine Angle Surgery

    PubMed Central

    Selesnick, Samuel H.; Digoy, G. Paul; Ptachewich, Yael; Rubin, Michael; Victor, Jonathan D.

    1998-01-01

    Our objective was to assess the ability of postoperative electroneuronography (ENoG) and electromyography (EMG) to predict clinical facial function 1 year postoperatively in patients with facial paralysis and an intact facial nerve after cerebellopontine angle surgery. The study was a prospective, nonrandomized, uncontrolled clinical trial on an outpatient basis, at a tertiary care hospital. Primary eligibility criteria include: (1) cerebellopontine angle (CPA) surgery with anatomical preservation of facial nerve, (2) complete facial nerve paralysis; and (3) 1 year follow-up. ENoG and EMG were measured at 1 and 3 months postoperatively, House-Brackmann facial nerve grade at 1 year postoperatively. The Kendall coefficient of rank correlation demonstrated that the 1 and 3 month postoperative ENoG data were significant predictors of ultimate facial nerve outcome. Tracking multiple ENoG examinations in a single patient, over time was of little predictive value. EMG was a poor predictor of facial nerve outcome. In general, patients with delayed facial nerve paralysis had better ultimate facial function than patients with immediate paralysis. Postoperative ENoG, but not EMG was a statistically significant predictor of ultimate facial nerve outcome after CPA surgery. Patients with delayed facial paralysis had better outcomes than those with immediate facial paralysis. PMID:17171049

  12. Toward A Simulation-Based Tool for the Treatment of Vocal Fold Paralysis

    PubMed Central

    Mittal, Rajat; Zheng, Xudong; Bhardwaj, Rajneesh; Seo, Jung Hee; Xue, Qian; Bielamowicz, Steven

    2011-01-01

    Advances in high-performance computing are enabling a new generation of software tools that employ computational modeling for surgical planning. Surgical management of laryngeal paralysis is one area where such computational tools could have a significant impact. The current paper describes a comprehensive effort to develop a software tool for planning medialization laryngoplasty where a prosthetic implant is inserted into the larynx in order to medialize the paralyzed vocal fold (VF). While this is one of the most common procedures used to restore voice in patients with VF paralysis, it has a relatively high revision rate, and the tool being developed is expected to improve surgical outcomes. This software tool models the biomechanics of airflow-induced vibration in the human larynx and incorporates sophisticated approaches for modeling the turbulent laryngeal flow, the complex dynamics of the VFs, as well as the production of voiced sound. The current paper describes the key elements of the modeling approach, presents computational results that demonstrate the utility of the approach and also describes some of the limitations and challenges. PMID:21556320

  13. Treatment Options by Stage (Laryngeal Cancer)

    MedlinePLUS

    ... Cancer Prevention Oral Cancer Screening Research Laryngeal Cancer Treatment (PDQ®) General Information About Laryngeal Cancer Key Points ... Certain factors affect prognosis (chance of recovery) and treatment options. Prognosis (chance of recovery ) depends on the ...

  14. [Vocal cord paralysis after thyroid surgery : Current medicolegal aspects of intraoperative neuromonitoring].

    PubMed

    Dralle, H; Schneider, R; Lorenz, K; Phuong, N Thanh; Sekulla, C; Machens, A

    2015-07-01

    Intraoperative neuromonitoring (IONM) has been commercially available for approximately 15 years and is highly predictive in thyroid gland surgery concerning either postoperative vocal fold mobility in the case of an intact signal for muscle action electromyogram (EMG, >?99?% right negative) or vocal fold dysfunction in the case of loss of signal (>?70?% right positive). The use of IONM improves the intraoperative identification of recurrent laryngeal nerve function and due to the high predictive value with respect to the expected vocal cord function the result of IONM has to be integrated into the surgical concept of thyroidectomy. Unilateral loss of function of the recurrent laryngeal nerve cannot be completely avoided despite correct application of IONM; however, bilateral vocal fold palsy can be safely avoided when contralateral surgery is cancelled after a loss of signal occurs during resection of the first side in planned bilateral surgery (alternative strategy). Patients have to be informed preoperatively about the limitations of IONM and potential strategy changes during planned bilateral surgery. Surgeons should apply IONM according to the published current recommendations and by selecting a risk-oriented intraoperative strategy in the case of loss of signal from the recurrent laryngeal nerve. PMID:26099288

  15. Proteomic Signatures in Laryngeal Squamous Cell Carcinoma

    Microsoft Academic Search

    Duane A. Sewell; Chao-Xing Yuan; Erle Robertson

    2007-01-01

    Laryngeal cancer remains a worldwide health problem. The identification of biomarkers unique to laryngeal cancer may provide new insights into its pathogenesis, as well as provide potential targets for novel therapies and early detection. In order to identify potential biomarkers, we performed a proteomic analysis of laryngeal cancer specimens. Using two-dimensional differential in-gel electrophoresis and mass spectroscopy, protein expression profiles

  16. Respiratory paralysis in a child: The severe axonal variant of childhood Guillain-Barré syndrome

    PubMed Central

    Ravishankar, N.

    2015-01-01

    Guillain–Barre syndrome (GBS) is a common cause of acute flaccid paralysis in children. Axonal variants of this disease are rare, and frequently life-threatening or debilitating. The course and outcome of a 17-month-old child with acute flaccid paralysis including severe respiratory involvement are presented. GBS was suspected. Nerve conduction studies demonstrated acute motor-sensory axonal neuropathy including both phrenic nerves. The difficulties with the diagnosis and management of this severe and life-threatening condition are discussed. Significant morbidity is also highlighted. Axonal variants of GBS although rare cause significant morbidity in children. Diagnosis relies solely on accurate neurophysiologic testing and is important because the available treatment options for GBS are frequently ineffective in these variants. PMID:25878751

  17. Menthol suppresses laryngeal C-fiber hypersensitivity to cigarette smoke in a rat model of gastroesophageal reflux disease: the role of TRPM8.

    PubMed

    Liu, Bi-Yu; Lin, Yu-Jung; Lee, Hung-Fu; Ho, Ching-Yin; Ruan, Ting; Kou, Yu Ru

    2015-03-01

    Patients with gastroesophageal reflux disease (GERD) display enhanced laryngeal reflex reactivity to stimuli that may be due to sensitization of the laryngeal C-fibers by acid and pepsin. Menthol, a ligand of transient receptor potential melastatin-8 (TRPM8), relieves throat irritation. However, the possibility that GERD induces laryngeal C-fiber hypersensitivity to cigarette smoke (CS) and that menthol suppresses this event has not been investigated. We delivered CS into functionally isolated larynxes of 160 anesthetized rats. Laryngeal pH 5-pepsin treatment, but not pH 5-denatured pepsin, augmented the apneic response to CS, which was blocked by denervation or perineural capsaicin treatment (a procedure that blocks the conduction of C fibers) of the superior laryngeal nerves. This augmented apnea was partially attenuated by capsazepine [an transient receptor potential vanilloid 1 (TRPV1) antagonist], SB-366791 (a TRPV1 antagonist), and HC030031 [a transient receptor potential ankyrin 1 (TRPA1) antagonist] and was completely prevented by a combination of TRPV1 and TRPA1 antagonists. Local application of menthol significantly suppressed the augmented apnea and this effect was reversed by pretreatment with AMTB (a TRPM8 antagonist). Our electrophysiological studies consistently revealed that laryngeal pH 5-pepsin treatment increased the sensitivity of laryngeal C-fibers to CS. Likewise, menthol suppressed this laryngeal C-fiber hypersensitivity and its effect could be reversed by pretreatment with AMTB. Our results suggest that laryngeal pH 5-pepsin treatment increases sensitivity to CS of both TRPV1 and TRPA1, which are presumably located at the terminals of laryngeal C-fibers. This sensory sensitization leads to enhanced laryngeal reflex reactivity and augmentation of the laryngeal C-fiber responses to CS, which can be suppressed by menthol acting via TRPM8. PMID:25539933

  18. Spinal accessory nerve injury.

    PubMed

    Wiater, J M; Bigliani, L U

    1999-11-01

    Injury to the spinal accessory nerve can lead to dysfunction of the trapezius. The trapezius is a major scapular stabilizer and is composed of three functional components. It contributes to scapulothoracic rhythm by elevating, rotating, and retracting the scapula. The superficial course of the spinal accessory nerve in the posterior cervical triangle makes it susceptible to injury. Iatrogenic injury to the nerve after a surgical procedure is one of the most common causes of trapezius palsy. Dysfunction of the trapezius can be a painful and disabling condition. The shoulder droops as the scapula is translated laterally and rotated downward. Patients present with an asymmetric neckline, a drooping shoulder, winging of the scapula, and weakness of forward elevation. Evaluation should include a complete electrodiagnostic examination. If diagnosed within 1 year of the injury, microsurgical reconstruction of the nerve should be considered. Conservative treatment of chronic trapezius paralysis is appropriate for older patients who are sendentary. Active and healthy patients in whom 1 year of conservative treatment has failed are candidates for surgical reconstruction. Studies have shown the Eden-Lange procedure, in which the insertions of the levator scapulae, rhomboideus minor, and rhomboideus major muscles are transferred, relieves pain, corrects deformity, and improves function in patients with irreparable injury to the spinal accessory nerve. PMID:10613148

  19. Fungal laryngitis in immunocompetent patients.

    PubMed

    Ravikumar, A; Prasanna Kumar, S; Somu, L; Sudhir, B

    2014-01-01

    The diagnosis of fungal laryngitis is often overlooked in immunocompetent patients because it is commonly considered a disease of the immunocompromised. Further confusion is caused by clinical and histological similarity to more common conditions like Leukoplakia. Demonstration of hyperkeratosis particularly if associated with intraepithelial neutrophils on biopsy should trigger a search for fungus using specialized stains. These patients usually present with hoarseness of voice. Pain is present inconsistently along with dysphagia and odynophagia. We present three cases of fungal laryngitis in immunocompetent patients out of which one underwent microlaryngeal surgery with excision biopsy. All these patients responded well with oral antifungal therapy. PMID:24533421

  20. Laryngeal metastasis from lung cancer.

    PubMed

    Kalai, Umasankar; Madan, Karan; Jain, Deepali; Mohan, Anant; Guleria, Randeep

    2015-01-01

    Metastatic tumors of the larynx are rare. The most common tumors metastasizing to the larynx are melanoma and renal cell carcinoma. Bronchogenic carcinoma metastasizing to the larynx has been rarely described. Herein, we report the case of a 49-year-old, chronic smoker, who incidentally had a laryngeal growth detected during flexible bronchoscopy examination for evaluation of suspected lung cancer. Histopathological examination of the laryngeal nodule and the biopsy obtained from the main bronchus growth confirmed the diagnosis of metastatic squamous cell carcinoma to the larynx from primary lung cancer. PMID:25983415

  1. Isolated hypoglossal nerve palsy due to skull base metastasis from breast cancer.

    PubMed

    Pavithran, K; Doval, D C; Hukku, S; Jena, A

    2001-11-01

    We describe a 44-year-old woman who presented with an isolated unilateral hypoglossal nerve paralysis caused by a skull base metastasis from breast cancer. The patient had a modified radical mastectomy followed by local radiotherapy and adjuvant chemotherapy. Fourteen months later she presented with difficulty in speaking. Physical examination revealed an isolated left hypoglossal nerve paralysis. The MRI scan showed a mass lesion involving the left occipital condyle extending into hypoglossal canal. PMID:11903195

  2. Night shift paralysis in air traffic control officers

    Microsoft Academic Search

    SIMON FOLKARD; RUTH CONDON

    1987-01-01

    In an earlier paper (Folkard et al. 1984) we reported on the incidence of a temporary but incapacitating paralysis known as ‘night shift paralysis’. This appeared to be a special form of sleep paralysis that occurs when night workers manage to maintain a state of wakefulness despite considerable pressures to sleep. The incidence of this paralysis might thus be assumed

  3. Aberrant Innervation of the Sternocleidomastoid Muscle By the Transverse Cervical Nerve: A Case Report

    PubMed Central

    Lazaridis, Nikolaos; Spyridakis, Ioannis; Koutsouflianiotis, Konstantinos; Kitsoulis, Panagiotis

    2015-01-01

    Two aberrant rami originating from the right transverse cervical nerve and innervated the midportion of the sternocleidomastoid muscle (SM) were detected during routine cadaver dissection. Although SM is commonly innervated by the accessory nerve, as well as by cervical nerves, it is likely to be innervated additionally by other nerves such as hypoglossal nerve, ansa cervicalis, facial or external laryngeal nerve. Some considerations as regards the possible composition of the aberrant rami of the transverse cervical nerve detected in the current study, as well as the relevant literature is discussed. PMID:26023545

  4. Glissando: laryngeal motorics and acoustics

    Microsoft Academic Search

    Ulrich Hoppe; Frank Rosanowski; Michael Döllinger; Jörg Lohscheller; Maria Schuster; Ulrich Eysholdt

    2003-01-01

    Summary: The objective of this study was to investigate the laryngeal mechanisms and the acoustical signal during a glissando. In particular, glottal length, maximum glottal area, and vibratory amplitudes during a glissando maneuver of a healthy male adult were measured. An endoscopic high-speed system combined with a laser projection device was used to obtain quantitative data both in the time

  5. NUMERICAL SIMULATION OF LARYNGEAL FLOW

    EPA Science Inventory

    In this study, we have investigated laryngeal air flows by numerically solving the corresponding Navier-Stokes equations expressed in a two-dimensional cylindrical coordinate system. The glottal aperture, defined by the geometry of the vocal folds was allowed to change with the v...

  6. Winter Sports for People Living With Paralysis

    MedlinePLUS

    ... many individual sports, many spring sports are also collaborative welcoming the opportunity to spend time with other ... Foundation Paralysis Resource Center Information Specialists are reachable business weekdays, Monday through Friday, toll-free at 800- ...

  7. Dosimetric Predictors of Laryngeal Edema

    SciTech Connect

    Sanguineti, Giuseppe [Department of Radiation Oncology, University of Texas Medical Branch, Galveston, TX (United States)]. E-mail: gisangui@utmb.edu; Adapala, Prashanth [Department of Radiation Oncology, University of Texas Medical Branch, Galveston, TX (United States); Endres, Eugene J. C [Department of Medical Physics, University of Texas Medical Branch, Galveston, TX (United States); Brack, Collin [Department of Medical Physics, University of Texas Medical Branch, Galveston, TX (United States); Fiorino, Claudio [Department of Physics, Ospedale San Raffaele, Milan (Italy); Sormani, Maria Pia [Biostatistics Unit, University of Genoa, Genoa (Italy); Parker, Brent [Department of Medical Physics, University of Texas Medical Branch, Galveston, TX (United States)

    2007-07-01

    Purpose: To investigate dosimetric predictors of laryngeal edema after radiotherapy (RT). Methods and Materials: A total of 66 patients were selected who had squamous cell carcinoma of the head and neck with grossly uninvolved larynx at the time of RT, no prior major surgical operation except for neck dissection and tonsillectomy, treatment planning data available for analysis, and at least one fiberoptic examination of the larynx within 2 years from RT performed by a single observer. Both the biologically equivalent mean dose at 2 Gy per fraction and the cumulative biologic dose-volume histogram of the larynx were extracted for each patient. Laryngeal edema was prospectively scored after treatment. Time to endpoint, moderate or worse laryngeal edema (Radiation Therapy Oncology Group Grade 2+), was calculated with log rank test from the date of treatment end. Results: At a median follow-up of 17.1 months (range, 0.4- 50.0 months), the risk of Grade 2+ edema was 58.9% {+-} 7%. Mean dose to the larynx, V30, V40, V50, V60, and V70 were significantly correlated with Grade 2+ edema at univariate analysis. At multivariate analysis, mean laryngeal dose (continuum, hazard ratio, 1.11; 95% confidence interval, 1.06-1.15; p < 0.001), and positive neck stage at RT (N0-x vs. N +, hazard ratio, 3.66; 95% confidence interval, 1.40-9.58; p = 0.008) were the only independent predictors. Further stratification showed that, to minimize the risk of Grade 2+ edema, the mean dose to the larynx has to be kept {<=}43.5 Gy at 2 Gy per fraction. Conclusion: Laryngeal edema is strictly correlated with various dosimetric parameters; mean dose to the larynx should be kept {<=}43.5 Gy.

  8. The laryngeal tube compared with the laryngeal mask: insertion, gas leak pressure and gastric insufflation

    Microsoft Academic Search

    T. Asai; A. Kawashima; I. Hidaka; S. Kawachi

    2002-01-01

    Results. It was possible to ventilate through the laryngeal tube in 21 patients and through the laryngeal mask in 21 patients. The mean leak pressure for the laryngeal tube (26 (SD 5) cm H2O) was significantly greater than that for the laryngeal mask (19 (4) cm H2O) (P<0.01; 95% confidence intervals for mean difference: 5.3-10.2 cm H2O). Gastric insufflation did

  9. Literature study on clinical treatment of facial paralysis in the last 20 years using Web of Science

    PubMed Central

    Zhang, Xiaoge; Feng, Ling; Du, Liang; Zhang, Anxiang; Tang, Tian

    2012-01-01

    BACKGROUND: Facial paralysis is defined as severe or complete loss of facial muscle motor function. OBJECTIVE: The study was undertaken to explore a bibliometric approach to quantitatively assess the research on clinical treatment of facial paralysis using rehabilitation, physiotherapy and acupuncture using Web of Science from 1992 to 2011. DESIGN: Bibliometric approach. DATA RETRIEVAL: A bibliometric analysis based on the publications on Web of Science was performed using key words such as “facial paralysis”, “rehabilitation”, “physiotherapy” and “acupuncture”. INCLUSIVE CRITERIA: (1) Research articles on the clinical treatment of facial paralysis using acupuncture or physiotherapy (e.g. exercise, electro-stimulation) and other rehabilitation methods; (2) researches on human and animal fundamentals, clinical trials and case reports; (3) Article types: article, review, proceedings paper, note, letter, editorial material, discussion, book chapter. (4) Publication year: 1992–2011 inclusive. Exclusion criteria: (1) Articles on the causes and diagnosis on facial paralysis; (2) Type of articles: correction; (3) Articles from following databases: all databases related to social science and chemical databases in Web of Science. MAIN OUTCOME MEASURES: (1) Overall number of publications; (2) number of publications annually; (3) number of citations received annually; (4) top cited paper; (5) subject categories of publication; (6) the number of countries in which the article is published; (7) distribution of output in journals. RESULTS: Overall population stands at 3 543 research articles addressing the clinical treatment of facial paralysis in Web of Science during the study period. There is also a markedly increase in the number of publications on the subject “facial paralysis treatments using rehabilitation” during the first decade of the 21st century, except in 2004 and 2006 when there are perceptible drops in the number of articles published. The only other year during the study period saw such a drop is 1993. Specifically, there are 192 published articles on facial paralysis treated by rehabilitation in the past two decades, far more than the output of physiotherapy treatment. Physiotherapy treatment scored only 25 articles including acupuncture treatment, with over 80% of these written by Chinese researchers and clinicians. Ranked by regions, USA is by far the most productive country in terms of the number of publications on facial paralysis rehabilitation and physiotherapy research. Seeing from another angle, the journals that focus on otolaryngology published the most number of articles in rehabilitation and physiotherapy studies, whereas most acupuncture studies on facial paralysis were published in the alternative and complementary medicine journals. CONCLUSION: Study of facial paralysis remains an area of active investigation and innovation. Further clinical studies in humans addressing the use of growth factors or stem cells continue to successful facial nerve regeneration. PMID:25767492

  10. Multidisciplinary Management of Laryngeal Carcinoma

    SciTech Connect

    Mendenhall, William M. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States)], E-mail: mendewil@shands.ufl.edu; Mancuso, Anthony A. [Department of Diagnostic Radiology, University of Florida College of Medicine, Gainesville, FL (United States); Hinerman, Russell W.; Malyapa, Robert S. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Werning, John W. [Department of Otolaryngology, University of Florida College of Medicine, Gainesville, FL (United States); Amdur, Robert J. [Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL (United States); Villaret, Douglas B. [Department of Otolaryngology, University of Florida College of Medicine, Gainesville, FL (United States)

    2007-10-01

    The management of head and neck cancer has evolved into a multidisciplinary approach in which patients are evaluated before treatment and decisions depend on prospective multi-institutional trials, as well as retrospective outcome studies. The choice of one or more modalities to use in a given case varies with the tumor site and extent, as exemplified in the treatment of laryngeal squamous cell carcinomas. The goals of treatment include cure, laryngeal voice preservation, voice quality, optimal swallowing, and minimal xerostomia. Treatment options include transoral laser excision, radiotherapy (both definitive and postoperative), open partial laryngectomy, total laryngectomy, and neck dissection. The likelihood of local control and preservation of laryngeal function is related to tumor volume. Patients who have a relatively high risk of local recurrence undergo follow-up computed tomography scans every 3-4 months for the first 2 years after radiotherapy. Patients with suspicious findings on computed tomography might benefit from fluorodeoxyglucose positron emission tomography to differentiate post-radiotherapy changes from tumor.

  11. Hypokalemic paralysis in a professional bodybuilder.

    PubMed

    Mayr, Florian B; Domanovits, Hans; Laggner, Anton N

    2012-09-01

    Severe hypokalemia is a potentially life-threatening disorder and is associated with variable degrees of skeletal muscle weakness, even to the point of paralysis. On rare occasions, diaphragmatic paralysis from hypokalemia can lead to respiratory arrest. There may also be decreased motility of smooth muscle, manifesting with ileus or urinary retention. Rarely, severe hypokalemia may result in rhabdomyolysis. Other manifestations of severe hypokalemia include alteration of cardiac tissue excitability and conduction. Hypokalemia can produce electrocardiographic changes such as U waves, T-wave flattening, and arrhythmias, especially if the patient is taking digoxin. Common causes of hypokalemia include extrarenal potassium losses (vomiting and diarrhea) and renal potassium losses (eg, hyperaldosteronism, renal tubular acidosis, severe hyperglycemia, potassium-depleting diuretics) as well as hypokalemia due to potassium shifts (eg, insulin administration, catecholamine excess, familial periodic hypokalemic paralysis, thyrotoxic hypokalemic paralysis). Although the extent of diuretic misuse in professional bodybuilding is unknown, it may be regarded as substantial. Hence, diuretics must always be considered as a cause of hypokalemic paralysis in bodybuilders. PMID:21871759

  12. [The modifed Eden-Lange procedure for paralysis of the trapezius muscle].

    PubMed

    Ozalp, Taçkin; Yercan, Hüseyin; Okçu, Güvenir; Erkan, Serkan

    2007-01-01

    Trapezius muscle paralysis results from injury to the spinal accessory nerve. Impairment in the trapezius muscle function may destabilize the muscle resulting in winged scapula. A 25-year-old university student who was active in sports had complaints of shoulder drop and pain on abduction. He had a three-year history of fall resulting in a scapular fracture for which he received conservative treatment. Physical examination showed asymmetry and drop of the right shoulder. Lateral scapular winging was apparent particularly above 90 degrees of abduction. Electromyography revealed isolated paralysis of the trapezius muscle. The patient underwent reconstruction with the modified Eden-Lange procedure. After a two-year follow-up, asymmetry in the shoulder decreased, there was no pain on active abduction, and the patient returned to active sports and was fully satisfied with the outcome. PMID:17483655

  13. Liquid-sensitive laryngeal receptors in the developing sheep, cat and monkey.

    PubMed Central

    Harding, R; Johnson, P; McClelland, M E

    1978-01-01

    1. Action potentials were recorded from single afferent units of the superior laryngeal nerves in neonatal and adult sheep, cats and monkeys when liquids were passed over the laryngeal mucosa. 2. Two types of mucosal receptors, sensitive to water but not to isotonic saline, were found in each species from birth. The most common type of unit responded after a short latency (less than 1 sec), discharged maximally in the first 1-3 sec and became inactive when the stimulus was withdrawn. The other type responded only after several seconds, the discharges gradually increasing in frequency and continuing after removal of the stimulus. 3. Reproducible responses were elicited by tactile stimulation of the laryngeal mucosa over the receptive field of each of the long-latency units. Fewer than 50% of the short-latency units were excited, the remainder responding only unreproducibly to firm pressure. 4. Short-latency, but not long-latency, units responded to milks, gastric contents, saliva and isotonic solutions of sugars. 5. The responses of long-latency units to water were often modified by, but rarely dependent on, reflexly evoked activity in laryngeal muscles. 6. The conduction velocities of afferent fibres of water sensitive units ranged from 22 to 49 m/sec, and differed little from those of water-insensitive laryngeal mechanoreceptors. 7. Histological examination of the laryngeal mucosa showed that taste buds were present in lambs from birth whereas they developed post-natally in kittens and monkeys. The evidence suggests that taste buds were not associated with water-sensitive units. PMID:418177

  14. Lip Injections May Ease Challenges of Facial Paralysis

    MedlinePLUS

    ... reserved. More Health News on: Paralysis Plastic and Cosmetic Surgery Recent Health News Related MedlinePlus Health Topics Facial Injuries and Disorders Paralysis Plastic and Cosmetic Surgery About MedlinePlus Site Map FAQs Contact Us Get ...

  15. [Does intraoperative nerve monitoring reduce the rate of recurrent nerve palsies during thyroid surgery?].

    PubMed

    Timmermann, W; Dralle, H; Hamelmann, W; Thomusch, O; Sekulla, C; Meyer, Th; Timm, S; Thiede, A

    2002-05-01

    Two different aspects of the influence of neuromonitoring on the possible reduction of post-operative recurrent laryngeal nerve palsies require critical examination: the nerve identification and the monitoring of it's functions. Due to the additional information from the EMG signals, neuromonitoring is the best method for identifying the nerves as compared to visual identification alone. There are still no randomized studies available that compare the visual and electrophysiological recurrent laryngeal nerve detection in thyroid operations with respect to the postoperative nerve palsies. Nevertheless, comparisons with historical collectives show that a constant low nerve-palsy-rate was achieved with electrophysiological detection in comparison to visual detection. The rate of nerve identification is normally very high and amounts to 99 % in our own patients. The data obtained during the "Quality assurance of benign and malignant Goiter" study show that in hemithyreoidectomy and subtotal resection, lower nerve-palsy-rates are achieved with neuromonitoring as compared to solely visual detection. Following subtotal resection, this discrepancy becomes even statistically significant. While monitoring the nerve functions with the presently used neuromonitoring technique, it is possible to observe the EMG-signal remaining constant or decreasing in volume. Assuming that a constant neuromonitoring signal represents a normal vocal cord, our evaluation shows that there is a small percentage of false negative and positive results. Looking at the permanent recurrent nerve palsy rates, this method has a specificity of 98 %, a sensitivity of 100 %, a positive prognostic value of 10 %, and a negative prognostic value of 100 %. Although an altered neuromonitoring signal can be taken as a clear indication of eventual nerve damage, an absolutely reliable statement about the postoperative vocal cord function is presently not possible with intraoperative neuromonitoring. PMID:12058296

  16. Ultrasonography of laryngeal masses in six cats and one dog.

    PubMed

    Rudorf, H; Brown, P

    1998-01-01

    Ultrasonography of laryngeal abnormalities in small animals allows the identification of laryngeal masses because of the resulting distortion of normal structural/anatomical relationships. It also allows fine-needle aspirates to be taken with minimal risk of causing hemorrhage or edema affecting the already narrowed laryngeal lumen. Findings in six cats and one dog with laryngeal abnormalities are described. PMID:9771595

  17. Detecting Unilateral Phrenic Paralysis by Acoustic Respiratory Analysis

    PubMed Central

    Fiz, José Antonio; Jané, Raimon; Lozano, Manuel; Gómez, Rosa; Ruiz, Juan

    2014-01-01

    The consequences of phrenic nerve paralysis vary from a considerable reduction in respiratory function to an apparently normal state. Acoustic analysis of lung sound intensity (LSI) could be an indirect non-invasive measurement of respiratory muscle function, comparing activity on the two sides of the thoracic cage. Lung sounds and airflow were recorded in ten males with unilateral phrenic paralysis and ten healthy subjects (5 men/5 women), during progressive increasing airflow maneuvers. Subjects were in sitting position and two acoustic sensors were placed on their back, on the left and right sides. LSI was determined from 1.2 to 2.4 L/s between 70 and 2000 Hz. LSI was significantly greater on the normal (19.3±4.0 dB) than the affected (5.7±3.5 dB) side in all patients (p?=?0.0002), differences ranging from 9.9 to 21.3 dB (13.5±3.5 dB). In the healthy subjects, the LSI was similar on both left (15.1±6.3 dB) and right (17.4±5.7 dB) sides (p?=?0.2730), differences ranging from 0.4 to 4.6 dB (2.3±1.6 dB). There was a positive linear relationship between the LSI and the airflow, with clear differences between the slope of patients (about 5 dB/L/s) and healthy subjects (about 10 dB/L/s). Furthermore, the LSI from the affected side of patients was close to the background noise level, at low airflows. As the airflow increases, the LSI from the affected side did also increase, but never reached the levels seen in healthy subjects. Moreover, the difference in LSI between healthy and paralyzed sides was higher in patients with lower FEV1 (%). The acoustic analysis of LSI is a relevant non-invasive technique to assess respiratory function. This method could reinforce the reliability of the diagnosis of unilateral phrenic paralysis, as well as the monitoring of these patients. PMID:24718599

  18. The Laryngeal Manifestations of Laryngeal-pharynx Reflux and its Correlation with the Population of Manaus City

    Microsoft Academic Search

    Alexandre Borges Barbosa; Luciana da Silva Barberena; Keila Lucas; Pansini Barbosa; Daniel Santana Ribeiro

    The present work is justified for the lack of local data regarding the problem and it aims: to detect the manifestations of laryngeal-pharynx reflux; to determine eating habits of the manauenses (people from Manaus) which damage laryngeal-pharynx structure; to correlate the laryngeal manifestations of laryngeal- pharynx reflux with the eating habits of the manauense population; to detect inadequate and harmful

  19. Skull base osteomyelitis presenting with an isolated hypoglossal nerve palsy

    PubMed Central

    Kasfiki, Eirini Vasileiou; Kelly, Ciaran; Smith, John; Nicolaides, Andreas

    2013-01-01

    This is the first case of skull base osteomyelitis presenting with isolated bilateral hypoglossal nerve palsy reported in the literature. A 75-year-old man presented with tongue paralysis without any other cranial nerve palsy. He was otherwise well apart from recently having a high prostate-specific antigen level recorded. Investigations for malignancy or cerebrovascular insult were negative with the diagnosis of skull base osteomyelitis confirmed using CT. Following treatment with intravenous antibiotics for 6?weeks, symptoms resolved. PMID:23853016

  20. Laryngeal foreign bodies among adults.

    PubMed

    Hada, Mahendra S; Samdhani, Sunil; Chadha, Vinit; Harshvardhan, Rathod S; Prakash, Mishra

    2015-04-01

    Impacted foreign body of the larynx in the middle-aged man is a rare occurrence. Occupational and habitual surroundings make them prone to foreign body aspiration and impaction in the larynx. Proper history helps in establishing the diagnosis. We report 2 cases of unusual laryngeal foreign body in middle-aged adults who presented with complaints of sudden onset of change in their voice without any respiratory difficulty with accurate history of aspiration. Foreign bodies were successfully removed by direct laryngoscopy under general anesthesia. PMID:25887012

  1. Laryngeal foreign body mimicking croup.

    PubMed

    Ibrahimov, Metin; Yollu, Umur; Akil, Ferit; Aydin, Faruk; Yener, Murat

    2013-01-01

    Foreign body aspiration can be a fatal problem in all groups of ages. However, it is a leading cause of accidental deaths in children. Especially in the pediatric age group, diagnosis can be delayed because of various challenges. Children younger than 3 years carry the highest risk, as they are inclined to explore objects with their mouths. In most cases of inhaled foreign body, a positive history of aspiration is obtained. We are reporting a case of laryngeal foreign body that is mistreated for 1 week as a croup syndrome. PMID:23348345

  2. Levator scapulae and rhomboid transfer for paralysis of trapezius. The Eden-Lange procedure.

    PubMed

    Romero, J; Gerber, C

    2003-11-01

    Spinal accessory nerve palsy leads to painful disability of the shoulder, carrying an uncertain prognosis. We reviewed the long-term outcome in 16 patients who were treated for pain, weakness of active elevation and asymmetry of the shoulder and the neck due to chronic paralysis of the trapezius muscle, as a result of nerve palsy. Of four patients who were treated conservatively, none regained satisfactory function, although two became pain-free. The other 12 patients were treated operatively with transfer of the levator scapulae to the acromion and the rhomboid muscles to the infraspinatus fossa (the Eden-Lange procedure). At a mean follow-up of 32 years, the clinical outcome of the operatively treated patients was excellent in nine, fair in two, and poor in one patient, as determined by the Constant score. Pain was adequately relieved in 11 and overhead function was restored in nine patients. Pre-operative electromyography had been carried out in four patients. In two, who eventually had a poor outcome, a concomitant long thoracic and dorsal scapular nerve lesion had been present. The Eden-Lange procedure gives very satisfactory long-term results for the treatment of isolated paralysis of trapezius. In the presence of an additional serratus anterior palsy or weak rhomboid muscles, the procedure is less successful in restoring shoulder function. PMID:14653596

  3. Botox induced muscle paralysis rapidly degrades bone

    Microsoft Academic Search

    Sarah E. Warner; David A. Sanford; Blair A. Becker; Steven D. Bain; Sundar Srinivasan; Ted S. Gross

    2006-01-01

    The means by which muscle function modulates bone homeostasis is poorly understood. To begin to address this issue, we have developed a novel murine model of unilateral transient hindlimb muscle paralysis using botulinum toxin A (Botox). Female C57BL\\/6 mice (16 weeks) received IM injections of either saline or Botox (n = 10 each) in both the quadriceps and calf muscles of the

  4. Bendamustine Associated with Irreversible Ascending Paralysis

    PubMed Central

    Aljitawi, Omar S.; Lin, Tara L.; Ganguly, Siddhartha; Abhyankar, Sunil; McGuirk, Joseph P.

    2013-01-01

    Bendamustine is an alkylating agent currently used in the treatment of lymphoproliferative disorders. Many adverse effects, including a rare case of reversible neurotoxicity, have been reported in association with bendamustine. Herein, we report the first case of irreversible ascending paralysis related to bendamustine. PMID:23533850

  5. Barium-induced skeletal muscle paralysis in the rat, and its relationship to human familial periodic paralysis

    Microsoft Academic Search

    G. D. Schott; B. McArdle

    1974-01-01

    An in vivo study of skeletal muscle paralysis induced by intravenous barium chloride has been made in curarized and non-curarized rats. The influence of potassium and calcium chlorides, propranolol, ouabain, and prior adrenalectomy on the paralysis has also been studied. Paralysis is found to be due to a direct effect on skeletal muscle, and to correlate well with the development

  6. JS-X syndrome: A multiple congenital malformation with vocal cord paralysis, ear deformity, hearing loss, shoulder musculature underdevelopment, and X-linked recessive inheritance.

    PubMed

    Hoeve, Hans L J; Brooks, Alice S; Smit, Liesbeth S

    2015-07-01

    We report on a family with a not earlier described multiple congenital malformation. Several male family members suffer from laryngeal obstruction caused by bilateral vocal cord paralysis, outer and middle ear deformity with conductive and sensorineural hearing loss, facial dysmorphisms, and underdeveloped shoulder musculature. The affected female members only have middle ear deformity and hearing loss. The pedigree is suggestive of an X-linked recessive inheritance pattern. SNP-array revealed a deletion and duplication on Xq28 in the affected family members. A possible aetiology is a neurocristopathy with most symptoms expressed in structures derived from branchial arches. PMID:25998214

  7. Laryngeal cancer: how does the radiologist help?

    PubMed Central

    Connor, Steve

    2007-01-01

    Abstract The radiologist makes a valuable contribution to the staging of laryngeal cancer and this has a direct influence on treatment planning. This review focuses on the main anatomical concepts, patterns of tumour spread and how to detect this with optimal cross sectional imaging. Issues surrounding the relationship of tumour to the ventricular complex, submucosal laryngeal spaces, anteroposterior extension, laryngeal cartilage involvement and metastatic spread are discussed and illustrated. The impact of these imaging findings on the array of therapeutic options is described. PMID:17535777

  8. Preliminary multi-institutional prospective pathologic and molecular studies support preservation of sublevel IIB and level IV for laryngeal squamous carcinoma with clinically negative neck

    Microsoft Academic Search

    Alfio Ferlito; Carl E. Silver; Carlos Suárez; Alessandra Rinaldo

    2007-01-01

    Level II–IV selective neck dissection, often performed bilaterally, has become the procedure of choice for elective dissection\\u000a of the clinically negative (N0) neck in the treatment of laryngeal cancer. The most significant morbidity of this procedure\\u000a is dysfunction of the accessory nerve, incurred by the necessity of mobilization and retraction of the nerve in order to remove\\u000a the contents of

  9. Telescopic laryngeal and pharyngeal surgery.

    PubMed

    Richtsmeier, W J; Scher, R L

    1997-12-01

    Surgery of the hypopharynx and larynx has traditionally been performed with either direct, unaided vision or the operating microscope. We proposed to extend the surgical capability provided by angled Hopkins telescopes to the larynx and hypopharynx. Forty-eight cases in which rigid telescopes were employed primarily for intervention were reviewed. We found significant advantages of the telescopic system when performing procedures on surfaces that were not 90 degrees from the observer, such as the walls of the hypopharynx, the petiole of the epiglottis, the ventricle, and the posterior commissure. Both 30 degree and 70 degree telescopes were found useful, but required complementary instruments. The potassium titanyl phosphate laser's flexible fiber provided a distinct advantage in resecting lesions that presented on vertical surfaces. Telescopes also permitted the use of large instruments designed for intraperitoneal and intrathoracic surgery that blocked the view of the operating microscope. Telescopic pharyngeal and laryngeal visualization allowed surgical procedures complementary to more traditional forms of endoscopic surgery. PMID:9415594

  10. [Principles of palliative motor surgery of paralysis of the hand].

    PubMed

    Revol, M

    1993-04-01

    The purpose of surgical restoration of the paralysed hand is to use or to reconstruct the physiological tenodesis effects which are linked on to flexion-extension motions of the wrist. Active movements of interphalangeal (IP) flexion and metacarpo-phalangeal (MP) extension of the fingers are made by extrinsic muscles coming from the forearm. The intrinsic muscles of the fingers produce MP flexion and IP extension. A claw deformity occurs when they are completely paralysed in a finger whose joints are flexible, and whose extrinsic muscles remains functional or are restored. When Bouvier's maneuver is positive, the claw is said simple, and its treatment is either MP capsuloplasty when there is no motors, or an active palliative procedure with proximal (or MP) effect when motors exist: lasso and/or direct interosseous activation. Indications of the classical active palliative procedures with distal (or IP) effect remain rare, only in a few complicated claw deformities. Circumduction of the thumb may be decomposed into three elementary movements: reposition, antepulsion, and adduction, which are respectively controlled by the radial, median, and ulnar nerves. Each of these movements may be restored by a specific tendinous transfer. In the total paralysis of the thumb as we observe in high tetraplegia, a key-grip may be restored by joint stabilization of the thumb, associated with activation of the Flexor Pollicis Longus and Extensor Pollicis Longus by means of tenodesis or tendinous transfers. PMID:8304744

  11. Laryngitis

    MedlinePLUS

    ... BH, Lund LJ, et al, eds. Cummings Otolaryngology: Head & Neck Surgery. 6th ed. Philadelphia, PA: Elsevier Mosby ; 2015: ... et al. Clinical practice guideline: hoarseness (dysphonia). Otolaryngol Head Neck Surg . 2009;141(3 Suppl 2):S1-S31. ...

  12. Nerve and Nerve Root Biomechanics

    Microsoft Academic Search

    Kristen J. Nicholson; Beth A. Winkelstein

    \\u000a Together, the relationship between the mechanical response of neural tissues and the related mechanisms of injury provide\\u000a a foundation for defining relevant thresholds for injury. The nerves and nerve roots are biologic structures with specific\\u000a and important functions, and whose response to mechanical loading can have immediate, long-lasting and widespread consequences.\\u000a In particular, when nerves or nerve roots are mechanically

  13. Bilateral phrenic nerve dysfunction: a late complication of mantle radiation.

    PubMed

    Avila, Edward K; Goenka, Anuj; Fontenla, Sandra

    2011-06-01

    Neurologic complications from radiotherapy can be immediate or can occur many years after treatment. A known complication of radiotherapy to the supraclavicular and axillary lymph nodes is brachial plexus neuropathy. Although not a common injury, phrenic nerve dysfunction has been reported in association with radiation-induced brachial neuropathy. We describe a patient who developed asymmetric diaphragmatic weakness secondary to phrenic nerve paralysis 37 years after receiving mantle radiation for Hodgkin lymphoma. The patient did not have an associated brachial plexus neuropathy or a secondary malignancy involving the phrenic nerves. A radiation-induced injury was the most likely cause. PMID:20838851

  14. What's New in Laryngeal and Hypopharyngeal Cancer Research and Treatment?

    MedlinePLUS

    ... Additional resources for laryngeal and hypopharyngeal cancers What’s new in laryngeal and hypopharyngeal cancers research and treatment? ... to better tests for early detection and to new targeted treatments. Chemoprevention Chemoprevention is the use of ...

  15. What Are the Key Statistics about Laryngeal and Hypopharyngeal Cancers?

    MedlinePLUS

    ... laryngeal and hypopharyngeal cancers? What are the key statistics about laryngeal and hypopharyngeal cancers? The American Cancer ... 725 in men and 675 in women). Survival statistics for these cancers are discussed in the section “ ...

  16. Phonology Project Part II: Laryngeal Neutralization and Syllable Structure

    E-print Network

    Ananian, C. Scott

    .3 Laryngeal Processes in Icelandic and Sanskrit . . . . . . . . . . . . . . . . . . . . 3 1.3.1 Icelandic Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1.3.2 Sanskrit Overview.3 Sanskrit: Repair Strategies for the Laryngeal Constraint . . . . . . . . . . . . . . 9 2.3.1 Interaction

  17. Monolimb Paralysis after Laparoscopic Appendectomy Due to Conversion Disorder

    PubMed Central

    Song, Sung Hyuk; Lee, Kyeong Hwan

    2014-01-01

    Limb paralysis can develop for various reasons. We found a 13-year-old patient who became paralyzed in her lower extremities after laparoscopic appendectomy. Some tests, including electrodiagnostic studies and magnetic resonance imaging, were performed to evaluate the cause of lower limb paralysis. None of the tests yielded definite abnormal findings. We subsequently decided to explore the possibility of psychological problems. The patient was treated with simultaneous rehabilitation and psychological counseling. Paralysis of the patient's lower extremity improved gradually and the patient returned to normal life. Our findings indicate that psychological problems can be related to limb paralysis without organ damage in patients who have undergone laparoscopic surgical procedures. PMID:25426280

  18. Facial-paralysis diagnostic system based on 3D reconstruction

    NASA Astrophysics Data System (ADS)

    Khairunnisaa, Aida; Basah, Shafriza Nisha; Yazid, Haniza; Basri, Hassrizal Hassan; Yaacob, Sazali; Chin, Lim Chee

    2015-05-01

    The diagnostic process of facial paralysis requires qualitative assessment for the classification and treatment planning. This result is inconsistent assessment that potential affect treatment planning. We developed a facial-paralysis diagnostic system based on 3D reconstruction of RGB and depth data using a standard structured-light camera - Kinect 360 - and implementation of Active Appearance Models (AAM). We also proposed a quantitative assessment for facial paralysis based on triangular model. In this paper, we report on the design and development process, including preliminary experimental results. Our preliminary experimental results demonstrate the feasibility of our quantitative assessment system to diagnose facial paralysis.

  19. Lifetime Prevalence Rates of Sleep Paralysis: A Systematic Review

    PubMed Central

    Barber, Jacques P.

    2011-01-01

    Objective To determine lifetime prevalence rates of sleep paralysis. Data Sources Keyword term searches using “sleep paralysis”, “isolated sleep paralysis”, or “parasomnia not otherwise specified” were conducted using MEDLINE (1950-present) and PsychINFO (1872-present). English and Spanish language abstracts were reviewed, as were reference lists of identified articles. Study Selection Thirty five studies that reported lifetime sleep paralysis rates and described both the assessment procedures and sample utilized were selected. Data Extraction Weighted percentages were calculated for each study and, when possible, for each reported subsample. Data Synthesis Aggregating across studies (total N = 36533), 7.6% of the general population, 28.3% of students, and 31.9% of psychiatric patients experienced at least one episode of sleep paralysis. Of the psychiatric patients with panic disorder, 34.6% reported lifetime sleep paralysis. Results also suggested that minorities experience lifetime sleep paralysis at higher rates than Caucasians. Conclusions Sleep paralysis is relatively common in the general population and more frequent in students and psychiatric patients. Given these prevalence rates, sleep paralysis should be assessed more regularly and uniformly in order to determine its impact on individual functioning and better articulate its relation to psychiatric and other medical conditions. PMID:21571556

  20. Epigenetic Dysregulation in Laryngeal Squamous Cell Carcinoma

    PubMed Central

    Wong, Thian-Sze; Gao, Wei; Li, Zeng-Hong; Chan, Jimmy Yu-Wai; Ho, Wai-Kuen

    2012-01-01

    Laryngeal carcinoma is a common head and neck cancer with poor prognosis. Patients with laryngeal carcinoma usually present late leading to the reduced treatment efficacy and high rate of recurrence. Despite the advance in the use of molecular markers for monitoring human cancers in the past decades, there are still no reliable markers for use to screen laryngeal carcinoma and follow the patients after treatment. Epigenetics emerged as an important field in understanding the biology of the human malignancies. Epigenetic alterations refer to the dysregulation of gene, which do not involve the alterations of the DNA sequence. Major epigenetic changes including methylation imbalance, histone modification, and small RNA dysregulation could play a role in the development of human malignancies. Global epigenetic change is now regarded as a molecular signature of cancer. The characteristics and behavior of a cancer could be predicted based on the specific epigenetic pattern. We here provide a review on the understanding of epigenetic dysregulation in laryngeal carcinoma. Further knowledge on the initiation and progression of laryngeal carcinoma at epigenetic level could promote the translation of the knowledge to clinical use. PMID:22645613

  1. Goiter and Laryngeal Sensory Neuropathy

    PubMed Central

    Hamdan, Abdul Latif; Jabour, Jad; Azar, Sami T.

    2013-01-01

    Objective. Examining the prevalence of laryngeal sensory neuropathy (LSN) in goiter patients versus a control group. Study Design. Cross-sectional study. Methods. 33 Goiter patients were enrolled versus 25 age-matched controls. TSH levels, size of thyroid gland, and presence or absence of thyroid nodules were reported. Subjects were asked about the presence or absence of any of the following symptoms: cough, globus pharyngeus, and/or throat clearing that persistented for more than 6 weeks. The presence of one or more of these symptoms for at least six weeks in the absence of LPRD, allergy, asthma, ACE inhibitor intake, and psychogenic disorder was defined as LSN. Results. For goitrous patients mean age (years) was (41.73 ± 9.47) versus (37.44 ± 10.89) for controls. 82% goitrous patients had known nodules and 27% carried a simultaneous diagnosis of hypothyroidism. Among those with documented size (61%), mean total thyroid volume was 26.996 ± 14.852?cm3, with a range from 9.430 to 67.022?cm3. The overall prevalence of LSN among goitrous patients was 42% versus 12% among controls (P = 0.0187). There was no correlation between LSN, size of thyroid gland, and TSH level. Conclusion. The prevalence of LSN in goitrous patients is significantly higher than that in a nongoitrous population. PMID:23818901

  2. A randomised trial comparing the laryngeal mask airway Supreme™ with the laryngeal mask airway Unique™ in children.

    PubMed

    Jagannathan, N; Sohn, L E; Sawardekar, A; Chang, E; Langen, K E; Anderson, K

    2012-02-01

    We conducted a randomised controlled trial comparing the laryngeal mask airway Supreme(™) with the laryngeal mask airway Unique(™) in children. Fifty children presenting for elective surgery were randomly assigned to receive either the laryngeal mask airway Supreme or laryngeal mask airway Unique. The outcomes measured were airway leak pressure, ease and time for insertion, insertion success rate, fibreoptic examination, incidence of gastric insufflation, ease of gastric tube placement through the laryngeal mask airway Supreme, quality of airway during anaesthetic maintenance and complications. Median (IQR [range]) time to successful device placement was shorter with the laryngeal mask airway Unique, 14.5 [13.5-16.3 (10.0-23.6)] s than with the laryngeal mask airway Supreme, 17.4 [14.8-19.8 (11.5-29.2)] s; p = 0.007. Median (IQR [range]) airway leak pressures for the laryngeal mask airway Supreme and laryngeal mask airway Unique were 20 [16-21 (12-22)] cmH(2)O and 15 [14-18 (10-24)] cmH(2)O, respectively (p = 0.001). The incidence of gastric insufflation was lower with the laryngeal mask airway Supreme (zero vs six patients), p = 0.01. In conclusion, the laryngeal mask airway Supreme performed as well as the laryngeal mask airway Unique and is a useful alternative for airway maintenance, particularly in children who require evacuation of gastric contents during anaesthesia. PMID:22070630

  3. Like a Deer in the Headlights: The Paralysis of Stuckness

    ERIC Educational Resources Information Center

    Anderson-Nathe, Ben

    2008-01-01

    When describing how they experience moments of not-knowing, youth workers often talk about a sense of paralysis, as though their uncertainty becomes physically constraining. This chapter describes the first of five themes associated with youth workers' experiences of not knowing what to do: the paralysis of stuckness. In addition to describing and…

  4. Progress in Paralysis | NIH MedlinePlus the Magazine

    MedlinePLUS

    ... patients to control devices and even navigate a wheelchair using only tongue movements. Do you believe there will ever be a cure for paralysis? This report of remarkable recovery in 4 of 4 patients with long-standing, complete motor paralysis is a medical milestone that ...

  5. [Surveillance of acute flaccid paralysis in Belarus].

    PubMed

    Samo?lovich, E O; Ermolovich, M A; Kotova, I F; Svirchevskaia, E Iu; Shimanovich, V P; Kozhemiakin, A K; Protas, I I; Fel'dman, E V

    2007-01-01

    The ten-years experience of acute flaccid paralysis (AFP) surveillance in Belarus has been summarized. Among 456 AFP cases reported from 1996 to 2005, 11 were classified as vaccine-associated paralytic poliomyelitis (VAPP), 445--as non-polio AFP. The risk of VAPP for the period 1996-2001 was 1 case per 745,000 used doses of oral poliovaccine (OPV). For the recipients of OPV the risk was 1 case per 911,700 doses and for the first-dose recipients--1 case per 96,000 doses. The high incidence of VAPP was a reason for implementation of sequential polio vaccination schedule in 2000. Guillain-Barre syndrome dominated among non-polio AFP (39.3% of cases); more rare were traumatic neuritis (27.9% of cases), transient monoparalysis (12.1%), myelitis (7.6%). Non-polio AFP differed from VAPP by following epidemiological and virological characteristics: predominance of previously repeatedly vaccinated against poliomyelitis; development of paralysis in long-term period after vaccination; isolation of non-polio viruses belonged to three serotypes of Coxsackie B viruses (B1, B4, B6) and six serotypes of Echo viruses (6, 7, 11, 14, 24, 25) in 8.1% of cases; absence of typical for polio residual paralyses in patients who excreted vaccine polioviruses. PMID:17523475

  6. Isolated sleep paralysis elicited by sleep interruption.

    PubMed

    Takeuchi, T; Miyasita, A; Sasaki, Y; Inugami, M; Fukuda, K

    1992-06-01

    We elicited isolated sleep paralysis (ISP) from normal subjects by a nocturnal sleep interruption schedule. On four experimental nights, 16 subjects had their sleep interrupted for 60 minutes by forced awakening at the time when 40 minutes of nonrapid eye movement (NREM) sleep had elapsed from the termination of rapid eye movement (REM) sleep in the first or third sleep cycle. This schedule produced a sleep onset REM period (SOREMP) after the interruption at a high rate of 71.9%. We succeeded in eliciting six episodes of ISP in the sleep interruptions performed (9.4%). All episodes of ISP except one occurred from SOREMP, indicating a close correlation between ISP and SOREMP. We recorded verbal reports about ISP experiences and recorded the polysomnogram (PSG) during ISP. All of the subjects with ISP experienced inability to move and were simultaneously aware of lying in the laboratory. All but one reported auditory/visual hallucinations and unpleasant emotions. PSG recordings during ISP were characterized by a REM/W stage dissociated state, i.e. abundant alpha electroencephalographs and persistence of muscle atonia shown by the tonic electromyogram. Judging from the PSG recordings, ISP differs from other dissociated states such as lucid dreaming, nocturnal panic attacks and REM sleep behavior disorders. We compare some of the sleep variables between ISP and non-ISP nights. We also discuss the similarities and differences between ISP and sleep paralysis in narcolepsy. PMID:1621022

  7. Sudden death from saccular laryngeal cyst.

    PubMed

    Kastowsky, Tina K; Stevenson, Melanie P; Duflou, Johan A

    2006-09-01

    Laryngeal cysts are benign, uncommon lesions of the larynx that have been reported on rare occasions to cause sudden death in infants and adults by acute airways obstruction. In this report, we document the sudden death of a 36-year-old woman from a previously undiagnosed, asymptomatic laryngeal saccular cyst that presented with acute, and consequent fatal, airway obstruction. Difficulty during intubation, both in theater and in emergency settings, is a frequent presenting problem. This can have significant medicolegal implications in determining possible negligence. The diagnosis, classification, and management of such cysts, and their importance to both the forensic pathologist and clinicians are discussed. PMID:17018096

  8. Isolated Sleep Paralysis and Fearful Isolated Sleep Paralysis in Outpatients With Panic Attacks

    PubMed Central

    Sharpless, Brian A.; McCarthy, Kevin S.; Chambless, Dianne L.; Milrod, Barbara L.; Khalsa, Shabad-Ratan; Barber, Jacques P.

    2013-01-01

    Isolated sleep paralysis (ISP) has received scant attention in clinical populations, and there has been little empirical consideration of the role of fear in ISP episodes. To facilitate research and clinical work in this area, the authors developed a reliable semistructured interview (the Fearful Isolated Sleep Paralysis Interview) to assess ISP and their proposed fearful ISP (FISP) episode criteria in 133 patients presenting for panic disorder treatment. Of these, 29.3% met lifetime ISP episode criteria, 20.3% met the authors’ lifetime FISP episode criteria, and 12.8% met their recurrent FISP criteria. Both ISP and FISP were associated with minority status and comorbidity. However, only FISP was significantly associated with posttraumatic stress disorder, body mass, anxiety sensitivity, and mood and anxiety disorder symptomatology. PMID:20715166

  9. Ventricular pressures in phonating excised larynges

    PubMed Central

    Alipour, Fariborz; Scherer, Ronald C.

    2012-01-01

    Pressure in the laryngeal ventricle was measured with a beveled needle connected to a pressure transducer in excised canine larynges. Air pressures within the ventricle were obtained for different adduction levels of the true vocal folds (TVFs), false vocal folds (FVFs), and subglottal pressures (Ps). Results indicated that the air pressures in the ventricle appear to be strongly related to the motion of the FVFs rather than to the effects of TVF vibration. Both dc and ac pressures depend on FVF adduction, amplitude of motion of the FVFs, and whether the FVFs touch each other during the vibratory cycle. Mean and peak-to-peak pressures in the ventricle were as high as 65% of the mean and peak-to-peak Ps, respectively, when the FVFs vibrated with large amplitude and contact each cycle. If the glottis was not closed, a medial movement of the FVFs appeared to create a positive pressure pulse on the Ps signal due to an increase in the laryngeal flow resistance. The electroglottograph signal showed evidence of tissue contact for both the TVFs and the FVFs. The study suggests that the laryngeal ventricle acts as a relatively independent aero-acoustic chamber that depends primarily upon the motion of the FVFs. PMID:22894222

  10. Laryngeal Trauma During Awake Fiberoptic Intubation

    Microsoft Academic Search

    Mazen A. Maktabi; Henry Hoffman; Gery Funk

    2002-01-01

    nesthesiologists often select fiberoptic endotra- cheal intubation as part of the care of patients with difficult airways. An important goal in airway management is to prevent damage to laryngeal struc- tures. We report three patients who sustained airway injury during fiberoptic intubation, suggesting that this procedure may not be free of traumatic complications.

  11. Epidemiological evidence indicates asbestos causes laryngeal cancer

    SciTech Connect

    Smith, A.H.; Handley, M.A.; Wood, R. (Univ. of California, Berkeley (USA))

    1990-06-01

    A variety of opinions have been expressed in the literature concerning asbestos and laryngeal cancer. This paper presents an analysis of epidemiological studies based on criteria that prioritized the most heavily exposed cohorts. Emphasis was given to the six cohorts or subcohorts with lung cancer relative risk estimates of 2 or more. The two groups of workers with the highest lung cancer relative risk estimates (4.06 and 3.28) both gave strong support for a causal association of asbestos and laryngeal cancer, with relative risk estimates of 1.91 (90% confidence limits 1.00 to 3.34) and 3.75 (90% confidence limits 1.01 to 9.68), respectively. Confounding with cigarette smoking or alcohol consumption does not explain the findings. Case-control studies gave mixed results, but generally supported the hypothesis. It was concluded that asbestos is a probable cause of laryngeal cancer in view of the reasonable consistency of the studies, the strength of the association in key studies, the evidence for dose-response relationships, and the biological plausibility for asbestos being a cause of laryngeal cancer. 48 references.

  12. Atraumatic laser treatment for laryngeal papillomatosis

    NASA Astrophysics Data System (ADS)

    McMillan, Kathleen; Pankratov, Michail M.; Wang, Zhi; Bottrill, Ian; Rebeiz, Elie E.; Shapshay, Stanley M.

    1994-09-01

    Ten to fifteen thousand new cases of recurrent respiratory papillomatosis (RRP) are diagnosed each year in the United States. RRP is caused by the human papillomavirus (HPV) and is characterized by recurrent, non-malignant, proliferative lesions of the larynx. Patients with RRP undergo numerous microsurgical procedures to remove laryngeal papilloma threatening airway patency and interfering with phonation. The standard surgical technique involves CO2 laser vaporization of laryngeal epithelium affected by the lesions, and requires general anesthesia. The pulsed dye laser operating at 585 nm has previously been demonstrated to be effective in clearing HPV lesions of the skin (verrucae). For treatment of RRP, the fiber- compatible pulsed dye laser radiation may be delivered under local anesthesia using a flexible intranasal laryngoscope. Potential advantages of the pulsed dye laser treatment over CO2 laser surgery include (1) reduced morbidity, especially a lower risk of laryngeal scarring; (2) lower cost; (3) reduced technical difficulty; and (4) reduced risk of viral dissemination or transmission. In vivo studies are underway to determine the effect of pulsed dye laser radiation on normal canine laryngeal tissue.

  13. Use of Lasers in Laryngeal Surgery

    PubMed Central

    Yan, Yan; Olszewski, Aleksandra E.; Hoffman, Matthew R.; Zhuang, Peiyun; Ford, Charles N.; Dailey, Seth H.; Jiang, Jack J.

    2012-01-01

    Lasers are a relatively recent addition to laryngeal surgery. Since their invention, laser use and applications have expanded rapidly. In this paper, we discuss the benefits and disadvantages of lasers for different procedures, as well as ways to overcome commonly faced clinical problems. The use of lasers in surgery has offered a time- and cost-efficient alternative to cold surgical techniques, and has been employed in the treatment of numerous laryngeal pathologies, including stenoses, recurrent respiratory papillomatosis, leukoplakia, nodules, malignant laryngeal disease, and polypoid degeneration (Reinke’s edema). However, lasers can incur adjacent tissue damage and vocal fold scarring. These problems can be minimized through understanding the mechanisms by which lasers function and correctly manipulating the parameters under a surgeon’s control. By varying fluence, power density, and pulsation, tissue damage can be decreased and lasers can be used with greater confidence. The various types of lasers and their applications to the treatment of specific pathologies are reviewed with the intention of helping surgeons select the best tool for a given procedure. Recent applications of lasers to treat benign laryngeal lesions and severe laryngomalacia demonstrate that additional research must be conducted in order to realize the full potential of this surgical tool. PMID:19487102

  14. Chemoradiotherapy Laryngeal Preservation for Advanced Hypopharyngeal Cancer

    Microsoft Academic Search

    Shyh-Kuan Tai; Muh-Hwa Yang; Ling-Wei Wang; Tung-Lung Tsai; Pen-Yuan Chu; Yi-Feng Wang; Jui-Lin Huang; Shyue-Yih Chang

    Objective: Laryngeal preservation is a challenge for the treatment of advanced hypopharyn- geal cancer. The objective of this study is to evaluate the results of chemoradiotherapy laryn- geal preservation for advanced hypopharyngeal cancer at a single institute and the impact of treatment factors on prognosis. Methods: The study population consisted of 42 consecutive patients with resectable stage III-IV hypopharyngeal cancer.

  15. Paralysis recovery in humans and model systems

    NASA Technical Reports Server (NTRS)

    Edgerton, V. Reggie; Roy, Roland R.

    2002-01-01

    Considerable evidence now demonstrates that extensive functional and anatomical reorganization following spinal cord injury occurs in centers of the brain that have some input into spinal motor pools. This is very encouraging, given the accumulating evidence that new connections formed across spinal lesions may not be initially functionally useful. The second area of advancement in the field of paralysis recovery is in the development of effective interventions to counter axonal growth inhibition. A third area of significant progress is the development of robotic devices to quantify the performance level of motor tasks following spinal cord injury and to 'teach' the spinal cord to step and stand. Advances are being made with robotic devices for mice, rats and humans.

  16. "Paratrigeminal" paralysis of the oculopupillary sympathetic system

    PubMed Central

    Goadsby, P

    2002-01-01

    Raeder described five patients with mixed features of trigeminal nerve pathology and oculosympathetic impairment, with or without other cranial nerve lesions. This constellation of clinical features drew the original author's attention to the paratrigeminal region as a likely site for the causative lesion in this syndrome. An analysis of the anatomy of the oculosympathetic innervation supports the view that a restricted lesion in the middle cranial fossa might cause the syndrome of trigeminal nerve involvement, neuralgic pain or sensory change, with ptosis or miosis, or both, but no anhidrosis. Such a paratrigeminal oculosympathetic syndrome (POSS) usefully reminds clinicians to pursue vigorously possible lesions of the middle cranial fossa with careful, and possibly repeated, imaging studies. Attaching the eponym Raeder's syndrome or Raeder's paratrigeminal neuralgia to this syndrome adds nothing valuable to the anatomical description (POSS), which might be preferred for clarity. PMID:11861683

  17. Botox induced muscle paralysis rapidly degrades bone.

    PubMed

    Warner, Sarah E; Sanford, David A; Becker, Blair A; Bain, Steven D; Srinivasan, Sundar; Gross, Ted S

    2006-02-01

    The means by which muscle function modulates bone homeostasis is poorly understood. To begin to address this issue, we have developed a novel murine model of unilateral transient hindlimb muscle paralysis using botulinum toxin A (Botox). Female C57BL/6 mice (16 weeks) received IM injections of either saline or Botox (n = 10 each) in both the quadriceps and calf muscles of the right hindleg. Gait dysfunction was assessed by multi-observer inventory, muscle alterations were determined by wet mass, and bone alterations were assessed by micro-CT imaging at the distal femur, proximal tibia, and tibia mid-diaphysis. Profound degradation of both muscle and bone was observed within 21 days despite significant restoration of weight bearing function by 14 days. The muscle mass of the injected quadriceps and calf muscles was diminished -47.3% and -59.7%, respectively, vs. saline mice (both P < 0.001). The ratio of bone volume to tissue volume (BV/TV) within the distal femoral epiphysis and proximal tibial metaphysis of Botox injected limbs was reduced -43.2% and -54.3%, respectively, while tibia cortical bone volume was reduced -14.6% (all P < 0.001). Comparison of the contralateral non-injected limbs indicated the presence of moderate systemic effects in the model that were most probably associated with diminished activity following muscle paralysis. Taken as a whole, the micro-CT data implied that trabecular and cortical bone loss was primarily achieved by bone resorption. These data confirm the decisive role of neuromuscular function in mediating bone homeostasis and establish a model with unique potential to explore the mechanisms underlying this relation. Given the rapidly expanding use of neuromuscular inhibitors for indications such as pain reduction, these data also raise the critical need to monitor bone loss in these patients. PMID:16185943

  18. 9 CFR 310.15 - Disposition of thyroid glands and laryngeal muscle tissue.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ...Disposition of thyroid glands and laryngeal muscle tissue. 310.15 Section 310.15...Disposition of thyroid glands and laryngeal muscle tissue. (a) Livestock thyroid glands and laryngeal muscle tissue shall not be used for human...

  19. 9 CFR 310.15 - Disposition of thyroid glands and laryngeal muscle tissue.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ...Disposition of thyroid glands and laryngeal muscle tissue. 310.15 Section 310.15...Disposition of thyroid glands and laryngeal muscle tissue. (a) Livestock thyroid glands and laryngeal muscle tissue shall not be used for human...

  20. 9 CFR 310.15 - Disposition of thyroid glands and laryngeal muscle tissue.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ...Disposition of thyroid glands and laryngeal muscle tissue. 310.15 Section 310.15...Disposition of thyroid glands and laryngeal muscle tissue. (a) Livestock thyroid glands and laryngeal muscle tissue shall not be used for human...

  1. 9 CFR 310.15 - Disposition of thyroid glands and laryngeal muscle tissue.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ...Disposition of thyroid glands and laryngeal muscle tissue. 310.15 Section 310.15...Disposition of thyroid glands and laryngeal muscle tissue. (a) Livestock thyroid glands and laryngeal muscle tissue shall not be used for human...

  2. 9 CFR 310.15 - Disposition of thyroid glands and laryngeal muscle tissue.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ...Disposition of thyroid glands and laryngeal muscle tissue. 310.15 Section 310.15...Disposition of thyroid glands and laryngeal muscle tissue. (a) Livestock thyroid glands and laryngeal muscle tissue shall not be used for human...

  3. [Professor HE Tianyou's clinical experience of acupuncture and medicine on intractable facial paralysis].

    PubMed

    Yan, Fenghua; Yao, Xuhong; Yan, Xingke; Zhang, Yongkui; Jing, Xiaohui; He, Tianyou

    2015-02-01

    Professor HE Tianyou's unique understanding and treatment characteristics for intractahle facial paralysis are introduced. In clinical practice professor HE highly values acupoint selection and manipulation application, and integrates Chinese and western medicine to flexibly choose acupoints and formulate prescriptions according to syndrome differentiation and location differentiation, besides, he creates several specialized manipulation methods including "tug-of war opposite acupuncture method" and "tractive flash cupping". Based on strengthening body and dredging collaterals. more attention is given on stimulation to local paralyzed facial nerves; meanwhile acupuncture and medication are combined to improve clinical efficacy. During the treatment, the important role of psychological counseling on patient's anxiety is emphasized, and comprehensive treatment is given physically and psychologically in order to achieve the purpose of total rehabilitation. PMID:25854027

  4. Severe Acute Orthopnea: Ipilimumab-Induced Bilateral Phrenic Nerve Neuropathy.

    PubMed

    Jinnur, Praveen; Lim, Kaiser G

    2015-08-01

    Ipilimumab is a monoclonal antibody used in the treatment of unresectable or metastatic melanoma. Several immune-related adverse events including potential fatal events have been reported following its use. We report a case of a 66-year-old man who presented with severe acute exertional dyspnea and orthopnea following administration of ipilimumab for metastatic melanoma. Although various peripheral neuropathy syndromes associated with ipilimumab have been reported, bilateral phrenic nerve paralysis has not been previously reported. This case also highlights the clinical features of bilateral phrenic nerve neuropathy. Pulmonologists have to be aware of these unusual immune-related respiratory adverse events in patients being treated with monoclonal antibodies. PMID:25956728

  5. Optic Nerve Drusen

    MedlinePLUS

    ... Conditions Frequently Asked Questions Español Condiciones Chinese Conditions Optic Nerve Drusen En Español Read in Chinese What are optic nerve drusen? Optic nerve drusen are abnormal globular ...

  6. An fMRI investigation of racial paralysis

    PubMed Central

    Mason, Malia F.; Vandello, Joseph A.; Biga, Andrew; Dyer, Rebecca

    2013-01-01

    We explore the existence and underlying neural mechanism of a new norm endorsed by both black and white Americans for managing interracial interactions: “racial paralysis’, the tendency to opt out of decisions involving members of different races. We show that people are more willing to make choices—such as who is more intelligent, or who is more polite—between two white individuals (same-race decisions) than between a white and a black individual (cross-race decisions), a tendency which was evident more when judgments involved traits related to black stereotypes. We use functional magnetic resonance imaging to examine the mechanisms underlying racial paralysis, to examine the mechanisms underlying racial paralysis, revealing greater recruitment of brain regions implicated in socially appropriate behavior (ventromedial prefrontal cortex), conflict detection (anterior cingulate cortex), deliberative processing (dorsolateral prefrontal cortex), and inhibition (ventrolateral prefrontal cortex). We also discuss the impact of racial paralysis on the quality of interracial relations. PMID:22267521

  7. Organ preservation strategies in the treatment of laryngeal cancer

    Microsoft Academic Search

    George E. Laramore; Marc D. Coltrera

    2003-01-01

    Opinion statement  For most patients, a total laryngectomy should not be used as the initial treatment for any stage laryngeal tumor. The goal\\u000a in treating a patient with laryngeal cancer must be not only to cure but also to provide the best functional outcome for the\\u000a patient. In the United States, the treatment of laryngeal cancer has moved from radical surgery

  8. Invasive Laryngeal Squamous Cell Carcinoma in a Boy

    PubMed Central

    Cheng, Qing; Lei, Wen-Ting; Fan, Guo-Run; Zhu, Dong

    2015-01-01

    Laryngeal squamous cell carcinoma (SCC) is rare in children. Usually, laryngeal SCC in children has a poor prognosis. A 9-year-old boy is reported who was diagnosed as having poorly differentiated laryngeal squamous cell carcinoma with neck metastasis. This report aims to highlight the importance of a comprehensive knowledge of differential diagnosis, putting great attention to the onset of symptoms, early application of flexible laryngoscopy, and intensive studies on similar cases.

  9. [Characteristics of psychoemotional sphere in children with chronic laryngeal obstruction].

    PubMed

    Shepina, A I; Makarchuk, A V; Soldatski?, Iu L; Tarabrina, N V; Onufrieva, E K; Shchepin, N V

    2002-01-01

    45 children from 10 to 14 years of age with chronic laryngeal obstruction were examined psychologically. 29 of them had recurrent respiratory papillomatosis, 16 ones had cicatrical laryngostenosis. The majority of the examinees (65%) showed symptoms of posttraumatic stress syndrome (PTSS). The children develop PTSS one-two years after onset of laryngeal obstruction. Later, the children underwent persistent specific maladaptation personality disorders. Thus, children with recurrent laryngeal papillomatosis, especially with cicatrical laryngostenosis, should undergo psychological correction. PMID:12227023

  10. Sleep paralysis, sexual abuse, and space alien abduction.

    PubMed

    McNally, Richard J; Clancy, Susan A

    2005-03-01

    Sleep paralysis accompanied by hypnopompic ('upon awakening') hallucinations is an often-frightening manifestation of discordance between the cognitive/perceptual and motor aspects of rapid eye movement (REM) sleep. Awakening sleepers become aware of an inability to move, and sometimes experience intrusion of dream mentation into waking consciousness (e.g. seeing intruders in the bedroom). In this article, we summarize two studies. In the first study, we assessed 10 individuals who reported abduction by space aliens and whose claims were linked to apparent episodes of sleep paralysis during which hypnopompic hallucinations were interpreted as alien beings. In the second study, adults reporting repressed, recovered, or continuous memories of childhood sexual abuse more often reported sleep paralysis than did a control group. Among the 31 reporting sleep paralysis, only one person linked it to abuse memories. This person was among the six recovered memory participants who reported sleep paralysis (i.e. 17% rate of interpreting it as abuse-related). People rely on personally plausible cultural narratives to interpret these otherwise baffling sleep paralysis episodes. PMID:15881271

  11. Organ preservation surgery for laryngeal cancer

    PubMed Central

    Chawla, Sharad; Carney, Andrew Simon

    2009-01-01

    The principles of management of the laryngeal cancer have evolved over the recent past with emphasis on organ preservation. These developments have paralleled technological advancements as well as refinement in the surgical technique. The surgeons are able to maintain physiological functions of larynx namely speech, respiration and swallowing without compromising the loco-regional control of cancer in comparison to the more radical treatment modalities. A large number of organ preservation surgeries are available to the surgeon; however, careful assessment of the stage of the cancer and selection of the patient is paramount to a successful outcome. A comprehensive review of various organ preservation techniques in vogue for the management of laryngeal cancer is presented. PMID:19442314

  12. Experimental autoimmune encephalomyelitis repressed by microglial paralysis.

    PubMed

    Heppner, Frank L; Greter, Melanie; Marino, Denis; Falsig, Jeppe; Raivich, Gennadij; Hövelmeyer, Nadine; Waisman, Ari; Rülicke, Thomas; Prinz, Marco; Priller, Josef; Becher, Burkhard; Aguzzi, Adriano

    2005-02-01

    Although microglial activation occurs in inflammatory, degenerative and neoplastic central nervous system (CNS) disorders, its role in pathogenesis is unclear. We studied this question by generating CD11b-HSVTK transgenic mice, which express herpes simplex thymidine kinase in macrophages and microglia. Ganciclovir treatment of organotypic brain slice cultures derived from CD11b-HSVTK mice abolished microglial release of nitrite, proinflammatory cytokines and chemokines. Systemic ganciclovir administration to CD11b-HSVTK mice elicited hematopoietic toxicity, which was prevented by transfer of wild-type bone marrow. In bone marrow chimeras, ganciclovir blocked microglial activation in the facial nucleus upon axotomy and repressed the development of experimental autoimmune encephalomyelitis. We conclude that microglial paralysis inhibits the development and maintenance of inflammatory CNS lesions. The microglial compartment thus provides a potential therapeutic target in inflammatory CNS disorders. These results validate CD11b-HSVTK mice as a tool to study the impact of microglial activation on CNS diseases in vivo. PMID:15665833

  13. Dihydropyridine receptor mutations cause hypokalemic periodic paralysis

    SciTech Connect

    Ptacek, L.J.; Leppert, M.F. [Univ. of Utah, Salt Lake City, UT (United States); Tawil, R. [Univ. of Rochester, MN (United States)] [and others

    1994-09-01

    Hypokalemic periodic paralysis (hypoKPP) is an autosomal dominant skeletal muscle disorder manifested by episodic weakness associated with low serum potassium. Genetic linkage analysis has localized the hypoKPP gene to chromosome 1q31-q32 near a dihydropyridine receptor (DHP) gene. This receptor functions as a voltage-gated calcium channel and is also critical for excitation-contraction coupling in a voltage-sensitive and calcium-independent manner. We have characterized patient-specific DHP receptor mutations in 11 probands of 33 independent hypoKPP kindreds that occur at one of two adjacent nucleotides within the same codon and predict substitution of a highly conserved arginine in the S4 segment of domain 4 with either histidine or glycine. In one kindred, the mutation arose de novo. Taken together, these data establish the DHP receptor as the hypoKPP gene. We are unaware of any other human diseases presently known to result from DHP receptor mutations.

  14. Peripheral Nerve Disorders

    MedlinePLUS

    ... spinal cord. Like static on a telephone line, peripheral nerve disorders distort or interrupt the messages between the brain ... body. There are more than 100 kinds of peripheral nerve disorders. They can affect one nerve or many nerves. ...

  15. Prediction of Facial Nerve Function After Surgery for Cerebellopontine Angle Tumors

    PubMed Central

    Kirkpatrick, P. J.; Watters, G.; Strong, A. J.; Walliker, J. R.; Gleeson, M. J.

    1991-01-01

    A series of 18 patients undergoing surgery for cerebellopontine angle tumors is reported. Patients were grouped according to size of tumor (0 to 2.5 cm, 11 cases; more than 2.5 cm, 7 cases). In all, the facial nerve was identified and conductance assessed by monitoring the facial electromyographic response to facial nerve stimulation. Postoperative facial nerve function was graded clinically after 3 months according to the House scale. Tumor removal was complete in all cases. In patients with tumors up to 2.5 cm the facial nerve was intact to visual inspection at the end of the procedure in all but one, where partial division was evident. In this group intraoperative facial nerve stimulation indicated electrical integrity in 8 of the 11 cases, all of which regained good facial nerve function postoperatively (House grades I and II). Nerve conduction was lost during the operation in the remaining three patients with small tumors; two subsequently developed a moderately severe (grade IV) dysfunction and the third, a total paralysis (grade VI). In the large (more than 2.5 cm) tumor group the facial nerve was anatomically intact in five of the seven cases, partially divided in one, and completely sectioned in the remaining case. Facial nerve stimulation indicated functional integrity in three patients, two of whom developed moderate (grade III) and the third a severe (grade V) dysfunction. In the other four cases nerve function could not be detected at operation; three of these developed a moderate facial nerve dysfunction (grade III/IV) and the final case a complete paralysis (grade VI). Intraoperative facial nerve monitoring appeared to predict eventual facial function accurately in the small tumor group, but did not predict facial nerve recovery reliably following surgery for larger tumors. PMID:17170808

  16. Concomitant abducens and facial nerve palsies following blunt head trauma associated with bone fracture.

    PubMed

    Ji, Min-Jeong; Han, Sang-Beom; Lee, Seung-Jun; Kim, Moosang

    2015-01-01

    A 22-year-old man was referred for horizontal diplopia that worsened on left gaze. He had been admitted for a head trauma caused by a traffic accident. Brain CT scan showed a longitudinal fracture of the left temporal bone with extension to the left carotid canal and central skull base, including sphenoid lateral wall and roof, and left orbit medial wall non-displaced fracture. Prism cover test revealed 20 prism diopters of esotropia and abduction limitation in the left eye. Hess screening test results were compatible with left abducens nerve paralysis. Symptoms suggesting complete lower motor neuron palsy of the left facial nerve, such as unilateral facial drooping, inability to raise the eyebrow and difficulty closing the eye, were present. As there was no improvement in facial paralysis, the patient received surgical intervention using a transmastoidal approach. Three months postoperatively, prism cover test showed orthotropia, however, the facial nerve palsy persisted. PMID:26178005

  17. Laryngeal Structure and Function in the Pediatric Larynx: Clinical Applications

    ERIC Educational Resources Information Center

    Sapienza, Christine M.; Ruddy, Bari Hoffman; Baker, Susan

    2004-01-01

    This article presents an overview of the normal anatomy and physiology of the pediatric larynx, followed by some examples of pediatric voice disorders that were chosen to exemplify the alterations to the laryngeal anatomy and the subsequent modifications to laryngeal function. Vocal fold nodules are primarily reviewed due to their high incidence…

  18. Phrenic-recurrent nerve anastomosis in animal models with unilateral cutting of the recurrent nerve.

    PubMed

    Engin, Omer; Ipekci, Fuat; Yildirim, Mehmet; Kulan, Ahmet; Yagci, Ayse; Dalgic, Abdullah; Calik, Bulent

    2010-10-01

    In our experimental study, the aim was to recover vocal cord physiology in cutting of recurrent laryngeal nerve, thus phrenic-recurrent nerve transposition was planned in rabbits. Experiments were performed on 10 experimental and 10 control rabbits. The right recurrent nerve was cut in the control group, while in the experiment group, the right recurrent nerve was cut. Then, a right phrenic-recurrent nerve end-to-end anastomosis was performed and the results were evaluated. After the 3rd postoperative week, videolaryngoscopy (VLS) and intramuscular electromyography (EMG) could not be evaluated in 1 rabbit from the experimental group which had died during anesthesia. In eight of the nine rabbits in the experiment which underwent VLS and EMG, activity was recorded in the right vocal cords. On light microscopic examination, atrophy was not detected in the vocal cord muscles of 9 rabbits among the 10 in the experiment group, while all rabbits in the control group and 1 rabbit in the experiment group were diagnosed with vocal cord atrophy. A success rate of approximately 90% was obtained based on the pathologic examination. We believe that the method can be used in patients without any contraindications, considering the complications of tracheostomy and the quality of life. PMID:21966133

  19. Central nervous system control of the laryngeal muscles in humans

    PubMed Central

    Ludlow, Christy L.

    2005-01-01

    Laryngeal muscle control may vary for different functions such as: voice for speech communication, emotional expression during laughter and cry, breathing, swallowing, and cough. This review discusses the control of the human laryngeal muscles for some of these different functions. Sensori-motor aspects of laryngeal control have been studied by eliciting various laryngeal reflexes. The role of audition in learning and monitoring ongoing voice production for speech is well known; while the role of somatosensory feedback is less well understood. Reflexive control systems involving central pattern generators may contribute to swallowing, breathing and cough with greater cortical control during volitional tasks such as voice production for speech. Volitional control is much less well understood for each of these functions and likely involves the integration of cortical and subcortical circuits. The new frontier is the study of the central control of the laryngeal musculature for voice, swallowing and breathing and how volitional and reflexive control systems may interact in humans. PMID:15927543

  20. Active upper airway closure during induced central apneas in lambs is complete at the laryngeal level only.

    PubMed

    Fortier, Pierre-Hugues; Reix, Philippe; Arsenault, Julie; Dorion, Dominique; Praud, Jean-Paul

    2003-07-01

    We tested the hypotheses that active upper airway closure during induced central apneas in nonsedated lambs 1). is complete and occurs at the laryngeal level and 2). is not due to stimulation of the superior laryngeal nerves (SLN). Five newborn lambs were surgically instrumented to record thyroarytenoid (TA) muscle (glottal constrictor) electromyographic (EMG) activity with supra- and subglottal pressures. Hypocapnic and nonhypocapnic central apneas were induced before and after SLN sectioning in the five lambs. A total of 174 apneas were induced, 116 before and 58 after sectioning of the internal branch of the SLN (iSLN). Continuous TA EMG activity was observed in 88% of apneas before iSLN section and in 87% of apneas after iSLN section. A transglottal pressure different from zero was observed in all apneas with TA EMG activity, with a mean subglottal pressure of 4.3 +/- 0.8 cmH2O before and 4.7 +/- 0.7 cmH2O after iSLN section. Supraglottal pressure was consistently atmospheric. Sectioning of both iSLNs had no effects on the results. We conclude that upper airway closure during induced central apneas in lambs is active, complete, and occurs at the glottal level only. Consequently, a positive subglottal pressure is maintained throughout the apnea. Finally, this complete active glottal closure is independent from laryngeal afferent innervation. PMID:12626486

  1. A Technique for Preoperative Identification of the Facial Nerve Mandibular Branch Using a Nerve Stimulator.

    PubMed

    Ijichi, Kei; Adachi, Makoto; Hamajima, Yuki; Murakami, Shingo

    2015-07-01

    We established the method of preoperative identification to facial nerve marginal mandibular branch (FNMB) identification using a nerve stimulator with bipolar probe for upper-neck surgery. The bipolar electrode is placed on the region while patients were awake; the patient should be in the same position and posture as during the surgery, with the neck skin stretched. A nerve course is confirmed by observing the movement of the lower lip. In this study, 5 upper-neck surgeries were conducted. Preoperative analysis revealed that 4 of the 5 cases had 2 branches of FNMB, and 1 with 3 branches. All FNMB immediately confirmed preoperatively were identified during surgery. We performed this method in much surgery including the surgery of the upper neck. It was easy to identify the facial nerve by this method and came to be able to do it precisely, and an operative time was shortened. We concluded that the preoperative FNMB identification using a nerve stimulator is most useful and benefit for upper-neck surgery patients and lead to avoid lower lip paralysis. PMID:26079125

  2. [Experience of professor Sun Liuhe in treating facial peripheral paralysis].

    PubMed

    Lu, Mei; Zhang, Huan-huan; Zhang, Hui-fang

    2009-06-01

    Professor Sun Liuhe is engaged in medical service for over 40 years. He is deeply involved in research on intractable and complicated diseases. Especially, in treating facial paralysis, he makes diagnosis and treatment based on overall analysis of symptoms and causes, differentiation of syndrome for etiology. Without confining himself to ancient treatment methods, by applying both acupuncture and Chinese medicine, selecting auxiliary acupoints according to differentiation of meridians related to illness, as well as considering anatomy. Professor Sun holds ancient and modern therapeutic methods, brings forth ideas of using new acupoints to prevent perversion based on pulse tracings, and uses cutting therapy for the cases suffering from facial paralysis for a long time. This method can shorten treatment courses, to a great extent, and achieve good therapeutic effects on intractable facial paralysis, which has revealed distinctness of acupuncture therapy. PMID:19563197

  3. An evaluation of the laryngeal mask airway supreme' in 100 patients.

    PubMed

    Tan, B H; Chen, E G; Liu, E H C

    2010-05-01

    The Laryngeal Mask Airway (LMA) Supreme is a new supraglottic airway incorporating features of the LMA Proseal, LMA Fastrach and LMA Unique. We evaluated the LMA Supreme in 100 patients with normal airways having elective surgery. Our success rates of insertion and ventilation were 96% at the first attempt and 100% after two attempts. The median time to successful placement was 15 seconds (interquartile range 12 to 18 seconds). Forty-five patients breathed spontaneously and 55 patients had controlled ventilation. The incidence of blood staining on removal was 7% and 7% of patients had mild sore throat one hour postoperatively. One patient who had been placed in the left lateral position during surgery had left lingual nerve palsy postoperatively, which recovered completely after one month. Our findings suggest that in patients with normal airways, the LMA Supreme is easy to insert and provides a satisfactory airway with adequate seal pressures for ventilation. PMID:20514967

  4. Expression of DNA topoisomerase II-?: Clinical significance in laryngeal carcinoma.

    PubMed

    Feng, Yan; Zhang, Haili; Gao, Wei; Wen, Shuxin; Huangfu, Hui; Sun, Ruifang; Bai, Wei; Wang, Binquan

    2014-10-01

    DNA topoisomerase II-? (Topo II-?) is essential for numerous cell processes, including DNA replication, transcription, recombination, and chromosome separation and condensation. Altered Topo II-? expression may lead to carcinogenesis and cancer progression. The aim of the present study was to investigate the association between Topo II-? expression levels and clinicopathological data from laryngeal cancer patients. Immunohistochemistry was used to analyze Topo II-? expression in laryngeal squamous cell carcinoma and distant healthy tissues obtained from 70 patients. In addition, fluorescence in situ hybridization was used to detect Topo II-? amplification and chromosome 17 ploidy using a laryngeal cancer tissue microarray. The expression of Topo II-? protein was detected in 71.43% (50/70) of laryngeal carcinoma tissues, in contrast to 9% of healthy tissues (2/22). Furthermore, the expression of Topo II-? protein was found to be associated with tumor de-differentiation and advanced tumor T stage. However, the expression of Topo II-? protein was not identified to be associated with Topo II-? amplification in laryngeal carcinoma, although was found to positively correlate with chromosome 17 aneuploidy (P<0.05). A higher aneuploidy rate contributed to increased expression levels of Topo II-? protein. Aberrant Topo II-? expression and chromosome 17 aneuploidy contributed to the development and progression of laryngeal cancer, indicating that targeting Topo II-? may provide a treatment strategy for patients with laryngeal cancer. PMID:25202370

  5. Concurrent Lpin1 and Nrcam mouse mutations result in severe peripheral neuropathy with transitory hindlimb paralysis.

    PubMed

    Douglas, Darlene S; Moran, Jennifer L; Bermingham, John R; Chen, Xiang-Jun; Brindley, David N; Soliven, Betty; Beier, David R; Popko, Brian

    2009-09-30

    Peripheral neuropathy is a broad category of disorders with a diverse etiology, grouped together by their common pathogenic effect on the peripheral nervous system (PNS). Because of the heterogeneity observed to be responsible for these disorders, a forward genetics method of gene discovery was used to identify additional affected pathways. In this report, we describe the mutant mouse line 20884, generated by N-ethyl-N-nitrosourea mutagenesis, which is characterized by adult-onset transitory hindlimb paralysis. Linkage mapping revealed that two point mutations are responsible for the phenotype: a partial loss-of-function mutation in the gene for phosphatidate phosphatase Lpin1 and a truncation mutation in the gene that encodes the neuronal cell adhesion molecule NrCAM. To investigate how the 20884 Lpin1 and Nrcam mutations interact to produce the paralysis phenotype, the double mutant and both single mutants were analyzed by quantitative behavioral, histological, and electrophysiological means. The Lpin1(20884) mutant and the double mutant are characterized by similar levels of demyelination and aberrant myelin structures. Nevertheless, the double mutant exhibits more severe electrophysiological abnormalities than the Lpin1(20884) mutant. The Nrcam(20884) mutant is characterized by normal sciatic nerve morphology and a mild electrophysiological defect. Comparison of the double mutant phenotype with the two single mutants does not point to an additive relationship between the two defects; rather, the Lpin1(20884) and Nrcam(20884) defects appear to act synergistically to produce the 20884 phenotype. It is proposed that the absence of NrCAM in a demyelinating environment has a deleterious effect, possibly by impairing the process of remyelination. PMID:19793967

  6. Combined nerve transfers for repair of the upper brachial plexus injuries through a posterior approach.

    PubMed

    Lu, Jiuzhou; Xu, Jianguang; Xu, Wendong; Xu, Lei; Fang, Yousheng; Chen, Liang; Gu, Yudong

    2012-02-01

    The upper brachial plexus injury leads to paralysis of muscles innervated by C5 and C6 nerve roots. In this report, we present our experience on the use of the combined nerve transfers for reconstruction of the upper brachial plexus injury. Nine male patients with the upper brachial plexus injury were treated with combined nerve transfers. The time interval between injury and surgery ranged from 3 to 11 months (average, 7 months). The combined nerve transfers include fascicles of the ulnar nerve and/or the median nerve transfer to the biceps and/or the brachialis motor branch, and the spinal accessory nerve (SAN) to the suprascapular nerve (SSN) and triceps branches to the axillary nerve through a posterior approach. At an average of 33 months of follow-up, all patients recovered the full range of the elbow flexion. Six out of nine patients were able to perform the normal range of shoulder abduction with the strength degraded to M3 or M4. These results showed that the technique of the combined nerve transfers, specifically the SAN to the SSN and triceps branches to the axillary nerve through a posterior approach, may be a valuable alternative in the repair of the upper brachial plexus injury. Further evaluations of this technique are necessary. PMID:22002897

  7. Risk Acceptance and Expectations of Laryngeal Allotransplantation

    PubMed Central

    Jo, Hyun Kyo; Park, Jang Wan; Hwang, Jae Ha; Lee, Sam Yong; Shin, Jun Ho

    2014-01-01

    Background Laryngeal allotransplantation (LA) is a technique involving transplantation of a deceased donor's larynx into a recipient, and it may be substituted for conventional laryngeal reconstruction. There are widely different views on LA, as the recipient is administered continuous, potentially life-threatening, immunosuppressive therapy for a functional or aesthetic result, which is not directly related to life extension. The purpose of this study was to analyze the difference in risk acceptance and expectations of LA between four population groups. Methods A survey was performed to examine patients' risk acceptance and expectations of LA. The survey included 287 subjects in total (general public, n=100; kidney transplant recipients, n=53; post-laryngectomy patients, n=34; doctors, n=100), using a Korean translated version of the louisville instrument for transplantation (LIFT) questionnaire. Results All four groups responded differently at various levels of their perception in risk acceptance and expectations. The kidney transplant recipients reported the highest risk acceptance and expectations, and the doctor group the lowest. Conclusions This study examined the disparate perception between specific population groups of the risks and benefits of using LA for the promotion of the quality of life. By addressing the information gaps about LA in the different populations that have been highlighted from this survey, we suggest that LA can become a more viable alternative to classical surgery with resultant improved quality of life for patients. PMID:25276642

  8. Diet, cigarettes and alcohol in laryngeal cancer

    SciTech Connect

    Freudenheim, J.L.; Graham, S.; Byers, T.E.; Marshall, J.R.; Haughey, B.P.; Swanson, M.K.; Wilkinson, G. (State Univ. of New York, Buffalo (United States))

    1991-03-11

    Diet and other risk factors for cancer of the larynx were examined in a case-control study among white males in Western New York, conducted in 1975-1985. Incident, pathologically-confirmed cases and age- and neighborhood-matched controls were interviewed to determine usual diet, and lifetime use of tobacco and alcohol. Because response rates were low for both cases and controls, this cannot be considered a population-based study. A strong association of risk with cigarette but not pipe and cigar smoking was found. Beer and hard liquor but not wine were associated with increased risk. After control for cigarettes, alcohol and education, the upper quartile odds ratio for fat was 2.40, while the odds ratio for high intake of carotenoids was 0.51. There was effect modification by smoking. Carotenoids were most negatively associated with risk among lighter smokers; dietary fat was most positively associated with risk among heavier smokers. Total calories, protein, and retinol were associated with increased risk; there was no relationship between laryngeal cancer and vitamins C and E or carbohydrate. This study again demonstrates the strong association between tobacco and alcohol and laryngeal cancer and also suggests that diets low in carotenoids and high fat may increase risk.

  9. Histopathological study of radionecrosis in laryngeal carcinoma

    SciTech Connect

    Keene, M.; Harwood, A.R.; Bryce, D.P.; van Nostrand, A.W.

    1982-02-01

    With modern radiotherapy techniques, clinical radionecrosis is uncommon following eradication of primary squamous cell carcinoma from the larynx. Histologic sections from 265 specimens, prepared by the technique of whole organ subserial step-sectioning were studied to determine the incidence and location of chondronecrosis and/or osteomyelitis in both irradiated and non-irradiated cases. Chondronecrosis occurred in only 1 of 41 early (pT1 - pT2) tumors but in 143 advanced tumors (pT - pT4) treated with radical radiotherapy and containing residual carcinoma, 27% had evidence of significant necrosis, compared with 24% of those not irradiated. Age, sex, tumor grade and previous laryngeal surgery did not appear to be significant factors in the development of necrosis in irradiated patients. The arytenoid cartilage was most frequently involved when chondronecrosis occurred in association with radiotherapy. Six total laryngectomy specimens (3%) were received from patients with symptoms of chondronecrosis and in whom no residual tumor was present. We conclude that although the incidence of clinical perichondritis is low, histologic chondronecrosis and/or osteomyelitis occurred in 26% of all the larynges studied. Radiotherapy appears to be a significant causative factor only in advanced supraglottic tumors.

  10. Laryngeal Chondrosarcoma as a Rare Cause of Subglottic Stenosis

    PubMed Central

    Köko?lu, Kerem; Canöz, Özlem; Do?an, Serap; Gülmez, Emrah; Yüce, ?mdat; Ça?l?, Sedat

    2014-01-01

    Laryngeal chondrosarcoma (CS) is a very rare entity. It is usually seen in 50–80-year olds. It is developed from cricoid cartilage largely. Patients have laryngeal CS complaint of respiratuvar distress, dysphonia, and dysphagia generally. A submucous mass is usually seen in physical examination with an intact mucosa. Distant metastasis is rare in CSs. Main treatment is surgical excision. An 82-year-old patient who has respiratuvar distress is presented in this paper and laryngeal CS is reviewed in the light of the literature. PMID:25197601

  11. A case of laryngeal angioleiomyoma and review of literature

    PubMed Central

    Zhao, Xue; Yu, Dan; Zhao, Yin; Liu, Yan; Qi, Xinmeng; Jin, Chunshun

    2015-01-01

    Angioleiomyoma is a rare benign vascular smooth muscle tumor that arise from the tunica media of veins and arteries. Here a case of laryngeal angioleiomyoma in a 57-year-old Chinese man is reported. The patient presented with dysphagia for one and half-month and dyspnea during the previous one week, was hospitalized for treatment with a tracheotomy and laryngofissure with the unblock mass excision. Final pathological evaluation of the neoplasm confirmed a diagnosis of laryngeal angioleiomyoma. The patient had been followed up 4 years with no recurrence of disease. This study demonstrated the clinical feature, pathology, treatment and outcome of the rare disease of laryngeal angioleiomyoma. PMID:25785153

  12. Partial airway obstruction following manufacturing defect in laryngeal mask airway (Laryngeal Mask Silken™).

    PubMed

    Jangra, Kiran; Malhotra, Surender Kumar; Saini, Vikas

    2014-10-01

    Laryngeal mask (LM) airway is commonly used for securing airway in day-care surgeries. Various problems have been described while using LM airway. Out of those, mechanical obstruction causing airway compromise is most common. Here, we describe a case report of 4-year-old child who had partial upper airway obstruction due to LM manufacturer's defect. There was a silicon band in upper one-third of shaft of LM airway. This band was made up of the same material as that of LM airway so it was not identifiable on external inspection of transparent shaft. We suggest that such as non-transparent laryngeal mask, a transparent LM airway should also be inspected looking inside the lumen with naked eyes or by using a probe to rule out any manufacturing defect before its insertion. PMID:25422617

  13. Partial airway obstruction following manufacturing defect in laryngeal mask airway (Laryngeal Mask Silken™)

    PubMed Central

    Jangra, Kiran; Malhotra, Surender Kumar; Saini, Vikas

    2014-01-01

    Laryngeal mask (LM) airway is commonly used for securing airway in day-care surgeries. Various problems have been described while using LM airway. Out of those, mechanical obstruction causing airway compromise is most common. Here, we describe a case report of 4-year-old child who had partial upper airway obstruction due to LM manufacturer's defect. There was a silicon band in upper one-third of shaft of LM airway. This band was made up of the same material as that of LM airway so it was not identifiable on external inspection of transparent shaft. We suggest that such as non-transparent laryngeal mask, a transparent LM airway should also be inspected looking inside the lumen with naked eyes or by using a probe to rule out any manufacturing defect before its insertion. PMID:25422617

  14. Secondary Sjogren's syndrome presenting with hypokalemic periodic paralysis

    PubMed Central

    Dormohammadi Toosi, Taraneh; Naderi, Neda; Movassaghi, Shafieh; Seradj, Mehran Heydari; Khalvat, Ali; Shahbazi, Fatemeh

    2014-01-01

    Renal tubular acidosis (RTA) may develop in a large population of patients with Sjogren's syndrome (SS), but most of the subjects are asymptomatic. Here, we report a patient with known rheumatoid arthritis and symptoms of xerostomia, xerophthalmia and periodic paralysis. SS should be considered as a cause of RTA. The treatment of the underlying disorder may ameliorate the symptoms. PMID:25988057

  15. Marek's disease virus induced transient paralysis--a closer look

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Marek’s Disease (MD) is a lymphoproliferative disease of domestic chickens caused by a highly cell-associated alpha herpesvirus, Marek’s disease virus (MDV). Clinical signs of MD include depression, crippling, weight loss, and transient paralysis (TP). TP is a disease of the central nervous system...

  16. Prevalence of Isolated Sleep Paralysis in Black Subjects

    PubMed Central

    Bell, Carl C.; Shakoor, Bambade; Thompson, Belinda; Dew, Donald; Hughley, Eugene; Mays, Raymond; Shorter-Gooden, Kumea

    1984-01-01

    Sleep paralysis is a state of consciousness experienced while waking from sleep or falling asleep. It is characterized by an experience of being unable to move for several seconds or minutes. This study represents the first survey to measure the incidence of this disorder in a black population of healthy subjects and psychiatric patients. PMID:6737506

  17. A rare case of paralysis in an endemic area

    PubMed Central

    Yardimci, Bulent; Kazancioglu, Rumeyza

    2015-01-01

    Thyrotoxicosis mostly presents with tachycardia, tremor, weight loss and other hypermetabolism signs. However, there are other unusual signs of thyrotoxicosis such as paralysis. This unusual clinical presentation may postpone prompt diagnosis and treatment. In this case report, we present a 27-years-old woman, who presented with quadriparesis at the emergency department.

  18. Hyperkalaemic periodic paralysis: a rare presentation of Addison's disease

    Microsoft Academic Search

    J. M. Sowden; D. Q. Borsey

    1989-01-01

    A 44 year old man with longstanding diabetes mellitus gave a 6-month history of periodic attacks of flaccid quadriplegia. Following one of these episodes he was admitted for assessment. In view of persistent hyperkalaemia, hypoadrenalism was suspected and Addison's disease was confirmed biochemically. Adrenal replacement therapy restored the potassium levels to normal and resulted in no further attacks of paralysis.

  19. Effect of complete striate muscle paralysis upon the learning process

    Microsoft Academic Search

    H. F. Harlow; R. Stagner

    1933-01-01

    Under complete skeletal muscle paralysis (obtained by the use of curare) animals failed to learn a simple adaptive reaction in thirty repetitions, although control animals learned in less than three. Experimental extinction of a previously acquired adaptive reaction was not possible under curare. However, conditioned pupillary dilatation was developed and extinguished under curare. During the condition it was impossible to

  20. Does Recurrent Isolated Sleep Paralysis Involve More Than Cognitive Neurosciences?

    Microsoft Academic Search

    JEAN-CHRISTOPHE TERRILLON; SIRLEY MARQUES-BONHAM

    Isolated sleep paralysis (ISP) is a poorly understood phenomenon that has attracted increased attention in recent years both in the medical com- munity (Dahlitz & Parkes, 1993; Hishikawa & Shimizu, 1995) and in psy- chological research (Fukuda et al., 1987, 1991; Fukuda, 1993; Takeuchi et al., 1994; Wing et al., 1994 ). Although the occurrence of ISP is relatively common,

  1. Femoral nerve dysfunction

    MedlinePLUS

    Neuropathy - femoral nerve; Femoral neuropathy ... Felice, KJ. Focal neuropathies of the femoral, obturator, lateral femoral cutaneous and other nerves of the thigh and pelvis. In: Bromberg MB, Smith ...

  2. Slide thyrocricotracheoplasty: a novel surgical technique for congenital laryngeal atresia

    Microsoft Academic Search

    Seong Min Kim; Seok Joo Han; Hong Sik Choi; Yong Taek Nam; Jung Tak Oh; Seung Hoon Choi

    2008-01-01

    The aim of this study was to introduce a new surgical technique for the correction of congenital laryngeal atresia. A female\\u000a baby had laryngeal atresia at birth and received emergency tracheostomy at another hospital. The baby visited our hospital\\u000a at 7 months of age for corrective surgery of airway obstruction. We used a new surgical technique for reconstruction of her\\u000a airway,

  3. Psychological profiles of patients with laryngeal contact granulomas

    Microsoft Academic Search

    C. Kiese-Himmel; L. Pralle; E. Kruse

    1998-01-01

    The association between laryngeal contact granuloma and demographic\\/psychological variables was examined by using a psychosomatic\\u000a approach to health research. A stepwise procedure of logistic regression analyses was utilized to get a final multivariate\\u000a model of variables associated with the clinical finding of a laryngeal contact granuloma. The subjects consisted of 47 patients\\u000a with contact granulomas and 110 patients with voice

  4. Connections between the facial, vestibular and cochlear nerve bundles within the internal auditory canal

    PubMed Central

    Özdo?mu?, Ömer; Sezen, Ozan; Kubilay, Utku; Saka, Erdinç; Duman, U?ur; ?an, Tangül; Çavdar, Safiye

    2004-01-01

    The vestibular, cochlear and facial nerves have a common course in the internal auditory canal (IAC). In this study we investigated the average number of nerve fibres, the average cross-sectional areas of the nerves and nerve fibres, and the apparent connections between the facial, cochlear and vestibular nerve bundles within the IAC, using light and scanning electron microscopy. The anatomical localization of the nerves within the IAC was not straightforward. The general course showed that the nerves rotated anticlockwise in the right ear from the inner ear end towards the brainstem end and vice versa for the left ear. The average number of fibres forming vestibular, cochlear, and facial nerves was not constant during their courses within the IAC. The superior and the inferior vestibular nerves showed an increase in the number of nerve fibres from the inner ear end towards the brainstem end of the IAC, whereas the facial and the cochlear nerves showed a reduction in the number of fibres. This suggests that some of the superior and inferior vestibular nerve bundles may receive fibres from the facial and/or cochlear nerves. Scanning electron microscopic evaluations showed superior vestibular–facial and inferior vestibular–cochlear connections within the IAC, but no facial–cochlear connections were observed. Connections between the nerves of the IAC can explain the unexpected vestibular disturbances in facial paralysis or persistence of tinnitus after cochlear neurectomy in intractable tinnitus cases. The present study offers morphometric and scanning electron microscopic data on the fibre connections of the nerves of the IAC. PMID:15255963

  5. Hyperbaric oxygen therapy for laryngeal radionecrosis

    SciTech Connect

    Ferguson, B.J.; Hudson, W.R.; Farmer, J.C. Jr.

    1987-01-01

    Radionecrosis of the larynx is a debilitating disease associated with pain, dysphagia, respiratory obstruction, and, in some cases, the need for laryngectomy. Persistent poor wound healing can lead to death. A series of eight patients with advanced (grades III and IV, Chandler classification) radionecrosis of the larynx treated with adjunctive hyperbaric oxygen therapy is presented. Signs and symptoms of radionecrosis were dramatically ameliorated in seven of eight patients, while one patient, despite subjective improvement, eventually required laryngectomy. There were no deaths. These results are compared to previous series on radionecrosis of the larynx in which hyperbaric oxygen was not used. This series indicates that hyperbaric oxygen therapy is a useful and effective adjunctive treatment modality in the management of laryngeal radionecrosis.

  6. [Laryngeal ultrasound studies: potential, prospects, limitations].

    PubMed

    Ol'khova, E B; Soldatski?, Iu L; Onufrieva, E K; Shchepin, N V

    2009-01-01

    In the last years, laryngeal ultrasound has been finding increasingly wide application due to the growing availability of relevant up-to-date equipment, apparent technical simplicity and non-invasive character of the study. However, poor knowledge of the physical basis of this method coupled to ungrounded self-confidence of the operators and uncritical treatment of the obtained findings may lead to the overestimation of the diagnostic potential of this sonographic technique. This paper is focused on disadvantages of ultrasound examination of the larynx and associated acoustic artefacts that can be taken for true abnormal structures. Attempts at qualitative and quantitative interpretation of such images are fraught with wrong conclusions. PMID:20037547

  7. Quantitative analysis of laryngeal mechanosensitivity in the cat and rabbit.

    PubMed Central

    Davis, P J; Nail, B S

    1987-01-01

    1. Single afferent fibres in the internal branch of the superior laryngeal nerve which responded to light touch or gentle probing of discrete areas of the exposed epithelium of the opened larynx were identified in anaesthetized, paralysed cats (148 fibres) and rabbits (58 fibres). 2. A quantitative examination of the sensitivity of these laryngeal mechanoreceptors to both static (step indentations) and dynamic (vibratory) forms of mechanical stimulation was undertaken using a servo-controlled mechanical stimulator. 3. In both species two predominant classes of mechanoreceptors were observed (Boushey, Richardson, Widdicombe & Wise, 1974). One class was distinguished by a regular and continuous pattern of activity at a frequency of 10-70 Hz (tonic fibres, sixty-six in cat, thirty-five in rabbit). The other class was silent or (more rarely) irregularly active at a very low frequency (silent fibres, eighty-two in cat, twenty-three in rabbit). 4. The location of the receptive fields was determined by manual probing. Inter-species and regional variations in receptive field location were observed for the two fibre groups. 5. Conduction velocity was measured for twenty-one tonic and seven silent fibres in the rabbit by a pre-triggered averaging technique. The results obtained (tonic: range 10.8-30.0, mean +/- S.E. of mean 21.4 +/- 1.2 m/s; silent: 14.8-28.6, 20.4 +/- 1.8 m/s) were characteristic of group III afferent fibres but were not significantly different for the two classes. 6. Both classes of receptor showed a response at the onset of a step indentation of the region of the mucosa that corresponded to their receptive field. Subsequent to this brief initial response the behaviour of the two classes diverged markedly. Tonic fibres were invariably slowly adapting whereas most (forty-four out of fifty-five in cat; twenty-two out of twenty-three in rabbit) silent fibres were rapidly adapting, at least for smaller indentation amplitudes. 7. Receptors of both classes were readily entrained to discharge at the same frequency as the probe stimulator (1:1 entrainment) when this was made to vibrate upon the receptive area for test periods of 0.5 or 1.0 s. Tuning curves were constructed of the minimum amplitudes required to elicit 1:1 entrainment throughout an entire test period at various frequencies. 8. Individual fibres in the two classes could be entrained at frequencies up to 400 Hz or more at sensitive (e.g. less than 100 microns) vibratory amplitudes. However, all fibres were less sensitive at these higher frequencies than at some lower point on the frequency scale.(ABSTRACT TRUNCATED AT 400 WORDS) PMID:3656197

  8. Thioredoxin and its reductase are present on synaptic vesicles, and their inhibition prevents the paralysis induced by botulinum neurotoxins.

    PubMed

    Pirazzini, Marco; Azarnia Tehran, Domenico; Zanetti, Giulia; Megighian, Aram; Scorzeto, Michele; Fillo, Silvia; Shone, Clifford C; Binz, Thomas; Rossetto, Ornella; Lista, Florigio; Montecucco, Cesare

    2014-09-25

    Botulinum neurotoxins consist of a metalloprotease linked via a conserved interchain disulfide bond to a heavy chain responsible for neurospecific binding and translocation of the enzymatic domain in the nerve terminal cytosol. The metalloprotease activity is enabled upon disulfide reduction and causes neuroparalysis by cleaving the SNARE proteins. Here, we show that the thioredoxin reductase-thioredoxin protein disulfide-reducing system is present on synaptic vesicles and that it is functional and responsible for the reduction of the interchain disulfide of botulinum neurotoxin serotypes A, C, and E. Specific inhibitors of thioredoxin reductase or thioredoxin prevent intoxication of cultured neurons in a dose-dependent manner and are also very effective inhibitors of the paralysis of the neuromuscular junction. We found that this group of inhibitors of botulinum neurotoxins is very effective in vivo. Most of them are nontoxic and are good candidates as preventive and therapeutic drugs for human botulism. PMID:25220457

  9. Guillain-Barré syndrome as a prominent cause of childhood acute flaccid paralysis in post polio eradication era in Egypt.

    PubMed

    Halawa, Eman F; Ahmed, Dalia; Nada, Mona A F

    2011-05-01

    Guillain-Barré syndrome often follows an antecedent gastrointestinal or respiratory illness but, in rare cases, follows vaccination. This study was conducted to identify preceding events, demographic, clinical characteristics and prognostic factors of childhood Guillain-Barré syndrome after post-poliomyelitis eradication era in Egypt. This is a prospective study of all children with GBS (no = 50) admitted to pediatric Cairo University Hospital between January 2006 and June 2007 (70.42% of all acute flaccid paralysis patients during this period). Upper respiratory infection was the most common preceding event (24%) while only 4 patients (8%) reported antecedent oral polio vaccine. Motor deficit was frequent and severe (quadriparesis in 92% and paraparesis in 8%). Autonomic dysfunction was recorded in 32% of patients. Forty two percent of patients had poor outcome with 16% deaths. Presence of severe disability on admission and on nadir, cranial nerve affection or the need for mechanical ventilator were found to be significant predictors for poor outcome. PMID:21169042

  10. Laser arytenoidectomy in the treatment of bilateral vocal cord paralysis

    Microsoft Academic Search

    Z. Szmeja; J. G. Wójtowicz

    1999-01-01

    The introduction of the CO2 surgical laser into laryngeal microsurgery has made resection of the posterior vocal cord together\\u000a with the arytenoid cartilage possible. Since November 1990, 30 arytenoidectomies, 17 partial cordectomies and 18 bilateral\\u000a cordectomies as described by Kashima were performed by means of a CO2 laser in patients with bilateral paralyses of the vocal cords. In this group

  11. Incidence and mortality of laryngeal cancer in China, 2011

    PubMed Central

    Du, Lingbin; Li, Huizhang; Zhu, Chen; Zheng, Rongshou; Zhang, Siwei

    2015-01-01

    Objective Laryngeal cancer is the common cancer of the upper aerodigestive tract. We aimed to use the national cancer registration data in 2011 to estimate the incidence and mortality of laryngeal cancer within China. Methods Comparable, high-quality data from 177 population-based cancer registries were qualified for analysis. The pooled data were stratified by area, sex and age group. National new cases and deaths of laryngeal cancer were estimated using age-specific rates and national population in 2010. All incidence and death rates were age-standardized to the 2000 Chinese standard population and Segi’s population, which were expressed per 100,000 populations. Results All 177 cancer registries covered a total of 175,310,169 population (98,341,507 in urban and 76,968,662 in rural areas), accounting for 13.01% of the national population. The data quality indicators of proportion of morphological verification (MV%), percentage of cancer cases identified with death certification only (DCO%) and mortality to incidence ratio (M/I) were 77.98%, 2.62% and 0.55, respectively. Estimated 20,875 new cases of laryngeal cancer were diagnosed and 11,488 deaths from laryngeal cancer occurred in China in 2011. The crude incidence rate of laryngeal cancer was 1.55/100,000 (2.69/100,000 in males and 0.35/100,000 in females). Age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 1.13/100,000 and 1.14/100,000, respectively. Laryngeal cancer is much rarer in females than in males. The incidence rate was higher in urban areas than that in rural areas. The crude mortality rate of laryngeal cancer was 0.85/100,000 (1.42/100,000 in males and 0.25/100,000 in females). Age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were both 0.61/100,000. The mortality rate in males was much higher than that in females. There was no definite difference in mortality rates of laryngeal cancer between urban and rural areas. Conclusions Larynx is a specialized area and cancer of larynx significantly affects the quality of life for the patients. Comprehensive measures should be carried out to prevent the ascent of laryngeal cancer. PMID:25717226

  12. Mounier-Kuhn syndrome and bilateral vocal cord paralysis.

    PubMed

    Dincer, H Erhan; Holweger, Joshua D

    2012-07-01

    Mounier-Kuhn syndrome is a rare disorder of unknown cause that is characterized by atrophy of the elastic and smooth muscle of the tracheobronchial tree leading to tracheobronchomegaly and bronchiectasis. The syndrome is likely underdiagnosed, because the patients usually present with common respiratory symptoms such as productive cough and usually labeled as chronic obstructive pulmonary disease. Diagnosis is established on the basis of radiologic findings. Association with bilateral vocal cord paralysis has not been described. Treatment is mainly supportive. Symptomatic patients may require endobronchial stenting if airway collapse is encountered. Here, we described a patient who presented with hoarseness and pneumonia. Further studies confirmed the diagnosis of Mounier-Kuhn syndrome with bilateral vocal cord paralysis. PMID:23207474

  13. Isolated sleep paralysis, vivid dreams and geomagnetic influences: II.

    PubMed

    Conesa, J

    1997-10-01

    This report describes a test of the hypothesis that significant changes in the ambient geomagnetic field are associated with altered normal nighttime dream patterns. Specifically, it was predicted that there would be a greater incidence of isolated sleep, paralysis or vivid dreams with abrupt rises and falls of geomagnetic activity. The author's (JC) and a second subject's (KC) daily reports of dream-recall were analyzed in the context of daily fluctuations of geomagnetic activity (K indices). Two analyses of variance indicated (i) significantly higher geomagnetic activity three days before a recorded isolated sleep paralysis event and (ii) significantly lower geomagnetic activity three days before an unusually vivid dream took place. Conversely, geomagnetic activity did not fluctuate significantly for randomly selected days. Testing a large sample over time is required for confirmation and extension of this work. PMID:9347546

  14. Layer 5 Pyramidal Neurons' Dendritic Remodeling and Increased Microglial Density in Primary Motor Cortex in a Murine Model of Facial Paralysis

    PubMed Central

    Urrego, Diana; Troncoso, Julieta; Múnera, Alejandro

    2015-01-01

    This work was aimed at characterizing structural changes in primary motor cortex layer 5 pyramidal neurons and their relationship with microglial density induced by facial nerve lesion using a murine facial paralysis model. Adult transgenic mice, expressing green fluorescent protein in microglia and yellow fluorescent protein in projecting neurons, were submitted to either unilateral section of the facial nerve or sham surgery. Injured animals were sacrificed either 1 or 3weeks after surgery. Two-photon excitation microscopy was then used for evaluating both layer 5 pyramidal neurons and microglia in vibrissal primary motor cortex (vM1). It was found that facial nerve lesion induced long-lasting changes in the dendritic morphology of vM1 layer 5 pyramidal neurons and in their surrounding microglia. Dendritic arborization of the pyramidal cells underwent overall shrinkage. Apical dendrites suffered transient shortening while basal dendrites displayed sustained shortening. Moreover, dendrites suffered transient spine pruning. Significantly higher microglial cell density was found surrounding vM1 layer 5 pyramidal neurons after facial nerve lesion with morphological bias towards the activated phenotype. These results suggest that facial nerve lesions elicit active dendrite remodeling due to pyramidal neuron and microglia interaction, which could be the pathophysiological underpinning of some neuropathic motor sequelae in humans.

  15. Neural repair in facial paralysis: clinical and experimental studies.

    PubMed

    Spector, J G

    1997-01-01

    Acute facial nerve injuries involving the total facial nerve (n = 202) and its segmental branches (n = 63) were repaired with a variety of neural (n = 225) and myofascial transfer (n = 40). A system for evaluating results based on facial symmetry and tone at rest, recovery of voluntary mimetic activity, synkinesis, and recovery of selective function in discrete facial nerve divisions is presented. The best results were achieved with immediate direct end-to-end neural-epineural anastomotic repairs. The least favorable results were seen with myofascial transpositions and long extratemporal rerouted autologous nerve grafts. A series of tissue culture and animal experiments were used to examine structural changes in neural repair. The requirements for successful motoneuron regeneration, causes of synkinesis and methods for nerve stump coaptation are elucidated. Tubulation experiments demonstrated the need for neurotrophic and neuropromotive factors. Problems associated with the use of autologous nerve grafts are discussed. PMID:9065632

  16. Laryngeal Lymphoma: The High and Low Grades of Rare Lymphoma Involvement Sites

    PubMed Central

    Degaetano, James; Farrugia, Eric; Magri, Claude; Refalo, Nicholas; Camilleri, David J.

    2014-01-01

    The larynx is an extremely rare site of involvement by lymphomatous disease. We present two cases of isolated laryngeal high-grade and another low-grade lymphoma, together with a literature review of laryngeal lymphoma management. PMID:25140179

  17. A rare case of thyrotoxic periodic paralysis precipitated by hydrocortisone

    PubMed Central

    Chakrabarti, Subrata

    2015-01-01

    Thyrotoxic periodic paralysis (TPP) is a rare, but serious condition characterized by acute paralytic attacks and hypokalemia in association with thyrotoxicosis. Although carbohydrate rich meals, strenuous exercise, alcohol, emotional stress are known precipitants of TPP, steroid treatment has rarely been reported to induce TPP. We report a case in which a patient with previously untreated Grave's disease developed TPP following administration of Intravenous hydrocortisone for control of severe anaphylaxis, which to best of our knowledge is very rare. PMID:25810683

  18. Periodic paralysis: An unusual presentation of drug-induced hyperkalemia

    PubMed Central

    Agrawal, Poonam; Chopra, Deepti; Patra, Surajeet K.; Madaan, Himanshu

    2014-01-01

    Hyperkalemia is a life-threatening electrolyte abnormality. The most common cause of hyperkalemia includes renal disease and ingestion of medications. Drug-induced hyperkalemia may develop in patients with underlying renal impairment, disturbed cellular uptake of potassium load, excessive ingestion or infusion of potassium-containing substances. We report a case of “drug-induced severe hyperkalemia” presenting as periodic paralysis. A 67-year-old diabetic and hypertensive woman presented to emergency department with the complaint of intermittent episode of inability to walk for the past 5 days. Each episode lasted for 15-20 minutes and was associated with breathlessness and restlessness. There was no family history of periodic paralysis and drug history revealed that the patient was onolmesartan 20 mg per day (for past 2 years), perindopril 4 mg per day (for past 16 months), and torsemide 10 mg/day. On examination patient was found to be conscious, alert, and afebrile. Vitals were normal. Examination of cardiovascular and respiratory system did not reveal any significant finding. Blood report of the patient showed serum K+ level 8.6 mmol/l. All other investigations were within normal limits. A diagnosis of drug-induced hyperkalemia was made. Patient responded well to the symptomatic treatment. To the best of the author's knowledge, this is the first case report of drug-induced hyperkalemia presenting as periodic paralysis. PMID:24554915

  19. Predictors of Outcome in an Open Label, Therapeutic Trial of High-Dose Omeprazole in Laryngitis

    Microsoft Academic Search

    R. B. H. Williams; M. M. Szczesniak; J. C. Maclean; H. M. Brake; I. E. Cole; I. J. Cook

    2004-01-01

    BACKGROUND:Gastroesophageal reflux is implicated in some cases of laryngitis. There are no established predictors of response to acid suppression therapy in suspected reflux laryngitis.AIM:In a population with laryngitis, the aim is to determine whether (a) omeprazole 20 mg tds (3 months) improves symptoms and laryngitis, and (b) the outcome in response to potent acid suppression can be predicted by esophageal

  20. A decade of laryngeal dysplasia in Paisley, Scotland.

    PubMed

    Montgomery, Jenny; White, Aileen

    2012-03-01

    Laryngeal dysplasia is a known premalignant condition. A recent consensus statement by otorhinolaryngologists and pathologists on the diagnosis and management of laryngeal dysplasia Mehanna et al. (Clin Otol 35:170-176, 2010) identified a need for retrospective data on epidemiological aspects of laryngeal dysplasia as well as responses to treatment. A retrospective search was made on the hospital pathology database for cases of laryngeal dysplasia. Searches were made under "Larynx", "Dysplasia", "Carcinoma in situ" and "Vocal Cord". The search dates were between 1998 to the present day. The returned records were checked with the pathology reports and the case notes of these patients requested for analysis. A proforma was completed for each patient with laryngeal dysplasia. These patients were then anonymised, entered into a spreadsheet and analysed. The initial search returned 937 patients. Of these patients, 505 (54%) had benign laryngeal pathology, 131 (14%) had laryngeal dysplasia and 301 (32%) had invasive cancer on biopsy. Patients who developed malignancy within 3 months of being diagnosed with laryngeal dysplasia were excluded. This left 110 patients for analysis. Of the dysplastic patients, 40 (36%) had mild dysplasia, 31 (28%) had moderate dysplasia and 39 (35%) had severe dysplasia/carcinoma in situ; 70% were male. The median age was 63 (min 21, max 90, ave 62.5); 74 (67%) were smokers or ex-smokers. Progression of dysplasia was seen in 7 (6%) patients. Malignant transformation was seen in 18 (16%) patients. The average time for malignant change was 43 months (min 4 months, max 192 months and median 15.5 months; 73 (66%) patients were treated by microlaryngeal resection, 2 (2%) were treated by vocal cord stripping, 28 (25%) were treated by endolaser therapy, and 1 (1%) patient was treated by using the microdebrider skimming blade and 6 (5%) were treated by radiotherapy. Cure of dysplasia or downgrading of severity in these treatment subgroups was 62 (85%), 2 (100%), 24 (86%), 1 (100%) and 4 (66%), respectively. Our study reiterates that laryngeal dysplasia carries a significant risk of developing malignancy. Management of this condition varies widely. Endolaser resection is becoming more frequently employed in the UK. Our study is biased heavily towards cold steel dissection. Although there is increasing practice in the UK to promote early discharge, we feel it may be safer to keep patients under surveillance for longer periods. Despite this, all patients who returned after discharge or failing to attend with invasive cancer did so with new symptoms. PMID:21739097

  1. Effects of Odontobuthus Doriae Scorpion Venom on Mouse Sciatic Nerve

    PubMed Central

    Vatanpour, Hossein; Jalali, Amir; G. Rowan, Edward; Rahim, Fakher

    2013-01-01

    Temporary paralysis is a rare manifestation of envenoming following the yellow Iranian scorpion, Odontobuthus doriae (O. doriae). Thus, to elucidate the underlying mechanism, we investigated the neurotoxic effect of venom in the sciatic nerve, the possible mechanism in a mice model. The neurotoxicity and temperature effects in the venom-induced neurotoxicity were examined using the mouse sciatic nerve and mouse phrenic nerve-hemidiaphragm (MHD) preparations. O .doriae venom (1 ?g/mL) caused changes in the perineural waveform associated with nerve terminal action potentials. Venom affected on both negative and positive components of the waveform which is known as a compound action potential. The timeresponse relationship of venom-induced depression of resting membrane potential (RMP) was significant (p < 0.05). No significant difference in augmentation was seen in room temperature in comparison with 37°C. In conclusion, although there was no evidence that the venom had any specific curarizing action at the neuromuscular junction, the results suggest that the venom exerts its neuromuscular transmission on the sciatic nerve through potassium and sodium ionic-currents. Furthermore, the influence of temperature on neurotoxicity was ineffective on blockade of the neuromuscular transmission in-vitro. PMID:24250682

  2. The vestibulocochlear nerve (VIII).

    PubMed

    Benoudiba, F; Toulgoat, F; Sarrazin, J-L

    2013-10-01

    The vestibulocochlear nerve (8th cranial nerve) is a sensory nerve. It is made up of two nerves, the cochlear, which transmits sound and the vestibular which controls balance. It is an intracranial nerve which runs from the sensory receptors in the internal ear to the brain stem nuclei and finally to the auditory areas: the post-central gyrus and superior temporal auditory cortex. The most common lesions responsible for damage to VIII are vestibular Schwannomas. This report reviews the anatomy and various investigations of the nerve. PMID:24095603

  3. Iatrogenic nerve injuries.

    PubMed

    Kretschmer, Thomas; Heinen, Christian W; Antoniadis, Gregor; Richter, Hans-Peter; König, Ralph W

    2009-01-01

    As long as humans have been medically treated, unfortunate cases of inadvertent injury to nerves afflicted by the therapist have occurred. Most microsurgically treated iatrogenic nerve injuries occur directly during an operation. Certain nerves are at a higher risk than others, and certain procedures and regions of the body are more prone to sustaining nerve injury. A high degree of insecurity regarding the proper measures to take can be observed among medical practitioners. A major limiting factor in successful treatment is delayed referral for evaluation and reconstructive surgery. This article on iatrogenic nerve injuries intends to focus on relevant aspects of management from a nerve surgeon's perspective. PMID:19064181

  4. Curative radiotherapy for anterior commissure laryngeal carcinoma.

    PubMed

    Persky, M S; Lagmay, V M; Cooper, J; Constantinides, M; O'Leary, R

    2000-02-01

    There is continuing controversy surrounding the most effective treatment of glottic carcinoma involving the anterior commissure (AC). Surgery has been the preferred method of treatment, since studies previously indicated early tumor invasion of the thyroid cartilage at the AC, thereby assuming less curability by radiotherapy (RT). Subsequent laryngeal anatomic studies and refinement of RT techniques have brought into question the ineffectiveness of curative irradiation. A retrospective review of 174 patients with early-stage glottic carcinoma treated with standard fractionation curative RT revealed 34 patients with T1 and T2 lesions involving the AC. Allowing for a follow-up of at least 3 years, we observed only a 12% (4 of 34 patients) local recurrence rate after RT alone, with excellent voice quality and no major complications related to the irradiation. The 4 local recurrences were controlled by total laryngectomy, although 2 patients developed distant metastatic disease. Radiotherapy represents an effective method of treating T1 squamous cell carcinoma of the glottis with AC involvement. The small number of T2 glottic carcinomas in this study prevents a meaningful conclusion concerning treatment of these lesions. PMID:10685566

  5. Immunohistochemical analysis of laryngeal muscles in normal horses and horses with subclinical recurrent laryngeal neuropathy.

    PubMed

    Rhee, Hannah S; Steel, Catherine M; Derksen, Frederik J; Robinson, N Edward; Hoh, Joseph F Y

    2009-08-01

    We used immunohistochemistry to examine myosin heavy-chain (MyHC)-based fiber-type profiles of the right and left cricoarytenoideus dorsalis (CAD) and arytenoideus transversus (TrA) muscles of six horses without laryngoscopic evidence of recurrent laryngeal neuropathy (RLN). Results showed that CAD and TrA muscles have the same slow, 2a, and 2x fibers as equine limb muscles, but not the faster contracting fibers expressing extraocular and 2B MyHCs found in laryngeal muscles of small mammals. Muscles from three horses showed fiber-type grouping bilaterally in the TrA muscles, but only in the left CAD. Fiber-type grouping suggests that denervation and reinnervation of fibers had occurred, and that these horses had subclinical RLN. There was a virtual elimination of 2x fibers in these muscles, accompanied by a significant increase in the percentage of 2a and slow fibers, and hypertrophy of these fiber types. The results suggest that multiple pathophysiological mechanisms are at work in early RLN, including selective denervation and reinnervation of 2x muscle fibers, corruption of neural impulse traffic that regulates 2x and slow muscle fiber types, and compensatory hypertrophy of remaining fibers. We conclude that horses afflicted with mild RLN are able to remain subclinical by compensatory hypertrophy of surviving muscle fibers. PMID:19398607

  6. Common peroneal nerve palsy: a clinical and electrophysiological review.

    PubMed Central

    Berry, H; Richardson, P M

    1976-01-01

    In a series of 70 patients (75 cases of common peroneal nerve palsy) the common causes were trauma about the knee or about the hip, compression, and underlying neuropathy. A few palsies occurred spontaneously for no apparent reason. The prognosis was uniformly good in the compression group; recovery was delayed but usually satisfactory in patients who had suffered stretch injuries. In the acute stage, when clinical paralysis appears to be complete, electrophysiological studies are a useful guide to prognosis. They may also indicate an underlying neuropathy and they detect early evidence of recovery. The anatomical peculiarities of the common peroneal nerve are noted and aspects of the clinical picture, management, and prognosis of palsy are discussed. PMID:1011026

  7. Chemotherapy alone for organ preservation in advanced laryngeal cancer

    PubMed Central

    Divi, Vasu; Worden, Francis P.; Prince, Mark E.; Eisbruch, Avraham; Lee, Julia S.; Bradford, Carol R.; Chepeha, Douglas B.; Teknos, Theodoros N.; Hogikyan, Norman D.; Moyer, Jeffrey S.; Tsien, Christina I.; Urba, Susan G.; Wolf, Gregory T.

    2009-01-01

    Background: For patients with advanced laryngeal cancer, a trial was designed to determine if chemotherapy alone, in patients achieving a complete histologic tumor response (HCR) after a single neoadjuvant cycle, was an effective treatment with less morbidity than concurrent chemoradiation (CRT). Methods: Thirty-two patients with advanced laryngeal or hypopharyngeal cancer received 1 cycle of induction chemotherapy and subsequent treatment was decided based on response. Results: A HCR was achieved in 4 patients and were treated with chemotherapy alone. All four patients relapsed in the neck and required surgery and postoperative RT. Twenty-five patients were treated with concomitant chemoradiation. Three patients were treated with surgery. Overall survival and disease specific survival at 3 years were 68% and 78%, respectively. Conclusions: Chemotherapy alone is not feasible for long term control of regional disease in patients with advanced laryngeal cancer even when they achieve a histologic complete response at the primary site. PMID:19953609

  8. Chondronecrosis of the larynx following use of the laryngeal mask airway.

    PubMed

    Beswick, Daniel M; Collins, Jeremy; Nekhendzy, Vladimir; Damrose, Edward J

    2015-04-01

    This case describes the development of laryngeal chondronecrosis after use of the laryngeal mask airway (LMA). A 69-year-old male with prior laryngeal irradiation underwent total knee replacement with general anesthesia via LMA. Postoperatively, he developed laryngeal chondronecrosis, bilateral vocal fold immobility, and aspiration, necessitating tracheostomy and gastrostomy placement. He improved with hyperbaric oxygen therapy, intravenous antibiotics, and endoscopic repair of a residual fistula. Vocal fold motion returned and he was decannulated. Chondronecrosis of the larynx may occur with the use of the LMA, and caution should be used in patients with a history of prior laryngeal irradiation. PMID:25345975

  9. The relationship between the Southern Oscillation Index, rainfall and the occurrence of canine tick paralysis, feline tick paralysis and canine parvovirus in Australia.

    PubMed

    Rika-Heke, Tamara; Kelman, Mark; Ward, Michael P

    2015-07-01

    The aim of this study was to describe the association between climate, weather and the occurrence of canine tick paralysis, feline tick paralysis and canine parvovirus in Australia. The Southern Oscillation Index (SOI) and monthly average rainfall (mm) data were used as indices for climate and weather, respectively. Case data were extracted from a voluntary national companion animal disease surveillance resource. Climate and weather data were obtained from the Australian Government Bureau of Meteorology. During the 4-year study period (January 2010-December 2013), a total of 4742 canine parvovirus cases and 8417 tick paralysis cases were reported. No significant (P???0.05) correlations were found between the SOI and parvovirus, canine tick paralysis or feline tick paralysis. A significant (P?paralysis occurrence and rainfall 1-3 months previously, and significant positive cross-correlations (0.29-0.47) between canine tick paralysis occurrence and rainfall 7-10 months previously. Significant positive cross-correlations (0.37-0.68) were found between cases of feline tick paralysis and rainfall 6-10 months previously. These findings may offer a useful tool for the management and prevention of tick paralysis and canine parvovirus, by providing an evidence base supporting the recommendations of veterinarians to clients thus reducing the impact of these diseases. PMID:25841899

  10. Electromechanical Nerve Stimulator

    NASA Technical Reports Server (NTRS)

    Tcheng, Ping; Supplee, Frank H., Jr.; Prass, Richard L.

    1993-01-01

    Nerve stimulator applies and/or measures precisely controlled force and/or displacement to nerve so response of nerve measured. Consists of three major components connected in tandem: miniature probe with spherical tip; transducer; and actuator. Probe applies force to nerve, transducer measures force and sends feedback signal to control circuitry, and actuator positions force transducer and probe. Separate box houses control circuits and panel. Operator uses panel to select operating mode and parameters. Stimulator used in research to characterize behavior of nerve under various conditions of temperature, anesthesia, ventilation, and prior damage to nerve. Also used clinically to assess damage to nerve from disease or accident and to monitor response of nerve during surgery.

  11. Ulnar nerve damage (image)

    MedlinePLUS

    ... arm. The nerve is commonly injured at the elbow because of elbow fracture or dislocation. The ulnar nerve is near ... surface of the body where it crosses the elbow, so prolonged pressure on the elbow or entrapment ...

  12. Reflux Laryngitis: Correlation between the Symptoms Findings and Indirect Laryngoscopy

    PubMed Central

    Silva, Carlos Eduardo Dilen da; Niedermeier, Bruno Taccola; Portinho, Fernando

    2015-01-01

    Introduction?The indirect laryngoscopy has an important role in the characterization of reflux laryngitis. Although many findings are nonspecific, some strongly suggest that the inflammation is the cause of reflux. Objective?The aim of this study was to evaluate the correlation between reflux symptoms and the findings of indirect laryngoscopy. Methods?We evaluated 27 patients with symptoms of pharyngolaryngeal reflux disease. Results?Laryngoscopy demonstrated in all patients the presence of hypertrophy of the posterior commissure and laryngeal edema. The most frequent symptoms were the presence of dry cough and foreign body sensation. Conclusion?There was a correlation between the findings at laryngoscopy and symptoms of reflux.

  13. Engineering Peripheral Nerve Repair

    PubMed Central

    Marquardt, Laura; Sakiyama-Elbert, Shelly E.

    2013-01-01

    Current approaches for treating peripheral nerve injury have resulted in promising, yet insufficient functional recovery compared to the clinical standard of care, autologous nerve grafts. In order to design a construct that can match the regenerative potential of the autograft, all facets of nerve tissue must be incorporated in a combinatorial therapy. Engineered biomaterial scaffolds in the future will have to promote enhanced regeneration and appropriate reinnervation by targeting the highly sensitive response of regenerating nerves to their surrounding microenvironment. PMID:23790730

  14. Cranial Nerves Model

    NSDL National Science Digital Library

    Juliann Garza (University of Texas-Pan American Physician Assistant Studies)

    2010-08-16

    Lesson is designed to introduce students to cranial nerves through the use of an introductory lecture. Students will then create a three-dimensional model of the cranial nerves. An information sheet will accompany the model in order to help students learn crucial aspects of the cranial nerves.

  15. Optic Nerve Imaging

    MedlinePLUS

    ... machines can help monitor and detect loss of optic nerve fibers. The Heidelberg Retina Tomograph (HRT) is a special ... can directly measure the thickness of the nerve fiber layer and create a three dimensional representation of the optic nerve. Last reviewed on May 02, 2012 Was ...

  16. [Progressive bulbar paralysis in childhood with pyramidal signs (author's transl)].

    PubMed

    Boel, M; de Cock, P; Casteels-Van Daele, M; Casaer, P

    1981-12-01

    We report on a 8 year-old boy who presented with progressive bulbar paralysis. Remarkable were the presence of pyramidal signs, the visual disturbances, the peculiar gait and the intermittent progression of the disease. Our case supports the idea that spinal muscular atrophies form a group of diseases with variable expression. We can classify our patient between the juvenile form and the adult form of spinal muscular atrophy with progressive bulbar palsy. We could follow this boy for almost 4 years. He died at the age of twelve years. Post mortem examination was not permitted. PMID:7332421

  17. [A bilateral diaphragmatic paralysis due to Parsonage and Turner syndrome--its evolution over eight years].

    PubMed

    Guinard, S; Huchot, E; Couturaud, F; Quiot, J-J; L'hévéder, G; Mialon, P; de Saint Martin, L; Le Gal, G; Leroyer, C

    2008-06-01

    The diaphragmatic paralysis is a rare disease whose causes and evolving forms are numerous. We report the development to eight years of paralysis diaphragmatic bilateral attributed to a Parsonage-Turner syndrome: the lack of recovery is proved by respiratory functional follow-up. The therapeutic possibilities, limited, are discussed. PMID:18656787

  18. Pseudo-paralysie du biceps brachial dans les paralysies obstétricales du plexus brachial (POPB) – À propos de l'« optimisme » de l'EMG

    Microsoft Academic Search

    J. L Benaim; J. L Jouve; J Bardot; D Casanova; G Magalon; G Bollini

    1999-01-01

    Pseudo-paralysis of the brachial biceps in obstetrical brachial plexus lesions (OBPL): concerning the `overly optimistic' EMG in OBPL.In birth palsy of the brachial plexus, the mixed interference pattern recorded for the brachial biceps on the electromyogram often conflicts with the muscle's inability to flex the elbow. We report our observations of a six-month-old infant who presented paralysis of the upper

  19. Practical aspects in the management of hypokalemic periodic paralysis

    PubMed Central

    Levitt, Jacob O

    2008-01-01

    Management considerations in hypokalemic periodic paralysis include accurate diagnosis, potassium dosage for acute attacks, choice of diuretic for prophylaxis, identification of triggers, creating a safe physical environment, peri-operative measures, and issues in pregnancy. A positive genetic test in the context of symptoms is the gold standard for diagnosis. Potassium chloride is the favored potassium salt given at 0.5–1.0 mEq/kg for acute attacks. The oral route is favored, but if necessary, a mannitol solvent can be used for intravenous administration. Avoidance of or potassium prophylaxis for common triggers, such as rest after exercise, high carbohydrate meals, and sodium, can prevent attacks. Chronically, acetazolamide, dichlorphenamide, or potassium-sparing diuretics decrease attack frequency and severity but are of little value acutely. Potassium, water, and a telephone should always be at a patient's bedside, regardless of the presence of weakness. Perioperatively, the patient's clinical status should be checked frequently. Firm data on the management of periodic paralysis during pregnancy is lacking. Patient support can be found at . PMID:18426576

  20. Bone blood flow after spinal paralysis in the rat

    SciTech Connect

    Takahashi, H.; Yamamuro, T.; Okumura, H.; Kasai, R.; Tada, K. (Kyoto Univ. (Japan))

    1990-05-01

    The goal of this study was to investigate the acute and chronic effects of paralysis induced by spinal cord section or sciatic neurotomy on bone blood flow in the rat. Regional bone blood flow was measured in the early stage with the hydrogen washout technique and the change of whole bone blood flow was measured in the early and the late stages with the radioactive microsphere technique. Four to 6 h after cordotomy at the level of the 13th thoracic vertebra, the regional bone blood flow in the denervated tibia increased significantly (p less than 0.01). After hemicordotomy with rhizotomy at the same level, the regional bone blood flow in the denervated tibia increased significantly (p less than 0.05) 6 h postoperatively. The whole bone blood flow in the denervated tibia had also increased significantly (p less than 0.05) at 6 h and at 4 and 12 weeks postoperatively. After sciatic neurotomy, the regional and the whole bone blood flow in the paralytic tibia did not change significantly. The present study demonstrated that monoplegic paralysis caused an increase in bone blood flow in the denervated hind limb from a very early stage. It was suggested that the spinal nervous system contributed to the control of bone blood flow.

  1. Laryngeal obstruction caused by lymphoma in an adult dairy cow

    PubMed Central

    Lardé, Hélène; Nichols, Sylvain; Babkine, Marie; Chénier, Sonia

    2014-01-01

    A Holstein cow was presented for inspiratory dyspnea. Endoscopic evaluation revealed swollen arytenoids and a presumptive diagnosis of bilateral arytenoidal chondritis was made. A partial arytenoidectomy was performed, the right arytenoid was submitted for histopathology, and a diagnosis of laryngeal lymphoma was made. Due to the poor prognosis, the cow was euthanized. PMID:24489391

  2. Laryngeal Manifestations of Relapsing Polychondritis And a Novel Treatment Option

    Microsoft Academic Search

    Lesley Childs; Scott Rickert; Oscar Calderon Wengerman; Robert Lebovics; Andrew Blitzer

    ObjectivesLaryngotracheal involvement in relapsing polychondritis (RP) is rare. However, it is one of the most common causes of death in this patient population. We present three patients who primarily presented with laryngeal manifestations of RP and a novel treatment option for bamboo nodules.

  3. Management of laryngeal radionecrosis: Animal and clinical experience

    SciTech Connect

    Oppenheimer, R.W.; Krespi, Y.P.; Einhorn, R.K.

    1989-05-01

    Radiation necrosis of the laryngeal cartilages is an uncommon complication of radiotherapy for laryngeal carcinoma. It is a devastating process for which there is no one acceptable treatment. Medical management offers only temporary, symptomatic relief, which further necessitates surgical treatment. Surgical management may start with a tracheotomy; however, it often ends with a total laryngectomy. Physiologically, the necrotic cartilages are the source of the problem. It is a general surgical principle that nonviable tissue must be excised to promote healing. Therefore, if the affected laryngeal cartilages were removed, the larynx should heal. Total or near total removal of the thyroid and cricoid cartilages with preservation of the endolaryngeal soft tissues has not been reported in the literature. Theoretically, if the entire cartilaginous framework is removed, there would be no structural support for the airway. We have found using animal models, that submucosal resection of the laryngeal cartilages, leaving the perichondrium and endolaryngeal soft tissues intact can result in a competent airway. Animal and clinical experience will be presented.

  4. Free skin flap reconstruction after partial hypopharyngectomy with laryngeal preservation.

    PubMed

    Ishida, Katsuhiro; Kato, Takakuni; Seino, Youichi; Uchida, Mitsuru

    2014-10-01

    Surgical resection of hypopharyngeal cancer often affects laryngeal function. The aim of this study is to assess the reliability and efficacy of free skin flap transfer after partial hypopharyngectomy with laryngeal preservation. This study designs a retrospective analysis. The subjects were 54 patients who underwent free skin flap reconstruction immediately after partial pharyngolaryngectomy or hypopharyngectomy with laryngeal preservation. The defects were classified into four types based on the location of the hypopharyngeal defect. Functional results were evaluated by routine physical examination findings and parameters related to swallowing function and X-ray barium deglutition examination. Perioperative mortalities and morbidities were reviewed. There were no perioperative mortalities and 98% of the flaps survived. Forty-three patients (80%) were able to eat an unrestricted diet and experienced no aspiration. Restriction of the diet was significantly associated with the extent of oesophageal mucosal resection. In conclusion, free skin flap reconstruction is confirmed to be a safe and effective strategy to maintain laryngeal function and good quality-of-life. PMID:24443773

  5. Association between Chromosome Instability and Histological Grading in Laryngeal Cancer

    Microsoft Academic Search

    Witold Szyfter; Zygmunt Szmeja; Krzysztof Szyfter

    2001-01-01

    An analysis of chromosome instability in peripheral blood lymphocytes provides information on the genetic risk of cancer. The study was attempted to find a relationship between chromosome instability and the histological grading of laryngeal cancer using bleomycin as a model agent inducing chromatid breaks. Indices of chromatid breaks were calculated separately for subjects with grade G1 (n = 19), G2

  6. Association between Chromosome Instability and Histological Grading in Laryngeal Cancer

    Microsoft Academic Search

    Piotr Dabrowski; Witold Szyfter; Zygmunt Szmeja; Krzysztof Szyfter

    2002-01-01

    An analysis of chromosome instability in peripheral blood lympho- cytes provides information on the genetic risk of cancer. The study was attempted to find a relationship between chromosome instabili- ty and the histological grading of laryngeal cancer using bleomycin as a model agent inducing chromatid breaks. Indices of chromatid breaks were calculated separately for subjects with grade G1 (n =

  7. The Activity of the Intrinsic Laryngeal Muscles in Voicing Control

    Microsoft Academic Search

    H. Hirose; T. Gay

    1972-01-01

    The primary purpose of this experiment was to systematically investigate the actions of the intrinsic muscles of the larynx during the production of voiced and voiceless consonants. Generally speaking, computer-averaged EMG curves for the laryngeal muscles showed participation of the posterior cricoarytenoid for voiceless consonants and suppression for voiced consonants. The reciprocal pattern was found for the interarytenoid muscle. Similar

  8. The neural correlates of movement intentions: A pilot study comparing hypnotic and simulated paralysis.

    PubMed

    Ludwig, Vera U; Seitz, Jochen; Schönfeldt-Lecuona, Carlos; Höse, Annett; Abler, Birgit; Hole, Günter; Goebel, Rainer; Walter, Henrik

    2015-09-01

    The distinct feeling of wanting to act and thereby causing our own actions is crucial to our self-perception as free human agents. Disturbances of the link between intention and action occur in several disorders. Little is known, however, about the neural correlates of wanting or intending to act. To investigate these for simple voluntary movements, we used a paradigm involving hypnotic paralysis and functional magnetic resonance imaging. Eight healthy women were instructed to sequentially perform left and right hand movements during a normal condition, as well as during simulated weakness, simulated paralysis and hypnotic paralysis of the right hand. Right frontopolar cortex was selectively hypoactivated for attempted right hand movement during simulated paralysis while it was active in all other conditions. Since simulated paralysis was the only condition lacking an intention to move, the activation in frontopolar cortex might be related to the intention or volition to move. PMID:26036837

  9. Bilateral Facial Paralysis Caused by Bilateral Temporal Bone Fracture: A Case Report and a Literature Review

    PubMed Central

    Eliçora, Sultan ?evik; Dinç, Aykut Erdem; Bi?kin, Sultan; Damar, Murat; Bilgin, Ergin

    2015-01-01

    Bilateral facial paralysis caused by bilateral temporal bone fracture is a rare clinical entity, with seven cases reported in the literature to date. In this paper, we describe a 40-year-old male patient with bilateral facial paralysis and hearing loss that developed after an occupational accident. On physical examination, House-Brackmann (HB) facial paralysis of grade 6 was observed on the right side and HB grade 5 paralysis on the left. Upon temporal bone computed tomography (CT) examination, a fracture line exhibiting transverse progression was observed in both petrous temporal bones. Our patient underwent transmastoid facial decompression surgery of the right ear. The patient refused a left-side operation. Such patients require extensive monitoring in intensive care units because the presence of multiple injuries means that facial functions are often very difficult to evaluate. Therefore, delays may ensue in both diagnosis and treatment of bilateral facial paralysis. PMID:26175920

  10. [Surgical treatment options in laryngeal and hypopharyngeal cancer].

    PubMed

    Eckel, Hans E; Schröder, Ursula; Jungehülsing, Markus; Guntinas-Lichius, Orlando; Markitz, Michael; Raunik, Wolfgang

    2008-01-01

    In Austria, around ten new cases of laryngeal cancer can currently be expected per 100.000 persons each year whereas three out of 100.000 men develope hypopharyngeal cancer. Among women, the incidence in both types of carcinoma is lower by a factor of around 5. All in all, the rate of new cases seems to have been constant or to have slightly decreased in the last few years. Approximately 70% of all laryngeal cancer are glottic cancer, that is to say originating from the vocal cords. About 30% are supraglottic tumours, true subglottic cancers are very rare. The majority of hypopharyngeal tumours originate from the piriform sinuses. Vocal cord tumours lead to a typical symptom that can be early detected: hoarseness. Thus, voice problems in adults that persist for several weeks should therefore always checked by laryngoscopy. This leads to there being a real possibility of early diagnosis of laryngeal cancer, which means that today, approximately 60% of all laryngeal tumours can be diagnosed in stage I or II according to UICC or as intraepithelial lesions (former carcinoma in situ). In glottic cancer about 75% are diagnosed in these early stages, whereas in supraglottic tumours the rate is only about 30% and in hypopharyngeal cancer it is less then 15%. Surgery, radiation therapy, chemo- or immunotherapy are the principal types of oncological treatments currently available. The following conditions generally need to be met for curative surgical treatment options: Local tumour, no systemic metastasis Tumour has to be resectable in healthy margins mortality/morbidity Surgery must not lead to unreasonable mutilation Lack of other therapeutic alternatives having an equal or lesser impact In the following pages, indications for the surgical treatment of laryngeal and hypopharyngeal cancer will be discussed and the results of surgical therapy will be summarised briefly. PMID:18560951

  11. [Role of surgery in modern treatment of laryngeal carcinoma].

    PubMed

    Jovi?, Rajko M

    2013-01-01

    The strategy of organ preservation by applying chemoradiotherapy in the treatment of laryngeal carcinoma, which has been extensively used since 1990s, is now being reviewed regarding its further justification. Despite good results in other localization of head and neck cancer, it has not met the expectations in case of laryngeal cancer. One explanation is the lower participation of human papillomavirus type 16 in the etiology of laryngeal cancer. A lot of developing countries base their concept on primary surgery with subsequent radiotherapy, because the cost of operations for cancer of the larynx is much lower than in developed countries. Endoscopic surgery of T1 cancers is feasible in all environments using cold surgery thanks to modern management of anesthesia with the possibility of local application of adrenaline. Its price is 481.46 euros, and if it is performed through laryngofissure, the price is 785.46 euros. The introduction of lasers into the treatment would justify the initial investment and extend indications, and the surgery of T1 and T2 cancers with laser application should be the standard practice in all countries and regions dealing with laryngeal pathology. T2 and some T3 cancers can be treated by conservation surgery of the larynx. Most of T3 and T4 cancers are indications for total laryngectomy or near-total laryngectomy in selected cases. If it is the primary surgery, wound healing is good and complications are rare. This greatly reduces the cost of operation, which is 1910.15 euros. Surgery after radiotherapy, particularly after chemoradiotherapy, may result in complications that significantly prolong the treatment and increase its costs. Thus, the biological nature of laryngeal cancer and its specificity make this approach to the treatment of cancer available in all regions of the world. PMID:24245441

  12. Microbiota in the Throat and Risk Factors for Laryngeal Carcinoma

    PubMed Central

    Gong, Hongli; Zhou, Xia; Wu, Chunping; Cao, Pengyu; Xu, Chen; Hou, Dongsheng; Wang, Yuezhu

    2014-01-01

    The compositions and abundances of the microbiota in the ecological niche of the human throat and the possible relationship between the microbiota and laryngeal cancer are poorly understood. To obtain insight into this, we enrolled 27 laryngeal carcinoma patients and 28 subjects with vocal cord polyps as controls. For each subject, we simultaneously collected swab samples from the upper throat near the epiglottis (site I) and tissue samples from the vestibulum laryngis to the subglottic region (site II). The microbiota of the throat were fully characterized by pyrosequencing of barcoded 16S rRNA genes. We found 14 phyla, 20 classes, 38 orders, 85 families, and 218 genera in the throats of enrolled subjects. The main phyla were Firmicutes (54.7%), Fusobacteria (14.8%), Bacteroidetes (12.7%), and Proteobacteria (10.6%). Streptococcus (37.3%), Fusobacterium (11.3%), and Prevotella (10.6%) were identified as the three most predominant genera in the throat. The relative abundances of 23 bacterial genera in site I were significantly different from those in site II (P < 0.05). The relative proportions of 12 genera largely varied between laryngeal cancer patients and control subjects (P < 0.05). Collectively, this study outlined the spatial structure of microbial communities in the human throat. The spatial structure of bacterial communities significantly varied in two anatomical sites of the throat. The bacterial profiles of the throat of laryngeal cancer patients were strongly different from those of control subjects, and several of these microorganisms may be related to laryngeal carcinoma. PMID:25239901

  13. Nerve Conduction Velocity of Small Components in Human Sensory Nerves

    Microsoft Academic Search

    W. Tackmann; R. Minkenberg

    1977-01-01

    Slow conducted components of sensory nerve action potentials were investigated in median and in sural nerves of controls and in patients with peripheral nerve diseases. In the normal group the slow components showed no relation to age which is in contrast to the maximum velocity. In both the median nerve and sural nerve of about 20% of the patients with

  14. A Novel Model for Examining Recovery of Phonation after Vocal Nerve Damage

    PubMed Central

    Bhama, Prabhat K.; Hillel, Allen D.; Merati, Albert L.; Perkel, David J.

    2010-01-01

    Objectives/Hypothesis Recurrent laryngeal nerve injury remains a dominant clinical issue in laryngology. To date, no animal model of laryngeal reinnervation has offered an outcome measure that can reflect the degree of recovery based on vocal function. We present an avian model system for studying recovery of learned vocalizations following nerve injury. Study Design Prospective animal study. Methods Digital recordings of bird song were made from 11 adult male zebra finches; 9 underwent bilateral crushing of the nerve supplying the vocal organ, and two birds underwent sham surgery. Song from all birds was then recorded regularly and analyzed based on temporal and spectral characteristics using computer software. Indices were calculated to indicate the degree of similarity between pre-operative and post-operative song. Results Nerve crush caused audible differences in song quality and significant drops (p<0.05) in measured spectral and, to a lesser degree, temporal indices. Spectral indices recovered significantly (mean=43.0%; SD=40.7; p<0.02), and there was an insignificant trend towards recovery of temporal index (mean=28.0%; SD=41.4;p=0.0771). In 5/9(56%) birds, there was a greater than 50% recovery of spectral indices within a four week period. Two birds exhibited substantially less recovery of spectral indices, and two had a persistent decline in spectral indices. Recovery of temporal index was highly variable as well, ranging from persistent further declines of 45.1% to recovery of 87%. Neither sham bird exhibited significant (p>0.05) differences in song following nerve crush. Conclusion The songbird model system allows functional analysis of learned vocalization following surgical damage to vocal nerves. PMID:20189348

  15. Pneumothorax spontané secondaire post opératoire compliquant une paralysie récurrentielle

    PubMed Central

    Joulali, Toufik; Derkaou, Ali; Shimi, Abdelkarim; Khatouf, Mohammed

    2014-01-01

    Le Pneumothorax spontané est défini par un épanchement gazeux de la grande cavité pleurale en dehors de tout traumatisme ou manipulation instrumentale. Son incidence est estimée à 28/100000 pour les hommes et 6/100000 pour les femmes. Les étiologies sont dominées par la broncho-pneumopathies chroniques et obstructives. Le tableau clinique est souvent grave d'emblé nécessitant une exsufflation à l'aiguille et/ou un drainage thoracique. Les récidives sont assez fréquentes et la mortalité reste assez élevée en comparaison avec les pneumothorax post traumatique ou les pneumothorax primaires. Nous rapportons le cas d'une patiente présentant en post opératoire un pneumothorax spontané sur un poumon métastatique et compliquant une paralysie récurrentielle. PMID:25419334

  16. Sensory nerves and pancreatitis

    PubMed Central

    Li, Qingfu

    2014-01-01

    Sensory nerves are a kind of nerve that conduct afferent impulses from the periphery receptors to the central nervous system (CNS) and are able to release neuromediators from the activated peripheral endings. Sensory nerves are particularly important for microcirculatory response, and stimulation of pancreatic sensory nerves releases a variety of neuropeptides such as substance P (SP), calcitonin gene-related peptide (CGRP), etc., leading to neurogenic inflammation characterized as the local vasodilatation and plasma extravasation. Deactivation of sensory nerves often leads to the disturbances of pancreatic microcirculation. Pancreatitis is a common digestive disease that can lead to severe complications and even death if it goes untreated. Experimental studies in animals and tissue analysis in patients with pancreatitis have shown significant changes in sensory nerves supplying the pancreatic gland. Thus making clear the whole mechanism of pancreatitis is essential to treat and cure it. Sensory nerves may have a close correlation with the development of pancreatitis, and knowing more about the role of sensory nerve in pancreatitis is important for the treatment for pancreatitis. This review is aimed to summarize the relationship between sensory nerves and pancreatitis. PMID:25493260

  17. Distal median nerve dysfunction

    MedlinePLUS

    ... type of distal median nerve dysfunction is carpal tunnel syndrome . ... repetitive movements increase the chance of developing carpal tunnel entrapment. Conditions that affect connective tissue or cause ...

  18. [A case of isolated hypoglossal nerve palsy with acute lymphoblastic leukemia].

    PubMed

    Kamii, Yasuhiro; Hashimoto, Masaya; Suzuki, Masahiko; Sakimoto, Yoshihiro; Kawasaki, Keiichi; Yoshioka, Masayuki

    2013-01-01

    We report a case of isolated hypoglossal nerve palsy with acute lymphoblastic leukemia. A 47-year-old woman had fever unknown origin during two months. Her tongue bent to the right and cephalalgia developed. She complained unable to speech and swallow. On admission, right isolated hypoglossal nerve palsy presented. Blood examination showed the mild elevation of CRP and soluble IL2 receptor. Examination of cerebrospinal fluid was negative. Gadolinium enhanced magnetic resonance imaging (MRI) of brain showed abnormal intensity on sphenoid bone. 2-[(18)F] fluoro-2-deoxy-D-glucose (FDG)-positron emission tomography (PET) showed abnormal accumulation on sphenoid bone, spleen, the left supraclavicular node, mesenteric lymph node. Blast cells appeared in peripheral blood afterwards. Acute lymphatic leukemia (ALL) was diagnosed by bone marrow biopsy. The central nervous system disorder by ALL tends to the invasion to meninges or cerebrovascular disorder. This is the first case report that isolated hypoglossal nerve paralysis resulted from ALL. PMID:23524607

  19. Positron emission tomography\\/computed tomography as a method for detection and monitoring of laryngeal chondritis

    Microsoft Academic Search

    Markus Gugatschka; Thomas Schwarz; Gerhard Friedrich

    2008-01-01

    Infections of the laryngeal cartilages occur clinically as local pain, dysphonia, dysphagia or dyspnoea and may lead to destruction\\u000a of the laryngeal skeleton. We present positron emission tomography\\/computed tomography (PET–CT) as a new method for detection\\u000a and monitoring of laryngotracheal chondritis. We prospectively analyzed all patients undergoing PET–CT examination, of whom\\u000a we were clinically suspicious of laryngeal cartilage chondritis. When

  20. Distribution, seasonality and risk factors for tick paralysis in Australian dogs and cats.

    PubMed

    Eppleston, K R; Kelman, M; Ward, M P

    2013-09-23

    Tick paralysis is a serious and potentially fatal condition of Australian companion animals induced by the paralysis ticks, Ixodes holocyclus and Ixodes cornuatus. Limited published information is available on the distribution, seasonality and risk factors for tick paralysis mortality in dogs and cats. This study describes 3479 cases of canine and feline tick paralysis in Australia using data extracted from a real-time disease surveillance program. Risk factors for mortality were identified, and maps of the distribution of cases were generated. Cluster analysis was performed using a space-time permutation scan statistic. Tick paralysis was found to be distinctly seasonal, with most cases reported during spring. Most cases were located on the eastern coast of Australia with New South Wales and Queensland accounting for the majority of reported cases. A cluster of cases was identified on the south coast of New South Wales. Dogs were found to be at significantly higher risk (P<0.05) of death if less than 6 months of age or if a toy breed. No significant risk factors for mortality were identified for cats. Some animals receiving chemoprophylactic treatment for tick infestation experienced tick paralysis during the products' period of effectiveness. There is a high risk of tick paralysis in dogs and cats on the eastern coast of Australia during the spring months. The risk factors for mortality identified can be used by veterinarians to determine prognosis in cases of canine tick paralysis and potentially to improve the treatment of cases. Daily tick searches of pets - particularly in high risk areas and during high risk periods - are recommended since the prevention of tick paralysis via chemoprophylaxis is not 100% guaranteed across the whole population. PMID:23643358

  1. Communication between radial nerve and medial cutaneous nerve of forearm

    PubMed Central

    Marathe, RR; Mankar, SR; Joshi, M; Sontakke, YA

    2010-01-01

    Radial nerve is usually a branch of the posterior cord of the brachial plexus. It innervates triceps, anconeous, brachialis, brachioradialis, extensor carpi radialis longus muscles and gives the posterior cutaneous nerve of the arm, lower lateral cutaneous nerve of arm, posterior cutaneous nerve of forearm; without exhibiting any communication with the medial cutaneous nerve of forearm or any other nerve. We report communication between the radial nerve and medial cutaneous nerve of forearm on the left side in a 58-year-old male cadaver. The right sided structures were found to be normal. Neurosurgeons should keep such variations in mind while performing the surgeries of axilla and upper arm. PMID:21799623

  2. 'The devil lay upon her and held her down' Hypnagogic hallucinations and sleep paralysis described by the Dutch physician Isbrand van Diemerbroeck (1609-1674) in 1664

    Microsoft Academic Search

    E. J. O. Kompanje

    2008-01-01

    Hypnagogic and hypnopompic hallucinations are visual, tactile, auditory or other sensory events, usually brief but sometimes prolonged, that occur at the transition from wakefulness to sleep (hypnagogic) or from sleep to wakefulness (hypnopompic). Hypnagogic and hypnopompic hallucinations are often associated with sleep paralysis. Sleep paralysis occurs immediately prior to falling asleep (hypnagogic paralysis) or upon waking (hypnopompic paralysis). In 1664,

  3. Postictal Todd’s Paralysis Associated with Focal Cerebral Hypoperfusion on Magnetic Resonance Perfusion Studies

    PubMed Central

    Yacoub, Hussam A.; Fenstermacher, Nathan; Castaldo, John

    2015-01-01

    Background The exact underlying physiology of postictal motor deficits, known as Todd’s paralysis, is not well understood and its vascular perfusion physiology is not well studied. Reversible postictal perfusion abnormalities have been sparsely described in the literature. Methods We report abnormal brain magnetic resonance perfusion maps in a 9-year-old boy who presented with postictal left hemiparesis. This case correlates postictal hemispheric cerebral hypoperfusion with clinical evidence of Todd’s paralysis. Conclusions Our case provides an insight into the potential pathophysiology mechanism underlying Todd’s paralysis and the practicality of magnetic resonance perfusion studies in localizing an epileptogenic zone in the postictal patient.

  4. Cuff leak test and laryngeal survey for predicting post-extubation stridor

    PubMed Central

    Patel, Anit B; Ani, Chizobam; Feeney, Colin

    2015-01-01

    Background and Aims: Evidence for the predictive value of the cuff leak test (CLT) for post-extubation stridor (PES) is conflicting. We evaluated the association and accuracy of CLT alone or combined with other laryngeal parameters with PES. Methods: Fifty-one mechanically ventilated adult patients in a medical-surgical intensive care unit were tested prior to extubation using; CLT, laryngeal ultrasound and indirect laryngoscopy. Biometric, laryngeal and endotracheal tube (ETT) parameters were recorded. Results: PES incidence was 4%. CLT demonstrated ‘no leak’ in 20% of patients. Laryngeal oedema was present in 10% of the patients on indirect laryngoscopy, and 71% of the patients had a Grades 1-3 indirect laryngoscopic view. Mean air column width on laryngeal ultrasound was 0.66 ± 0.15 cm (cuff deflated), mean ratio of ETT to laryngeal diameter was 0.48 ± 0.07, and the calculated CLT and laryngeal survey composite was 0.86 ± 1.25 (range 0-5). CLT and the CLT and Laryngeal survey composite measure were not associated with or predict PES. Age, sex, peri-extubation steroid use, intubation duration and body mass index were not associated with PES. Conclusion: Even including ultrasonographic and indirect laryngoscopic examination of the airway, no single aspect of the CLT or combination with laryngeal parameters accurately predicts PES. PMID:25788742

  5. [Chromosome damage in the course of laryngeal squamous cell carcinoma].

    PubMed

    Szyfter, K; Kujawski, M; Dabrowski, P; Jarmuz, M; Kita, S; Biegalski, W; Szyfter, W

    1999-01-01

    The aim of the article is a review of own cytogenic studies on laryngeal cancer confronted with the literature data. Spontaneous and bleomycin-induced chromosome instability was analysed in peripheral blood lymphocytes in relation to genetic risk of cancer incidence and progression. Comparative genome hybridization (CGH) was applied to demonstrate gains and losses of DNA copy number in tumour and non-tumour laryngeal mucosa. The profiles of imbalances of DNA copy number were shown to differ between metastazing and non-metastazing tumours. Preliminary data indicate a frequent loss of Y chromosome in tumour cells. The loss of heterozygosity at chromosome p53 locus (17p) has been shown to be more frequent than at chromosome locus coding 16 gene (9p). Altogether, the experiments have proven that a dynamics of chromosome aberrations is highest at the stage of metastasis. PMID:10689907

  6. Therapeutic strategies for laryngeal manifestations of gastroesophageal reflux disease.

    PubMed

    Yuksel, Elif S; Vaezi, Michael F

    2013-03-01

    Gastroesophageal reflux disease is increasingly associated with ear, nose, and throat symptoms, including laryngitis. Many patients are unaware of the gastroesophageal etiology of their symptoms. A variety of criteria are used to diagnose this condition, including laryngoscopy, esophagogastroduodenoscopy, and the use of ambulatory pH and impedance monitoring. However, no test serves as the gold standard for the diagnosis given their lack of sensitivity and specificity for reflux disease. Numerous trials have assessed the role of proton pump inhibitor therapy in patients with laryngopharyngeal reflux and most have revealed no benefit to acid suppression over placebo. Despite many uncertainties there has been some progress regarding the role of acid-suppressive therapy as well as other agents in this unique group of patients. In this review we explore therapeutic options and their rationale for patients with laryngeal signs and symptoms. PMID:23340061

  7. Virological and immunological aspects in the juvenile laryngeal papillomatosis.

    PubMed

    Gheorghe, D C; Ardelean, C; Anton, G

    1999-01-01

    The juvenile laryngeal papillomatosis, a disease which in the absence of an adequate monitoring may have an invalidating character, represented for a long time a problem as regards both its treatment and its possible etiology. The use of monoclonal antibodies, as well as of molecular biology techniques, permitted to elucidate some aspects, such as the viral origin of the infection. Twenty five juvenile laryngeal papillomas, removed intra-operatively, were investigated immunohistochemically, a significant increase of the epidermal growth factor (EGF) receptor being found. Ten samples were also analyzed with the PCR technique, for the purpose of detecting the presence of the corresponding DNA sequences of human papillomaviruses (HPV): all were positive. The HPV genotyping showed the presence of only the HPV6 and 11 genotypes. PMID:11601383

  8. DNA hypermethylation markers of poor outcome in laryngeal cancer

    Microsoft Academic Search

    Josena K. Stephen; Kang Mei Chen; Veena Shah; Shaleta Havard; Alissa Kapke; Mei Lu; Michael S. Benninger; Maria J. Worsham

    2010-01-01

    This study examined molecular (DNA hypermethylation), clinical, histopathological, demographical, smoking, and alcohol variables\\u000a to assess diagnosis (early versus late stage) and prognosis (survival) outcomes in a retrospective primary laryngeal squamous\\u000a cell carcinoma (LSCC) cohort. The study cohort of 79 primary LSCC was drawn from a multi-ethnic (37% African American), primary\\u000a care patient population, diagnosed by surgical biopsies in the Henry

  9. Analysis of aromatic DNA adducts in laryngeal biopsies

    Microsoft Academic Search

    J. Banaszewski; Z. Szmeja; W. Szyfter; K. Szyfter; P. Baranczewski; L. Möller

    2000-01-01

    Epidemiological studies have confirmed the correlation between tobacco smoking, environmental pollution and the incidence\\u000a of cancers of the respiratory tract. The occurrence of laryngeal cancer in Poland is relatively high compared to other European\\u000a countries. Since 1969 the mortality related to larynx cancer appears to be increasing. Tobacco smoke contains an abundance\\u000a of such carcinogenic compounds as polycyclic aromatic hydrocarbons

  10. Mandarin Loanwords in Yanbian Korean I: Laryngeal Features

    Microsoft Academic Search

    Chiyuki Ito

    The paper documents and then discusses the motivation for the loanword adaptation of the Mandarin binary aspirated vs. unaspirated contrast with respect to the Yanbian ternary aspirated-tense-lax contrast. The way in which the Yanbian tense vs. lax\\/aspirated contrast in fricatives behaves with respect to loans from Mandarin, English and Japanese is also discussed. The laryngeal features of voicing and aspiration

  11. Motor nerve transplantation.

    PubMed

    Gray, W P; Keohane, C; Kirwan, W O

    1997-10-01

    The motor nerve transplantation (MNT) technique is used to transfer an intact nerve into a denervated muscle by harvesting a neurovascular pedicle of muscle containing motor endplates from the motor endplate zone of a donor muscle and implanting it into a denervated muscle. Thirty-six adult New Zealand White rabbits underwent reinnervation of the left long peroneal (LP) muscle (fast twitch) with a motor nerve graft from the soleus muscle (slow twitch). The right LP muscle served as a control. Reinnervation was assessed using microstimulatory single-fiber electromyography (SFEMG), alterations in muscle fiber typing and grouping, and isometric response curves. Neurofilament antibody was used for axon staining. The neurofilament studies provided direct evidence of nerve growth from the motor nerve graft into the adjacent denervated muscle. Median motor endplate jitter was 13 microsec preoperatively, and 26 microsec at 2 months, 29.5 microsec at 4 months, and 14 microsec at 6 months postoperatively (p < 0.001). Isometric tetanic tension studies showed a progressive functional recovery in the reinnervated muscle over 6 months. There was no histological evidence of aberrant reinnervation from any source outside the nerve pedicle. Isometric twitch responses and adenosine triphosphatase studies confirmed the conversion of the reinnervated LP muscle to a slow-type muscle. Acetylcholinesterase studies confirmed the presence of functioning motor endplates beneath the insertion of the motor nerve graft. It is concluded that the MNT technique achieves motor reinnervation by growth of new nerve fibers across the pedicle graft into the recipient muscle. PMID:9322851

  12. Transient Paralysis of the Bladder due to Wound Botulism

    Microsoft Academic Search

    Th. Sautter; A. Herzog; D. Hauri; B. Schurch

    2001-01-01

    In the last 10 years, wound botulism has increasingly been reported and nearly all of these new cases have occurred in injecting–drug abusers. After absorption into the bloodstream, botulinum toxin binds irreversibly to the presynaptic nerve endings, where it inhibits the release of acetylcholine. Diplopia, blurred vision, dysarthria, dysphagia, respiratory failure and paresis of the limbs are common symptoms of

  13. p53 Overexpression in laryngeal squamous cell carcinoma and dysplasia

    PubMed Central

    Barbatis, C; Loukas, L; Grigoriou, M; Nikolaou, I; Tsikou-Papafragou, A; Marsan, N; Gatter, K C; Kaklamanis, L

    1995-01-01

    Aim—To investigate the expression of p53 protein in invasive squamous cell carcinoma (SCC) of the larynx and dysplasia in relation to histological grade and tobacco smoking. Method—Paraffin wax embedded tissue sections from 41 cases of invasive SCC of the larynx, 28 cases of dysplasia and 14 control laryngeal biopsy specimens were studied immunohistochemically using two anti-p53 monoclonal antibodies (DO7 and 1801). The Streptavidin/horseradish peroxidase method was used after microwave antigen retrieval and a semiquantitative method was applied to assess the extent of p53 expression. Results—Of the cases of invasive SCC of the larynx, 78% (32/41), regardless of histological grade, overexpressed p53 compared with only 30% (eight of 28) of cases of mild dysplasia. A gradual increase in p53 expression from mild to severe dysplasia (60%) was observed, and only three of 14 control biopsy specimens of laryngeal nodules showed occasional weakly positive basal cells. Conclusion—The gradual increase in p53 expression from mild to severe dysplasia to invasive SCC indicates that p53 overexpression is an early event in laryngeal carcinogenesis which may lead to invasive malignancy. p53 overexpression may be related to environmental factors as most of the patients smoked tobacco. Microwave postfixation may be essential for the reliable detection of p53. Images PMID:16696005

  14. Analysis of aromatic DNA adducts in laryngeal biopsies.

    PubMed

    Banaszewski, J; Szmeja, Z; Szyfter, W; Szyfter, K; Baranczewski, P; Möller, L

    2000-01-01

    Epidemiological studies have confirmed the correlation between tobacco smoking, environmental pollution and the incidence of cancers of the respiratory tract. The occurrence of laryngeal cancer in Poland is relatively high compared to other European countries. Since 1969 the mortality related to larynx cancer appears to be increasing. Tobacco smoke contains an abundance of such carcinogenic compounds as polycyclic aromatic hydrocarbons (PAH), aromatic amines and N-nitrosoamines, which can react with DNA and form adducts. We analyzed aromatic DNA adducts in laryngeal tissues from patients with primary laryngeal, which was confirmed histopathologically to be squamous cell carcinoma. The group consisted of 33 patients (5 women and 28 men). Total laryngectomy was performed in patients. A detergentphenol method was used for DNA isolation. Aromatic DNA adducts were analyzed by a 32P-postlabelling technique with butanol extraction and high performance liquid chromatography. The presence of aromatic DNA adducts was demonstrated in all tissues. Large interindividual differences of DNA adduct levels were seen in each tissue studied. There was a higher mean level of DNA adducts in interarytenoid area non-tumors (51.96/10(8) +/- 91.71 NN) than in non-tumor tissue elsewhere (46.91/10(8) +/- 46.36 NN) and tumor tissue (43.52/10(8) +/- 45.88 NN). Adduct levels were correlated with age, sex, cigarette smoking and TNM stage. PMID:10839488

  15. Biomechanical Contributions of Posterior Deltoid and Teres Minor in the Context of Axillary Nerve Injury: A Computational Study

    PubMed Central

    Crouch, Dustin L.; Plate, Johannes F.; Li, Zhongyu; Saul, Katherine R.

    2013-01-01

    Purpose To determine if transfer to only the anterior branch of the axillary nerve will restore useful function following axillary nerve injury with persistent posterior deltoid and teres minor paralysis. Methods We used a computational musculoskeletal model of the upper limb to determine the relative contributions of posterior deltoid and teres minor to maximum joint moment generated during a simulated static strength assessment and to joint moments during 3 sub-maximal shoulder movements. Movement simulations were performed with and without simulated posterior deltoid and teres minor paralysis to identify muscles which may compensate for their paralysis. Results In the unimpaired limb model, teres minor and posterior deltoid accounted for 16% and 14% of the total isometric shoulder extension and external rotation joint moments, respectively. During the 3 movement simulations, posterior deltoid produced as much as 20% of the mean shoulder extension moment, while teres minor accounted for less than 5% of the mean joint moment in all directions of movement. When posterior deltoid and teres minor were paralyzed, the mean extension moments generated by the supraspinatus, long head of triceps, latissimus dorsi, and middle deltoid increased to compensate. Compensatory muscles were not fully activated during movement simulations when posterior deltoid and teres minor were paralyzed. Conclusions Reconstruction of the anterior branch of the axillary nerve only is an appropriate technique for restoring shoulder abduction strength following isolated axillary nerve injury. When shoulder extension strength is compromised by extensive neuromuscular shoulder injury, reconstruction of both the anterior and posterior branches of the axillary nerve should be considered. Clinical Relevance By quantifying the biomechanical role of muscles during sub-maximal movement, in addition to quantifying muscle contributions to maximal shoulder strength, we can inform pre-operative planning and permit more accurate predictions of functional outcomes. PMID:23294649

  16. Cervical neoplasia originating from the vagus nerve in a dog.

    PubMed

    Ruppert, C; Hartmann, K; Fischer, A; Hirschberger, J; Hafner, A; Schmidt, P

    2000-03-01

    An eight-year-old intact male Bernese mountain dog was referred with a history of chronic vomiting, coughing and signs of respiratory distress. Other historical findings included lethargy, weight loss and choking. On presentation, clinical findings were Horner's syndrome, ipsilateral laryngeal hemiplegia, coughing, gagging, respiratory distress and vomiting. Lateral cervical radiographs showed ill-defined mineralisation in the soft tissue ventral to the third cervical vertebra, while ultrasonography of the neck revealed a well marginated heterogeneous mass with focal hyperechogenic lesions and acoustic shadowing. Results of an ultrasound-guided fine needle aspirate suggested neoplasia. At necropsy, a large tumour was detected in the ventral cervical region, originating from the right vagosympathetic trunk. In view of the infiltrating pattern, the cellular pleomorphism and the numerous mitoses on histopathological examination, the tumour was classified as a malignant peripheral nerve sheath tumour. PMID:10759381

  17. On the maxillary nerve.

    PubMed

    Higashiyama, Hiroki; Kuratani, Shigeru

    2014-01-01

    The trigeminal, the fifth cranial nerve of vertebrates, represents the rostralmost component of the nerves assigned to pharyngeal arches. It consists of the ophthalmic and maxillomandibular nerves, and in jawed vertebrates, the latter is further divided into two major branches dorsoventrally. Of these, the dorsal one is called the maxillary nerve because it predominantly innervates the upper jaw, as seen in the human anatomy. However, developmentally, the upper jaw is derived not only from the dorsal part of the mandibular arch, but also from the premandibular primordium: the medial nasal prominence rostral to the mandibular arch domain. The latter component forms the premaxillary region of the upper jaw in mammals. Thus, there is an apparent discrepancy between the morphological trigeminal innervation pattern and the developmental derivation of the gnathostome upper jaw. To reconcile this, we compared the embryonic developmental patterns of the trigeminal nerve in a variety of gnathostome species. With the exception of the diapsid species studied, we found that the maxillary nerve issues a branch (nasopalatine nerve in human) that innervates the medial nasal prominence derivatives. Because the trigeminal nerve in cyclostomes also possesses a similar branch, we conclude that the vertebrate maxillomandibular nerve primarily has had a premandibular branch as its dorsal element. The presence of this branch would thus represent the plesiomorphic condition for the gnathostomes, implying its secondary loss within some lineages. The branch for the maxillary process, more appropriately called the palatoquadrate component of the maxillary nerve (V(2)), represents the apomorphic gnathostome trait that has evolved in association with the acquisition of an upper jaw. PMID:24151219

  18. Sleep paralysis in medieval Persia – the Hidayat of Akhawayni (?–983 AD)

    PubMed Central

    Golzari, Samad EJ; Khodadoust, Kazem; Alakbarli, Farid; Ghabili, Kamyar; Islambulchilar, Ziba; Shoja, Mohammadali M; Khalili, Majid; Abbasnejad, Feridoon; Sheikholeslamzadeh, Niloufar; Shahabi, Nasrollah Moghaddam; Hosseini, Seyed Fazel; Ansarin, Khalil

    2012-01-01

    Among the first three manuscripts written in Persian, Akhawayni’s Hidayat al-muta’allemin fi al-tibb was the most significant work compiled in the 10th century. Along with the hundreds of chapters on hygiene, anatomy, physiology, symptoms and treatments of the diseases of various organs, there is a chapter on sleep paralysis (night-mare) prior to description and treatment of epilepsy. The present article is a review of the Akhawayni’s teachings on sleep paralysis and of descriptions and treatments of sleep paralysis by the Greek, medieval, and Renaissance scholars. Akhawayni’s descriptions along with other early writings provide insight into sleep paralysis during the Middle Ages in general and in Persia in particular. PMID:22701323

  19. Sleep paralysis in medieval Persia - the Hidayat of Akhawayni (?-983 AD).

    PubMed

    Golzari, Samad Ej; Khodadoust, Kazem; Alakbarli, Farid; Ghabili, Kamyar; Islambulchilar, Ziba; Shoja, Mohammadali M; Khalili, Majid; Abbasnejad, Feridoon; Sheikholeslamzadeh, Niloufar; Shahabi, Nasrollah Moghaddam; Hosseini, Seyed Fazel; Ansarin, Khalil

    2012-01-01

    Among the first three manuscripts written in Persian, Akhawayni's Hidayat al-muta'allemin fi al-tibb was the most significant work compiled in the 10th century. Along with the hundreds of chapters on hygiene, anatomy, physiology, symptoms and treatments of the diseases of various organs, there is a chapter on sleep paralysis (night-mare) prior to description and treatment of epilepsy. The present article is a review of the Akhawayni's teachings on sleep paralysis and of descriptions and treatments of sleep paralysis by the Greek, medieval, and Renaissance scholars. Akhawayni's descriptions along with other early writings provide insight into sleep paralysis during the Middle Ages in general and in Persia in particular. PMID:22701323

  20. Comparison of Supreme Laryngeal Mask Airway and ProSeal Laryngeal Mask Airway during Cholecystectomy

    PubMed Central

    Ho?ten, Tülay; Y?ld?z, Tülay ?ahin; Ku?, Alparslan; Solak, Mine; Toker, Kamil

    2012-01-01

    Objective: This study compared the safety and efficacy of the Supreme Laryngeal Mask Airway (S-LMA) with that of the ProSeal-LMA (P-LMA) in laparoscopic cholecystectomy. Material and Methods: Sixty adults were randomly allocated. Following anaesthesia induction, experienced LMA users inserted the airway devices. Results: Oropharyngeal leak pressure was similar in groups (S-LMA, 27.8±2.9 cmH2O; P-LMA, 27.0±4.7 cmH2O; p=0.42) and did not change during the induction of and throughout pneumoperitoneum. The first attempt success rates were 93% with both S-LMA and P-LMA. Mean airway device insertion time was significantly shorter with S-LMA than with P-LMA (12.5±4.1 seconds versus 15.6±6.0 seconds; p=0.02). The first attempt success rates for the drainage tube insertion were similar (P-LMA, 93%; S-LMA 100%); however, drainage tubes were inserted more quickly with S-LMA than with P-LMA (9.0±3.2 seconds versus 14.7±6.6 seconds; p=0.001). In the PACU, vomiting was observed in five patients (three females and two males) in the S-LMA group and in one female patient in the P-LMA group (p=0.10). Conclusion: Both airway devices can be used safely in laparoscopic cholecystectomies with suitable patients and experienced users. However, further studies are required not only for comparing both airway devices in terms of postoperative nausea and vomiting but also for yielding definitive results. PMID:25207022

  1. Identification of the transmitter and receptor mechanisms responsible for REM sleep paralysis.

    PubMed

    Brooks, Patricia L; Peever, John H

    2012-07-18

    During REM sleep the CNS is intensely active, but the skeletal motor system is paradoxically forced into a state of muscle paralysis. The mechanisms that trigger REM sleep paralysis are a matter of intense debate. Two competing theories argue that it is caused by either active inhibition or reduced excitation of somatic motoneuron activity. Here, we identify the transmitter and receptor mechanisms that function to silence skeletal muscles during REM sleep. We used behavioral, electrophysiological, receptor pharmacology and neuroanatomical approaches to determine how trigeminal motoneurons and masseter muscles are switched off during REM sleep in rats. We show that a powerful GABA and glycine drive triggers REM paralysis by switching off motoneuron activity. This drive inhibits motoneurons by targeting both metabotropic GABA(B) and ionotropic GABA(A)/glycine receptors. REM paralysis is only reversed when motoneurons are cut off from GABA(B), GABA(A) and glycine receptor-mediated inhibition. Neither metabotropic nor ionotropic receptor mechanisms alone are sufficient for generating REM paralysis. These results demonstrate that multiple receptor mechanisms trigger REM sleep paralysis. Breakdown in normal REM inhibition may underlie common sleep motor pathologies such as REM sleep behavior disorder. PMID:22815493

  2. Laser arytenoidectomy in the treatment of bilateral vocal cord paralysis.

    PubMed

    Szmeja, Z; Wójtowicz, J G

    1999-01-01

    The introduction of the CO2 surgical laser into laryngeal microsurgery has made resection of the posterior vocal cord together with the arytenoid cartilage possible. Since November 1990, 30 arytenoidectomies, 17 partial cordectomies and 18 bilateral cordectomies as described by Kashima were performed by means of a CO(2) laser in patients with bilateral paralyses of the vocal cords. In this group there were 58 women and 7 men. The patients' ages ranged from 28 to 71 years (mean, 46.7 years). In one case the operation was performed twice: the right arytenoid cartilage was excised initially and the left arytenoid cartilage was removed in the second procedure. Three patients required tracheotomy before being transformed to the ENT Clinic, Poznañ. The etiologies of the vocal cord paralyses were complications arising from thyroid gland surgery (n = 62), trauma (n = 2) and excision of a bilateral glomus caroticum tumor. In all patients except one postoperative recovery was correct and no breathing difficulties were observed after extubation. In the one failure after operation endolaryngeal scar tissue resulted in glottic stenosis. PMID:10525940

  3. Nerve fiber planimetry in acute and chronic nerve lesions and in nerve lesions in continuity.

    PubMed

    Guelinckx, P J; Boeckx, W D; Dom, R; Gruwez, J A

    1985-10-01

    The level of resection of damaged nerve tissue in acute and chronic nerve lesions was determined on the basis of the vascular structure, the consistency of the nerve during palpation, the amount of interfascicular connective tissue, and the mushroom formation of the fascicles. Intraoperative electrophysiologic recordings were performed on the cut nerve ends to determine the function of the axons. Postoperative planimetric analyses of cross sections made through the resected nerve stumps were performed to measure axonal and endoneural tube diameters and to correlate these results with the clinical criteria used through the operating microscope. Axons in the proximal nerve ends of acute and chronic nerve lesions displayed a similar mean diameter. Endoneural tubes in chronic nerve lesions shrunk significantly as nerve repair was delayed. In several nerve lesions in continuity, axons remained present across the injured site despite absence of electrical conduction. When comparing the results of axonal or endoneural tube diameters of chronic nerve lesions to the results of other studies or acute nerve lesions, we demonstrated that careful examination through the operating microscope provided valid information about the proper management and resection level of chronic nerve lesions. Electrophysiologic evaluation aided the surgical management but was not useful for the resection of the distal damaged nerve segment. The presence of an evoked potential in the proximal nerve ends guaranteed a nearly normal nerve fiber diameter distribution, while the absence of such a potential in the distal nerve ends indicated an abnormal, absent, or disturbed endoneural tube diameter histogram. PMID:4034768

  4. Suprascapular nerve entrapment.

    PubMed

    Corò, L; Azuelos, A; Alexandre, A

    2005-01-01

    It is important to be aware of neuropathy involving the suprascapular nerve. While direct trauma to the suprascapular nerve is the usual cause (direct blow to the base of the neck or posterior shoulder, shoulder dislocation or fracture), the problem may result from overuse injuries (such as repetitive tennis serving or spiking of a volley ball), excessive horizontal adduction, weight lifting, backpacking or no apparent reason. These last three years we have operated 8 cases of suprascapular nerve neurolysis at the level of suprascapular incision, and section of the transverse scapular ligament through the back supraspinal approach. PMID:15830964

  5. Intracranial facial nerve reconstruction.

    PubMed

    Yammine, F G; Dufour, J J; Mohr, G

    1999-06-01

    Surgery for tumours of the cerebellopontine angle (CPA) or the internal auditory canal (IAC) is sometimes complicated by the severing of the seventh nerve. Many procedures are available for facial reanimation. Among these, primary intracranial VII-VII reanastomosis is considered as the method of choice. This series reviews all the cases of primary intracranial facial nerve reconstruction that we have performed either directly or with the use of a nerve graft interposition. Functional results are analyzed according to the House-Brackmann grading scale. The advantages and benefits of this technique are discussed as compared with other methods of facial reanimation, namely, the hypoglossal-facial anastomosis. PMID:10410348

  6. Upper Gastrointestinal Bleeding as a Manifestation of Metastasis from Laryngeal Cancer

    PubMed Central

    Nazeer, Hammad; Thakur, Kshitij; Zeitz, Monica

    2015-01-01

    Upper gastrointestinal (GI) bleeding can be a rare manifestation of primary or metastatic tumor in the stomach. Tumors that commonly metastasize to stomach include breast, lung, and malignant melanoma. Laryngeal cancer usually metastasizes to the lung and cervical spine. We report the first case of upper GI bleed as a manifestation of laryngeal cancer in the stomach.

  7. Reflux-Associated Laryngitis and Laryngopharyngeal Reflux: A Gastroenterologist’s Point of View

    Microsoft Academic Search

    Heinz F. Hammer

    2009-01-01

    Laryngopharyngeal reflux of liquid and gaseous gastric contents should be considered in every patient with unexplained hoarseness. Pathophysiology and treatment of reflux-associated laryngitis are different from those of reflux esophagitis and therefore remain an unsolved puzzle. The laryngeal mucosa is considerably more sensitive to acid and pepsin than the mucosa of the esophagogastric junction. Therefore definitions of acid and nonacid

  8. Respiratory and Laryngeal Function during Spontaneous Speaking in Teachers with Voice Disorders

    ERIC Educational Resources Information Center

    Lowell, Soren Y.; Barkmeier-Kraemer, Julie M.; Hoit, Jeannette D.; Story, Brad H.

    2008-01-01

    Purpose: To determine if respiratory and laryngeal function during spontaneous speaking were different for teachers with voice disorders compared with teachers without voice problems. Method: Eighteen teachers, 9 with and 9 without voice disorders, were included in this study. Respiratory function was measured with magnetometry, and laryngeal

  9. Respiratory and Laryngeal Responses to an Oral Air Pressure Bleed during Speech

    ERIC Educational Resources Information Center

    Huber, Jessica E.; Stathopoulos, Elaine T.

    2003-01-01

    Researchers have hypothesized that the respiratory and laryngeal speech subsystems would respond to an air pressure bleed, but these responses have not been empirically studied. The present study examined the nature of the responses of the respiratory and laryngeal subsystems to an air pressure bleed in order to provide information relevant to the…

  10. Results of laryngeal cancer surgery in four ENT centers in Poland

    Microsoft Academic Search

    W. Golabek; B. Semczuk; J. Sekula; Z. Szmeja; G. Janczewski; A. Kruk-Zagajewska; E. Olszewski

    1989-01-01

    The results of laryngeal cancer surgery were assessed in a group of 832 patients treated in four major ENT centers in Poland. Five-year survival rates were as follows: stage I, 86%; stage II, 71%; stage III, 54%; and stage IV, 42%. In experienced hands and for properly selected cases, cure rates after partial (conservation) laryngeal surgery were similar to those

  11. Decellularized grafts with axially aligned channels for peripheral nerve regeneration.

    PubMed

    Sridharan, Rukmani; Reilly, Richard B; Buckley, Conor T

    2015-01-01

    At least 2 million people worldwide suffer annually from peripheral nerve injuries (PNI), with estimated costs of $7 billion incurred due to paralysis alone. The current "gold" standard for treatment of PNI is the autograft, which poses disadvantages such as high fiscal cost, possible loss of sensation at donor site and the requirement of two surgeries. Allografts are viable alternatives; however, intensive immunosuppressive treatments are often necessary to prevent host rejection. For this reason, significant efforts have been made to remove cellular material from allografts. These decellularized nerve grafts perform better than other clinically available grafts but not as well as autografts; therefore, current research on these grafts includes the incorporation of additional components such as growth factors and cells to provide chemical guidance to regenerating axons. However, effective cellular and axonal penetration is not achieved due to the small pore size (5-10?m) of the decellularized grafts. The overall objective of this study was to induce axially aligned channels in decellularized nerve grafts to facilitate enhanced cell penetration. The specific aims of this study were to optimize a decellularization method to enhance cellular removal, to induce axially aligned pore formation in decellularized grafts through a novel unidirectional freeze drying method, to study the bulk mechanical properties of these modified decellularized grafts and to assess cell penetration into these grafts. To this end we modified an existing decellularization protocol to improve cellular removal while preserving matrix structure in rat sciatic nerve sections. Standard freeze drying and unidirectional freeze drying were employed to impart the necessary pore architecture, and our results suggest that unidirectional freezing is a pertinent modification to the freeze drying process to obtain axially aligned channels. These highly porous scaffolds obtained using unidirectional freeze-drying possessed similar tensile properties to native nerve tissue and exhibited enhanced cellular penetration after 14 days of culture when compared to non-freeze dried and standard freeze-dried scaffolds. The results of this study not only highlight the importance of aligned pores of diameters ~20-60?m on cellular infiltration, but also presents unidirectional freeze drying as a viable technique for producing this required architecture in decellularized nerves. To the best of our knowledge, this study represents the first attempt to manipulate the physical structure of decellularized nerves to enhance cell penetration which may serve as a basis for future peripheral nerve regenerative strategies using decellularized allografts. PMID:25460409

  12. ProSeal™ laryngeal mask airway cuff pressure changes with and without use of nitrous oxide during laparoscopic surgery

    PubMed Central

    Sharma, Bimla; Gupta, Rajat; Sehgal, Raminder; Koul, Archna; Sood, Jayashree

    2013-01-01

    Background: The ProSeal™ laryngeal mask (PLMA) is increasingly being used as an airway device for laparoscopic surgery. Its silicone cuff allows diffusion of nitrous oxide, carbon dioxide and other gases with resultant rise in its intracuff pressure during anesthesia. The present study was designed to investigate the intracuff pressure changes during anesthesia with and without nitrous oxide in patients undergoing laparoscopic surgery lasting up to two hours. Materials and Methods: One hundred patients, American Society of Anesthesiologists physical status 2 and 3, undergoing general anesthesia with muscle paralysis, were randomized into two groups of 50 patients each to receive an anesthetic gas mixture containing either oxygen and nitrous oxide (group N) or oxygen and air (group A). Following insertion of an appropriate size PLMA, its cuff was inflated with air to an intracuff pressure of 45 mm Hg. The cuff pressure was measured every 10 minutes for the entire course of anesthesia. The position of the device was also assessed fiberoptically and postoperative airway complications were recorded. Results: The maximum intracuff pressure recorded in group N was 103 ± 4.7 mm Hg vs. 45.5 ± 1.5 mm Hg in group A. The percentage rise in cuff pressure every 10 minutes was also highly significant (P < 0.001) being maximum in first 10 min in group N. The incidence of postoperative airway complications was comparable between the two groups. Conclusion: The results of this study demonstrate that the intracuff pressure of the PLMA increases progressively over time when the breathing gas mixture contains nitrous oxide. PMID:23493234

  13. Life-threatening hypokalemic paralysis in a young bodybuilder.

    PubMed

    Cheung, Kitty K T; So, Wing-Yee; Kong, Alice P S; Ma, Ronald C W; Chow, Francis C C

    2014-01-01

    We report a case of life-threatening hypokalemia in a 28-year-old bodybuilder who presented with sudden onset bilateral lower limbs paralysis few days after his bodybuilding competition. His electrocardiogram (ECG) showed typical u-waves due to severe hypokalemia (serum potassium 1.6?mmol/L, reference range (RR) 3.5-5.0?mmol/L). He was admitted to the intensive care unit (ICU) and was treated with potassium replacement. The patient later admitted that he had exposed himself to weight loss agents of unknown nature, purchased online, and large carbohydrate loads in preparation for the competition. He made a full recovery after a few days and discharged himself from the hospital against medical advice. The severe hypokalemia was thought to be caused by several mechanisms to be discussed in this report. With the ever rising number of new fitness centers recently, the ease of online purchasing of almost any drug, and the increasing numbers of youngsters getting into the bodybuilding arena, clinicians should be able to recognize the possible causes of sudden severe hypokalemia in these patients in order to revert the pathophysiology. PMID:24660073

  14. Acute-onset paralysis in a patient of rheumatoid arthritis.

    PubMed

    Varshney, Ankur Nandan; Prasad, Pratibha; Kumar, Nilesh; Singh, Nand Kumar

    2015-01-01

    Renal tubular acidosis (RTA) is a disorder of renal acidification characterized by inability to acidify urine to pH < 5.5 despite the presence of severe systemic metabolic acidosis and hypokalemia. Hypokalemia leads to acute-onset paralysis and may be a presenting manifestation of RTA. Its association with various autoimmune disease has been reported previously in published reports, but has not been much em.phasized. We, hereby, report a case of RTA that presented during the flare of rheumatoid arthritis (RA). A 42-year-old female, a known case of RA for 5 years, presented with persistent joint pain for 1 week and acute-onset quadriparesis for 3 days. Primary investigations revealed hypokalemia with metabolic acidosis. She was managed conservatively with potassium supplements and bicarbonate supplements along with steroids and disease-modifying anti-rheumatic drugs. Such a presentation of renal tubular acidosis in a patient during the flare of rheumatoid arthritis is distinctly rare and previously unreported in published studies. PMID:26142942

  15. Pseudobulbar paralysis in the Renaissance: Cosimo I de' Medici case.

    PubMed

    Arba, F; Inzitari, D; Lippi, D

    2014-07-01

    Cosimo I de' Medici (1519-1574) was the first Grand Duke of Tuscany. He was one of the most important members of the Medici family. He was an excellent conqueror and a good politician. Moreover, he was able to attract and encourage artists, scientists and architects to promote Florence as the cultural capital of the Italian Renaissance. Historical chronicles report that he suffered from a stroke when he was 49 years old. Together with the acute manifestation of stroke, he displayed peculiar symptoms. He had gait disturbances and sphincter dysfunctions. His language became poor and hard to understand. His mood was very fluctuating and in the last years of his life he was a short-tempered man. In addition, he had a characteristic symptom, so-called pathological laughing and crying. The course of his disease was slow and stuttering. Taken together, these data seem to be one of the first reports of pseudobulbar paralysis. The disease of Cosimo I was probably due to a chronic cerebral vasculopathy, known as small vessels disease. We discuss this hypothesis regarding an ancient clinical case, with the support of current studies. PMID:24604411

  16. Assembly of Recombinant Israeli Acute Paralysis Virus Capsids

    PubMed Central

    Ren, Junyuan; Cone, Abigail; Willmot, Rebecca; Jones, Ian M.

    2014-01-01

    The dicistrovirus Israeli Acute Paralysis Virus (IAPV) has been implicated in the worldwide decline of honey bees. Studies of IAPV and many other bee viruses in pure culture are restricted by available isolates and permissive cell culture. Here we show that coupling the IAPV major structural precursor protein ORF2 to its cognate 3C-like processing enzyme results in processing of the precursor to the individual structural proteins in a number of insect cell lines following expression by a recombinant baculovirus. The efficiency of expression is influenced by the level of IAPV 3C protein and moderation of its activity is required for optimal expression. The mature IAPV structural proteins assembled into empty capsids that migrated as particles on sucrose velocity gradients and showed typical dicistrovirus like morphology when examined by electron microscopy. Monoclonal antibodies raised to recombinant capsids were configured into a diagnostic test specific for the presence of IAPV. Recombinant capsids for each of the many bee viruses within the picornavirus family may provide virus specific reagents for the on-going investigation of the causes of honeybee loss. PMID:25153716

  17. [Laser surgery in the treatment of bilateral vocal cord paralysis].

    PubMed

    Szmeja, Zygmunt; Wójtowicz, Jerzy G; Nowak, Katarzyna; Leszczy?ska, Ma?gorzata

    2003-01-01

    The introduction of surgical lasers into microsurgery of the larynx has made the resection of the posterior vocal cord with or without the arytenoid cartilage possible. This method of surgical treatment allows one to carry out a fast, non-open larynx procedure and practically bloodless operation with minimal postoperative trauma and edema of the surrounding tissues. Since November 1990 at the Clinic of Otolaryngology of the University School of Medical Sciences 48 arytenoidectomies (40 on the right side, 8 on the left side), 19 partial chordectomies and 25 Kashima operations. All surgical treatment were performed by means of CO2 laser in patients with bilateral paralysis of the vocal cords. In all patients postoperative recovery was correct and breathing difficulties were not observed after extubation. Laryngoscopic control examinations were performed a day after operation and a wide lumen of air through the operative field was observed. At the control examination, narrowing of the lumen of the larynx was not observed, the healing process of the operation area was without granulation. Laser arytenoidectomy allows good results of the breathing and phonation function. No changes of granulation proliferation were observed at the side of the CO2 laser treatment. Lack of reaction to laser beam there was possibility to use endoscopic procedures in patients who did not undergo a tracheotomy. PMID:15049179

  18. Life-Threatening Hypokalemic Paralysis in a Young Bodybuilder

    PubMed Central

    Cheung, Kitty K. T.; So, Wing-Yee; Kong, Alice P. S.; Ma, Ronald C. W.; Chow, Francis C. C.

    2014-01-01

    We report a case of life-threatening hypokalemia in a 28-year-old bodybuilder who presented with sudden onset bilateral lower limbs paralysis few days after his bodybuilding competition. His electrocardiogram (ECG) showed typical u-waves due to severe hypokalemia (serum potassium 1.6?mmol/L, reference range (RR) 3.5–5.0?mmol/L). He was admitted to the intensive care unit (ICU) and was treated with potassium replacement. The patient later admitted that he had exposed himself to weight loss agents of unknown nature, purchased online, and large carbohydrate loads in preparation for the competition. He made a full recovery after a few days and discharged himself from the hospital against medical advice. The severe hypokalemia was thought to be caused by several mechanisms to be discussed in this report. With the ever rising number of new fitness centers recently, the ease of online purchasing of almost any drug, and the increasing numbers of youngsters getting into the bodybuilding arena, clinicians should be able to recognize the possible causes of sudden severe hypokalemia in these patients in order to revert the pathophysiology. PMID:24660073

  19. Post Traumatic Delayed Bilateral Facial Nerve Palsy (FNP): Diagnostic Dilemma of Expressionless Face.

    PubMed

    Kumar, Rakesh; Mittal, Radhey Shyam

    2015-04-01

    Bilateral facial nerve palsy [FNP] is a rare condition. Mostly it is idiopathic. Post traumatic bilateral FNP is even more rare and having unique neurosurgical considerations. Post traumatic delayed presentation of bilateral FNP is socially debilitating and also having diagnostic challenge. Due to lack of facial asymmetry as present in unilateral facial paralysis, it is difficult to recognize. We are presenting a case of delayed onset bilateral FNP who developed FNP after 12 days of head injury with a brief discussion of its diagnostic dilemma and management along with literature review. PMID:26023597

  20. Post Traumatic Delayed Bilateral Facial Nerve Palsy (FNP): Diagnostic Dilemma of Expressionless Face

    PubMed Central

    Mittal, Radhey Shyam

    2015-01-01

    Bilateral facial nerve palsy [FNP] is a rare condition. Mostly it is idiopathic. Post traumatic bilateral FNP is even more rare and having unique neurosurgical considerations. Post traumatic delayed presentation of bilateral FNP is socially debilitating and also having diagnostic challenge. Due to lack of facial asymmetry as present in unilateral facial paralysis, it is difficult to recognize. We are presenting a case of delayed onset bilateral FNP who developed FNP after 12 days of head injury with a brief discussion of its diagnostic dilemma and management along with literature review. PMID:26023597

  1. Ulnar nerve dysfunction

    MedlinePLUS

    ... surface of the body where it crosses the elbow. The damage destroys the nerve covering ( myelin sheath) ... be caused by: Long-term pressure on the elbow An elbow fracture or dislocation Temporary pain and ...

  2. Diabetic Nerve Problems

    MedlinePLUS

    ... the wrong times. This damage is called diabetic neuropathy. Over half of people with diabetes get it. ... change positions quickly Your doctor will diagnose diabetic neuropathy with a physical exam and nerve tests. Controlling ...

  3. Vagus Nerve Stimulation

    PubMed Central

    Howland, Robert H.

    2014-01-01

    The vagus nerve is a major component of the autonomic nervous system, has an important role in the regulation of metabolic homeostasis, and plays a key role in the neuroendocrine-immune axis to maintain homeostasis through its afferent and efferent pathways. Vagus nerve stimulation (VNS) refers to any technique that stimulates the vagus nerve, including manual or electrical stimulation. Left cervical VNS is an approved therapy for refractory epilepsy and for treatment resistant depression. Right cervical VNS is effective for treating heart failure in preclinical studies and a phase II clinical trial. The effectiveness of various forms of non-invasive transcutaneous VNS for epilepsy, depression, primary headaches, and other conditions has not been investigated beyond small pilot studies. The relationship between depression, inflammation, metabolic syndrome, and heart disease might be mediated by the vagus nerve. VNS deserves further study for its potentially favorable effects on cardiovascular, cerebrovascular, metabolic, and other physiological biomarkers associated with depression morbidity and mortality. PMID:24834378

  4. Vagus Nerve Stimulation.

    PubMed

    Howland, Robert H

    2014-06-01

    The vagus nerve is a major component of the autonomic nervous system, has an important role in the regulation of metabolic homeostasis, and plays a key role in the neuroendocrine-immune axis to maintain homeostasis through its afferent and efferent pathways. Vagus nerve stimulation (VNS) refers to any technique that stimulates the vagus nerve, including manual or electrical stimulation. Left cervical VNS is an approved therapy for refractory epilepsy and for treatment resistant depression. Right cervical VNS is effective for treating heart failure in preclinical studies and a phase II clinical trial. The effectiveness of various forms of non-invasive transcutaneous VNS for epilepsy, depression, primary headaches, and other conditions has not been investigated beyond small pilot studies. The relationship between depression, inflammation, metabolic syndrome, and heart disease might be mediated by the vagus nerve. VNS deserves further study for its potentially favorable effects on cardiovascular, cerebrovascular, metabolic, and other physiological biomarkers associated with depression morbidity and mortality. PMID:24834378

  5. Sural nerve defects after nerve biopsy or nerve transfer as a sensory regeneration model for peripheral nerve conduit implantation.

    PubMed

    Radtke, C; Kocsis, J D; Reimers, K; Allmeling, C; Vogt, P M

    2013-09-01

    Nerve repair after injury can be effectively accomplished by direct suture approximation of the proximal and distal segments. This is more successful if coadaptation can be achieved without tension. Currently, the gold standard repair of larger deficits is the transplantation of an autologous sensory sural nerve graft. However, a significant disadvantage of this technique is the inevitable donor morbidity (sensory loss, neuroma and scar formation) after harvesting of the sural nerve. Moreover, limitation of autologous donor nerve length and fixed diameter of the available sural nerve are major drawbacks of current autograft treatment. Another approach that was introduced for nerve repair is the implantation of alloplastic nerve tubes made of, for example, poly-L-lactide. In these, nerve stumps of the transected nerves are surgically bridged using the biosynthetic conduit. A number of experimental studies, primarily in rodents, indicate axonal regeneration and remyelination after implantation of various conduits. However, only limited clinical studies with conduit implantation have been performed in acute peripheral nerve injuries particularly on digital nerves. Clinical transfer of animal studies, which can be carefully calibrated for site and extent of injury, to humans is difficult to interpret due to the intrinsic variability in human nerve injuries. This prevents effective quantification of improvement and induces bias in the study. Therefore, standardization of lesion/repair in human studies is warranted. Here we propose to use sural nerve defects, induced due to nerve graft harvesting or from diagnostic nerve biopsies as a model site to enable standardization of nerve conduit implantation. This would help better with the characterization of the implants and its effectiveness in axonal regeneration and remyelination. Nerve regeneration can be assessed, for example, by recovery of sensation, measured non-invasively by threshold to von Frey filaments and cold allodynia. Moreover, the implantation of nerve conduits may not only serve as a model to examine nerve repair, but it could also prevent neuroma formation, which is a major morbidity of sural nerve extraction. PMID:23867139

  6. Optic nerve aspergillosis.

    PubMed

    Yuan, Lisi; Prayson, Richard A

    2015-07-01

    We report a 55-year-old woman with optic nerve Aspergillosis. Aspergillus is an ubiquitous airborne saprophytic fungus. Inhaled Aspergillus conidia are normally eliminated in the immunocompetent host by innate immune mechanisms; however, in immunosuppressed patients, they can cause disease. The woman had a past medical history of hypertension and migraines. She presented 1year prior to death with a new onset headache behind the left eye and later developed blurred vision and scotoma. A left temporal artery biopsy was negative for giant cell arteritis. One month prior to the current admission, she had an MRI showing optic nerve thickening with no other findings. Because of the visual loss and a positive antinuclear antibody test, she was given a trial of high dose steroids and while it significantly improved her headache, her vision did not improve. At autopsy, the left optic nerve at the level of the cavernous sinus and extending into the optic chiasm was enlarged in diameter and there was a 1.3cm firm nodule surrounding the left optic nerve. Histologically, an abscess surrounded and involved the left optic nerve. Acute angle branching, angioinvasive fungal hyphae were identified on Grocott's methenamine silver stained sections, consistent with Aspergillus spp. No gross or microscopic evidence of systemic vasculitis or infection was identified in the body. The literature on optic nerve Aspergillosis is reviewed. PMID:25861888

  7. Ultrasound in Dual Nerve Impairment after Proximal Radial Nerve Lesion

    PubMed Central

    Lämmer, Alexandra B; Schwab, Stefan; Schramm, Axel

    2015-01-01

    Introduction Sonography in classical nerve entrapment syndromes is an established and validated method. In contrast, few publications highlight lesions of the radial nerve, particularly of the posterior interosseus nerve (PIN). Method Five patients with a radial nerve lesion were investigated by electromyography, nerve conduction velocity and ultrasound. Further normative values of 26 healthy subjects were evaluated. Results Four patients presented a clinical and electrophysiological proximal axonal radial nerve lesion and one patient showed a typical posterior interosseous nerve syndrome (PINS). The patient with PINS presented an enlargement of the PIN anterior to the supinator muscle. However four patients with proximal lesions showed an unexpected significant enlargement of the PIN within the supinator muscle. Conclusion High-resolution sonography is a feasible method to demonstrate the radial nerve including its distal branches. At least in axonal radial nerve lesions, sonography might reveal abnormalities far distant from a primary proximal lesion site clearly distinct from the appearance in classical PINS. PMID:25992766

  8. Raman spectroscopy for optical diagnosis of laryngeal cancer

    NASA Astrophysics Data System (ADS)

    Teh, Seng Khoon; Zheng, Wei; Lau, David P.; Huang, Zhiwei

    2008-02-01

    In this report, the diagnostic ability of near-infrared (NIR) Raman spectroscopy for identifying the malignant tumors from normal tissues in the larynx was studied. A rapid NIR Raman system was utilized. Multivariate statistical techniques were employed to develop effective diagnostic algorithms. Raman spectra in the range of 800-1,800 cm-1 differed significantly between normal and malignant tumor tissues. The diagnostic algorithms can yielded a diagnostic sensitivity of 92.9% and specificity 83.3% for separating malignant tumors from normal laryngeal tissues. NIR Raman spectroscopy with multivariate statistical techniques has a potential for the non-invasive detection of malignant tumors in the larynx.

  9. [Immunophenotype of blood lymphocytes in elderly patients with laryngeal cancer].

    PubMed

    Dworacki, G; Trybus, M; Jezewska, E; Kruk-Zagajewska, A; Szmeja, Z; Zeromski, J

    1998-01-01

    In a group of 42 patients with surgically treated laryngeal carcinoma, who were divided into those before their 50 and after 60 years of age, main lymphocyte subsets of peripheral blood lymphocytes were assessed by means of flow cytometry. In the group after 60 years of age significantly increased percentage and raised total number of NK (natural killer) cells were found. In the whole group increased total number of all lymphocyte subsets was found. These data indicate that older patients despite an increased number of total to lymphocytes NK cells show higher percentage and total number as compared with normal population at that age. PMID:9814021

  10. Management of advanced laryngeal and hypopharyngeal plexiform neurofibroma in adults.

    PubMed

    Dave, Sandeep P; Farooq, Uzma; Civantos, Francisco J

    2008-01-01

    Laryngeal neurofibromas are rare. The plexiform subtype is less common and often presents during childhood in association with neurofibromatosis type I. Because it is unencapsulated and more aggressive, plexiform neurofibroma presents a management dilemma. Imaging, particularly magnetic resonance imaging, can aid in diagnosing neurofibroma, differentiating the nonplexiform and plexiform subtypes, and planning the subsequent operative approach. The importance of conservative surgery to relieve symptoms, but preserve laryngopharyngeal function, and close follow-up are stressed. We report 2 adult cases of plexiform neurofibroma involving the larynx and hypopharynx and discuss the controversies in management. PMID:18598841

  11. A calcium channel mutant mouse model of hypokalemic periodic paralysis

    PubMed Central

    Wu, Fenfen; Mi, Wentao; Hernández-Ochoa, Erick O.; Burns, Dennis K.; Fu, Yu; Gray, Hillery F.; Struyk, Arie F.; Schneider, Martin F.; Cannon, Stephen C.

    2012-01-01

    Hypokalemic periodic paralysis (HypoPP) is a familial skeletal muscle disorder that presents with recurrent episodes of severe weakness lasting hours to days associated with reduced serum potassium (K+). HypoPP is genetically heterogeneous, with missense mutations of a calcium channel (CaV1.1) or a sodium channel (NaV1.4) accounting for 60% and 20% of cases, respectively. The mechanistic link between CaV1.1 mutations and the ictal loss of muscle excitability during an attack of weakness in HypoPP is unknown. To address this question, we developed a mouse model for HypoPP with a targeted CaV1.1 R528H mutation. The Cav1.1 R528H mice had a HypoPP phenotype for which low K+ challenge produced a paradoxical depolarization of the resting potential, loss of muscle excitability, and weakness. A vacuolar myopathy with dilated transverse tubules and disruption of the triad junctions impaired Ca2+ release and likely contributed to the mild permanent weakness. Fibers from the CaV1.1 R528H mouse had a small anomalous inward current at the resting potential, similar to our observations in the NaV1.4 R669H HypoPP mouse model. This “gating pore current” may be a common mechanism for paradoxical depolarization and susceptibility to HypoPP arising from missense mutations in the S4 voltage sensor of either calcium or sodium channels. PMID:23187123

  12. Golli-induced paralysis: a study in anergy and disease.

    PubMed

    Clark, L; Otvos, L; Stein, P L; Zhang, X M; Skorupa, A F; Lesh, G E; McMorris, F A; Heber-Katz, E

    1999-04-01

    The Golli-MBP transcription unit contains three Golli-specific exons as well as the seven exons of the classical myelin basic protein (MBP) gene and encodes alternatively spliced proteins that share amino acid sequence with MBP. Unlike MBP, which is a late Ag expressed only in the nervous system, Golli exon-containing gene products are expressed both pre- and postnatally at many sites, including lymphoid tissue, as well as in the central nervous system. To investigate whether Golli-MBP peptides unique to Golli would result in neurological disease, we immunized rats and observed a novel neurological disease characterized by mild paralysis and the presence of groups of lymphocytes in the subarachnoid space but not in the parenchyma of the brain. Disease was induced by Th1-type T cells that displayed an unusual activation phenotype. Primary stimulation in vitro induced T cell proliferation with increased surface CD45RC that did not become down-regulated as it did in other Ag-stimulated cultures. Secondary stimulation of this CD45RChigh population with Ag, however, did not induce proliferation or IL-2 production, although an IFN-gamma-producing population resulted. Proliferation could be induced by secondary stimulation with IL-2 or PMA-ionomycin, suggesting an anergic T cell population. Cells could adoptively transfer disease after secondary stimulation with IL-2, but not with Ag alone. These responses are suggestive of a chronically stimulated, anergic population that can be transiently activated to cause disease, fall back into an anergic state, and reactivated to cause disease again. Such a scenario may be important in chronic human disease. PMID:10201962

  13. Resolution of sleep paralysis by weak electromagnetic fields in a patient with multiple sclerosis.

    PubMed

    Sandyk, R

    1997-08-01

    Sleep paralysis refers to episodes of inability to move during the onset of sleep or more commonly upon awakening. Patients often describe the sensation of struggling to move and may experience simultaneous frightening vivid hallucinations and dreams. Sleep paralysis and other manifestations of dissociated states of wakefulness and sleep, which reflect deficient monoaminergic regulation of neural modulators of REM sleep, have been reported in patients with multiple sclerosis (MS). A 40 year old woman with remitting-progressive multiple sclerosis (MS) experienced episodes of sleep paralysis since the age of 16, four years prior to the onset of her neurological symptoms. Episodes of sleep paralysis, which manifested at a frequency of about once a week, occurred only upon awakening in the morning and were considered by the patient as a most terrifying experience. Periods of mental stress, sleep deprivation, physical fatigue and exacerbation of MS symptoms appeared to enhance the occurrence of sleep paralysis. In July of 1992 the patient began experimental treatment with AC pulsed applications of picotesla intensity electromagnetic fields (EMFs) of 5Hz frequency which were applied extracerebrally 1-2 times per week. During the course of treatment with EMFs the patient made a dramatic recovery of symptoms with improvement in vision, mobility, balance, bladder control, fatigue and short term memory. In addition, her baseline pattern reversal visual evoked potential studies, which showed abnormally prolonged latencies in both eyes, normalized 3 weeks after the initiation of magnetic therapy and remained normal more than 2.5 years later. Since the introduction of magnetic therapy episodes of sleep paralysis gradually diminished and abated completely over the past 3 years. This report suggests that MS may be associated with deficient REM sleep inhibitory neural mechanisms leading to sleep paralysis secondary to the intrusion of REM sleep atonia and dream imagery into the waking state. Pineal melatonin and monoaminergic neurons have been implicated in the induction and maintenance of REM sleep and the pathogenesis of sleep paralysis and it is suggested that resolution of sleep paralysis in this patient by AC pulsed applications of EMFs was related to enhancement of melatonin circadian rhythms and cerebral serotoninergic neurotransmission. PMID:9352423

  14. Repair of sciatic nerve defects using tissue engineered nerves

    PubMed Central

    Zhang, Caishun; Lv, Gang

    2013-01-01

    In this study, we constructed tissue-engineered nerves with acellular nerve allografts in Sprague-Dawley rats, which were prepared using chemical detergents-enzymatic digestion and mechanical methods, in combination with bone marrow mesenchymal stem cells of Wistar rats cultured in vitro, to repair 15 mm sciatic bone defects in Wistar rats. At postoperative 12 weeks, electrophysiological detection results showed that the conduction velocity of regenerated nerve after repair with tissue-engineered nerves was similar to that after autologous nerve grafting, and was higher than that after repair with acellular nerve allografts. Immunohistochemical staining revealed that motor endplates with acetylcholinesterase-positive nerve fibers were orderly arranged in the middle and superior parts of the gastrocnemius muscle; regenerated nerve tracts and sprouted branches were connected with motor endplates, as shown by acetylcholinesterase histochemistry combined with silver staining. The wet weight ratio of the tibialis anterior muscle at the affected contralateral hind limb was similar to the sciatic nerve after repair with autologous nerve grafts, and higher than that after repair with acellular nerve allografts. The hind limb motor function at the affected side was significantly improved, indicating that acellular nerve allografts combined with bone marrow mesenchymal stem cell bridging could promote functional recovery of rats with sciatic nerve defects. PMID:25206507

  15. Vitamin D3 potentiates myelination and recovery after facial nerve injury.

    PubMed

    Montava, Marion; Garcia, Stéphane; Mancini, Julien; Jammes, Yves; Courageot, Joël; Lavieille, Jean-Pierre; Feron, François

    2014-09-27

    Roles of vitamin D on the immune and nervous systems are increasingly recognized. Two previous studies demonstrated that ergocalciferol (vitamin D2) or cholecalciferol (vitamin D3) induced functional recovery and increased myelination in a rat model of peroneal nerve transection. The current report assessed whether cholecalciferol was efficient in repairing transected rabbit facial nerves. Animals were randomized into two groups of rabbits with an unilateral facial nerve surgery: the vitamin D group included animals receiving a weekly oral bolus of vitamin D3 (200 IU/kg/day), from day 1 post-surgery; the control group included animals receiving a weekly oral bolus of vehicle (triglycerides). Contralateral unsectioned facial nerves from all experimental animals were used as controls for the histological study. The facial functional index was measured every week while the inner diameter of myelin sheath and the G ratio were quantified at the end of the 3 month experiment. The current report indicates that cholecalciferol significantly increases functional recovery and myelination, after 12 weeks of treatment. To the best of our knowledge, this is the first study investigating the therapeutic benefit of vitamin D supplementation in an animal model of facial paralysis. It paves further the way for clinical trials based on the administration of this steroid in individuals with injured facial nerves. PMID:25261104

  16. Observation of arytenoid movement during laryngeal elevation using videoendoscopic evaluation of swallowing.

    PubMed

    Abe, Hiromasa; Tsubahara, Akio

    2011-06-01

    The purpose of this study was to confirm that the arytenoid regions dynamically adduct and extend upward toward the epiglottis during laryngeal elevation. While 14 healthy volunteers aged 19-32 years old swallowed 5 ml of white soft yogurt in one gulp without chewing, the movement of the arytenoid regions was observed for videoendoscopic evaluation of swallowing (VE). Each moving image was stored simultaneously on videotape. A cross-sectional area surrounded by the epiglottis and the bilateral arytenoid regions (S) and the length of a straight line passing through the anterior borders of the left and right arytenoid regions (L) were measured. The relative area of the entrance in the laryngeal vestibule was calculated as [S/L (2)] before the swallowing reflex (resting condition), just before laryngeal closure, and just after laryngeal closure. [S/L (2)] was smaller just before epiglottal descent than at the resting condition, and became smallest just after the epiglottis started to ascend. The mean area narrowed to 37.9% of the resting area just after laryngeal closure and in the most extreme case to 8.7% of the resting area. It was demonstrated that the arytenoid regions adducted and extended up toward the epiglottis during laryngeal elevation. The technique used to measure the cross-sectional area of the entrance in the laryngeal vestibule employing VE was an effective analytical procedure. PMID:20640582

  17. [Rare problem with the insertion of a Supreme™ laryngeal mask airway device. Case of the trimester].

    PubMed

    2014-03-01

    A breast tumor was resected under general anesthesia. After induction, the airway was managed with a Supreme™ laryngeal mask airway device. The insertion of the laryngeal mask airway device, the insertion of the orogastric tube through the drain tube, as well as the mechanical ventilation, were very difficult from the beginning. On removing the laryngeal mask airway device to solve the problem, it was observed that the drain tube was broken, and the orogastric tube had passed into the anterior, laryngeal part of the device through the split. It was later found out that the laryngeal mask airway device, as well as the whole manufacturing batch, had suffered a design modification: the cuff was constructed with a softer material without reinforcement in the tip, and the drain tube had a heat-sealing defect that facilitated the break. The incident was reported to the local supplier and the manufacturer, and the defective batch of laryngeal mask airway devices was recalled. The incident was also reported to other hospitals via SENSAR, to warn other users of the potential dangers of the design modification in the Supreme™ laryngeal mask airway. PMID:24156888

  18. A foreign body of the larynx misdiagnosed as vocal cord paralysis

    PubMed Central

    Kumar, Sunil; Singh, Devendra Bahadur; Singh, Abhishek Bahadur

    2013-01-01

    Foreign bodies in the aerodigestive tract continue to be a common problem that contribute significantly to high morbidity and mortality all over the world. Laryngeal foreign bodies may present with less severe symptoms compared with lower respiratory tract foreign bodies, resulting in misdiagnosis, confusion and delay in diagnosis. Rigid endoscopy with forceps removal under general anaesthesia is the preferred management modality. This case is described to show the importance of a detailed history and examination including X-ray neck in children to rule out any radiopaque laryngeal foreign body as a delay in diagnosis and management can lead to life-threatening complications. PMID:23853027

  19. Laryngeal effects of nasal allergen provocation in singers with allergic rhinitis.

    PubMed

    Verguts, Monique M L; Eggermont, Anita; Decoster, Wivine; de Jong, Felix I C R S; Hellings, Peter W

    2011-03-01

    In spite of our recent insight into nasobronchial interaction mechanisms in allergic airway disease, the association between allergic rhinitis and voice complaints remains obscure. To evaluate the effects of nasal allergen provocation and seasonal grass pollen exposure on subjective and objective laryngeal parameters in singers with and without allergic rhinitis, an observational case control study was conducted. Prior to the pollen season, six grass pollen allergic and six non-allergic semiprofessional singers were exposed to nebulized sham solution and grass pollen extract (HAL°) in rising concentrations. After 3 min, 60 min and 24 h, nasal and laryngeal complaints were evaluated by the use of a visual analog scale (VAS). Laryngeal parameters like voice appearance (video stroboscopic images), voice range profile and subjective (GRBAS) and objective (jitter, shimmer, H/N, DSI) voice quality were evaluated before provocation, after 60 min and 24 h. During the pollen season, the allergic singers were re-evaluated. Results showed that in allergic singers both nasal (TNS of 4.0 ± 2.4 vs. 0.0 ± 0.0, p < 0.05) and laryngeal complaints (TLS of 1.4 ± 1.1 vs. 0.0 ± 0.2, p < 0.05) were induced at 3 min after the provocation. The induced laryngeal complaints were the feeling of laryngeal irritation, secretions and globus. No change in voice quality or stroboscopy score was measured. During the pollen season, laryngeal complaints were present (TLS of 2.4 ± 2.4) in allergic singers, without evidence for objective voice and laryngeal changes. In conclusion, we here demonstrate the rapid induction of laryngeal complaints in allergic singers by nasal allergen provocation and during the pollen season. There was no subject reported or investigator measured change in voice quality. No change in stroboscopy score was measured. PMID:21072528

  20. Very late-onset friedreich ataxia with laryngeal dystonia.

    PubMed

    Rota, Silvia; Marchina, Eleonora; Todeschini, Alice; Nanetti, Lorenzo; Rinaldi, Fabrizio; Vanotti, Alessandra; Mariotti, Caterina; Padovani, Alessandro; Filosto, Massimiliano

    2014-01-01

    Friedreich ataxia (FRDA) is an autosomal recessive neurodegenerative disorder characterized by progressive gait and limb ataxia, cerebellar, pyramidal and dorsal column involvement, visual defects, scoliosis, pes cavus and cardiomyopathy. It is caused by a homozygous guanine-adenine-adenine (GAA) trinucleotide repeat expansion in intron 1 of the frataxin gene (FXN) on chromosome 9q13-q21.1. Onset is usually in the first or second decade of life; however, late-onset cases of Freidreich ataxia (LOFA), after the age of 25 years, and very late-onset cases of Freidreich ataxia (VLOFA), after the age of 40 years, have been reported. VLOFA is quite rare and usually presents a milder progression of the disease. We report the case of a 64-year-old woman affected with VLOFA whose first symptoms (balance and gait disturbances) occurred at the age of 44 years. At the age of 62 years, she started complaining of a slowly progressive dysphonia showing the clinical aspects of laryngeal dystonia. Molecular analysis showed a 210- and 230-trinucleotide GAA repeat expansion in the two alleles of the FXN gene. Laryngeal dystonia has been reported only in very few cases of ataxia syndrome and never before in FRDA patients. It may represent a rare clinical manifestation of VLOFA thus confirming the high variability of the clinical spectrum of FRDA. PMID:25685137

  1. Evaluation of Voice Disorders in Patients with Active Laryngeal Tuberculosis

    PubMed Central

    Lucena, Marcia Mendonça; da Silva, Fernanda dos Santos; da Costa, Ananda Dutra; Guimarães, Gabriela Rodrigues; Ruas, Ana Cristina Nunes; Braga, Frederico Pereira Bom; Braga, Mateus Pereira Bom; Reis, João Gustavo Corrêa; da Costa, Daniel César Silva; Palmeiro, Mariana Reuter; Rolla, Valéria Cavalcanti; Valete-Rosalino, Cláudia Maria

    2015-01-01

    Introduction Laryngeal tuberculosis (LTB) is the most frequent larynx granulomatous disease. In general there is lung involvement, but in an important proportion of cases you can find LTB without pulmonary disease. The lesions observed in LTB, such as ulceration and fibrosis, can interfere in the process of voice production. The involvement of the mucous lining of the vocal folds can change their flexibility and, consequently, change voice quality, and the main symptom is dysphonia present in almost 90% of cases. Objective To describe the anatomical characteristics and voice quality in LTB patients. Material and Method A descriptive cross-sectional study was conducted with 24 patients. Result The most frequently affected sites were vocal folds in 87.5% patients, vestibular folds in 66.7%, epiglottis in 41.7%, arytenoid in 50%, aryepiglottic folds in 33.3%, and interarytenoid region in 33.3% patients. We found 95.8% cases of dysphonia. The voice acoustic analysis showed 58.3% cases of Jitter alterations, 83.3% of Shimmer and 70.8% of GNE. Conclusion Voice disorders found in active laryngeal tuberculosis are similar to those reported after clinical healing of the disease, suggesting that sequelae and vocal adjustments may install during the active phase of the disease, negatively impacting the process of vocal quality reestablishment. PMID:26009888

  2. Radiotherapy of advanced laryngeal cancer using three small fractions daily

    SciTech Connect

    Bradley, P.J.; Morgan, D.A. (Combined Head and Neck Oncology Clinic, University Hospital, Nottingham (England))

    1991-06-01

    Since 1983, the authors have treated advanced (UICC stages 3 and 4) squamous carcinomas of the larynx by primary radiotherapy, using three small fractions a day, 3-4 h interfraction interval, 5 days per week. The early patients received doses per fraction of 1.5 Gy, and a total dose of approximately 70 Gy, given as a split-course over 6 to 7 weeks. While overall tumor control and laryngeal preservation was good, a number of severe late radiation reactions were seen. The schedule was then modified, with a reduction in the fraction size to 1.1 Gy, the total dose to 60 Gy, and the overall time to 4 weeks, with omission of the mid-treatment split. Since 1986, we have treated 26 patients in this way. Acute reactions are brisk, but rapidly healing. Loco-regional control was achieved in 22 patients, only one of whom has relapsed to date, in a solitary node, salvaged by radical neck dissection. Four have died of uncontrolled loco-regional malignancy, and three of intercurrent disease while in clinical remission. No serious late morbidity has been observed in surviving patients, and vocal quality is good in the majority. These results suggest that this hyperfractionated and accelerated radiotherapy schedule may offer an acceptable nonsurgical, voice-preserving treatment for advanced laryngeal carcinoma; it can be used in a normally working radiotherapy department.

  3. [Hidden chromosome instability and risk of laryngeal cancer incidence].

    PubMed

    Dabrowski, P; Kita, S; Szyfter, W; Szmeja, Z; Jarmuz, M; Szyfter, K

    1999-01-01

    The bleomycin test is a recognised method of evaluation of hidden genetical instability. The concept of the test consists in inducing chromosome aberrations in lymphocytes exposed in vitro to bleomycin and subsequent quantitative analysis of chromosome breaks. The study material was whole venous blood from 61 laryngeal cancer patients and from 30 healthy persons taken as a control. For each patient two parallel cultures where carried out in the standard procedure. Bleomycin was added to one of the cultures to induce chromosome breaks. Then, in microscopic metaphasal plates stained by Giemsa dye, the chromosome instability index estimated as a number of chromosome breaks per cell (b/c) and the percentage of cells with chromosome breaks were calculated. Higher indices of chromosome instability were demonstrated in laryngeal cancer patients in comparison to the controls. The persons with chromosome instability (b/c > 0.8) or with chromosome oversensitivity to mutagens (b/c > 1) were identified only among larynx cancer subjects. Furthermore, it was established that an increased chromosome instability is associated with high aggressiveness recognised by histological grading. The latter finding requires confirmation on an enlarged group of subjects. PMID:10481492

  4. Very Late-Onset Friedreich Ataxia with Laryngeal Dystonia

    PubMed Central

    Rota, Silvia; Marchina, Eleonora; Todeschini, Alice; Nanetti, Lorenzo; Rinaldi, Fabrizio; Vanotti, Alessandra; Mariotti, Caterina; Padovani, Alessandro; Filosto, Massimiliano

    2014-01-01

    Friedreich ataxia (FRDA) is an autosomal recessive neurodegenerative disorder characterized by progressive gait and limb ataxia, cerebellar, pyramidal and dorsal column involvement, visual defects, scoliosis, pes cavus and cardiomyopathy. It is caused by a homozygous guanine-adenine-adenine (GAA) trinucleotide repeat expansion in intron 1 of the frataxin gene (FXN) on chromosome 9q13-q21.1. Onset is usually in the first or second decade of life; however, late-onset cases of Freidreich ataxia (LOFA), after the age of 25 years, and very late-onset cases of Freidreich ataxia (VLOFA), after the age of 40 years, have been reported. VLOFA is quite rare and usually presents a milder progression of the disease. We report the case of a 64-year-old woman affected with VLOFA whose first symptoms (balance and gait disturbances) occurred at the age of 44 years. At the age of 62 years, she started complaining of a slowly progressive dysphonia showing the clinical aspects of laryngeal dystonia. Molecular analysis showed a 210- and 230-trinucleotide GAA repeat expansion in the two alleles of the FXN gene. Laryngeal dystonia has been reported only in very few cases of ataxia syndrome and never before in FRDA patients. It may represent a rare clinical manifestation of VLOFA thus confirming the high variability of the clinical spectrum of FRDA. PMID:25685137

  5. Petrositis With Bilateral Abducens Nerve Palsies complicated by Acute Otitis Media

    PubMed Central

    Choi, Kyu Young

    2014-01-01

    Petrous apicitis is a rare but fatal complication of otitis media. An infection within the middle ear can extend within the temporal bone into the air cells of the petrous apex. With only the thin dura mater separating the trigeminal ganglion and the 6th cranial nerve from the bony petrous apex, they are vulnerable to inflammatory processes, resulting in deep facial pain, lateral rectus muscle paralysis, and diplopia. In 1904, Gradenigo described a triad of symptoms related to petrous apicitis, including acute suppurative otitis media, deep facial pain resulting from trigeminal involvement, and abducens nerve palsy. It has traditionally been treated with surgery, but recent advances in imaging, with improved antibiotic treatment, allow conservative management. In this case report, we describe a clinical and neuroradiological evolution of a child with a petrous apicitis after acute otitis media, which was managed medically with a positive outcome. PMID:24587883

  6. Management of the Facial Nerve in Lateral Skull Base Surgery Analytic Retrospective Study

    PubMed Central

    El Shazly, Mohamed A.; Mokbel, Mahmoud A.M.; Elbadry, Amr A.; Badran, Hatem S.

    2011-01-01

    Background: Surgical approaches to the jugular foramen are often complex and lengthy procedures associated with significant morbidity based on the anatomic and tumor characteristics. In addition to the risk of intra-operative hemorrhage from vascular tumors, lower cranial nerves deficits are frequently increased after intra-operative manipulation. Accordingly, modifications in the surgical techniques have been developed to minimize these risks. Preoperative embolization and intra-operative ligation of the external carotid artery have decreased the intraoperative blood loss. Accurate identification and exposure of the cranial nerves extracranially allows for their preservation during tumor resection. The modification of facial nerve mobilization provides widened infratemporal exposure with less postoperative facial weakness. The ideal approach should enable complete, one stage tumor resection with excellent infratemporal and posterior fossa exposure and would not aggravate or cause neurologic deficit. The aim of this study is to present our experience in handling jugular foramen lesions (mainly glomus jugulare) without the need for anterior facial nerve transposition. Methods: In this series we present our experience in Kasr ElEini University hospital (Cairo—Egypt) in handling 36 patients with jugular foramen lesions over a period of 20 years where the previously mentioned preoperative and operative rules were followed. The clinical status, operative technique and postoperative care and outcome are detailed and analyzed in relation to the outcome. Results: Complete cure without complications was achieved in four cases of congenital cholesteatoma and four cases with class B glomus. In advanced cases of glomus jugulare (28 patients) (C and D stages) complete cure was achieved in 21 of them (75%). The operative complications were also related to this group of 28 patients, in the form of facial paralysis in 20 of them (55.6%) and symptomatic vagal paralysis in 18 of them (50%). Conclusions: Total anterior rerouting of the facial nerve carries a high risk of facial paralysis. So it should be reserved for cases where the lesion extends beyond the vertical ICA. Otherwise, for less extensive lesions and less aggressive pathologies, less aggressive approaches could be adopted with less hazards. PMID:24179402

  7. Monkey median nerve repaired by nerve graft or collagen nerve guide tube.

    PubMed

    Archibald, S J; Shefner, J; Krarup, C; Madison, R D

    1995-05-01

    Nerve regeneration was followed in 15 median and 1 ulnar nerve of eight Macaca fascicularis monkeys by serial electrophysiological assessments over a period of three and a half years. Nerve gaps of 5 mm at the wrist were bridged by collagen-based nerve guides, nerve autografts, or direct suture repairs. Thenar muscle reinnervation occurred between 50 and 70 d for all groups, indicating axonal elongation rates of approximately 1 mm/d. The recovery rates of the compound muscle action potential (CMAP) and the compound sensory action potential (CSAP) amplitudes were significantly slower after direct suture repair compared to the other two procedures, although the final levels of recovery were all comparable. Similar results were achieved in one median and one ulnar nerve following nerve guide repair of a 15 mm nerve gap. The functional reinnervation of Pacinian corpuscles was detected in all cases following either nerve graft or nerve guide repair, with similar amplitudes and latencies of the tactile evoked CSAP for both types of repair. Histological analysis demonstrated a significant increase in the number of myelinated axons in the median nerve distal to the nerve lesions following both nerve graft and nerve guide repairs compared to proximal and normal controls, with significant reductions of fiber diameter and corresponding increases in g-ratio. The return of a bimodal frequency distribution of myelinated axon fiber diameter was confirmed by three-dimensional surface plots which illustrate the frequency distribution of the relationship between fiber diameter and g-ratio. These combined results demonstrate that nerve regeneration after repair of a 5 mm nerve gap with a collagen nerve guide in the nonhuman primate is similar to that after graft repair, and the final level of physiological recovery for both repair procedures is comparable to direct suture repair of the median nerve. PMID:7751969

  8. Relationship between isolated sleep paralysis and geomagnetic influences: a case study.

    PubMed

    Conesa, J

    1995-06-01

    This preliminary report, of a longitudinal study, looks at the relationship between geomagnetic activity and the incidence of isolated sleep paralysis over a 23.5-mo. period. The author, who has frequently and for the last 24 years experienced isolated sleep paralysis was the subject. In addition, incidence of lucid dreaming, vivid dreams, and total dream frequency were looked at with respect to geomagnetic activity. The data were in the form of dream-recall frequency recorded in a diary. These frequency data were correlated with geomagnetic activity k-index values obtained from two observatories. A significant correlation was obtained between periods of local geomagnetic activity and the incidence of isolated sleep paralysis. Specifically, periods of relatively quiet geomagnetic activity were significantly associated with an increased incidence of episodes. PMID:7478886

  9. Sprouting and regression of the nerve at the frog neuromuscular junction in normal conditions and after prolonged paralysis with curare

    Microsoft Academic Search

    A. Wernig; M. Pécot-Dechavassine; H. Stöver

    1980-01-01

    Summary A light microscopical, histochemical and electron microscopical investigation of the frog neuromuscular junction has been performed on muscles from animals in different functional states of activity.

  10. Overview of Optic Nerve Disorders

    MedlinePLUS

    ... each optic nerve splits, and half of its fibers cross over to the other side. Because of this anatomic arrangement, damage along the optic nerve pathway causes specific patterns of vision loss. ...

  11. A scientific note on Israeli acute paralysis virus infection of Eastern honeybee Apis cerana and vespine predator

    E-print Network

    A scientific note on Israeli acute paralysis virus infection of Eastern honeybee Apis cerana / IAPV / virus / honeybee The Israeli acute paralysis virus (IAPV; Maori et al. 2007; de Miranda et al. 2010) is widespread in Western honeybees (Apis mellifera) for whom it can be a marker of colony losses

  12. Vagus Nerve Stimulation

    Microsoft Academic Search

    Arun Paul Amar; Michael L. Levy; Charles Y. Liu; Michael L. J. Apuzzo

    2008-01-01

    Vagus nerve stimulation (VNS) is a safe and reliable treatment adjunct for patients with medically intractable epilepsy. It is both a preventive and an abortive form of therapy, potentially effective against both partial and generalized seizures in adults and children. VNS also has a number of serendipitous effects on mood, memory, and attention and has been approved for the treatment

  13. Ischemic Nerve Block.

    ERIC Educational Resources Information Center

    Williams, Ian D.

    This experiment investigated the capability for movement and muscle spindle function at successive stages during the development of ischemic nerve block (INB) by pressure cuff. Two male subjects were observed under six randomly ordered conditions. The duration of index finger oscillation to exhaustion, paced at 1.2Hz., was observed on separate…

  14. Effects of C fiber blockade on cardiorespiratory responses to laryngeal stimulation in concious lambs.

    PubMed

    Roulier, Sébastien; Arsenault, Julie; Reix, Philippe; Dorion, Dominique; Praud, Jean-Paul

    2003-06-12

    The primary aim of the study was to explore cardiorespiratory reflexes originating from laryngeal C fiber endings in the neonatal period. Seventeen lambs were instrumented for recording glottal adductor and diaphragm EMG, heart rate, systemic arterial pressure and respiratory movements. C fiber blockade was induced in eight lambs by 30 mg/kg capsaicin, the remaining nine lambs serving as controls. Cardiorespiratory reflexes were induced in non-sedated lambs by flowing air, menthol or 13% CO2, or by injecting water or 50 microg capsaicin in the laryngeal inlet through an endoscope. Responses to all stimuli but capsaicin were similar between the two groups. While cardiorespiratory responses were induced by capsaicin in control lambs, the responses were significantly inhibited in lambs with C fiber blockade. We conclude that laryngeal C fiber endings are functional and responsible for laryngeal chemoreflexes in newborn lambs. PMID:12809795

  15. A Case of Vogt-Koyanagi-Harada Syndrome with Persistent Dyspnea Secondary to Laryngeal Edema

    PubMed Central

    Mantopoulos, Dimosthenis; deSilva, Brad W.; Cebulla, Colleen M.

    2014-01-01

    Purpose We report a case of laryngeal edema associated with the Vogt-Koyanagi-Harada (VKH) syndrome. Patient and Methods A 32-year-old African-American female presented with a 12-day prodrome, including headache, tinnitus and shortness of breath, which preceded sudden photophobia and bilateral visual loss. Examination and clinical testing were most consistent with VKH, and the patient improved with intravenous methylprednisolone therapy. Results The patient had persistent dyspnea, which was out of proportion to chest CT findings and which was exacerbated during a recurrence of VKH. Flexible fiberoptic laryngoscopy with stroboscopy revealed diffuse laryngeal edema. Symptoms were alleviated with breathing exercises. Conclusions Several autoimmune diseases may cause diffuse laryngeal edema. In this case, VKH was associated with the patient's glottic edema and dyspnea. We recommend that laryngeal edema be considered in the differential diagnosis for patients with dyspnea and VKH. PMID:25759662

  16. Laryngeal Chondrosarcoma: an Exceptional Localisation of a not Unfrequent Bone Tumor

    PubMed Central

    Moerman, Mieke; Kreps, Bernard; Forsyth, Ramses

    2009-01-01

    After osteosarcoma, chondrosarcoma is the second most common primary bone tumor accounting for 26% of all malignancies. In the laryngeal region however, chondrosarcomas are rather rare. Only 300 cases are reported in literature. Considering laryngeal chondrosarcoma, about 75% occur in the cricoid cartilage, whereas 20% occur in the thyroid cartilage. In this paper we report a case of thyroidal chondrosarcoma, and based on a thorough literature search we suggest some practical guidelines concerning diagnosis and therapy. PMID:20066164

  17. Automatic segmentation of equine larynx for diagnosis of laryngeal hemiplegia

    NASA Astrophysics Data System (ADS)

    Salehin, Md. Musfequs; Zheng, Lihong; Gao, Junbin

    2013-10-01

    This paper presents an automatic segmentation method for delineation of the clinically significant contours of the equine larynx from an endoscopic image. These contours are used to diagnose the most common disease of horse larynx laryngeal hemiplegia. In this study, hierarchal structured contour map is obtained by the state-of-the-art segmentation algorithm, gPb-OWT-UCM. The conic-shaped outer boundary of equine larynx is extracted based on Pascal's theorem. Lastly, Hough Transformation method is applied to detect lines related to the edges of vocal folds. The experimental results show that the proposed approach has better performance in extracting the targeted contours of equine larynx than the results of using only the gPb-OWT-UCM method.

  18. Idiopathic CD4+ lymphocytopenia and juvenile laryngeal papillomatosis.

    PubMed

    Pasic, Srdjan; Minic, Predrag; Dzudovic, Slobodan; Minic, Aleksandra; Slavkovic, Bojana

    2005-03-01

    We report on an association of idiopathic CD4+ lymphocytopenia (ICL) and juvenile laryngeal papillomatosis (JLP) in a pediatric-aged patient. Because of a past medical history of recurrent lung infections and severe chickenpox in infancy, immunologic investigations were done at age 6 years. On several occasions, a CD4+lymphocyte count of <300 cells/mm3 was detected, supporting the diagnosis of ICL. During follow-up, both medical (interferon-alpha) and surgical treatments of JLP were only partially efficient. Our patient developed disseminated infection with Mycobacterium avium and died at 10 years of age. Human papillomavirus is an important pathogen in pediatric and adult patients with ICL. In pediatric patients with JLP who develop other unusually severe viral or opportunistic infections, immunological investigations should be considered. PMID:15668935

  19. Stabilisation of Laryngeal AL Amyloidosis with Long Term Curcumin Therapy

    PubMed Central

    Golombick, Terry; Diamond, Terrence H.; Manoharan, Arumugam; Ramakrishna, Rajeev

    2015-01-01

    Multiple myeloma (MM), smoldering myeloma (SMM), and monoclonal gammopathy of undetermined significance (MGUS) represent a spectrum of plasma cell dyscrasias (PCDs). Immunoglobulin light chain amyloidosis (AL) falls within the spectrum of these diseases and has a mortality rate of more than 80% within 2 years of diagnosis. Curcumin, derived from turmeric, has been shown to have a clinical benefit in some patients with PCDs. In addition to a clinical benefit in these patients, curcumin has been found to have a strong affinity for fibrillar amyloid proteins. We thus administered curcumin to a patient with laryngeal amyloidosis and smoldering myeloma and found that the patient has shown a lack of progression of his disease for a period of five years. This is in keeping with our previous findings of clinical benefits of curcumin in patients with plasma cell dyscrasias. We recommend further evaluation of curcumin in patients with primary AL amyloidosis. PMID:26199769

  20. Is the Frequency Content of the Calls in North American Treefrogs Limited by Their Larynges?

    PubMed Central

    2014-01-01

    A high diversity of mating calls is found among frogs. The calls of most species, however, are simple, in comparison to those of mammals and birds. In order to determine if the mechanics of the larynx could explain the simplicity of treefrog calls, the larynges of euthanized males were activated with airflow. Laryngeal airflow, sound frequency, and sound intensity showed a positive direct relationship with the driving air pressure. While the natural calls of the studied species exhibit minimal frequency modulation, their larynges produced about an octave of frequency modulation in response to varying pulmonary pressure. Natural advertisement calls are produced near the higher extreme of frequency obtained in the laboratory and at a slightly higher intensity (6?dB). Natural calls also exhibit fewer harmonics than artificial ones, because the larynges were activated with the mouth of the animal open. The results revealed that treefrog larynges allow them to produce calls spanning a much greater range of frequencies than observed in nature; therefore, the simplicity of the calls is not due to a limited frequency range of laryngeal output. Low frequencies are produced at low intensities, however, and this could explain why treefrogs concentrate their calling at the high frequencies. PMID:25332838

  1. Efficacy of the laryngeal tube during intermittent positive-pressure ventilation.

    PubMed

    Asai, T; Murao, K; Shingu, K

    2000-11-01

    We studied the efficacy of the laryngeal tube (VBM, Germany) during intermittent positive-pressure ventilation in 50 patients. After induction of anaesthesia and neuromuscular blockade, a size 4 laryngeal tube was inserted for patients of height 155 cm or greater. After insertion of the laryngeal tube, its pharyngeal and oesophageal balloons were inflated to an intracuff pressure of 60 cmH(2)O. An Ambu self-inflating bag was attached to the laryngeal tube and the lungs were ventilated manually at 15 breath.min(-1). It was possible to ventilate the lungs at the first attempt in 47 patients (94%). The airway pressure at which air leaked around the laryngeal tube exceeded 18 cmH(2)O in 41 patients (82%), and was > 30 cmH(2)O in 25 (50%). Median [interquartile range (range)] leak pressure was 30 [20-30 (6 to > 30)] cmH(2)O. Median [interquartile range (range)] tidal volume was 587 [533-653 (133-800)] ml or 8.8 [8.2-10.6 (1.9-12.6)] ml.kg(-1). We conclude that the laryngeal tube has a potential role in airway management during intermittent positive-pressure ventilation for anaesthesia or cardiopulmonary resuscitation. PMID:11069337

  2. Interobserver variability of laryngeal mucosal premalignant lesions: a histopathological evaluation.

    PubMed

    Fleskens, Stijn A J H M; Bergshoeff, Verona E; Voogd, Adri C; van Velthuysen, Marie-Louise F; Bot, Freek J; Speel, Ernst-Jan M; Kremer, Bernd; Takes, Robert; Slootweg, Piet

    2011-07-01

    The objective of this study is to measure interobserver variability in the classification of laryngeal mucosal premalignant lesions by reassessing the histopathology of previously diagnosed cases and to determine the possible therapeutic consequences of disagreement among observers. Histopathological assessment of 110 laryngeal mucosal premalignant lesions was done by three pathologists. Each slide had to be classified according to the World Health Organization, Squamous Intraepithelial Neoplasia, and the Ljubljana Squamous Intraepithelial Lesions systems. After the independent assessment, a joint meeting took place. To assess the relation between histopathological grading and subsequent clinical management, we created a two- and a three-grade system besides one comprising all options. For all analyses, the SAS/STAT statistical software was used. The highest unweighted ?-values concerning the all-options system are observed for the Squamous Intraepithelial Neoplasia classification (0.28, 95% confidence interval 0.23-0.33), followed by the World Health Organization and Ljubljana classifications. For the two-grade system the Ljubljana classification shows the highest unweighted ?-values (0.50, 95%, 0.39-0.61), followed by the World Health Organization and Squamous Intraepithelial Neoplasia classifications. For the three-grade system, the unweighted ?-values are similar. The implementation of weighted ?-values led to higher scores within all three classification systems, although these did not exceed 0.55 (moderate agreement). Given the high level of consensus, simultaneous pathological assessment may be said to provide added value in comparison with independent assessment. In the current study, no clear tendency is observed in favor of any one classification system. The proposed three-grade system could be an improved histopathological tool because it is easier to correlate with clinical decision making and because it yields better unweighted ?-values and proportions of concordance than the all-options system. Furthermore, clinical management could benefit from assessment by more than one pathologist in suspected cases of dysplasia or carcinoma. PMID:21499237

  3. Diaphragmatic paralysis due to spinal muscular atrophy. An unrecognised cause of respiratory failure in infancy?

    Microsoft Academic Search

    R C McWilliam; D Gardner-Medwin; D Doyle; J B Stephenson

    1985-01-01

    An unusual form of spinal muscular atrophy presenting with respiratory failure was observed in four infants from two families. In one, whose death was attributed to pneumonia, the diagnosis was inferred retrospectively after two siblings died from an identical illness and were shown to have diaphragmatic paralysis and the typical electrophysiological and histological features of spinal muscular atrophy. Other signs

  4. Wasp Venom Blocks Central Cholinergic Synapses to Induce Transient Paralysis in Cockroach Prey

    E-print Network

    Libersat, Frederic

    Wasp Venom Blocks Central Cholinergic Synapses to Induce Transient Paralysis in Cockroach Prey G 2002 ABSTRACT: The parasitoid wasp Ampulex com- pressa induces a set of unique behavioral effects upon. Using radiolabeled wasps, we demonstrate that the wasp injects its venom directly into the cockroach

  5. Brain correlates of hypnotic paralysis-a resting-state fMRI study.

    PubMed

    Pyka, M; Burgmer, M; Lenzen, T; Pioch, R; Dannlowski, U; Pfleiderer, B; Ewert, A W; Heuft, G; Arolt, V; Konrad, C

    2011-06-15

    Hypnotic paralysis has been used since the times of Charcot to study altered states of consciousness; however, the underlying neurobiological correlates are poorly understood. We investigated human brain function during hypnotic paralysis using resting-state functional magnetic resonance imaging (fMRI), focussing on two core regions of the default mode network and the representation of the paralysed hand in the primary motor cortex. Hypnotic suggestion induced an observable left-hand paralysis in 19 participants. Resting-state fMRI at 3T was performed in pseudo-randomised order awake and in the hypnotic condition. Functional connectivity analyses revealed increased connectivity of the precuneus with the right dorsolateral prefrontal cortex, angular gyrus, and a dorsal part of the precuneus. Functional connectivity of the medial frontal cortex and the primary motor cortex remained unchanged. Our results reveal that the precuneus plays a pivotal role during maintenance of an altered state of consciousness. The increased coupling of selective cortical areas with the precuneus supports the concept that hypnotic paralysis may be mediated by a modified representation of the self which impacts motor abilities. PMID:21497656

  6. Vertical migration of adult Ixodes rubicundus, the Karoo paralysis tick (Acari: Ixodidae)

    Microsoft Academic Search

    Agnes Snyman; L. J. Fourie; D. J. Kok; I. G. Horak

    1994-01-01

    Mortality due to Karoo paralysis amongst livestock is of considerable economic importance in South Africa. Indications are that the extent of vertical migration of adult ticks, to reach questing positions on grasses, is influenced by sudden climatic chages. Such influences as well as selection of questing substrates were investigated under controlled conditions. Vertical migration of adult Ixodes rubicundus on copper

  7. Genetic Evidence for Coinfection of Honey Bees by Acute Bee Paralysis and Kashmir Bee Viruses

    Microsoft Academic Search

    Jay D Evans

    2001-01-01

    Nucleotide sequence analyses were used to identify acute bee paralysis virus (ABPV) and Kashmir bee virus (KBV) isolated from a single honey bee colony. Most of the bees in this colony carried KBV. Some individual bees also carried ABPV, a coexistence not yet seen between these two viruses. Implications of coinfection on viral efficacy are discussed, along with a restriction

  8. Molecular characterisation and phylogenetic analysis of Chronic bee paralysis virus, a honey bee virus

    Microsoft Academic Search

    Violaine Olivier; Philippe Blanchard; Soraya Chaouch; Perrine Lallemand; Frank Schurr; Olivier Celle; Eric Dubois; Noël Tordo; Richard Thiéry; Rémi Houlgatte; Magali Ribière

    2008-01-01

    The complete sequences of the two major RNAs of Chronic bee paralysis virus (CBPV) have been determined. RNA 1 (3674nt long) and RNA 2 (2305nt long) are positive single-stranded RNAs that are capped but not polyadenylated. The 3? ends of both RNAs are unreactive to polymerisation or ligation even in denaturing conditions, a feature already observed in alphanodavirus RNAs. The

  9. A 60 year old Ethiopian farmer diagnosed with tick paralysis at Adera Medical Center.

    PubMed

    Bane, Abate

    2014-07-01

    A 60 year old farmer from west Shewa in Ethiopia presented on February 13 2014, with right arm flaccid monoplegia after bitten by a tick stuck to his right arm pit. The case was initially misdiagnosed as cellulitis. To our knowledge, tick paralysis has not been reported from Ethiopia. We report the case presentation with literature review. PMID:25812288

  10. Identification of genetic loci associated with paralysis, inflammation and weight loss in mouse experimental autoimmune encephalomyelitis

    Microsoft Academic Search

    Jeffrey A. Encinas; Marjorie B. Lees; Raymond A. Sobel; Cammie Symonowicz; Howard L. Weiner; Christine E. Seidman; J. G. Seidman; Vijay K. Kuchroo

    2001-01-01

    Experimental autoimmune encephalomyelits (EAE), a model for human multiple sclerosis, is an inducible inflammatory and demyelinating disease of the central nervous system (CNS). Susceptibility to this disease is heritable and is demonstrated by the development of an ascending paralysis accompanied by a loss in body wt 2-3 weeks following immunization with proteins derived from CNS myelin. In a previous genetic

  11. Motor Evoked Potentials in Predicting Recovery from Upper Extremity Paralysis after Acute Stroke

    Microsoft Academic Search

    Henk T. Hendricks; Jaco W. Pasman; Jacques van Limbeek; Machiel J. Zwarts

    2003-01-01

    Objective: The use of motor evoked potentials (MEPs) in predicting recovery after stroke still appears to be somehow equivocal. We assessed the prognostic value of MEPs with respect to arm and hand motor recovery in acute stroke patients. Methods: This cohort study included 43 consecutive acute stroke patients with complete paralysis of the upper extremity. MEPs of the abductor digiti

  12. Oropharyngeal leak pressure with the laryngeal mask airway Supreme™ at different intracuff pressures: a randomized controlled trial

    Microsoft Academic Search

    Lianfeng Zhang; Edwin Seet; Vanita Mehta; Rajeev Subramanyam; Saravanan P. Ankichetty; David T. Wong; Frances Chung

    2011-01-01

    Background  A higher oropharyngeal leak pressure (OLP) is a marker of efficacy and safety when using laryngeal mask airway devices. The\\u000a new disposable laryngeal mask airway (LMA™) Supreme™ has lower OLP compared with the LMA ProSeal™. Increased intracuff pressure\\u000a of laryngeal mask airway devices may improve OLP but may result in more postoperative pharyngolaryngeal adverse events. This\\u000a study was designed to

  13. Value of Narrow Band Imaging (NBI) Endoscopy in the Early Diagnosis of Laryngeal Cancer and Precancerous Lesions

    ClinicalTrials.gov

    2015-03-03

    Chronic Inflammation of Hypopharynx; Hoarseness; Macroscopic Laryngeal Lesions; Histological Confirmation of Dysplasia; Carcinoma in Situ; Invasive Carcinoma of Larynx; Invasive Carcinoma of Hypo Pharynx; Recurrent Respiratory Papillomatosis

  14. Myelinated Nerve Fibre, Myelin

    Microsoft Academic Search

    Margit Pavelka; Jürgen Roth

    \\u000a Nerve fibres designed for particularly rapid and efficient conduction of action potentials are equipped with a myelin sheath,\\u000a a lipid-enriched layer, produced by specialised glial cells, the oligodendrocytes in the central nervous system, and the Schwann\\u000a cells in the peripheral nervous system. The myelin sheath isolates the axon from the surrounding compartments. It reduces\\u000a the current flow across the axonal

  15. 'The devil lay upon her and held her down'. Hypnagogic hallucinations and sleep paralysis described by the Dutch physician Isbrand van Diemerbroeck (1609-1674) in 1664.

    PubMed

    Kompanje, E J O

    2008-12-01

    Hypnagogic and hypnopompic hallucinations are visual, tactile, auditory or other sensory events, usually brief but sometimes prolonged, that occur at the transition from wakefulness to sleep (hypnagogic) or from sleep to wakefulness (hypnopompic). Hypnagogic and hypnopompic hallucinations are often associated with sleep paralysis. Sleep paralysis occurs immediately prior to falling asleep (hypnagogic paralysis) or upon waking (hypnopompic paralysis). In 1664, the Dutch physician Isbrand Van Diemerbroeck (1609-1674) published a collection of case histories. One history with the title 'Of the Night-Mare' describes the nightly experiences of the 50-year-old woman. This case report is subject of this article. The experiences in this case could without doubt be diagnosed as sleep paralysis accompanied by hypnagogic hallucinations. This case from 1664 should be cited as the earliest detailed account of sleep paralysis associated with hypnagogic illusions and as the first observation that sleep paralysis and hypnagogic experiences occur more often in supine position of the body. PMID:18691361

  16. Ultrasound guidance of uncommon nerve blocks

    PubMed Central

    Thallaj, Ahmed

    2011-01-01

    In the past nerve stimulation was considered the standard tool for anesthesiologists to locate the peripheral nerve for nerve blocks. However, with the recent introduction of ultrasound (US) technology for regional anesthesia, the use of nerve stimulation has become a rarity nowadays. There is a growing interest by most anesthesiologists in using US for nerve blocks because of its simplicity and accuracy. US is now available in most hospitals practicing regional anesthesia and is a popular tool for performance of nerve blocks. Although nerve stimulation became a rarity, however the use of it is now limited to identify small nerve structures, such as greater auricular nerve and medial antebrachial cutaneous nerve of the forearm. However, in this review article we discuss the role of ultrasonography for greater auricular and antebrachial cutaneous nerve blocks, which could replace nerve stimulation technique. We look at the available literature on the role of US for the performance of uncommon nerve blocks and its benefits. PMID:22144927

  17. Secular trends in the survival of patients with laryngeal carcinoma, 1995–2007

    PubMed Central

    MacNeil, S.D.; Liu, K.; Shariff, S.Z.; Thind, A.; Winquist, E.; Yoo, J.; Nichols, A.; Fung, K.; Hall, S.; Garg, A.X.

    2015-01-01

    Background Recent reports suggest a decline over time in the survival of patients newly diagnosed with laryngeal cancer in spite of developments in treatment practices. Our study set out to determine whether the survival of patients with laryngeal cancer in Ontario has changed over time. Methods This population-based cohort study of patients diagnosed with laryngeal cancer in the province of Ontario between 1995 and 2007 used data extracted from linked provincial administrative and registry databases. Its main outcomes were overall survival, laryngectomy-free survival, and survival ratio relative to an age- and sex-matched general population. Results The 4298 patients newly diagnosed with laryngeal cancer during the period of interest were predominantly men (n = 3615, 84.1%) with glottic cancer (n = 2787, 64.8%); mean age in the group was 66 years (interquartile range: 59–74 years). Patient demographics did not significantly change over time. Overall, 5-year survival was 57.4%; laryngectomy-free survival was 45.4%. Comparing patients from three eras (1995–1998, 1999–2003, 2004–2007) and adjusting for age, sex, and comorbidity status, we observed no differences in overall survival or laryngectomy-free survival over time. The 5-year relative survival ratio for patients with laryngeal cancer compared with an age- and sex-matched group from the general population was 81.1% for glottic cancer and 44.5% for supraglottic cancer. Conclusions In patients with a new diagnosis of laryngeal cancer, overall and laryngectomy-free survival have remained unchanged since the mid-1990s. New methods to improve survival and the rate of laryngeal preservation in this patient population are needed. PMID:25908925

  18. Neuromuscular Ultrasound of Cranial Nerves

    PubMed Central

    Tawfik, Eman A.; Cartwright, Michael S.

    2015-01-01

    Ultrasound of cranial nerves is a novel subdomain of neuromuscular ultrasound (NMUS) which may provide additional value in the assessment of cranial nerves in different neuromuscular disorders. Whilst NMUS of peripheral nerves has been studied, NMUS of cranial nerves is considered in its initial stage of research, thus, there is a need to summarize the research results achieved to date. Detailed scanning protocols, which assist in mastery of the techniques, are briefly mentioned in the few reference textbooks available in the field. This review article focuses on ultrasound scanning techniques of the 4 accessible cranial nerves: optic, facial, vagus and spinal accessory nerves. The relevant literatures and potential future applications are discussed. PMID:25851889

  19. Nerve Cross-Bridging to Enhance Nerve Regeneration in a Rat Model of Delayed Nerve Repair

    PubMed Central

    2015-01-01

    There are currently no available options to promote nerve regeneration through chronically denervated distal nerve stumps. Here we used a rat model of delayed nerve repair asking of prior insertion of side-to-side cross-bridges between a donor tibial (TIB) nerve and a recipient denervated common peroneal (CP) nerve stump ameliorates poor nerve regeneration. First, numbers of retrogradely-labelled TIB neurons that grew axons into the nerve stump within three months, increased with the size of the perineurial windows opened in the TIB and CP nerves. Equal numbers of donor TIB axons regenerated into CP stumps either side of the cross-bridges, not being affected by target neurotrophic effects, or by removing the perineurium to insert 5-9 cross-bridges. Second, CP nerve stumps were coapted three months after inserting 0-9 cross-bridges and the number of 1) CP neurons that regenerated their axons within three months or 2) CP motor nerves that reinnervated the extensor digitorum longus (EDL) muscle within five months was determined by counting and motor unit number estimation (MUNE), respectively. We found that three but not more cross-bridges promoted the regeneration of axons and reinnervation of EDL muscle by all the CP motoneurons as compared to only 33% regenerating their axons when no cross-bridges were inserted. The same 3-fold increase in sensory nerve regeneration was found. In conclusion, side-to-side cross-bridges ameliorate poor regeneration after delayed nerve repair possibly by sustaining the growth-permissive state of denervated nerve stumps. Such autografts may be used in human repair surgery to improve outcomes after unavoidable delays. PMID:26016986

  20. Magnetic property of the nerve.

    PubMed

    Varga, L; Barrett, J S; Keszthelyi, L; Madarász, E

    1978-01-01

    An electromagnet of inhomogeneous magneticfield has been used to measure the magnetic susceptibility of the frog's nerve. Specimen of frog sciatic nerve were attached to a thin tungsten wire hanging into the inhomogeneous magnetic field, and from the deviation of this pendulum from the perpendicular position the magnetic susceptibility of the nerve has been determined to be -0.8 . 10(-6) cm3g-1 in a good agreement with the known magnetic property of the constituents of the nerve. PMID:754499

  1. Nerve Agents: A Comprehensive Review

    Microsoft Academic Search

    Sage W. Wiener; Robert S. Hoffman

    2004-01-01

    Nerve agents are perhaps the most feared of potential agents of chemical attack. The authors review the history, physical characteristics, pharmacology, clinical effects, and treatment of these agents.

  2. Facial nerve neuromas: radiologic evaluation.

    PubMed

    Latack, J T; Gabrielsen, T O; Knake, J E; Kemink, J L; Graham, M D; Gebarski, S S; Yang, P J

    1983-12-01

    Eight patients who had facial nerve neuromas were examined, and the radiographic findings are reported. Thin section tomography, high resolution computed tomography, posterior fossa computed tomography, and cerebellopontine angle cisternography using Pantopaque (iophendylate) demonstrated bone erosions and soft tissue masses conforming to the course of the facial nerve. The lesions generally exhibited either a proximal or a distal pattern of nerve involvement. Radiologic imaging frequently permits a correct preoperative diagnosis and accurate definition of the extent of facial nerve neuromas, assessments that are important for proper patient management. PMID:6606188

  3. Nerve conduction and electromyography studies.

    PubMed

    Kane, N M; Oware, A

    2012-07-01

    Nerve conduction studies (NCS) and electromyography (EMG), often shortened to 'EMGs', are a useful adjunct to clinical examination of the peripheral nervous system and striated skeletal muscle. NCS provide an efficient and rapid method of quantifying nerve conduction velocity (CV) and the amplitude of both sensory nerve action potentials (SNAPs) and compound motor action potentials (cMAPs). The CV reflects speed of propagation of action potentials, by saltatory conduction, along large myelinated axons in a peripheral nerve. The amplitude of SNAPs is in part determined by the number of axons in a sensory nerve, whilst amplitude of cMAPs reflects integrated function of the motor axons, neuromuscular junction and striated muscle. Repetitive nerve stimulation (RNS) can identify defects of neuromuscular junction (NMJ) transmission, pre- or post-synaptic. Needle EMG examination can detect myopathic changes in muscle and signs of denervation. Combinations of these procedures can establish if motor and/or sensory nerve cell bodies or peripheral nerves are damaged (e.g. motor neuronopathy, sensory ganglionopathy or neuropathy), and also indicate if the primary target is the axon or the myelin sheath (i.e. axonal or demyelinating neuropathies). The distribution of nerve damage can be determined as either generalised, multifocal (mononeuropathy multiplex) or focal. The latter often due to compression at the common entrapment sites (such as the carpal tunnel, Guyon's canal, cubital tunnel, radial groove, fibular head and tarsal tunnel, to name but a few of the reported hundred or so 'entrapment neuropathies'). PMID:22614870

  4. The near-nerve sensory nerve conduction in tarsal tunnel syndrome

    Microsoft Academic Search

    S J Oh; H S Kim; B K Ahmad

    1985-01-01

    The near-nerve sensory nerve conduction in the medial and lateral plantar nerves was studied in 25 cases of tarsal tunnel syndrome. Sensory nerve conduction was abnormal in 24 cases (96%) The most common abnormalities were slow nerve conduction velocities and dispersion phenomenon (prolonged duration of compound nerve action potentials). These two electrophysiological abnormalities are indicative of a focal segmental demyelination

  5. Innovative laser based approaches to laryngeal cancer: what an engineer and physicist need to know

    NASA Astrophysics Data System (ADS)

    Burns, James A.

    2008-02-01

    Innovative laser-based approaches to laryngeal cancer include the clinical applications of two new technologies, photoangiolysis using a 532nm wavelength pulsed-KTP laser and fiber-based cutting using a 2?m wavelength thulium laser. Photoangiolysis is well-suited for treatment of minimally invasive glottic cancer and allows maximum preservation of phonatory surfaces needed for optimal voicing. The thulium laser offers an alternative to the carbon dioxide laser as an endolaryngeal cutting tool due to its enhanced hemostatic properties and fiber-based delivery. Clinical examples of pulsed-KTP laser involution of early glottic cancer will be presented in order to highlight the concept of targeting tumor angiogenesis in treating laryngeal cancer. The surgical experience using the thulium laser for complex endoscopic endolaryngeal excisions of large laryngeal cancers is presented to demonstrate the expanded clinical applications of endolaryngeal cutting offered by this laser. The laryngeal tissue effects of various laser power and pulse width (PW) settings, mode of delivery, active cooling to reduce thermal trauma, and wavelength selection have been extensively studied for the KTP and thulium lasers in both ex-vivo and live-perfusing models. The results from these studies, included herein, determine the clinical efficacy and safety of these innovative laser-based approaches to laryngeal cancer.

  6. Resection of a laryngeal hemangioma in an adult using an ultrasonic scalpel: A case report

    PubMed Central

    WANG, XURUI; ZHAO, XIAODONG; ZHU, WEI

    2015-01-01

    Adult laryngeal hemangioma is an extremely rare and slowly progressing vascular tumor. The present study describes the first reported case of a male with a large laryngeal hemangioma that was treated by ultrasonic scalpel. A 61-year-old male presented to our hospital with a recurrent pharyngeal foreign body sensation, without hoarseness, hemoptysis, expectoration or dyspnea. A blue-black mass was detected in the right pyriform sinus, with a morular surface and a wide pedicle positioned lateral to the right arytenoid cartilage and aryepiglottic fold under electronic laryngoscopy. Following tracheotomy under local anesthesia, right superior laryngeal artery ligation and laryngeal hemangioma resection via a lateral neck hypopharyngeal approach were performed under general anesthesia using an ultrasonic scalpel. Pathological examination verified that the tumor was a cavernous hemangioma. On day 11, subsequent to post-operative anti-inflammatory and symptomatic treatment, electronic laryngoscopy showed that the arytenoid mucosal edema had decreased and that the movement of the arytenoid was good. There was no recurrence of hemangioma during a 2-year follow-up period. Therefore, it is recommended that complete surgical resection using an ultrasonic scalpel should be considered for similar cases involving large laryngeal hemangiomas. PMID:26137093

  7. Design of a New Somatosensory Stimulus Delivery Device for Measuring Laryngeal Mechanosensory Detection Thresholds in Humans

    PubMed Central

    2009-01-01

    Laryngeal control is essential for airway protection, breathing, deglutition, speech, and voice. Unfortunately, integration of laryngeal sensory assessment in research and clinical practice is limited by technical and practical limitations of commercially available technology. A commercial device is available, but reported limitations include procedural complexity requiring two or three individuals to operate, limited stimulus dynamic range, device generated noise, and questionable stimulus reproducibility. The objective of this study was to design a new laryngeal somatosensory stimulus delivery device that provides direct, reliable control over the timing, duration, and dynamic range of stimulus presentation, and test the device in individuals who may manifest a laryngeal sensory deficit. The new device operates silently and has more than four times greater stimulus dynamic range than the commercial device. Testing with the new device revealed laryngeal mechanosensory detection thresholds in an individual with Parkinson’s disease that were seven times higher than those of healthy controls. These data would have otherwise gone undetected due to limited stimulus dynamic range in the commercial device. The new design resulted in a new assessment instrument that is simple to use for routine clinical assessment, yet sufficiently versatile for integration within rigorous clinical research protocols. PMID:19272888

  8. [Clinical examination to screen for laryngeal cancer: results, problems and prospects].

    PubMed

    Ogata, A; Suzuki, M; Tanaka, K; Yamashita, T; Ohba, T; Shinden, S

    1999-10-01

    The Yokohama Municipal Cancer Detection Center, established as an affiliate of the Yokohama Municipal Citizen's Hospital in June, 1981, has performed clinical examinations to screen for laryngeal cancer in a total of 26,377 patients (12,205 men and 14,172 women) 40 years of age or older, in the past 15 years. Approximately 9.3% (2,398) of the patients required further examination, surgery, or observation. Thirty-one cases of malignant tumor were found, 26 of laryngeal cancer, 2 of hypopharyngeal cancer, and 1 each of thyroid cancer, tonsillar cancer and acute lymphoid leukemia. In addition, 51 cases of vocal fold leukoplakia and approximately 700 cases of vocal fold polyp and polypoid vocal fold were diagnosed. As mentioned in previous reports, examinations of this type present both definite benefits and deficiencies. Many problems still remain. Examples of these are the small absolute numbers of examinees, the rather heavy burden placed upon the examining doctor, and the low incidence of laryngeal cancer in female patients. Laryngeal cancer is predominantly a male disease, but female patients should not be excluded from receiving screening examinations. In recent years, many thyroid tumors have been detected in female patients. In the future, laryngeal cancer examination may develop into a head and neck cancer examination that includes screening for thyroid cancer. PMID:10565177

  9. The clinical relevance of Ki-67 expression in laryngeal squamous cell carcinoma.

    PubMed

    Gioacchini, Federico Maria; Alicandri-Ciufelli, Matteo; Magliulo, Giuseppe; Rubini, Corrado; Presutti, Livio; Re, Massimo

    2015-07-01

    The aim of this study was to determine the prognostic value of Ki-67 immunostaining in patients affected by laryngeal squamous cell carcinoma. A systematic review was carried out in a tertiary university referral center. An appropriate string was run on PubMed to retrieve articles dealing with Ki-67 immunohistochemical staining and laryngeal squamous cell carcinoma. A double cross-check was performed on citations and full-text articles by two investigators independently to review all manuscripts and perform a comprehensive quality assessment. Of 85 abstracts identified, 18 articles were included. These studies reported on 1,342 patients with histological confirmed diagnosis of laryngeal squamous cell carcinoma. Most studies showed a statistical association between Ki-67 immunohistochemical expression and at least one of the clinical and histopathological parameters considered by the authors. Overall the studies analyzed suggested that the tumoral proliferative index was statistically connected respectively with T stage (2/18), N stage (4/18), grading (6/18), disease-free survival (10/18) and overall survival (4/18). Our review strongly suggests that immunohistochemical staining of Ki-67 correlates with tumoral aggressiveness and worse prognosis in patients affected by laryngeal squamous cell carcinoma. Further high-quality prospective studies should be carried out to confirm our finding and determine the eventual differences between cancers of specific laryngeal subsites. PMID:24890978

  10. Nervous System, Neurons, Nerves

    NSDL National Science Digital Library

    How does the nervous system work? It is a question that has engaged the minds of scientists, doctors, and others for centuries. The National Science Teachers Association (NSTA) has created this tour of the nervous system for teachers and students. First-time visitors can start with the Explore a Nerve Cell area, which goes over the membrane, nucleus, axon, dendrites, and the synapse in exquisite detail with interactive graphics. Moving on, The Basics area provides summaries of the operation of the nervous system and a rather illustrative area named Ouch! The site is rounded out by the Nervous Systems Explorations section, which has some nice simulations covering Brainstorms and Simple Reflexes.

  11. Exercise therapy for a patient with persistent dyspnea after combined traumatic diaphragmatic rupture and phrenic nerve injury.

    PubMed

    Han, Kyu Yong; Bang, Heui Je

    2015-02-01

    We present a case report of a patient with a history of diaphragmatic rupture who had persistent dyspnea for 9 months after primary surgical repair of a right diaphragmatic rupture caused by a car accident. A phrenic nerve conduction study was performed, which demonstrated a rare accompanying ipsilateral phrenic nerve injury with resultant hemidiaphragmatic paralysis. Aerobic exercise therapy for the purpose of improving endurance and dietary modification for weight reduction were prescribed and continued for 6 months. The exercise intensity was prescribed based on the percentage of maximum heart rate as confirmed by an exercise tolerance test. The duration of exercise was gradually increased. In this case, the long-persistent dyspnea was successfully alleviated via nonoperative management to the point that the patient could resume regular activities of daily living. PMID:25460207

  12. Acoustic Correlates of Fatigue in Laryngeal Muscles: Findings for a Criterion-Based Prevention of Acquired Voice Pathologies

    ERIC Educational Resources Information Center

    Boucher, Victor J.

    2008-01-01

    Purpose: The objective was to identify acoustic correlates of laryngeal muscle fatigue in conditions of vocal effort. Method: In a previous study, a technique of electromyography (EMG) served to define physiological signs of "voice fatigue" in laryngeal muscles involved in voicing. These signs correspond to spectral changes in contraction…

  13. Bronchoscope-guided intubation through a Laryngeal Mask Airway Supreme in a patient with a difficult-to-manage airway

    Microsoft Academic Search

    Michele Carron; Ulderico Freo; Carlo Ori

    2009-01-01

    We report a case of an obese patient who presented with laryngeal edema and difficult ventilation after failed attempts to\\u000a intubate. A Laryngeal Mask Airway Supreme (LMA Supreme) reestablished the ventilation and allowed bronchoscope- guided intubation\\u000a of the trachea. The case suggests that the LMA Supreme may be useful in patients with a difficult airway.

  14. Human Papillomavirus Types 6 and 11 DNA Sequences in Genital and Laryngeal Papillomas and in Some Cervical Cancers

    Microsoft Academic Search

    Lutz Gissmann; Lutz Wolnik; Hans Ikenberg; Ursula Koldovsky; Hans Georg Schnurch; Harald Zur Hausen

    1983-01-01

    Human genital tumors as well as recurrent laryngeal papillomas were analyzed for the presence of human papillomavirus (HPV) 6 and HPV 11 sequences. HPV 11 DNA was found in 7 of 14 laryngeal papillomas; in the 7 other tumors no HPV DNA was demonstrated. HPV 11 DNA was also found in all five atypical condylomata of the cervix included in

  15. Detection and micro-scale isolation of a low molecular mass paralysis toxin from the tick, Argas (Persicargas) walkerae

    Microsoft Academic Search

    C. Maritz; A. I. Louw; R. Gothe; A. W. H. Neitz

    2000-01-01

    This study describes the isolation of a 11?kDa paralysis toxin from crude larval extracts of Argas (Persicargas) walkerae by exploiting the cross-reactivity of a monoclonal antibody (4B12), directed against the paralysis toxin of Rhipicephalus evertsi evertsi. This low molecular mass is in contrast to previous findings of a 60–70?kDa toxin for A. (P.) walkerae but is similar to neurotoxins isolated

  16. Demyelinating hypertrophic inferior alveolar nerve mimicking a nerve tumor.

    PubMed

    Fujita, Hiroaki; Kokubun, Norito; Sada, Tsubasa; Nagashima, Takahide; Komagamine, Tomoko; Kawabe, Kiyokazu; Hirata, Koichi

    2015-01-01

    We herein report a patient with demyelinating inferior alveolar nerve hypertrophy, which was initially suspected to have a nerve tumor. A 39-year-old woman with childhood-onset polyneuropathy presented with tooth pain and visited a dental clinic. An X-ray examination of the mandible revealed enlargement of the mandibular canal, and a nerve tumor was suspected. CT scan and MRI showed hypertrophy of the inferior alveolar nerve along its entire length. We diagnosed the patient with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), which was supported by the spontaneous recovery reported in her childhood, the results from a nerve conduction study and MRI data. CIDP should be considered in the differential diagnosis of mandibular canal enlargement. PMID:25948359

  17. [Professor DONG Gui-rong's experience for the treatment of peripheral facial paralysis].

    PubMed

    Cao, Lian-Ying; Shen, Te-Li; Zhang, Wei; Chen, Si-Hui

    2012-05-01

    Professor DONG Gui-rong's theoretical principle and manipulation points for peripheral facial paralysis were introduced in details from the angels of syndrome differentiation, timing, acupoint prescription and needling methods. For the syndrome differentiation and timing, the professor emphasized to check the treatment timing and follow the symptoms, which should be treated by stages, besides, it was necessary to find and distinguish the reason and nature of diseases to have a combined treatment of tendons and muscles. For the acupoint prescription and needling methods, he has proposed that the acupoints selection should be compatible of distal and lacal, and made a best of Baihui (GV 20) to regulate the whole yang qi, also he has paid much attention to the needling methods and staging treatment. Under the consideration of late stage of peripheral facial paralysis, based on syndrome differentiation Back-shu points have been selected to regulate zang-fu function, should achieve much better therapeutic effect. PMID:22650134

  18. Severe Generalized Weakness, Paralysis, and Aphasia following Administration of Irinotecan and Oxaliplatin during FOLFIRINOX Chemotherapy

    PubMed Central

    Chandar, Manisha; de Wilton Marsh, Robert

    2015-01-01

    Background Irinotecan is commonly used in combination with oxaliplatin as a component of FOLFIRINOX chemotherapy for several gastrointestinal malignancies. The purpose of this case report is to describe a patient who developed acute paralysis and aphasia while receiving her initial infusion of irinotecan. Case Report A 67-year-old woman with newly diagnosed metastatic pancreatic adenocarcinoma presented for her first cycle of FOLFIRINOX chemotherapy. During her infusion of irinotecan, she developed acute onset of generalized weakness, paralysis of all extremities, and nonfluent aphasia with complete inability to communicate. This episode was self-limited and resolved within 2 h. Prior to subsequent infusions she received intravenous repletion of potassium and had no recurrence of symptoms. Discussion In selected cases, coadministration of irinotecan and oxaliplatin may result in severe generalized weakness and aphasia, which may be triggered by underlying electrolyte disturbances. Careful monitoring and correction of potassium may help prevent this reaction. PMID:25873880

  19. Paralysis Developing as a Paradoxical Response During the Treatment for Tuberculous Spondylitis: A Case Report

    PubMed Central

    Park, Jae Hyeon; Kim, Yeo Hyung; Kwon, Chan Hyuk

    2014-01-01

    It can be difficult for clinicians to distinguish a paradoxical response to antituberculous therapy, worsening of an existing lesion despite adequate treatment, treatment failure, and drug resistance. We report a case of a 69-year-old woman who experienced bilateral lower extremity paralysis secondary to a paradoxical response. She had been suffering for 1 month from low back pain, due to tuberculous spondylitis. Her low back pain improved after antituberculous therapy. The low back pain, however, reappeared 2 months after treatment, accompanied by newly developed lower extremity weakness. Imaging studies showed an increased extent of her previous lesions. Consequently, the patient underwent a vertebral corpectomy with interbody fusion of the thoracolumbar spine. Histopathological examination showed chronic inflamed granulation tissue with no microorganisms. Although the antituberculous medication was not changed, the patient's symptoms and signs, including the paralysis, resolved after surgery. PMID:25024967

  20. Laryngeal spasm mimicking asthma and vitamin d deficiency.

    PubMed

    Masoero, Monica; Bellocchia, Michela; Ciuffreda, Antonio; Ricciardolo, Fabio Lm; Rolla, Giovanni; Bucca, Caterina

    2014-05-01

    We present a woman with heterozygous carnitine palmitoyl transferase 2 (CPT-2) deficiency who in the last 6 months suffered from episodic dyspnea and choking. Symptoms could not be attributed to her muscular energy defect, since heterozygous CPT-2 deficiency is usually asymptomatic or causes only mild muscle fatigability. Myopathy is usually triggered by concurrent factors, either genetic (additional muscle enzymes defects) or acquired (metabolic stress). The patient was referred to our respiratory clinic for suspect bronchial asthma. Spirometry showed mild decrease in inspiratory flows. Methacholine challenge was negative. Dyspnea was triggered by hyperventilation-induced hypocapnia, which produced marked decrease in airflow rates, particularly in inspiratory flows, consistent with laryngospasm. Nutritional assessment of the patient showed low serum level of calcium and vitamin D, attributable to avoidance of milk and dairy products for lactose intolerance and to insufficient sunlight exposure. After calcium and vitamin D supplementation episodic laryngospasm disappeared and hypocapnic hyperventilation test induced very mild change in airflow rates. Calcium and vitamin D deficiency may favour laryngeal spasm mimicking asthma, particularly in subjects with underlying myopathy. PMID:24843804

  1. Comparison of two laryngeal tissue fiber constitutive models

    NASA Astrophysics Data System (ADS)

    Hunter, Eric J.; Palaparthi, Anil Kumar Reddy; Siegmund, Thomas; Chan, Roger W.

    2014-02-01

    Biological tissues are complex time-dependent materials, and the best choice of the appropriate time-dependent constitutive description is not evident. This report reviews two constitutive models (a modified Kelvin model and a two-network Ogden-Boyce model) in the characterization of the passive stress-strain properties of laryngeal tissue under tensile deformation. The two models are compared, as are the automated methods for parameterization of tissue stress-strain data (a brute force vs. a common optimization method). Sensitivity (error curves) of parameters from both models and the optimized parameter set are calculated and contrast by optimizing to the same tissue stress-strain data. Both models adequately characterized empirical stress-strain datasets and could be used to recreate a good likeness of the data. Nevertheless, parameters in both models were sensitive to measurement errors or uncertainties in stress-strain, which would greatly hinder the confidence in those parameters. The modified Kelvin model emerges as a potential better choice for phonation models which use a tissue model as one component, or for general comparisons of the mechanical properties of one type of tissue to another (e.g., axial stress nonlinearity). In contrast, the Ogden-Boyce model would be more appropriate to provide a basic understanding of the tissue's mechanical response with better insights into the tissue's physical characteristics in terms of standard engineering metrics such as shear modulus and viscosity.

  2. Laryngeal electromyographic responses to perturbations in voice pitch auditory feedback

    PubMed Central

    Liu, Hanjun; Behroozmand, Roozbeh; Bove, Michel; Larson, Charles R

    2011-01-01

    The present study was conducted to test the hypothesis that intrinsic laryngeal muscles are involved in producing voice fundamental frequency (F0) responses to perturbations in voice pitch auditory feedback. Electromyography (EMG) recordings of the cricothyroid and thyroarytenoid muscles were made with hooked-wire electrodes, while subjects sustained vowel phonations at three different voice F0 levels (conversational, high pitch in head register, and falsetto register) and received randomized pitch shifts (±100 or ±300 cents) in their voice auditory feedback. The median latencies from stimulus onset to the peak in the EMG and voice F0 responses were 167 and 224 ms, respectively. Among the three different F0 levels, the falsetto register produced compensatory EMG responses that occurred prior to vocal responses and increased along with rising voice F0 responses and decreased for falling F0 responses. For the conversational and high voice levels, the EMG response timing was more variable than in the falsetto voice, and changes in EMG activity with relevance to the vocal responses did not follow the consistent trend observed in the falsetto condition. The data from the falsetto condition suggest that both the cricothyroid and thyroarytenoid muscles are involved in generating the compensatory vocal responses to pitch-shifted voice feedback. PMID:21682416

  3. Activity of lingual, laryngeal and oesophageal receptors in conscious sheep.

    PubMed Central

    Falempin, M; Rousseau, J P

    1984-01-01

    Vagal afferent impulse traffic has been studied in conscious sheep by electromyographic recording from the motor units of the sterno-cleido-mastoid (s.c.m.) muscle reinnervated by sensory vagal axons. Units which responded during movements of the tongue and during the pharyngolaryngeal and oesophageal stages of swallowing were chosen for this study. Lingual units showed a phasic discharge bearing a temporal relation to movements of the tongue during licking of the lips or chewing of a bolus before swallowing. Laryngeal units had no spontaneous activity. A discharge occurred with the ascending movement of the larynx during swallowing. Oesophageal units did not exhibit any tonic activity. They fired only at the time of primary or secondary oesophageal peristalsis. The oesophageal units showed a bimodal distribution. The oesophageal receptors are more concentrated at the beginning and the end of the thoracic oesophagus. During primary peristalsis, the afferent discharge was reinforced in only 57% of the cases when sheep swallowed a bolus (pellets or inflated balloons). When the discharge was reinforced, its increase ceased as volumes of the bolus were increased from 20 to 40 ml. During local oesophageal contractions, the afferent discharge was only present when the inflated balloon was located at the site of the receptor. It was enhanced at the time the primary peristaltic wave passed over the balloon. Inflation of a second balloon cranially in the oesophagus led to abolition of the activity of the unit at the caudal site though the distension there was maintained. PMID:6707965

  4. Metagenomic Detection of Viral Pathogens in Spanish Honeybees: Co-Infection by Aphid Lethal Paralysis, Israel Acute Paralysis and Lake Sinai Viruses

    PubMed Central

    Rubio-Guerri, Consuelo; Karlsson, Oskar E.; Kukielka, Deborah; Belák, Sándor; Sánchez-Vizcaíno, José Manuel

    2013-01-01

    The situation in Europe concerning honeybees has in recent years become increasingly aggravated with steady decline in populations and/or catastrophic winter losses. This has largely been attributed to the occurrence of a variety of known and “unknown”, emerging novel diseases. Previous studies have demonstrated that colonies often can harbour more than one pathogen, making identification of etiological agents with classical methods difficult. By employing an unbiased metagenomic approach, which allows the detection of both unexpected and previously unknown infectious agents, the detection of three viruses, Aphid Lethal Paralysis Virus (ALPV), Israel Acute Paralysis Virus (IAPV), and Lake Sinai Virus (LSV), in honeybees from Spain is reported in this article. The existence of a subgroup of ALPV with the ability to infect bees was only recently reported and this is the first identification of such a strain in Europe. Similarly, LSV appear to be a still unclassified group of viruses with unclear impact on colony health and these viruses have not previously been identified outside of the United States. Furthermore, our study also reveals that these bees carried a plant virus, Turnip Ringspot Virus (TuRSV), potentially serving as important vector organisms. Taken together, these results demonstrate the new possibilities opened up by high-throughput sequencing and metagenomic analysis to study emerging new diseases in domestic and wild animal populations, including honeybees. PMID:23460860

  5. A real-time PCR based survey on acute bee paralysis virus in German bee colonies

    Microsoft Academic Search

    Reinhold Siede; Matthias König; Ralph Büchler; Klaus Failing; Heinz-Jürgen Thiel

    2008-01-01

    The significance of Acute Bee Paralysis Virus (ABPV) for the overwintering capacity of honeybee colonies was studied under\\u000a field conditions. A case-control study of samples collected in Germany from 2004 to 2006 was performed. Successfully wintering\\u000a colonies (control) were compared with winter fatalities (cases), using a binary logistic regression model that focused on\\u000a the pre-winter ABPV burden as the explanatory

  6. The Optical Stretcher Nerve Regeneration

    E-print Network

    Steiner, Ullrich

    standing paradigm that neurons in the CNS cannot regenerate is gone (after 3500 years). While most research!"# $ %& ' "!((! )# The Optical Stretcher Nerve Regeneration Cells as Optical Fibres Novel Imaging present after neurological trauma to see whether those pose mechanical barriers to nerve regeneration. We

  7. Temporal Adaptation Silicon Auditory Nerve

    E-print Network

    Lazzaro, John

    Temporal Adaptation in a Silicon Auditory Nerve John Lazzaro CS Division UC Berkeley 571 Evans Hall Berkeley, CA 94720 Abstract Many auditory theorists consider the temporal adaptation of the auditory nerve localization and pitch perception also suggest temporal adaptation is an important ele- ment of practical

  8. NERVE INJURY AFTER LAPAROSCOPIC VARICOCELECTOMY

    Microsoft Academic Search

    KRISTIN CHROUSER; DAVID VANDERSTEEN; JULIE CROCKER; YURI REINBERG

    2004-01-01

    Purpose:Laparoscopic varicocelectomy is a minimally invasive option for varicoceles in children. Occasional reports of nerve injury after inguinal laparoscopic procedures have been published. There is anatomical variation in the sensory innervation of the anterior thigh and variable branching patterns of the nerves involved. We report a retrospective analysis of our patients, focusing on the incidence of sensory changes on the

  9. Lesions of the optic nerve

    Microsoft Academic Search

    Edward J. Atkins; Nancy J. Newman; Valerie Biousse

    2011-01-01

    As experts on the central nervous system, neurologists are expected to be familiar with the many conditions that can result in visual loss arising from lesions of the optic nerve. The optic nerves are unique central nervous system structures in terms of surrounding anatomy, size, location, and blood supply; therefore, they are uniquely vulnerable to every pathological process that can

  10. Nerve Regeneration After Radiofrequency Application

    Microsoft Academic Search

    Nobuyasu Ochiai; James P. Tasto; Seiji Ohtori; Norimasa Takahashi; Hideshige Moriya; David Amiel

    Background: Many patients with chronic tendinosis have experienced early pain relief after application of bipolar radiofrequency treatment. It is hypothesized that the mechanism of action may be the acute degeneration and\\/or ablation of sensory nerve fibers. Hypothesis: After ablation or degeneration by bipolar radiofrequency, nerve fibers will have the ability to regenerate with time. Study Design: Controlled laboratory study. Methods:

  11. Insect paralysis by baculovirus-mediated expression of a mite neurotoxin gene.

    PubMed

    Tomalski, M D; Miller, L K

    1991-07-01

    Female mites of the species Pyemotes tritici inject an extremely potent venom into their insect prey that causes muscle-contraction and paralysis. These mites are able to paralyse insects 150,000 times their size and their venom is effective in a broad range of insect species. A toxin (TxP-I) associated with the mite venom apparatus causes immediate muscle-contractive paralysis when injected into insects but not mice. In this report, we describe the cloning, sequencing and expression of a complementary DNA (Tox-34) encoding TxP-I. Insect cells infected with a recombinant baculovirus (vEV-Tox34) expressing Tox-34 secrete three polypeptides related to TxP-I which cause paralysis on injection. Larvae infected with vEV-Tox34 become paralysed during infection, thus reflecting the potential application of this toxin gene in insect biocontrol methods. The toxin gene expression system will also allow further exploration of the neurophysiological basis of its insect-specific effects. PMID:1840646

  12. Novel mutations in human and mouse SCN4A implicate AMPK in myotonia and periodic paralysis

    PubMed Central

    Corrochano, Silvia; Männikkö, Roope; Joyce, Peter I.; McGoldrick, Philip; Lassi, Glenda; Raja Rayan, Dipa L.; Blanco, Gonzalo; Quinn, Colin; Liavas, Andrianos; Lionikas, Arimantas; Amior, Neta; Dick, James; Healy, Estelle G.; Stewart, Michelle; Carter, Sarah; Hutchinson, Marie; Bentley, Liz; Fratta, Pietro; Cortese, Andrea; Cox, Roger; Brown, Steve D. M.; Tucci, Valter; Wackerhage, Henning; Amato, Anthony A.; Greensmith, Linda; Koltzenburg, Martin; Hanna, Michael G.; Acevedo-Arozena, Abraham

    2014-01-01

    Mutations in the skeletal muscle channel (SCN4A), encoding the Nav1.4 voltage-gated sodium channel, are causative of a variety of muscle channelopathies, including non-dystrophic myotonias and periodic paralysis. The effects of many of these mutations on channel function have been characterized both in vitro and in vivo. However, little is known about the consequences of SCN4A mutations downstream from their impact on the electrophysiology of the Nav1.4 channel. Here we report the discovery of a novel SCN4A mutation (c.1762A>G; p.I588V) in a patient with myotonia and periodic paralysis, located within the S1 segment of the second domain of the Nav1.4 channel. Using N-ethyl-N-nitrosourea mutagenesis, we generated and characterized a mouse model (named draggen), carrying the equivalent point mutation (c.1744A>G; p.I582V) to that found in the patient with periodic paralysis and myotonia. Draggen mice have myotonia and suffer from intermittent hind-limb immobility attacks. In-depth characterization of draggen mice uncovered novel systemic metabolic abnormalities in Scn4a mouse models and provided novel insights into disease mechanisms. We discovered metabolic alterations leading to lean mice, as well as abnormal AMP-activated protein kinase activation, which were associated with the immobility attacks and may provide a novel potential therapeutic target. PMID:25348630

  13. Normokalemic Thyrotoxic Periodic Paralysis with Preserved Reflexes- A Unique Case Report

    PubMed Central

    2015-01-01

    Although serum potassium levels are usually subnormal in Thyrotoxic Periodic Paralysis (TPP), but in exceptionally rare circumstances, it may be normal leading to the entity called normokalemic TPP. The diagnosis of normokalemic TPP is more often overlooked and/or delayed due to lack of awareness among the physicians and associated mild symptoms of hyperthyroidism. Here, the author describes the case of a 27-year-old male with newly diagnosed but untreated Grave’s disease and TPP who was normokalemic during the acute phase of paralysis. Hypokalemia was documented only after resolution of paralytic attacks during subsequent days of admission. The importance of the case report is to highlight upon the fact that TPP should always be considered in an “previously asymptomatic” young Asian individual with acute paralysis with or without hypokalemia , and thyroid function and serial potassium values should be evaluated for diagnosing the usual hypokalemic type or the more rarer variant normokalemic TPP. This case report also deserves mention as the patient of TPP had a notable feature of having preserved reflexes in the face of hypokalemia. PMID:25859483

  14. Adipose derived stem cells and nerve regeneration

    PubMed Central

    Faroni, Alessandro; Smith, Richard JP; Reid, Adam J

    2014-01-01

    Injuries to peripheral nerves are common and cause life-changing problems for patients alongside high social and health care costs for society. Current clinical treatment of peripheral nerve injuries predominantly relies on sacrificing a section of nerve from elsewhere in the body to provide a graft at the injury site. Much work has been done to develop a bioengineered nerve graft, precluding sacrifice of a functional nerve. Stem cells are prime candidates as accelerators of regeneration in these nerve grafts. This review examines the potential of adipose-derived stem cells to improve nerve repair assisted by bioengineered nerve grafts. PMID:25221589

  15. Peripheral nerve lengthening as a regenerative strategy

    PubMed Central

    Vaz, Kenneth M.; Brown, Justin M.; Shah, Sameer B.

    2014-01-01

    Peripheral nerve injury impairs motor, sensory, and autonomic function, incurring substantial financial costs and diminished quality of life. For large nerve gaps, proximal lesions, or chronic nerve injury, the prognosis for recovery is particularly poor, even with autografts, the current gold standard for treating small to moderate nerve gaps. In vivo elongation of intact proximal stumps towards the injured distal stumps of severed peripheral nerves may offer a promising new strategy to treat nerve injury. This review describes several nerve lengthening strategies, including a novel internal fixator device that enables rapid and distal reconnection of proximal and distal nerve stumps. PMID:25317163

  16. Towards Computational Modeling of Phonation Using CT--Based Laryngeal Models

    NASA Astrophysics Data System (ADS)

    Mohsen Karimian, S. A.; Mittal, Rajat

    2008-11-01

    The oscillatory flow generated in human larynx plays a key role in the process of phonation. While much has been done to understand the main features of such flow by using idealized geometry models and simplified flow conditions, there is still little known about the 3D features of laryngeal flow. In this work, anatomically realistic models of the human larynx are used to analyze the fluid dynamics of 3D laryngeal flow using high--fidelity numerical simulations. A Cartesian--grid--based, finite--difference Navier--Stokes solver is used to carry out these simulations. Three--dimensional models of human larynx are extracted from CT images and unstructured surface grids are generated for the model geometries. The pressure driven flow is simulated for a range of Reynolds numbers. The main objective in this work is to understand more in--depth the effect of 3D geometric features of glottal airway on the laryngeal flow structure.

  17. Association of history of allergies and influenza-like infections with laryngeal cancer in a case-control study.

    PubMed

    Filippidis, Filippos T; Schwartz, Stephen M; Becker, Nikolaus; Dyckhoff, Gerhard; Kirschfink, Michael; Dietz, Andreas; Becher, Heiko; Ramroth, Heribert

    2015-08-01

    Prior studies suggest that history of allergy and infections early in life might be inversely associated with cancer. We explored the association between allergies, recent influenza infections and laryngeal cancer risk. We used data from a case-control study which included 229 cases of laryngeal cancer and 769 population controls matched for age and sex. History of a physician-diagnosed allergy, influenza-like infections in the past 5 years, smoking, alcohol consumption and occupational exposure to carcinogens were self-reported. Allergies were classified into two groups (Type I and Type IV), according to the underlying immunologic mechanism. Conditional logistic regression models were fitted using laryngeal cancer as the outcome, adjusting for smoking, alcohol consumption and occupational exposure and stratified for age and sex. Having any allergy was not associated significantly with laryngeal cancer. Although Type I and Type IV allergies were non-significantly associated with laryngeal cancer, Type IV allergies showed a strong inverse association after adjusting for smoking and alcohol (OR 0.50, 95 % CI 0.22-1.2). Participants who reported at least one influenza-like infection during the past 5 years were significantly less likely to have laryngeal cancer (OR 0.57, 95 % CI 0.39-0.81). After considering fever (?38.5 °C) as a criterion for influenza infection, the association between influenza infection and laryngeal cancer was even stronger (OR 0.29, 95 % CI 0.13-0.63). We found no significant association between any allergy and laryngeal cancer, some indication of an inverse association between Type IV allergy and laryngeal cancer, whereas recent influenza infections were inversely associated with laryngeal cancer risk. PMID:25634066

  18. Peptide GE11-Polyethylene Glycol-Polyethylenimine for targeted gene delivery in laryngeal cancer.

    PubMed

    Ren, Henglei; Zhou, Liang; Liu, Min; Lu, Weiyue; Gao, Chunli

    2015-07-01

    The objective of this study was to evaluate the possibility of using GE11-polyethylene glycol-polyethylenimine (GE11-PEG-PEI) for targeted gene delivery to treat epidermal growth factor receptor (EGFR)-overexpressing laryngeal cancer. This study described the design, characterization, and in vitro and in vivo study of the nanocarrier GE11-PEG-PEI for gene delivery to treat laryngeal cancer. Analysis of the sizes and zeta potentials indicated that the formation of PEGylated complexes was dependent on the N/P ratio, and these complexes were capable of binding plasmid DNA and condensing DNA into small positively charged nanoparticles. The results also revealed that GE11-PEG-PEI had a weaker effect on cell survival in vitro. Gene transfection was performed on human laryngeal cancer Hep-2 cells in vitro and in vivo. Both the in vitro and in vivo results demonstrated that GE11-PEG-PEI had greater transfection efficiency than mPEG-PEI. Compared with mPEG-PEI/pORF-hTRAIL and saline, GE11-PEG-PEI/pORFh-TRAIL significantly (p < 0.05) reduced tumor growth in nude mice with laryngeal cancer. Moreover, the GE11-PEG-PEI/pORF-hTRAIL-treated groups showed more apoptosis than the mPEG-PEI/pORF-hTRAIL-treated groups. Therefore, our results showed that the peptide GE11 conjugated to PEG-PEI delivered significantly more genes to EGFR-overexpressing laryngeal cancer cells in vivo, indicating that GE11-PEG-PEI may be a suitable gene vector for treating EGFR-overexpressing laryngeal cancer. PMID:26008151

  19. Occupational exposure and laryngeal and hypopharyngeal cancer risk in central and eastern Europe

    SciTech Connect

    Shangina, O.; Brennan, P.; Szeszenia-Dabrowska, N.; Mates, D.; Fabianova, E.; Fletcher, T.; Mannetje, A.; Boffetta, P.; Zaridze, D. [International Agency for Research Center, Lyon (France)

    2006-08-15

    A multicenter case-control study was conducted during 1999-2002 in four European countries (Poland, Romania, Russia, and Slovakia) to evaluate the role of occupational exposures in risk of laryngeal/hypopharyngeal cancer. Male cancer cases (34 hypopharyngeal, 316 laryngeal) with full data on occupational history and nonoccupational factors were compared with 728 hospital controls for occupational exposure to 73 suspected carcinogens. Occupational history was evaluated by industrial hygienists blinded to case/control status. Elevated risks for over exposure to coal dust were found for both hypopharyngeal (odds ratio (OR) = 4.19, 95% confidence interval (CI): 1.18, 14.89) and laryngeal (OR = 1.81, 95% CI: 0.94, 3.47) cancer, with clear dose-response patterns. Inclusion of a 20-year lag in the analysis strengthened these associations. Hypopharyngeal cancer risk was also significantly associated with exposure to mild steel dust (OR = 3.04, 95% CI: 1.39, 6.64) and iron compounds and fumes (OR = 2.74, 95% CI: 1.29, 5.84), without clear dose-response relations. Laryngeal cancer was significantly associated with exposure to hard-alloys dust (OR = 2.23, 95% CI: 1.08, 4.57) and chlorinated solvents (OR = 2.18, 95% CI: 1.03, 4.61), without dose-response relations. A possible link between high formaldehyde exposure and laryngeal cancer was suggested. These data indicate that occupational exposure to coal dust may play a role in laryngeal and hypopharyngeal cancer. Other possible relations need further evaluation.

  20. Concurrent Chemotherapy and Intensity-Modulated Radiotherapy for Locoregionally Advanced Laryngeal and Hypopharyngeal Cancers

    SciTech Connect

    Lee, Nancy Y. [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)], E-mail: leen2@mskcc.org; O'Meara, William; Chan, Kelvin [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Della-Bianca, Cesar; Mechalakos, James G. [Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Zhung, Joanne; Wolden, Suzanne L.; Narayana, Ashwatha [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Kraus, Dennis; Shah, Jatin P. [Department of Surgery, Division of Head and Neck Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Pfister, David G. [Department of Medicine, Division of Head and Neck Medical Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY (United States)

    2007-10-01

    Purpose: To perform a retrospective review of laryngeal/hypopharyngeal carcinomas treated with concurrent chemotherapy and intensity-modulated radiotherapy (IMRT). Methods and Materials: Between January 2002 and June 2005, 20 laryngeal and 11 hypopharyngeal carcinoma patients underwent IMRT with concurrent platinum-based chemotherapy; most patients had Stage IV disease. The prescription of the planning target volume for gross, high-risk, and low-risk subclinical disease was 70, 59.4, and 54 Gy, respectively. Acute/late toxicities were retrospectively scored using the Common Toxicity Criteria scale. The 2-year local progression-free, regional progression-free, laryngectomy-free, distant metastasis-free, and overall survival rates were calculated using the Kaplan-Meier method. Results: The median follow-up of the living patients was 26 months (range, 17-58 months). The 2-year local progression-free, regional progression-free, laryngectomy-free, distant metastasis-free, and overall survival rate was 86%, 94%, 89%, 92%, and 63%, respectively. Grade 2 mucositis or higher occurred in 48% of patients, and all experienced Grade 2 or higher pharyngitis during treatment. Xerostomia continued to decrease over time from the end of RT, with none complaining of Grade 2 toxicity at this analysis. The 2-year post-treatment percutaneous endoscopic gastrostomy-dependency rate for those with hypopharyngeal and laryngeal tumors was 31% and 15%, respectively. The most severe late complications were laryngeal necrosis, necrotizing fascitis, and a carotid rupture resulting in death 3 weeks after salvage laryngectomy. Conclusion: These preliminary results have shown that IMRT achieved encouraging locoregional control of locoregionally advanced laryngeal and hypopharyngeal carcinomas. Xerostomia improved over time. Pharyngoesophageal stricture with percutaneous endoscopic gastrostomy dependency remains a problem, particularly for patients with hypopharyngeal carcinoma and, to a lesser extent, those with laryngeal cancer. Strategies using IMRT to limit the dose delivered to the esophagus/inferior constrictor musculature without compromising target coverage might be useful to further minimize this late complication.

  1. The Assessment Methods of Laryngeal Muscle Activity in Muscle Tension Dysphonia: A Review

    PubMed Central

    Khoddami, Seyyedeh Maryam; Nakhostin Ansari, Noureddin; Izadi, Farzad; Talebian Moghadam, Saeed

    2013-01-01

    The purpose of this paper is to review the methods used for the assessment of muscular tension dysphonia (MTD). The MTD is a functional voice disorder associated with abnormal laryngeal muscle activity. Various assessment methods are available in the literature to evaluate the laryngeal hyperfunction. The case history, laryngoscopy, and palpation are clinical methods for the assessment of patients with MTD. Radiography and surface electromyography (EMG) are objective methods to provide physiological information about MTD. Recent studies show that surface EMG can be an effective tool for assessing muscular tension in MTD. PMID:24319372

  2. Fracture of the laryngeal cartilage. An incidental finding on bone scintigraphy.

    PubMed

    Steuart, R D; Morrison, R T

    1992-10-01

    A patient complaining of headaches and bone pain at multiple sites had Tc-99m MDP scintigraphy performed for possible bone trauma after a motor vehicle accident. Bone imaging revealed a small focal increase in tracer uptake in the area of the laryngeal cartilage. There was some reluctance to place a label on this abnormality because the findings were so unusual. The initial diagnosis was a probable fracture of the laryngeal cartilage. Computed tomography of the neck also demonstrated a fracture but correctly localized it to the thyroid cartilage. PMID:1424360

  3. Computed tomography of the larynx: correlation with anatomic and pathologic studies in cases of laryngeal carcinoma

    SciTech Connect

    Mafee, M.F.; Schild, J.A.; Valvassori, G.E.; Capek, V.

    1983-04-01

    Seven patients with known carcinoma of the larynx underwent computed tomography (CT) of the larynx prior to surgery. Whole-mount sections of the extirpated larynx cut in the horizontal plane were compared with the corresponding level of the preoperaive CT sections to demonstrate the validity of CT scanning in the evaluation of tumors of the larynx. The results indicate that CT scanning accurately demonstrates the anatomic location and gross size of laryngeal tumor, although early invasion of the laryngeal cartilages may be difficult to diagnose with CT. It is concluded that preoperative CT scanning of the larynx is the radiologic procedure of choice for evaluating carcinoma of the larynx.

  4. Isosulfan Blue Dye Anaphylaxis Presenting as Impaired Ability to Ventilate via a Laryngeal Mask Airway.

    PubMed

    Reed, Heather; Shaw, Christiana; Rice, Mark; Le, Huong Thi

    2014-07-01

    A 44-year-old woman presented for sentinel node biopsy and segmental mastectomy. After anesthetic induction, a laryngeal mask airway was placed, and ventilation was satisfactory. Three minutes after isosulfan blue dye injection, ventilation became difficult. The laryngeal mask airway was removed, and an endotracheal tube was easily placed. Twenty minutes later, she became hypotensive and unresponsive to phenylephrine, ephedrine, and vasopressin. With erythema and swelling in her arm and chest, low-dose epinephrine was titrated until her mean arterial blood pressure stabilized. Serum tryptase was increased to 27.2 ?g/L (normal 0.4-10.9 ?g/L). PMID:25612264

  5. Nickel dental alloys can induce laryngeal edema attacks: a case report.

    PubMed

    Buyukozturk, Suna; Gelincik, Asli; Demirtürk, Mustafa; Erdo?du, Derya; Pur, Leyla; Colako?lu, Bahattin; Deniz, Gunnur; Erdem Kuruca, Serap

    2013-09-01

    Nickel is a strong immunological sensitizer and may result in contact hypersensitivity. Case reports of allergic reactions to intraoral nickel have occasionally been reported in the published work and these allergic reactions are generally of a delayed type (type IV). Here, we present a case of a nickel allergic patient displaying frequent laryngeal edema attacks which required treatment with epinephrine injections followed by parenteral corticosteroid doses. Her complaints ceased after the removal of the dental bridge and the foods containing nickel. In summary, we propose that in the case of recurrent laryngeal edema attacks without any explainable cause, an allergic reaction due to nickel exposure should be taken into consideration. PMID:23834453

  6. Options for preserving the larynx in patients with advanced laryngeal and hypopharyngeal cancer.

    PubMed

    Wolf, G T

    2001-12-01

    The introduction of newer surgical and combined-modality approaches to organ preservation in patients with advanced laryngeal or hypopharyngeal cancer is the most exciting clinical frontier in head and neck cancer treatment today. The use of these techniques at other sites, the exploration of improved methods for patient selection and tumor assessment, and the development of newer combination regimens will need to be rigorously studied in future clinical trials. In all these efforts, the major focus must remain on improving survival. This article reviews the latest developments in organ-preservation strategies and techniques for patients with advanced laryngeal or hypopharyngeal cancer. PMID:11775526

  7. Postvaccinal inflammatory neuropathy: peripheral nerve biopsy in 3 cases.

    PubMed

    Vital, Claude; Vital, Anne; Gbikpi-Benissan, Georges; Longy-Boursier, Maïté; Climas, Marie-Thérèse; Castaing, Yves; Canron, Marie-Hélène; Le Bras, Michel; Petry, Klaus

    2002-09-01

    Autoimmune inflammatory polyneuropathy (PN) can be triggered by vaccination. We report 3 such cases. A 36-year-old female nurse presented 15 days after a hepatitis B vaccination (HBV) with acute sensory disturbances in the lower limbs. She had severe ataxia but no weakness. Cerebrospinal fluid (CSF) protein level was 84 mg/100 mL, with 3 lymphocytes. A 66-year-old man presented 21 days after HBV with severe motor and sensory PN involving all 4 limbs. A 66-year-old man presented 15 days after a yellow fever vaccination with progressive motor and sensory PN involving all 4 limbs and bilateral facial paralysis. CSF protein level was 300 mg/100 mL, with 5 lymphocytes. Six weeks later, a tracheostomy was performed. In these 3 patients, the nerve deficits lasted for months. In each case, peripheral nerve biopsy showed KP1-positive histiocytes but no T-lymphocytes in the endoneurium. On ultrastructural examination, there was axonal degeneration in the first 2 cases; in case 2, a few myelinated fibers exhibited an intra-axonal macrophage but the myelin sheath was preserved. There was only 1 example of macrophage-associated demyelination in case 2, but these were numerous in case 3. It is likely that in the first 2 cases, an autoimmune reaction against some axonal or neuronal components was triggered by HBV. It induced an acute sensory ataxic PN in case 1 and an acute motor and sensory axonal neuropathy (AMSAN) in case 2. The third patient had a chronic inflammatory demyelinating PN, likely triggered by yellow fever vaccination. PMID:12365564

  8. Laryngoceles

    MedlinePLUS

    ... Abscess Epiglottitis Laryngitis Vocal Cord Polyps, Nodules, and Granulomas Vocal Cord Contact Ulcers Vocal Cord Paralysis Laryngoceles ... Abscess Epiglottitis Laryngitis Vocal Cord Polyps, Nodules, and Granulomas Vocal Cord Contact Ulcers Vocal Cord Paralysis Laryngoceles ...

  9. Hypoglossal-facial nerve anastomosis in the rabbits using laser welding.

    PubMed

    Hwang, Kun; Kim, Sun Goo; Kim, Dae Joong

    2008-10-01

    The aim of this study is to compare laser nerve welding of hypoglossal-facial nerve to microsurgical suturing and a result of immediate and delayed repair, and to evaluate the effectiveness of laser nerve welding in reanimation of facial paralysis of the rabbit models. The first group of 5 rabbits underwent immediate hypoglossal-facial anastomosis (HFA) by microsurgical suturing and the second group of 5 rabbits by CO2 laser welding. The third group of 5 rabbits underwent delayed HFA by microsurgical suturing and the fourth group of 5 rabbits by laser nerve welding. The fifth group of 5 rabbits sustained intact hypoglossal and facial nerve as control. In all rabbits of the 4 different groups, cholera toxin subunit B (CTb) was injected in the epineurium distal to the anastomosis site on the postoperative sixth week and in normal hypoglossal nerve in the 5 rabbits of control group. Neurons labeled CTb of hypoglossal nuclei were positive immunohistochemically and the numbers were counted. In the immediate HFA groups, CTb positive neurons were 1416 +/- 118 in the laser welding group (n = 5) and 1429 +/- 90 in the microsurgical suturing group (n = 5). There was no significant difference (P = 0.75). In the delayed HFA groups, CTb positive neurons were 1503 +/- 66 in the laser welding group (n = 5) and 1207 +/- 68 in the microsurgical suturing group (n = 5). Difference was significant (P = 0.009). There was no significant difference between immediate and delayed anastomosis in the laser welding group (P = 0.208), but some significant difference was observed between immediate and delayed anastomosis in the microsurgical suturing group (P = 0.016). Injected CTb in intact hypoglossal neurons (n = 5) were labeled 1970 +/- 165. No dehiscence was seen on the laser welding site of nerve anastomosis in all the rabbits as re-exploration was done for injection of CTb. This study shows that regeneration of the anastomosed hypoglossal-facial nerve was affected similarly by either laser welding or microsurgical suturing in immediate repair; however, the welding was more effective especially in delayed repair. PMID:18812720

  10. Nerve Agents ATSDR ? General Information 1

    E-print Network

    Baloh, Bob

    Nerve Agents ATSDR ? General Information 1 Nerve Agents Tabun (GA) CAS 77-81-6; Sarin (GB) CAS 107-diisopropylaminoethyl methylphosphonothiolate ? Persons whose skin or clothing is contaminated with nerve agent can contaminate rescuers by direct contact orthrough off-gassing vapor. Persons whose skin is exposed only to nerve agent vapor pose

  11. Endometriotic lesions of the lower troncular nerves.

    PubMed

    Niro, J; Fournier, M; Oberlin, C; Le Tohic, A; Panel, P

    2014-10-01

    Although exceptional, endometriotic lesions of the troncular nerves of the lower limb may occur and are often diagnosed with delay. We report, hereby, the first case of femoral nerve endometriosis the treatment of which consisted of radical resection with femoral nerve transplant. We completed a review of the literature on sciatic nerve endometriotic lesions and discussed the physiopathology and surgical treatment. PMID:25267476

  12. Distribution of sodium channels during nerve elongation in rat peripheral nerve

    Microsoft Academic Search

    Harumitsu Ichimura; Takashi Shiga; Ichiro Abe; Yuki Hara; Naoto Terui; Akihito Tsujino; Naoyuki Ochiai

    2005-01-01

    A number of studies have investigated electrophysiological and morphological changes of peripheral nerves during gradual elongation. There has been, however, no report on the distribution of sodium channels at Ranvier’s nodes during peripheral nerve elongation. We investigated peripheral nerve injury after the gradual elongation of rat sciatic nerves. Indirect nerve elongation was induced by leg lengthening at a rate of

  13. The Composition of Microbiome in Larynx and the Throat Biodiversity between Laryngeal Squamous Cell Carcinoma Patients and Control Population

    PubMed Central

    Gong, Hong-Li; Shi, Yi; Zhou, Liang; Wu, Chun-Ping; Cao, Peng-Yu; Tao, Lei; Xu, Chen; Hou, Dong-Sheng; Wang, Yue-Zhu

    2013-01-01

    The throat is an ecological assemblage involved human cells and microbiota, and the colonizing bacteria are important factors in balancing this environment. However, this bacterial community profile has thus been poorly investigated. The purpose of this study was to investigate the microbial biology of the larynx and to analyze the throat biodiversity in laryngeal carcinoma patients compared to a control population in a case-control study. Barcoded pyrosequencing analysis of the 16S rRNA gene was used. We collected tissue samples from 29 patients with laryngeal carcinoma and 31 control patients with vocal cord polyps. The findings of high-quality sequence datasets revealed 218 genera from 13 phyla in the laryngeal mucosa. The predominant communities of phyla in the larynx were Firmicutes (54%), Fusobacteria (17%), Bacteroidetes (15%), Proteobacteria (11%), and Actinobacteria (3%). The leading genera were Streptococcus (36%), Fusobacterium (15%), Prevotella (12%), Neisseria (6%), and Gemella (4%). The throat bacterial compositions were highly different between laryngeal carcinoma subjects and control population (p?=?0.006). The abundance of the 26 genera was significantly different between the laryngeal cancer and control groups by metastats analysis (p<0.05). Fifteen genera may be associated with laryngeal carcinoma by partial least squares discriminant analysis (p<0.001). In summary, this study revealed the microbiota profiles in laryngeal mucosa from tissue specimens. The compositions of bacteria community in throat were different between laryngeal cancer patients and controls, and probably were related with this carcinoma. The disruption of this bio-ecological niche might be a risk factor for laryngeal carcinoma. PMID:23824228

  14. Anesthesia for Intranasal Surgery: A Comparison Between Tracheal Intubation and the Flexible Reinforced Laryngeal Mask Airway

    Microsoft Academic Search

    Anthony C. Webster; Patricia K. Morley-Forster; Victor Janzen; Steven L. Dain; Donald Taves; Dale Dantzer

    The purpose of the study was to assess the suitability and safety of the flexible reinforced laryngeal mask airway (FRLMA) for intranasal surgery (INS) anesthesia. A sec- ondary objective was to compare the incidence of compli- cations of removal of the FRLMA with tracheal extubation in awake and anesthetized patients. One hundred four- teen ASA physical status I and II

  15. Comparison between intubation and the laryngeal mask airway in moderately obese adults

    Microsoft Academic Search

    M. ZOREMBA; H. AUST; L. EBERHART; S. BRAUNECKER; H. WULF

    2009-01-01

    Background: Obesity is a well-established risk factor for perioperative pulmonary complications. Anaesthetic drugs and the effect of obesity on respiratory mechanics are responsible for these pathophysiological changes, but tracheal intubation with muscle relaxation may also con- tribute. This study evaluates the influence of airway man- agement, i.e. intubation vs. laryngeal mask airway (LMA), on postoperative lung volumes and arterial oxygen

  16. Effect of Dystrophin Deficiency on Selected Intrinsic Laryngeal Muscles of the "mdx" Mouse

    ERIC Educational Resources Information Center

    Fry, Lisa T.; Stemple, Joseph C.; Andreatta, Richard D.; Harrison, Anne L.; Andrade, Francisco H.

    2010-01-01

    Background: Intrinsic laryngeal muscles (ILM) show biological differences from the broader class of skeletal muscles. Yet most research regarding ILM specialization has been completed on a few muscles, most notably the thyroarytenoid and posterior cricoarytenoid. Little information exists regarding the biology of other ILM. Early evidence suggests…

  17. The use of laryngeal mask airway Supreme™ in rescue airway situation in the critical care unit

    PubMed Central

    Siddiqui, Shahla; Seet, Edwin; Chan, Wing Yan

    2014-01-01

    We herein report a witnessed cardiopulmonary collapse of a patient with difficult mask ventilation and near-impossible laryngoscopy-cum-intubation in the critical care unit. The airway was successfully rescued with a laryngeal mask airway Supreme™, followed by an open, crash tracheostomy by the otolaryngologist. PMID:25630328

  18. The use of laryngeal mask airway Supreme™ in rescue airway situation in the critical care unit.

    PubMed

    Siddiqui, Shahla; Seet, Edwin; Chan, Wing Yan

    2014-12-01

    We herein report a witnessed cardiopulmonary collapse of a patient with difficult mask ventilation and near-impossible laryngoscopy-cum-intubation in the critical care unit. The airway was successfully rescued with a laryngeal mask airway Supreme™, followed by an open, crash tracheostomy by the otolaryngologist. PMID:25630328

  19. LARYNGEAL ACTIVITY IN ICELANDIC OBSTRUENT PRODUCTION* Anders L6fqvist+ and Hirohide Yoshioka++

    E-print Network

    or more continuous laryngeal opening and closing gestures occurred depending on the segments, and examine ho\\'If they are used to produce the acoustic signals that are required by the phonology of the language. Fourth International Conference June, 1980, and will appear NS-1 17 and NS-NINCDS Gr

  20. Coordination of Oral and Laryngeal Movements in the Perceptually Fluent Speech of Adults Who Stutter

    ERIC Educational Resources Information Center

    Max, Ludo; Gracco, Vincent L.

    2005-01-01

    This work investigated whether stuttering and nonstuttering adults differ in the coordination of oral and laryngeal movements during the production of perceptually fluent speech. This question was addressed by completing correlation analyses that extended previous acoustic studies by others as well as inferential analyses based on the…

  1. Developmental Changes in Laryngeal and Respiratory Function with Variations in Sound Pressure Level.

    ERIC Educational Resources Information Center

    Stathopoulos, Elaine T.; Sapienza, Christine M.

    1997-01-01

    The development of the speech production system was investigated among 120 children (ages 4-14 years) and 20 adults. Aerodynamic and acoustic results suggest that men and 14-year-old boys function differently than women and all other groups of children. Data generally suggest that laryngeal and respiratory behavior of children is not easily…

  2. Expression of the tumor suppressor gene hypermethylated in cancer 1 in laryngeal carcinoma

    PubMed Central

    MARKOWSKI, JAROS?AW; SIERO?, ALEKSANDER L.; KASPERCZYK, KATARZYNA; CIUPI?SKA-KAJOR, MONIKA; AUGU?CIAK-DUMA, ALEKSANDRA; LIKUS, WIRGINIA

    2015-01-01

    Hypermethylated in cancer 1 (HIC1) is a putative suppressor gene, cooperating with TP53 in the regulation of apoptosis. The promoter site of this gene contains CpG islands susceptible to methylation. Altered methylation leads to the silencing of HIC1. Persistent loss of HIC1 function reflects the attenuation of proapoptotic characteristics of TP53 and may constitute the background for carcinogenesis. Altered methylation profiles along with diminished expression of HIC1 were documented in a number of solid neoplasms. The aim of this study was to evaluate the expression of the HIC1 gene in laryngeal carcinoma. RNA was extracted from samples of laryngeal cancer and corresponding healthy tissues of 21 patients with advanced laryngeal cancer (T3-T4). The amount of RNA (cDNA) was evaluated using reverse transcription-quantitative polymerase chain reaction with GADPH as the reference gene. Data demonstrated that HIC1 expression was significantly reduced in laryngeal cancer tissues. The relative expression of HIC1 was found to be ~40% lower in tumor samples compared to that in healthy controls. The median tumor/normal tissue ratio for HIC1 was 0.615. These results suggest that low HIC1 expression may be associated with neoplastic transformation in the larynx.

  3. Carbon-11 tyrosine PET for visualization and protein synthesis rate assessment of laryngeal and hypopharyngeal carcinomas.

    PubMed

    de Boer, Jurjan R; van der Laan, Bernard F A M; Pruim, Jan; Que, Tjin H; Burlage, Fred; Krikke, Allard; Willemsen, Antoon T M; Tiebosch, Anton T M G; Albers, Frans W J; Vaalburg, Willem

    2002-09-01

    Accurate assessment of tumour extent and lymph node involvement in squamous cell carcinomas of the head and neck region is essential for therapy planning. Unfortunately, conventional diagnostic examination and imaging techniques, which monitor tumours on the basis of anatomical parameters, have drawbacks in clinical practice. The aim of this study was to investigate the feasibility of L-[1-(11)C]-tyrosine (TYR) positron emission tomography (PET) for visualisation of squamous cell carcinoma of the larynx and hypopharynx and quantification of tumour activity by assessment of protein synthesis rate (PSR). Dynamic TYR PET was performed on 31 patients with T1-T4 laryngeal or hypopharyngeal carcinoma before therapy. Plasma activity of TYR, (11)CO(2) and (11)C-protein levels were measured, and PSRs were calculated for primary malignancies. All 31 laryngeal and hypopharyngeal tumours were visualised as a hotspot (sensitivity 100%). The median PSR of the tumours (2.06 nmol ml(-1) min(-1); range 0.72-6.96) was significantly higher ( P<0.001) than that of non-tumour (background) tissue (0.51 nmol ml(-1) min(-1); range 0.22-0.89). L-[1-(11)C]-Tyrosine PET appears to be a potential method for visualisation of primary laryngeal and hypopharyngeal tumours. In vivo quantification of tumour activity by assessment of PSR is possible and may have a future role in the therapy planning and therapy evaluation of laryngeal and hypopharyngeal tumours. PMID:12192563

  4. LARYNGEAL TWO-PHASE FLOW IN REALISTIC BREATHING Adam Scheinherr 1,2,3

    E-print Network

    Paris-Sud XI, Université de

    breathing, using EVA2 sensor [Ghio, 2004], and the glottis motion, using a flexible nasofiberscope (StorzLARYNGEAL TWO-PHASE FLOW IN REALISTIC BREATHING CONDITIONS Adam Scheinherr 1,2,3 , Lucie Bailly 1 been carried out to characterize the airflow behaviour during human breathing [Baier, 1977

  5. Bone Augmentation and Nerve Repositioning

    MedlinePLUS

    ... Types of Bone-Augmentation Procedures Nerve Repositioning For dental implants to be successful, the jawbone must have enough ... of procedures used to "build" bone so that dental implants can be placed. These procedures typically involve grafting ( ...

  6. Ion Channels in Nerve Membranes

    ERIC Educational Resources Information Center

    Ehrenstein, Gerald

    1976-01-01

    Discusses research that indicates that nerve membranes, which play a key role in the conduction of impulses, are traversed by protein channels with ion pathways opened and closed by the membrane electric field. (Author/MLH)

  7. Selective measurement of digital nerve conduction velocity

    Microsoft Academic Search

    Yuji Terai; Masuo Senda; Hiroyuki Hashizume; Hiroaki Nagashima; Hajime Inoue

    2001-01-01

    We developed a new method to measure the nerve conduction velocity of a single digital nerve. In 27 volunteers (27 hands),\\u000a we separately stimulated each digital nerve on the radial and ulnar sides of the middle and ring fingers. A double-peaked\\u000a potential was recorded above the median nerve at the wrist joint when either the radial-side nerve or the ulnar-side

  8. Nerve Regeneration After Radiofrequency Application

    Microsoft Academic Search

    Nobuyasu Ochiai; James P. Tasto; Seiji Ohtori; Norimasa Takahashi; Hideshige Moriya; David Amiel

    2007-01-01

    Background: Many patients with chronic tendinosis have experienced early pain relief after application of bipolar radiofrequency treatment. It is hypothesized that the mechanism of action may be the acute degeneration and\\/or ablation of sensory nerve fibers.Hypothesis: After ablation or degeneration by bipolar radiofrequency, nerve fibers will have the ability to regenerate with time.Study Design: Controlled laboratory study.Methods: Eighteen Sprague-Dawley rats

  9. Reversible paralysis of Schistosoma mansoni by forchlorfenuron, a phenylurea cytokinin that affects septins

    PubMed Central

    Zeraik, Ana E.; Galkin, Vitold E.; Rinaldi, Gabriel; Garratt, Richard C.; Smout, Michael J.; Loukas, Alex; Mann, Victoria H.; Araujo, Ana P.U.; DeMarco, Ricardo; Brindley, Paul J.

    2014-01-01

    Septins are guanosine-5?-triphosphate-binding proteins involved in wide-ranging cellular processes including cytokinesis, vesicle trafficking, membrane remodeling and scaffolds, and with diverse binding partners. Precise roles for these structural proteins in most processes often remain elusive. Identification of small molecules that inhibit septins could aid in elucidating the functions of septins and has become increasingly important, including the description of roles for septins in pathogenic phenomena such as tumorigenesis. The plant growth regulator forchlorfenuron (FCF), a synthetic cytokinin known to inhibit septin dynamics, likely represents an informative probe for septin function. This report deals with septins of the human blood fluke Schistosoma mansoni and their interactions with FCF. Recombinant forms of three schistosome septins, SmSEPT5, SmSEPT7.2 and SmSEPT10, interacted with FCF, leading to rapid polymerization of filaments. Culturing developmental stages (miracidia, cercariae, adult males) of schistosomes in FCF at 50 – 500 ?M rapidly led to paralysis, which was reversible upon removal of the cytokinin. The reversible paralysis was concentration-, time- and developmental stage-dependent. Effects of FCF on the cultured schistosomes were monitored by video and/or by an xCELLigence-based assay of motility, which quantified the effect of FCF on fluke motility. The findings implicated a mechanism targeting a molecular system controlling movement in these developmental stages: a direct effect on muscle contraction due to septin stabilization might be responsible for the reversible paralysis, since enrichment of septins has been described within the muscles of schistosomes. This study revealed the reversible effect of FCF on both schistosome motility and its striking impact in hastening polymerization of septins. These novel findings suggested routes to elucidate roles for septins in this pathogen, and exploitation of derivatives of FCF for anti-schistosomal drugs. PMID:24768753

  10. Escherichia coli-induced immune paralysis is not exacerbated during chronic filarial infection.

    PubMed

    Buerfent, Benedikt C; Gondorf, Fabian; Wohlleber, Dirk; Schumak, Beatrix; Hoerauf, Achim; Hübner, Marc P

    2015-05-01

    Sepsis initially starts with a systemic inflammatory response (SIRS phase) and is followed by a compensatory anti-inflammatory response syndrome (CARS) that causes impaired adaptive T-cell immunity, immune paralysis and an increased susceptibility to secondary infections. In contrast, parasitic filariae release thousands of microfilariae into the peripheral blood without triggering inflammation, as they induce regulatory, anti-inflammatory host responses. Hence, we investigated the impact of chronic filarial infection on adaptive T-cell responses during the SIRS and CARS phases of a systemic bacterial infection and analysed the development of T-cell paralysis following a subsequent adenovirus challenge in BALB/c mice. Chronic filarial infection impaired adenovirus-specific CD8(+) T-cell cytotoxicity and interferon-? responses in the absence of a bacterial challenge and led to higher numbers of splenic CTLA-4(+)  CD4(+) T cells, whereas splenic T-cell expression of CD69 and CD62 ligand, serum cytokine levels and regulatory T-cell frequencies were comparable to naive controls. Irrespective of filarial infection, the SIRS phase dominated 6-24 hr after intravenous Escherichia coli challenge with increased T-cell activation and pro-inflammatory cytokine production, whereas the CARS phase occurred 6 days post E. coli challenge and correlated with high levels of transforming growth factor-? and increased CD62 ligand T-cell expression. Escherichia coli-induced impairment of adenovirus-specific CD8(+) T-cell cytotoxicity and interferon-? production was not additionally impaired by chronic filarial infection. This suggests that filarial immunoregulation does not exacerbate E. coli-induced T-cell paralysis. PMID:25521437

  11. Invited Article: Recommendations of the Neurolaryngology Study Group on Laryngeal Electromyography

    PubMed Central

    Blitzer, Andrew; Crumley, Roger L.; Dailey, Seth H.; Ford, Charles N.; Floeter, Mary Kay; Hillel, Allen D.; Hoffman, Henry T.; Ludlow, Christy L.; Merati, Albert; Munin, Michael C.; Robinson, Lawrence R.; Rosen, Clark; Saxon, Keith G.; Sulica, Lucian; Thibeault, Susan L.; Titze, Ingo; Woo, Peak; Woodson, Gayle E.

    2009-01-01

    The Neurolaryngology Study Group convened a multidisciplinary panel of experts in neuromuscular physiology, electromyography, physical medicine and rehabilitation, neurology, and laryngology to meet with interested members from the American Academy of Otolaryngology Head and Neck Surgery, the Neurolaryngology Subcommittee and the Neurolaryngology Study Group to address the use of laryngeal electromyography (LEMG) for electrodiagnosis of laryngeal disorders. The panel addressed the use of LEMG for: 1) diagnosis of vocal fold paresis, 2) best practice application of equipment and techniques for LEMG, 3) estimation of time of injury and prediction of recovery of neural injuries, 4) diagnosis of neuromuscular diseases of the laryngeal muscles, and, 5) differentiation between central nervous system and behaviorally based laryngeal disorders. The panel also addressed establishing standardized techniques and methods for future assessment of LEMG sensitivity, specificity and reliability for identification, assessment and prognosis of neurolaryngeal disorders. Previously an evidence-based review of the clinical utility of LEMG published in 2004 only found evidence supported that LEMG was possibly useful for guiding injections of botulinum toxin into the laryngeal muscles. An updated traditional/narrative literature review and expert opinions were used to direct discussion and format conclusions. In current clinical practice, LEMG is a qualitative and not a quantitative examination. Specific recommendations were made to standardize electrode types, muscles to be sampled, sampling techniques, and reporting requirements. Prospective studies are needed to determine the clinical utility of LEMG. Use of the standardized methods and reporting will support future studies correlating electro-diagnostic findings with voice and upper airway function. PMID:19467391

  12. Optic Nerve Monitoring

    PubMed Central

    Schumann, Paul; Kokemüller, Horst; Tavassol, Frank; Lindhorst, Daniel; Lemound, Juliana; Essig, Harald; Rücker, Martin; Gellrich, Nils-Claudius

    2013-01-01

    Orbital and anterior skull base surgery is generally performed close to the prechiasmatic visual pathway, and clear strategies for detecting and handling visual pathway damage are essential. To overcome the common problem of a missed clinical examination because of an uncooperative or unresponsive patient, flash visual evoked potentials and electroretinograms should be used. These electrophysiologic examination techniques can provide evidence of intact, pathologic, or absent conductivity of the visual pathway when clinical assessment is not feasible. Visual evoked potentials and electroretinograms are thus essential diagnostic procedures not only for primary diagnosis but also for intraoperative evaluation. A decision for or against treatment of a visual pathway injury has to be made as fast as possible due to the enormous importance of the time elapsed with such injuries; this can be achieved additionally using multislice spiral computed tomography. The first-line conservative treatment of choice for such injuries is megadose methylprednisolone therapy. Surgery is used to decompress the orbital compartment by exposure of the intracanalicular part of the optic nerve in the case of optic canal compression. Modern craniomaxillofacial surgery requires detailed consideration of the diagnosis and treatment of traumatic visual pathway damage with the ultimate goal of preserving visual acuity. PMID:24436741

  13. Conjunctival Attachment of a Live Paralysis Tick, Ixodes holocyclus, in a Child: A Case Report

    PubMed Central

    Teong, Joanne M.Y.; Adler, Paul A.; Doggett, Stephen L.; Daneshvar, Dariush; Shields, Melissa K.

    2015-01-01

    We describe a rare clinical finding of conjunctival tick attachment in a child. A 10-year-old boy presented to the clinic with right-eye itch. He was found to have a live tick firmly attached to his right temporal conjunctiva. The tick was identified as the larval stage of the paralysis tick, Ixodes holocyclus. The tick was removed completely by conjunctival excision. Although various methods of removing a tick have been described in the literature, the goal of treatment is the safe and complete removal of the tick to prevent further transmission of pathogens, allergens, and toxins to the patient. PMID:25969685

  14. Unusual Presentation of a Metastatic Tumor to the Temporal Bone: Severe Otalgia and Facial Paralysis

    PubMed Central

    Choi, Sung Ho; Park, Il-Seok; Kim, Young Bok

    2014-01-01

    Metastatic temporal bone tumors are rare diseases and they are usually clinically asymptomatic, so it is difficult to diagnose them. Breasts are the most common sites of temporal bone metastasis. Tumors of lung, kidney, gastrointestinal tract, prostate gland, larynx and thyroid gland are the other sites. The pathogenesis of the temporal bone is most commonly related to the hematogenous route. We present the case of a 78-year-old man with facial paralysis combined with severe otalgia. This patient was initially diagnosed with Bell's palsy. However, based on the radiologic findings, the patient was diagnosed with lung cancer with temporal bone metastasis. PMID:24782949

  15. Locating the target nerve and injectate spread in rabbit sciatic nerve block

    Microsoft Academic Search

    Duk Hyun Sung

    2004-01-01

    Background and objectivesThe purpose of this study is to determine how close the needle tip is placed to the target nerve using a nerve stimulator and to determine how far the injectate spreads in percutaneous nerve blocks.

  16. Surgical management of Gerhardt syndrome.

    PubMed

    Chiril?, M; Mure?an, R; Cosgarea, M; Tomescu, E

    2010-01-01

    Adduction bilateral vocal fold immobility syndrome may be due by both recurrent laryngeal nerves paralysis--Gerhardt syndrome--and all intrinsic laryngeal muscles paralysis--Riegel syndrome. Etiology of Gerhardt syndrome is thyroid surgery, intubation's maneuver, trauma, neurological disorders, extrala-ryngeal malignancies. The manifestations of Gerhardt syndrome are inspiratory dyspnea and slightly influenced voicing by paramedian vocal folds paralysis with an important narrowing of the airway at the glottic level. The surgical procedures for enlargement of the glottic space can be classified in many ways and their major characteristics are: changes at the glottic level; surgical approach: open neck or endoscopic, with or without opening of the mucosal lining; the need for tracheostomy; the equipment used. The aim of this review is to expound the variety of interventions through the last century marked by the development of the diagnostic methods, the anesthesia and the surgical armament with sophisticated instruments and technologies. PMID:20726297

  17. Jaw-opening and -closing premotoneurons in the nucleus of the solitary tract making contacts with laryngeal and pharyngeal afferent terminals in rats.

    PubMed

    Oka, Ayaka; Yamamoto, Masaaki; Takeda, Rieko; Ohara, Haruka; Sato, Fumihiko; Akhter, Fatema; Haque, Tahsinul; Kato, Takafumi; Sessle, Barry J; Takada, Kenji; Yoshida, Atsushi

    2013-12-01

    This study clarified the neural mechanisms underlying jaw movements in pharyngolaryngeal reflexes such as swallowing in rats. After retrograde tracer injections into the ventromedial division (Vmovm) of the trigeminal motor nucleus (Vmo) containing jaw-opening (JO) motoneurons or into the dorsolateral division (Vmodl) of Vmo containing jaw-closing (JC) motoneurons, JO and JC premotoneurons were labeled with an ipsilateral predominance in the medial and intermediate subnuclei of the rostrocaudal middle two-thirds of the nucleus of the solitary tract (Sol); JC premotoneurons were also in the lateral subnucleus of Sol. After anterograde tracer injections into the Sol, axons were labeled with an ipsilateral predominance in the Vmovm and Vmodl, prominently in the ipsilateral Vmovm. After transganglionic tracer applications to the superior laryngeal nerve (SLN) or the cervical trunk of the glossopharyngeal nerve (GpN-ct), labeled afferents were seen in the medial, intermediate, lateral and interstitial subnuclei of Sol at the rostral three-fourths of Sol, indicating considerable overlap with the JO and JC premotoneurons in the Sol. Double labeling experiments demonstrated contacts between the afferent terminals and the JO and JC premotoneurons. The present study has for the first time revealed the differential distribution of JO and JC premotoneurons in the Sol and features of their projections from the Sol, as well as their connections with SLN and GpN-ct afferent inputs. The JO and JC premotoneurons in the Sol may play an important role in generation and organization of jaw movements in pharyngolaryngeal reflexes evoked by SLN and GpN-ct inputs, such as swallowing. PMID:24125811

  18. similarly indicates that scaling a simple laryngeal model down to sizes appropriate for women and children yields

    E-print Network

    for women and children yields a smaller range of conditions that permit voicing. The wide variety this as analogous to studies that explore the behavior of a particular laryngeal model, with some constant

  19. Cigarette Smoking and Alcohol Ingestion as Risk Factors for Laryngeal Squamous Cell Carcinoma at Kenyatta National Hospital, Kenya

    PubMed Central

    Menach, Pyeko; Oburra, Herbert O.; Patel, Asmeeta

    2012-01-01

    Laryngeal squamous cell carcinoma (SCC) is strongly linked to cigarette smoking. It is estimated to account for more than 70% of laryngeal SCCs and up to 89% in combination with alcohol. We wished to determine the prevalence of cigarette smoking and alcohol ingestion among patients with laryngeal squamous cell carcinoma and estimate risk attributed to cigarette smoking and alcohol ingestion. Fifty experimental group patients and fifty controls were recruited of matching age, sex and region of residence. History of smoking and alcohol intake was taken and analyzed to estimate the relative strengths of these exposures. Cessation of smoking was associated with reduced risk of SCC. Smokers had increased risk compared to controls. Those who smoked only had a higher glottic cancer risk. Those who smoked and drank alcohol had a higher supraglottic cancer risk. Being a current smoker and long duration of smoking were independent risk factors of laryngeal SCC. PMID:24179405

  20. Nerve-Muscle-Endplate Band Grafting: A New Technique for Muscle Reinnervation

    PubMed Central

    Mu, Liancai; Sobotka, Stanislaw; Su, Hungxi

    2011-01-01

    Background As currently existing reinnervation methods result in poor functional recovery, there is a great need to develop new treatment strategies. Objectives To investigate the efficacy of our recently developed nerve-muscle-endplate band grafting (NMEG) technique for muscle reinnervation. Methods Twenty-five adult rats were used in this study. Sternohyoid (SH) and sternomastoid (SM) muscles served as a donor and a recipient muscle, respectively. Neural organization of the SH and SM muscles and surgical feasibility of the NMEG technique were determined. A NMEG contained a muscle block, a nerve branch with nerve terminals, and a motor endplate (MEP) band with numerous neuromuscular junctions. After a 3-month recovery period, the degree of functional recovery was evaluated using maximal tetanic force measurement. Retrograde horseradish peroxidase (HRP) tracing was used to track the origin of the motor innervation of the reinnervated muscles. The reinnervated muscles were examined morphohistologically and immunohistochemicaly to assess the extent of axonal regeneration. Results Nerve supply patterns and locations of the MEP bands in the SH and SM muscles were documented. The results demonstrated that the reinnervated SM muscles gained motor control from the SH motoneurons. NMEG technique yielded extensive axonal regeneration and significant recovery of SM muscle force generating capacity (67% of the control). The mean wet weight of the NMEG reinnervated muscles (87% of the control) was greater than that of the denervated SM muscles (36% of the control). Conclusion NMEG resulted in successful muscle reinnervation and functional recovery. This technique holds promise in the treatment of muscle paralysis. PMID:21796004

  1. Characterisation of Structural Proteins from Chronic Bee Paralysis Virus (CBPV) Using Mass Spectrometry.

    PubMed

    Chevin, Aurore; Coutard, Bruno; Blanchard, Philippe; Dabert-Gay, Anne-Sophie; Ribière-Chabert, Magali; Thiéry, Richard

    2015-01-01

    Chronic bee paralysis virus (CBPV) is the etiological agent of chronic paralysis, an infectious and contagious disease in adult honeybees. CBPV is a positive single-stranded RNA virus which contains two major viral RNA fragments. RNA 1 (3674 nt) and RNA 2 (2305 nt) encode three and four putative open reading frames (ORFs), respectively. RNA 1 is thought to encode the viral RNA-dependent RNA polymerase (RdRp) since the amino acid sequence derived from ORF 3 shares similarities with the RdRP of families Nodaviridae and Tombusviridae. The genomic organization of CBPV and in silico analyses have suggested that RNA 1 encodes non-structural proteins, while RNA 2 encodes structural proteins, which are probably encoded by ORFs 2 and 3. In this study, purified CBPV particles were used to characterize virion proteins by mass spectrometry. Several polypeptides corresponding to proteins encoded by ORF 2 and 3 on RNA 2 were detected. Their role in the formation of the viral capsid is discussed. PMID:26110588

  2. The transfer of the abductor digiti quinti: palliative treatment for paralysis of the superficial thenar muscles.

    PubMed

    Iselin, F; Pradet, G

    1984-01-01

    Described by Huber in 1921, the transfer of the abductor digiti quinti constitutes an elegant solution to paralysis of thumb opposition. Interest in this operation was renewed and defended by Littler and more recently by Manske and McCarroll. The technique is simple and we do not believe that it is necessary to detach the muscle from its proximal insertion, thus preserving the force of the transfer. The advantages are as follows: elective reconstitution of antepulsion of the thumb column, which supposes that the adductors and the flexors are intact. A small operative field with limited routes of approach reducing scarring to a minimum. The cosmetic advantage is evident with reconstitution of the thenar contour. The functional loss is minor and in our opinion the abductor digiti quinti appears to be less inexpendable than the flexor digitorum sublimis or the extensor pollicis. The limitations of the operation are the absence of functional deep thenar muscles and adductors as well as, of course, the absence of a healthy abductor digiti quinti as in associated ulnar palsy. The results in 8 operations lead us to think that, when possible, the transfer of the abductor digiti quinti is a particularly interesting solution to paralysis in women and children, but probably insufficient in manual hard labor workers, at least in those who need strong abduction of their thumb. PMID:6084983

  3. Characterisation of Structural Proteins from Chronic Bee Paralysis Virus (CBPV) Using Mass Spectrometry

    PubMed Central

    Chevin, Aurore; Coutard, Bruno; Blanchard, Philippe; Dabert-Gay, Anne-Sophie; Ribière-Chabert, Magali; Thiéry, Richard

    2015-01-01

    Chronic bee paralysis virus (CBPV) is the etiological agent of chronic paralysis, an infectious and contagious disease in adult honeybees. CBPV is a positive single-stranded RNA virus which contains two major viral RNA fragments. RNA 1 (3674 nt) and RNA 2 (2305 nt) encode three and four putative open reading frames (ORFs), respectively. RNA 1 is thought to encode the viral RNA-dependent RNA polymerase (RdRp) since the amino acid sequence derived from ORF 3 shares similarities with the RdRP of families Nodaviridae and Tombusviridae. The genomic organization of CBPV and in silico analyses have suggested that RNA 1 encodes non-structural proteins, while RNA 2 encodes structural proteins, which are probably encoded by ORFs 2 and 3. In this study, purified CBPV particles were used to characterize virion proteins by mass spectrometry. Several polypeptides corresponding to proteins encoded by ORF 2 and 3 on RNA 2 were detected. Their role in the formation of the viral capsid is discussed. PMID:26110588

  4. Closed-loop control of spinal cord stimulation to restore hand function after paralysis.

    PubMed

    Zimmermann, Jonas B; Jackson, Andrew

    2014-01-01

    As yet, no cure exists for upper-limb paralysis resulting from the damage to motor pathways after spinal cord injury or stroke. Recently, neural activity from the motor cortex of paralyzed individuals has been used to control the movements of a robot arm but restoring function to patients' actual limbs remains a considerable challenge. Previously we have shown that electrical stimulation of the cervical spinal cord in anesthetized monkeys can elicit functional upper-limb movements like reaching and grasping. Here we show that stimulation can be controlled using cortical activity in awake animals to bypass disruption of the corticospinal system, restoring their ability to perform a simple upper-limb task. Monkeys were trained to grasp and pull a spring-loaded handle. After temporary paralysis of the hand was induced by reversible inactivation of primary motor cortex using muscimol, grasp-related single-unit activity from the ventral premotor cortex was converted into stimulation patterns delivered in real-time to the cervical spinal gray matter. During periods of closed-loop stimulation, task-modulated electromyogram, movement amplitude, and task success rate were improved relative to interleaved control periods without stimulation. In some sessions, single motor unit activity from weakly active muscles was also used successfully to control stimulation. These results are the first use of a neural prosthesis to improve the hand function of primates after motor cortex disruption, and demonstrate the potential for closed-loop cortical control of spinal cord stimulation to reanimate paralyzed limbs. PMID:24904251

  5. Bumetanide prevents transient decreases in muscle force in murine hypokalemic periodic paralysis

    PubMed Central

    Wu, Fenfen; Mi, Wentao

    2013-01-01

    Objective: To test the hypothesis that inhibition of the Na-K-2Cl transporter with bumetanide will reduce the susceptibility to decreases in muscle force in a mouse model of hypokalemic periodic paralysis (HypoPP). Methods: In vitro contraction tests were performed on soleus muscle isolated from mice with knock-in missense mutations that result in HypoPP (sodium channel NaV1.4-R669H) or hyperkalemic periodic paralysis (HyperPP; sodium channel NaV1.4-M1592V). Results: Bumetanide prevented the development of weakness in 2 mM K+ and also restored force during an established attack of HypoPP. Stimulation of the Na-K-2Cl transporter via induction of hyperosmolality exacerbated the weakness seen in low K+ and was also prevented by bumetanide. Bumetanide was more efficacious than acetazolamide for preventing weakness in low K+ conditions. Decreases in force in HyperPP muscle exposed to 10 mM K+ were not prevented by treatment with bumetanide. Conclusions: The Na-K-2Cl inhibitor bumetanide was highly effective in preventing attacks of weakness in the NaV1.4-R669H mouse model of HypoPP and should be considered for management of patients with HypoPP due to sodium channel mutations. Dehydration may aggravate HypoPP by stimulating the Na-K-2Cl transporter. PMID:23427324

  6. Idiopathic Generalized Epilepsy and Hypokalemic Periodic Paralysis in a Family of South Indian Descent

    PubMed Central

    Subramanian, Muthiah; Senthil, N.; Sujatha, S.

    2015-01-01

    Inherited channelopathies are a heterogeneous group of disorders resulting from dysfunction of ion channels in cellular membranes. They may manifest as diseases affecting skeletal muscle contraction, the conduction system of the heart, nervous system function, and vision syndromes. We describe a family of South Indian descent with hypokalemic periodic paralysis in which four members also have idiopathic generalized epilepsy. Hypokalemic periodic paralysis is a genetically heterogeneous channelopathy that has been linked to mutations in genes encoding three ion channels CACNIAS, SCN4A, and KCNJ2 predominantly. Although data on specific gene in idiopathic generalized epilepsy is relatively scarce, mutations of voltage gated sodium channel subunit genes (CACNB4) and nonsense mutations in voltage gated calcium channels (CACNA1A) have been linked to idiopathic generalized epilepsy in two families. We speculate that gene mutations altering the ability of the beta subunit to interact with the alpha subunit of the CaV1.1 channel and mutations in the pore-forming potassium channel subunit may be possible explanations for the combined manifestation of both diseases. Functional analysis of voltage gated calcium channel and other ion channels mutations may provide additional support and insight for the causal role of these mutations. The understanding of mutations in ion-channel genes will lead to improved diagnosis and treatment of such inherited channelopathies. PMID:25893123

  7. Randomized crossover comparison of the ProSeal with the classic laryngeal mask airway in unparalysed anaesthetized patients

    Microsoft Academic Search

    T. M. Cook; J. P. Nolan; C. Verghese; P. J. Strube; M. Lees; J. M. Millar; P. J. F. Baskett

    2002-01-01

    drugs. Results. The ProSeal took more time and more attempts to insert successfully than the classic laryngeal mask airway. Insertion was successful on the first attempt in 81% of cases with the ProSeal and 90% with the classic laryngeal mask airway. The ProSeal required more air to achieve an intracuff pressure of 60 cm H2O (6 ml more for size

  8. Phonology at the interface of phonetics and morphology: Root-final laryngeals in Chong, Korean, and Sanskrit

    Microsoft Academic Search

    Daniel Silverman

    1996-01-01

    Root-final laryngealized stops in the Mon-Khmer language of Chong are realized with the laryngeal gesture preceding the oral closure, implemented as a creak on the latter portion of the tautosyllabic vowel. This realization is phonologically sub-optimal, as the aerodynamic, articulatory, acoustic, and auditory properties of pre-glottalized stops do not culminate in a maximally salient percept. In contrast, those timing relations

  9. Todd's Paralysis

    MedlinePLUS

    ... is a neurological condition experienced by individuals with epilepsy, in which a seizure is followed by a ... the seizure and the subsequent treatment of the epilepsy. What research is being done? The National Institute ...

  10. Higher levels of total pepsin and bile acids in the saliva as a possible risk factor for early laryngeal cancer

    PubMed Central

    Sereg-Bahar, Maja; Jerin, Ales; Hocevar-Boltezar, Irena

    2015-01-01

    Background Gastroesophageal reflux is suspected to be an etiological factor in laryngeal and pharyngeal cancer. The aim of this study was to establish, using a non-invasive method, whether laryngopharyngeal reflux (LPR) appears more often in patients with early laryngeal cancer than in a control group. Patients and methods We compared the pH, the level of bile acids, the total pepsin and the pepsin enzymatic activity in saliva in a group of 30 patients with T1 laryngeal carcinoma and a group of 34 healthy volunteers. Results The groups differed significantly in terms of levels of total pepsin and bile acids in the saliva sample. Higher levels of total pepsin and bile acids were detected in the group of cancer patients. No significant impact of other known factors influencing laryngeal mucosa (e.g. smoking, alcohol consumption, and the presence of irritating substances in the workplace) on the results of saliva analysis was found. Conclusions A higher level of typical components of LPR in the saliva of patients with early laryngeal cancer than in the controls suggests the possibility that LPR, especially biliary reflux, has a role in the development of laryngeal carcinoma. PMID:25810702

  11. iTRAQ-Based Quantitative Proteomic Analysis on S100 Calcium Binding Protein A2 in Metastasis of Laryngeal Cancer

    PubMed Central

    Zha, Cong; Jiang, Xue Hua; Peng, Shi Fang

    2015-01-01

    Laryngeal cancer is the most frequent neoplasm in the head and neck region, with the vast majority of tumors originating from squamous cells. The survival rate of patients with laryngeal cancer has not improved substantially over the past 25 years. To acquire further knowledge regarding the molecules responsible for laryngeal cancer oncogenesis and, in turn, to improve target therapy?iTRAQ and mass spectrometry analysis were utilized to detect differences in protein expression from 15 paired laryngeal cancer and adjacent non-cancerous tissue samples. Using mass spectrometry analysis, the expression levels of 100 proteins in laryngeal cancer samples were distinct from the non-tumor, non-cancerous samples. Further validation of the differentially expressed proteins S100A2, KRT16, FGB and HSPB1 were carried out using quantitative real-time RT-PCR, immunoblot and immunohistochemistry. Functional analysis of one of the highly expressed proteins, S100 calcium binding protein A2 (S100A2), was performed using RNA interference. As a consequence, attenuated S100A2 expression enhanced the ability of HEp-2 cell lines to migrate and invade in vitro. Our investigation complements the current understanding of laryngeal cancer progression. Furthermore, this study supports the concept that enhanced expression of S100A2 may be a promising strategy in developing novel cancer therapeutic drugs. PMID:25874882

  12. Facial-hypoglossal nerve anastomosis using laser nerve welding.

    PubMed

    Hwang, Kun; Kim, Sun Goo; Kim, Dae Joong

    2006-07-01

    The aim of this study is to compare laser nerve welding to microsurgical suturing of hypoglossal-facial nerve anastomosis (HFA), and a result of immediate to delayed repair, and to evaluate the effect of laser nerve welding on HFA for reanimation of facial palsy. The first group of five rats underwent immediate HFA by microsurgical suturing and the second group of five rats by CO2 laser welding. The third group of five rats underwent delayed HFA by microsurgical suturing, and the fourth group of five rats by laser nerve welding. The fifth group of five rats served as controls, with intact hypoglossal and facial nerve. In all rats of the four different treatment groups, cholera toxin B subunit (CTb) was injected in the epineurium distal to the anastomosis site on the postoperative 6th week and in the normal hypoglossal nerve in the five rats of the control group. Neurons labeled CTb of hypoglossal nuclei were positive immunohistochemically, and the numbers were counted. In the immediate HFA groups, CTb-positive neurons were 751 +/- 247 in the laser welding group (n = 5) and 888 +/- 60 in the microsurgical suturing group (n = 5). There was no significant difference (P = 0.117). In the delayed HFA groups, CTb-positive neurons were 749 +/- 54 in the laser welding group (n = 5) and 590 +/- 169 in the microsurgical suturing group (n = 5). The difference was not significant (P = 0.116). There was no significant difference between immediate and delayed anastomosis in the laser welding group (P = 0.600), but there was significance between immediate and delayed anastomosis in the microsurgical suturing group (P = 0.009). Injected CTb in intact hypoglossal neurons (n = 5) were labeled 1,003 +/- 52. No dehiscence in the laser welding site of nerve anastomosis was seen at the time of re-exploration for injection of CTb in all 10 rats. This study shows that the regeneration of anastomosed hypoglossal-facial nerve was affected similarly by laser welding and microsurgical suturing, and more effective, especially in delayed repair. PMID:16877915

  13. A precision mechanical nerve stimulator

    NASA Astrophysics Data System (ADS)

    Tcheng, Ping; Supplee, Frank H., Jr.; Prass, Richard L.

    1988-11-01

    An electromechanical device, used to apply and monitor stimulating pulses to a mammalian motor nerve, has been successfully developed at NASA Langley Research Center. Two existing force transducers, a flight skin friction balance and a miniature skin friction balance which were designed for making aerodynamic drag measurements, were modified and incorporated to form this precision instrument. The nerve stimulator is a type one servomechanism capable of applying and monitoring stimulating pulses of 0 to 10 grams with a precision of better than +/- 0.05 grams. Additionally, the device can be independently used to apply stimulating pulses by displacing the nerve from 0 to 0.25 mm with a precision of better than +/- 0.001 mm while measuring the level of the load applied.

  14. Nerve blocks in palliative care.

    PubMed

    Chambers, W A

    2008-07-01

    Although between 85% and 90% of patients with advanced cancer can have their pain well controlled with the use of analgesic drugs and adjuvants, there are some patients who will benefit from an interventional procedure. This includes a variety of nerve blocks and also some neurosurgical procedures. Approximately 8-10% of patients may benefit from a peripheral nerve block and around 2% from a central neuraxial block. The most common indication is because opioid dose escalation is limited by signs of opioid toxicity but some patients will benefit from one component of their pain being relieved by a simple peripheral block. Most patients about to undergo these procedures are already taking high doses of opiods and obtaining valid consent may pose problems. The use of peripheral nerve blocks, epidural and intrathecal infusions, and plexus blocks is discussed. PMID:18495677

  15. Neuromodulation of the suprascapular nerve.

    PubMed

    Elahi, Foad; Reddy, Chandan G

    2014-01-01

    The shoulder joint is an enarthrodial or ball-and-socket joint. A complex network of anatomic structures endows the human shoulder with tremendous mobility, greater than any other joint in the body. Many pathologies can been found in those patients with chronic shoulder pain. The painful limitation of shoulder motion affects hand and arm motion as well; therefore, it significantly influences work performance and everyday activities as well as the quality of life. Therefore, the treatment of patients with chronic shoulder pain has major social and health economic implications. In this article we present a patient with a complex history of shoulder pathology including 7 surgeries that left the patient with chronic debilitating shoulder pain. She was suffering from chronic pain and limited mobility of the shoulder joint due to adhesive shoulder capsulitis. She was treated with a multimodality approach with the goals of increasing shoulder range of motion and decreasing her pain. This did not provide significant improvement. The suprascapular nerve supplies motor and sensory innervation to the shoulder, and can be easily accessible in the supraspinatus fossa. A suprascapular nerve block dramatically decreased her pain. This clinical observation along with confirmatory nerve block play an important role during the decision-making process for a trial period of electrical neuromodulation. She was followed for 3 months after the permanent implantation of a suprascapular nerve stimulator. Her pain and shoulder range of motion in all planes improved dramatically. Peripheral nerve stimulation (PNS) of the suprascapular nerve, in addition to multimodality pain management, is one approach to the difficult task of treating adhesive capsulitis with accompanying pain and the inability to move the shoulder. We conducted a literature review on PubMed and found no case describing a similar patient to our knowledge. PMID:25415792

  16. Nerve lesioning with direct current

    NASA Astrophysics Data System (ADS)

    Ravid, E. Natalie; Shi Gan, Liu; Todd, Kathryn; Prochazka, Arthur

    2011-02-01

    Spastic hypertonus (muscle over-activity due to exaggerated stretch reflexes) often develops in people with stroke, cerebral palsy, multiple sclerosis and spinal cord injury. Lesioning of nerves, e.g. with phenol or botulinum toxin is widely performed to reduce spastic hypertonus. We have explored the use of direct electrical current (DC) to lesion peripheral nerves. In a series of animal experiments, DC reduced muscle force by controlled amounts and the reduction could last several months. We conclude that in some cases controlled DC lesioning may provide an effective alternative to the less controllable molecular treatments available today.

  17. [Ultrasound-guided sciatic nerve block].

    PubMed

    Ota, Junichi; Hara, Kaoru

    2008-05-01

    Theoretically, sciatic nerve block can be used alone or in combination with lumbar plexus block or femoral nerve block for anesthesia and/or analgesia of lower limb surgery. However, clinical use of sciatic nerve block was limited by technical difficulties in performing the block since techniques used relies only on surface anatomical landmarks. Recent advances in ultrasound technology allow direct visualization of nerves and other surrounding structures and have increased the interest in performing many kinds of peripheral nerve blocks including sciatic nerve block. Preliminary data suggest that ultrasound-guided technique can help perform the sciatic nerve block more reliably and safely. In this article we describe the anatomy of the sciatic nerve, sonographic features, and technique of three major approaches including subgluteal, anterior, and popliteal approaches. The use of this technique for postoperative analgesia is also discussed. PMID:18516885

  18. Electromagnetic mechanism of magnetic nerve stimulation

    NASA Astrophysics Data System (ADS)

    Yamaguchi, Masuhiro; Yamada, Satoshi; Daimon, Nobuo; Yamamoto, Isao; Kawakami, Tadashi; Takenaka, Toshibumi

    1989-08-01

    Rabbit sciatic nerves were stimulated by pulsed magnetic fields and nerve responses were analyzed on the basis of electromagnetic theory to understand the dominant factors in magnetic stimulation. Some conducting substance surrounding the nerve is required to induce the currents exciting it. The strength of a magnetic stimulus is evaluated by the rate of change in the vector potential at the nerve, dA/dt, which equals the magnitude of the induced electric field E. The minimum strength of dA/dt for exciting the nerve is 18 Wb/ms (18 V/m) in the agar with a conductivity of 0.6 S/m. The induced current density of 10 A/m2 is comparable to that used in the electric stimulation of peripheral nerves. The component of the vector potential parallel to the nerve is more effective in stimulating the nerve than the component perpendicular to it.

  19. 21 CFR 882.5275 - Nerve cuff.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ...aid in repairing the nerve (e.g., to prevent ingrowth of scar tissue) and for capping the end of the nerve to prevent the formation of neuroma (tumors). (b) Classification. Class II (performance...

  20. 21 CFR 882.5275 - Nerve cuff.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ...aid in repairing the nerve (e.g., to prevent ingrowth of scar tissue) and for capping the end of the nerve to prevent the formation of neuroma (tumors). (b) Classification. Class II (performance...

  1. 21 CFR 882.5275 - Nerve cuff.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ...aid in repairing the nerve (e.g., to prevent ingrowth of scar tissue) and for capping the end of the nerve to prevent the formation of neuroma (tumors). (b) Classification. Class II (performance...

  2. 21 CFR 882.5275 - Nerve cuff.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ...aid in repairing the nerve (e.g., to prevent ingrowth of scar tissue) and for capping the end of the nerve to prevent the formation of neuroma (tumors). (b) Classification. Class II (performance...

  3. 21 CFR 882.5275 - Nerve cuff.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ...aid in repairing the nerve (e.g., to prevent ingrowth of scar tissue) and for capping the end of the nerve to prevent the formation of neuroma (tumors). (b) Classification. Class II (performance...

  4. Voluntary Nerve Signals from Severed Mammalian Nerves: Long-Term Recordings

    E-print Network

    De Luca, Carlo J.

    and peroneal nerves in rabbits. This electrode may prove suitable for implantation in human amputeesVoluntary Nerve Signals from Severed Mammalian Nerves: Long-Term Recordings Abstract. An electrode unit capable ofdetecting voluntarily elicited nerve signals for prolonged periods oftime has been

  5. The influence of the position of the laryngeal endoscope on videokymography.

    PubMed

    Pontes, Paulo Augusto de Lima; Madazio, Glaucya; Behlau, Mara; Cantoni, Luiz Alian

    2005-01-01

    Videokymography is a new high-speed imaging technique to investigate vocal fold vibration. The system has been considered useful in the analysis of irregular signals, making it possible to observe left-right asymmetries, open quotient, propagation of mucosal waves, and movement of the upper and lower margins. The aim of the present study was to verify the correspondence of the videokymographic images with larynx exposition angle variation. Three Brazilian adult female subjects, with no vocal complains, were evaluated. Videokymographic images were obtained with the laryngeal endoscope 90 degrees positioned on the measuring line, perpendicular to the glottal axis-zero degree, during a sustained "ae" vowel, using habitual frequency and intensity. The procedure was repeated twice and adjusted by rotating the camera in fifteen degrees from the perpendicular line to the right and to the left. The results showed clear differences depending on the position of the endoscope, suggesting the standardization of laryngeal exposition to interpret videokymographic images correctly. PMID:16878252

  6. Prognostic significance of lymph node reactivity in patients with laryngeal carcinoma.

    PubMed

    Stankiewicz, C

    1994-01-01

    Apart from the presence or absence of metastases in patients with laryngeal carcinoma, there are changes of reactivity in cervical lymph nodes that are seen histologically as nonspecific reactive lymphadenitis. These changes are morphological manifestations of the regional lymphatic system reactivity in relation to tumor, and their presence may be of prognostic value. To test this hypothesis, 45 patients with laryngeal carcinoma were examined for the evidence of node reactivity. The classification applied by Tsakraklides et al. was used, defining patterns of lymphocyte predominance, germinal center appearance (indicating lymph node stimulation) and whether or not lymphocyte depletion had occurred. The presence of node reactivity was compared with long-term (5-year) survivals in the group of patients studied. By applying statistical analysis it was found that lymph node stimulation was a favorable prognostic factor, while its absence worsened prognosis. PMID:7857630

  7. Basaloid Squamous Cell Carcinoma: An Unusual Ball-Valve Laryngeal Obstruction

    PubMed Central

    Tan, Sien Hui; Hindi, Khalid W; Chandran, Patricia Ann; Chong, Aun Wee

    2015-01-01

    Introduction: A rare case of basaloid squamous cell carcinoma (BSCC) of the larynx, which has not been previously reported, is described. Case Report: A 60-year-old man was presented to the Otolaryngology Department with progressive dyspnoea and dysphagia to solids for over a period of 1 week. Direct laryngoscopy revealed a tumour at the laryngeal aspect of the epiglottis, which prolapsed into the laryngeal inlet each time the patient inspired. This resulted in an inspiratory stridor despite adequate glottic opening and normal mobility of the vocal cords. Conclusion: Therefore, in cases where a ball-valve lesion causes intermittent life-threatening airway obstruction, BSCC of the larynx, though rare, must be considered as a differential diagnosis.

  8. Prognostic factors of laryngeal solitary extramedullary plasmacytoma: a case report and review of literature

    PubMed Central

    Xing, Yong; Qiu, Jun; Zhou, Min-Li; Zhou, Shui-Hong; Bao, Yang-Yang; Wang, Qin-Ying; Zheng, Zhou-Jun

    2015-01-01

    A paucity of data exists concerning the presentation, natural course and outcome of extramedullary plasmcytoma (EMP). It is difficult to determine the optimal treatment strategy and prognostic factors for EMP. We present an additional case of laryngeal EMP and systemic review relevant reports in the English and Chinese literature. We found, to our knowledge, 147 cases in larynx in the English-language literature and Chinese-literature. The most common treatment modality was radiotherapy alone. The mean survival duration was ~184 months, and the 5- and 10- year survival rates were 76.1% and 67.4%, respectively. The univariate analysis suggested that progression to multiple myeloma and amyloid deposits may be poor prognostic factors. The multivariate analysis suggested that only progression to multiple myeloma may be a poor prognostic factor. Laryngeal EMP is uncommon. Progression to multiple myeloma may be a poor prognostic factor. PMID:26045749

  9. Prognostic factors of laryngeal solitary extramedullary plasmacytoma: a case report and review of literature.

    PubMed

    Xing, Yong; Qiu, Jun; Zhou, Min-Li; Zhou, Shui-Hong; Bao, Yang-Yang; Wang, Qin-Ying; Zheng, Zhou-Jun

    2015-01-01

    A paucity of data exists concerning the presentation, natural course and outcome of extramedullary plasmcytoma (EMP). It is difficult to determine the optimal treatment strategy and prognostic factors for EMP. We present an additional case of laryngeal EMP and systemic review relevant reports in the English and Chinese literature. We found, to our knowledge, 147 cases in larynx in the English-language literature and Chinese-literature. The most common treatment modality was radiotherapy alone. The mean survival duration was ~184 months, and the 5- and 10- year survival rates were 76.1% and 67.4%, respectively. The univariate analysis suggested that progression to multiple myeloma and amyloid deposits may be poor prognostic factors. The multivariate analysis suggested that only progression to multiple myeloma may be a poor prognostic factor. Laryngeal EMP is uncommon. Progression to multiple myeloma may be a poor prognostic factor. PMID:26045749

  10. [Clinical symptoms of vascular laryngeal tumors in children depending on their location].

    PubMed

    Soldatski?, Iu L; Strygina, Iu V; Onufrieva, E K; Tikhonenkova, L P

    2003-01-01

    To study peculiarities of clinical symptoms of laryngeal angiomas in children, 71 case histories for children with vascular tumor aged 27 days to 14 years have been analysed. The cases were divided into two groups by location of the tumor: group 1--with hemangioma located in the subvocal larynx (45 children admitted to hospital at the age of 27 days to 2 years); group 2--with laryngeal vascular tumor located in the vocal or supravocal larynx (26 children admitted to hospital at the age of 3 months to 14 years). It was established that the age of the first angioma symptoms and the symptoms manifestation depend on the tumor location. Subvocal hemangioma should be considered an independent nosological unit of the disease. PMID:12666603

  11. [Gastroesophageal reflux disease and pharyngolaryngeal reflux in children with chronic laryngeal pathology].

    PubMed

    Soldatski?, Iu L; Onufrieva, E K; Pogosova, i E; Zaviktorina, T G; Strygina, Iu V; Gasparian, S F; Shchepin, N V; Steklov, A M

    2008-01-01

    A prospective non-randomized trial was made to evaluate incidence of gastroesophageal reflux disease (GERD) and pharyngolaryngeal reflux (PLR) in children with chronic laryngeal pathology. A total of 46 children aged 6 to 15 years were examined including 16 patients with recurrent respiratory papillomatosis, 15 patients with acquired laryngotracheal scarry stenosis and 15 patients with vocal nodules and functional dysphonia. Combination of GERD with PLR is a factor of risk for scarry laryngostenosis in a child with recurrent respiratory papillomatosis. If it is impossible to perform 24-h pH-monitoring of the esophagus for detection of GERD or PLR in patients with chronic laryngeal pathology, antireflux therapy is prescribed empirically. It is necessary to establish significant diagnostic criteria of PLR. PMID:18454071

  12. Microsurgical anatomy of the ocular motor nerves

    Microsoft Academic Search

    Yi ZhangHao; Hao Liu; En-Zhong Liu; You-Zhi Lin; Shi-Guang Zhao; Guo-Hua Jing

    2010-01-01

    This study was designed to provide anatomic data to help surgeons avoid damage to the ocular motor nerves during intraorbital\\u000a operations. The microsurgical anatomy of the ocular motor nerves was studied in 50 adult cadaveric heads (100 orbits). Dissections\\u000a were performed with a microscope. The nerves were exposed and the neural and muscular relationships of each portion of the\\u000a nerve

  13. Analysis of Speech Disorders in Acute Pseudobulbar Palsy: a Longitudinal Study of a Patient with Lingual Paralysis.

    ERIC Educational Resources Information Center

    Leroy-Malherbe, V.; Chevrie-Muller, C.; Rigoard, M. T.; Arabia, C.

    1998-01-01

    This case report describes the case of a 52-year-old man with bilateral central lingual paralysis following a myocardial infarction. Analysis of speech recordings 15 days and 18 months after the attack were acoustically analyzed. The case demonstrates the usefulness of acoustic analysis to detect slight acoustic differences. (DB)

  14. Israeli acute paralysis virus: epidemiology, pathogenesis and implications for honey bee health and Colony Collapse Disorder (CCD)

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Israeli acute paralysis virus (IAPV) is a widespread RNA virus that was linked with honey bee Colony Collapse Disorder (CCD), the sudden and massive die-off of honey bee colonies in the U.S. in 2006-2007. Here we describe the transmission, prevalence and genetic diversity of IAPV, host transcripti...

  15. Very virulent plus strains of MDV induce acute form of transient paralysis in both susceptible and resistant chicken lines

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Marek’s Disease (MD) is a lymphoproliferative disease of domestic chickens caused by a highly cell-associated alpha herpesvirus, Marek’s disease virus (MDV). Clinical signs of MD include depression, crippling, weight loss, and transient paralysis (TP). TP is a disease of the central nervous system...

  16. Detection of Acute Bee Paralysis Virus and Black Queen Cell Virus from Honeybees by Reverse Transcriptase PCR

    Microsoft Academic Search

    MONGI BENJEDDOU; NEIL LEAT; MIKE ALLSOPP; SEAN DAVISON

    2001-01-01

    A reverse transcriptase PCR (RT-PCR) assay was developed for the detection of acute bee paralysis virus (ABPV) and black queen cell virus (BQCV), two honeybee viruses. Complete genome sequences were used to design unique PCR primers within a 1-kb region from the 3* end of both genomes to amplify a fragment of 900 bp from ABPV and 700 bp from

  17. Brain–computer interfaces: communication and restoration of movement in paralysis

    PubMed Central

    Birbaumer, Niels; Cohen, Leonardo G

    2007-01-01

    The review describes the status of brain–computer or brain–machine interface research. We focus on non-invasive brain–computer interfaces (BCIs) and their clinical utility for direct brain communication in paralysis and motor restoration in stroke. A large gap between the promises of invasive animal and human BCI preparations and the clinical reality characterizes the literature: while intact monkeys learn to execute more or less complex upper limb movements with spike patterns from motor brain regions alone without concomitant peripheral motor activity usually after extensive training, clinical applications in human diseases such as amyotrophic lateral sclerosis and paralysis from stroke or spinal cord lesions show only limited success, with the exception of verbal communication in paralysed and locked-in patients. BCIs based on electroencephalographic potentials or oscillations are ready to undergo large clinical studies and commercial production as an adjunct or a major assisted communication device for paralysed and locked-in patients. However, attempts to train completely locked-in patients with BCI communication after entering the complete locked-in state with no remaining eye movement failed. We propose that a lack of contingencies between goal directed thoughts and intentions may be at the heart of this problem. Experiments with chronically curarized rats support our hypothesis; operant conditioning and voluntary control of autonomic physiological functions turned out to be impossible in this preparation. In addition to assisted communication, BCIs consisting of operant learning of EEG slow cortical potentials and sensorimotor rhythm were demonstrated to be successful in drug resistant focal epilepsy and attention deficit disorder. First studies of non-invasive BCIs using sensorimotor rhythm of the EEG and MEG in restoration of paralysed hand movements in chronic stroke and single cases of high spinal cord lesions show some promise, but need extensive evaluation in well-controlled experiments. Invasive BMIs based on neuronal spike patterns, local field potentials or electrocorticogram may constitute the strategy of choice in severe cases of stroke and spinal cord paralysis. Future directions of BCI research should include the regulation of brain metabolism and blood flow and electrical and magnetic stimulation of the human brain (invasive and non-invasive). A series of studies using BOLD response regulation with functional magnetic resonance imaging (fMRI) and near infrared spectroscopy demonstrated a tight correlation between voluntary changes in brain metabolism and behaviour. PMID:17234696

  18. Gene and protein expression of O-GlcNAc-cycling enzymes in human laryngeal cancer.

    PubMed

    Starska, Katarzyna; Forma, Ewa; Brzezi?ska-B?aszczyk, Ewa; Lewy-Trenda, Iwona; Bry?, Magdalena; Jó?wiak, Pawe?; Krze?lak, Anna

    2014-10-15

    Aberrant protein O-GlcNAcylation may contribute to the development and malignant behavior of many cancers. This modification is controlled by O-linked ?-N-acetylglucosamine transferase (OGT) and O-GlcNAcase (OGA). The aim of this study was to determine the expression of O-GlcNAc cycling enzymes mRNA/protein and to investigate their relationship with clinicopathological parameters in laryngeal cancer. The mRNA levels of OGT and MGEA5 genes were determined in 106 squamous cell laryngeal cancer (SCLC) cases and 73 non-cancerous adjacent laryngeal mucosa (NCLM) controls using quantitative real-time PCR. The level of OGT and OGA proteins was analyzed by Western blot. A positive expression of OGT and MGEA5 transcripts and OGT and OGA proteins was confirmed in 75.5 and 68.9 % and in 43.7 and 59.4 % samples of SCLC, respectively. Higher levels of mRNA/protein for both OGT and OGA as well as significant increases of 60 % in total protein O-GlcNAcylation levels were noted in SCLC compared with NCLM (p < 0.05). As a result, an increased level of OGT and MGEA5 mRNA was related to larger tumor size, nodal metastases, higher grade and tumor behavior according to TFG scale, as well as incidence of disease recurrence (p < 0.05). An inverse association between OGT and MGEA5 transcripts was determined with regard to prognosis (p < 0.05). In addition, the highest OGT and OGA protein levels were observed in poorly differentiated tumors (p < 0.05). No correlations with other parameters were noted, but the results showed a trend of more advanced tumors to be more frequently OGT and OGA positive. The results suggest that increased O-GlcNAcylation may have an effect on tumor aggressiveness and prognosis in laryngeal cancer. PMID:25315705

  19. Intracellular CTLA4 and regulatory T cells in patients with laryngeal squamous cell carcinoma.

    PubMed

    Erfani, Nasrollah; Khademi, Behzad; Haghshenas, Mohammad Reza; Mojtahedi, Zahra; Khademi, Bijan; Ghaderi, Abbas

    2013-01-01

    To explore if the increased percentages of Regulatory T (Treg) cells, as well as, overexpression of Cytotoxic T-Lymphocyte Antigen-4 (CTLA-4) are involved in laryngeal-squamous cell carcinoma (SCC), 45 patients with laryngeal-SCC and 27 healthy controls were enrolled. Flow cytometry was performed to investigate, in the peripheral blood, the prevalence of CD4+CD25+FoxP3+ Treg cells, as well as, surface and intracellular expression of CTLA-4 by the main lymphocyte subsets (CD4+, CD8+ and CD19+). The results indicated intracellular (In)CTLA4 with considerable higher expression in the CD8+ lymphocytes among patients with laryngeal-SCC compared with the control group (8.2 ± 8.7 versus 2.3 ± 3.5, P = 0.001). The mean percentage of InCTLA4+CD4+ and InCTLA4+CD19+ lymphocytes was also significantly higher in patients (8.7 ± 7.8 versus 4.4 ± 4.2, P = 0.018 and 0.6 ± 0.8 versus 0.2 ± 0.2, P = 0.024, respectively). With respect to surface (Sur)CTLA4, the difference between patients and controls was, however, significant only in the case of CD8+ lymphocytes (0.7 ± 0.6 versus 0.3 ± 0.3, P = 0.003, respectively). The percentage of Treg cells was observed to be significantly higher in patients (7.5 ± 6.3 and 3.2 ± 1.9, P < 0.0001). Furthermore, association analysis revealed the association of Treg cell increase with the higher tumor-size and lymphnode stage (P < 0.005). These data collectively suggest that patients with laryngeal-SCC may benefit from immunotherapy targeting CTLA4 and Treg cells. PMID:23252863

  20. An artificial neural network improves prediction of observed survival in patients with laryngeal squamous carcinoma

    Microsoft Academic Search

    Andrew S. Jones; Azzam G. F. Taktak; Timothy R. Helliwell; John E. Fenton; Martin A. Birchall; David J. Husband; Anthony C. Fisher

    2006-01-01

    The accepted method of modelling and predicting failure\\/survival, Cox’s proportional hazards model, is theoretically inferior to neural network derived models for analysing highly complex systems with large datasets. A blinded comparison of the neural network versus the Cox’s model in predicting survival utilising data from 873 treated patients with laryngeal cancer. These were divided randomly and equally into a training