The Management of Foreign Body Sensation in the Throat after Stroke by Trigger Point Injection on Posterior Belly of Digastric Muscles
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Abstract:
<p>Foreign body (FB) sensation in the throat is often a common symptom encountered in clinical practice. FB sensation in throat has numerous causes mainly caused by reflex diseases such as laryngopharyngeal reflux. Its treatment has been focused on organic problems or hysteria while musculoskeletal problem has been neglected. We hereby report a patient with dysphagia and complaint of FB sensation in the throat after nasogastric tube removal. It was relieved by trigger point injection on the posterior belly of digastric muscles.Keywords:
Throat
Sensation
The length of the styloid process was analyzed on 111 (oral) panoramic radiograms. Visualization of the styloid processes on the films was achieved in 178 of the 222 sides. Of these, 66 were taken from patients suffering from abnormal sensation in the throat. The other 112 were the films taken from patients not related to pharyngolaryngeal discomfort and served as controls.The mean length of the styloid processes among the controls was 22.1mm (S. D.±7.2mm). The mean length among the patients suffering from abnormal sensation was 24.1mm (S. D.±8.0mm) and was significantly longer than that of the controls (p<0.05). Patients, who had abnormal sensation in the epi and/or mesopharynx, and had the identical sensation by palpating the tonsilar fossa, and whose abnormal sensation subsided by blocking the area, were suspected of having styloid syndrome. Those patients had slightly longer styloid processes than that of the entire group of patients with abnormal sensation in the throat.There was no statistically significant relationship between the length of the stybid process and age, or sex.
Throat
Sensation
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Throat
Fish bone
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Background
Dysphagia is a frequent finding in patients with HD. Up to 75% of the patients die of aspiration pneumonia. Symptoms of dysphagia already start in the very beginning of HD and become more severe when the disease progresses. The different symptoms of dysphagia in HD are already known. It is also known that there are treatment possibilities for dysphagia, such as the Masako and the Mendelsohn manoeuvre, but these are validated for other diseases, like a cerebro vascular accident or Parkinson's disease. There is no evidence that patients with HD benefit from this treatment. In our experience with HD, patients do benefit from dysphagia treatment. In this presentation dysphagia symptoms are presented using X-ray imaging, further, some treatment possibilities for dysphagia will be introduced by presenting a case study.Method
X-ray images on dysphagia symptoms during the different stages of HD were collected. More than 30 HD patients with dysphagia were treated using the Masako and Mendelsohn manoeuvre. For one specific patient a video was made to make a report of her swallowing progress.Results
X-ray images of dysphagia in HD were collected and will be shown in the presentation. More than 30 HD patients were treated for dysphagia using the Masako and Mendelsohn manoeuvre. Most patients could perform at least one manoeuvre, and most patients reported that they benefit from the treatment. For one specific patient a video was made to document the swallowing progress. The video was published on www.huntingtonplein.nl.Conclusion
An impressive collection of X-ray imaging on dysphagia in HD exists. For treatment possibilities, patients with HD seem to benefit from especially the Masako and Mendelsohn manoeuvre. For one patient the findings were documented and recorded on a video. This video was published on www.huntingtonplein.nl, and parts of this video will be presented during the presentation.Aspiration Pneumonia
Presentation (obstetrics)
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Value (mathematics)
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[Objective]To discussion the incidences of dysphagia after stroke at different age stages and in different parts of lesions,as well as corresponding measures.[Methods]The proportions of dysphagia of 620 cases of stroke patients in different age stages and parts of lesions were compared.[Results]The 60-90 age group(77%),the basal ganglia(48%)and brainstem lesion(23%)had higher proportion of dysphagia,which were significantly different with other age stages and other parts of lesions(P﹤0.05).[Conclusions]Elderly patients after stroke are more prone to be with dysphagia than young patients,Basal ganglia and brainstem lesions more easily cause dysphagia than other parts of lesions.
Stroke
Basal (medicine)
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Objective:Todetermineifcomorbiddysphagiainallhospitalizedpatientshasthepotentialtoprolonghospitalstay and increase morbidity. Dysphagia is increasingly prevalent with age and comorbid medical conditions. Our researchgrouphaspreviouslyshownthatdysphagiaisabad prognostic indicator in patients with stroke. Design: Analysis of national database. Main Outcome Measures: The National Hospital Discharge Survey (NHDS), 2005-2006, was evaluated for presence of dysphagia and the most common comorbid medicalconditions.Patientdemographics,associateddisease,lengthofhospitalstay,morbidityandmortalitywere also evaluated. Results: There were over 77 million estimated hospital admissionsintheperiodevaluated,ofwhich271983were associated with dysphagia. Dysphagia was most commonlyassociatedwithfluidorelectrolytedisorder,esophagealdisease,stroke,aspirationpneumonia,urinarytract infection,andcongestiveheartfailure.Themediannumber of hospitalization days for all patients with dysphagia was 4.04 compared with 2.40 days for those patients without dysphagia. Mortality increased substantially in patients with dysphagia associated with rehabilitation, intervertebral disk disorders, and heart diseases. Conclusions:Dysphagiahasasignificantimpactonhospitallengthofstayandisabadprognosticindicator.Early recognition of dysphagia and intervention in the hospitalized patient is advised to reduce morbidity and length of hospital stay.
Stroke
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Objective With the recent aging trend in the Japanese population, dysphagia appears to be increasing. However, few epidemiologic surveys have been conducted to determine the prevalence of dysphagia in local inhabitants. Ohkuma et al. prepared a highly reliable questionnaire using a simple test and safe examination method. We investigated the presence/absence of symptoms of dysphagia in local inhabitants, evaluated their association with subjective symptoms, and examined whether the inhabitants were following a particular diet, which is the most important factor in management of dysphagia. Methods A cross-sectional study involving 743 inhabitants (age: over 20) of an isolated island was performed. Each subject was asked basic questions (awareness about the presence/absence of dysphagia and dietary habits), and the data was analyzed by chi-square test. Based on their responses, dysphagia incidence was determined and rated on a 3-category scale (severe, mild, and no dysphagia). Results Responses were recollected from 368 subjects (response rate, 49.5%). The percentage of subjects aware of dysphagia in the severe, mild, and no dysphagia groups was 13.8%, 3.2%, and 0%, respectively and the percentage of subjects who changed their dietary habits was 17.2%, 2.6%, and 0%. These percentages were significantly higher in the severe group than in the mild and no dysphagia groups, though the value was less than 20% in the 3 groups. Conclusion Most subjects in the present study were unaware of dysphagia, suggesting that patients with dysphagia tend to be unaware of the key symptoms of dysphagia.
Association (psychology)
Cross-sectional study
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In order to examine the hypothesis that the sensation of a lump in the throat is mainly caused by local inflammatory changes and consequently elicits emotional or psychological disturbances, a statistical survey was conducted on 1000 of elder subjects than 60 years of age. The results obtained are as follows:1. Of the 1000 subjects, 137 (13.7%) experienced the sensation of a lump in the throat in the past.2. There was no significant correlation between the history of any specific disease and the experience of the sensation of lump in the throat, except that female subjects with respiratory tract diseases experienced the sensation with significantly (p<0.05) higher rate (31.3%) than those without the disease (16.5%).3. According to the result of self-evaluation, 46.7% of the 137 subjects appreciated themselves as nervous. The rate was higher than that (38.7%) obtained from the subjects without the experience but the difference is statistically insignificant.4. Among the 137 subjects, 38 (27.7%) had a history of habitual tonsillitits in their childhood and 69 (50.9%) reported to have recurrent pharyngoaryngitis. Both rates were significantly higher (p<0.005) than those obtained from the subjects with no experience of the sensation of a lump in the throat.The results of the present survey seem to suggest that the sensation of the lump in the throat is caused by local inflammatory changes. As the sensation progresses, apprehension and subsequent cancerphobia may develop.
Throat
Sensation
Phlegm
Apprehension
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