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  • 1
    ISSN: 1432-0509
    Keywords: Pharynx, abnormalities ; Video radiology ; UES/pharyngeal manometry ; Dysphagia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective: Dynamic barium radiology with cine- or video recording has been the most frequently used technique for assessing patients with pharyngeal dysphagia. Although the diagnostic yield of the barium swallow has been high, many patients with pharyngeal dysphagia have normal dynamic barium radiology and remain a diagnostic dilemma. Could manometry add important diagnostic information in these patients? Material and methods: We examined 19 patients (12 men and 7 women, mean age 47 years, range 19–69 years) with pharyngeal dysphagia but a normal barium swallow with simultaneous videoradiography and pharyngeal manometry and compared their manometry to that found in 24 normal volunteers (11 men and 13 women, mean age 37 years, range 23–59 years). Results: Comparing mean values, the patient group showed statistically significant differences from the control group for eight of 10 manometric parameters. Fourteen of 19 patients showed at least one (five patients) and in most cases multiple (nine patients) manometric abnormalities (values exceeding normal mean by ±2SD) which might have contributed to their dysphagia: five patients with high upper esophageal sphincter (UES) resting pressures, five with high LIES residual pressures, three with weak pharyngeal contractions, three with pharyngeal “spasms,” seven with prolonged contraction/relaxation times, five with reduced compliance, and seven with UES/P incoordination. Conclusions: Solid-state computerized manometry is a useful adjunct to videoradiography and can provide potentially important additional information in the diagnosis of dysphagia patients.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1435-0130
    Keywords: Scalp cancer ; Sagittal sinus ; Tissue expander ; Obstruction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract An extensive basal cell carcinoma of the mid-parietal scalp penetrating the skull and invading the posterior third of the superior sagittal sinus was successfully treated in a 60-year-old man. This was accomplished by gradually obstructing the sinus over a period of five weeks unit it was possible to resect the tumor along with 15 cm of the sagittal sinus. Total obstruction of the sinus was achieved using two miniature tissue expanders surgically placed and affixed to the vessel. By gradual filling of the expanders, it was possible, after five weeks, to demonstrate angiographically that the sagittal sinus between the two tissue expanders was obliterated. The one piece resection included a wide margin of skin, bone, dura mater and sagittal sinus. The extensive defect of the dura mater was covered by a free fascia lata graft and the scalp defect by a visor bipedicled forehead flap. The forehead donor area was skin grafted. There were no complications during surgery and the patient recovered uneventfully. There has been no recurrence after one year.
    Type of Medium: Electronic Resource
    Library Location Call Number Volume/Issue/Year Availability
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