Nasal Backflow and the Difficulty of Relaxation in the Upper Esophageal Sphincter.

Nasal backflow and the difficulty of relaxation in the upper esophageal sphincter.

Filed under: Rehab Centers

Laryngoscope. 2012 Nov 20;
Park JW, Kwon BS, Chang JH, Sim KB

OBJECTIVES/HYPOTHESIS: Nasal backflow is the regurgitation of material into nasopharynx during swallowing and it can be easily observed by videofluoroscopy. We aimed to evaluate the association between nasal backflow and the prevalence of aspiration, as well as the relationship between nasal backflow and the opening of the upper esophageal sphincter. STUDY DESIGN: Retrospective case-control study. METHODS: There were 182 cases of videofluoroscopic swallowing studies that were retrospectively reviewed. The presence of nasal backflow and laryngeal aspirations were checked, and the anteroposterior maximum width of the upper esophageal sphincter opening was measured on lateral images of videofluoroscopic swallowing studies. The difference in maximum upper esophageal sphincter width between the group with nasal backflow and the group without nasal backflow was statistically verified. RESULTS: Twenty patients showed nasal backflow, which was closely related to laryngeal aspiration (odds ratio = 10.97; 95% CI = 2.46-48.85; P < 0.05). Their maximal upper esophageal sphincter width (mean ± standard deviation) was 6.82 ± 1.96 mm and significantly different from the group without nasal backflow (9.35 ± 1.56 mm) (P < 0.05). CONCLUSION: Nasal backflow was closely associated with the presence of aspiration; the opening of upper esophageal sphincters significantly decreased in the cases of nasal backflow. HubMed – rehab


Reasons for using swelling ratio in sonographic diagnosis of carpal tunnel syndrome and a reliable method for its calculation.

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Muscle Nerve. 2012 Jul 20;
Ula?li AM, Duymu? M, Nacir B, Rana Erdem H, Ko?ar U

INTRODUCTION: The aim of this study was to investigate factors affecting median nerve cross-sectional area (CSA) and determine a dependable swelling ratio (SR) calculation method. METHODS: Using ultrasonography, median nerve CSAs were measured at the tunnel inlet, midtunnel, and outlet, and at 4 cm and 12 cm proximal to the wrist. We used CSAmax as the largest of the tunnel measurements and calculated swelling ratios (SRs) by using the CSAmax. Sonographic measurements were correlated with electrophysiologic findings. We evaluated the effects of gender, weight, and height on median nerve thickness. RESULTS: We studied 95 wrists of 55 CTS patients and 48 wrists of 27 volunteers. Gender, weight, and height had effects on certain median nerve CSA measurements. CSAmax, SRmax4, and SRmax12 had superior correlations with electrophysiologic findings. The correlation between 4-cm and 12-cm median nerve CSAs was statistically significant (r = 0.879 and P < 0,001). CONCLUSION: We have developed a reliable SR method considering factors affecting median nerve CSA. Muscle Nerve, 2012. HubMed – rehab


Six-minute walk test in healthy children: Is the leg length important?

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Pediatr Pulmonol. 2012 Nov 20;
Oliveira AC, Rodrigues CC, Rolim DS, Souza AA, Nascimento OA, Jardim JR, Rozov T

RATIONALE: Measures as height, age, and weight influence the six-minute walk test (6MWT). It was shown that children’s true leg length (TLL) influence the 6MWT distance but so far it has never been evaluated how much this variable could predict the distance walked related to height. Our hypothesis is that there should not have any significant difference between models including height or TLL. OBJECTIVE: To establish and to compare the predicted walked distance of healthy children in the 6MWT by two distinct models, one including TLL and other including height. METHODS: Observational cross sectional study. A total of 161 healthy children (84 girls, 52.2%), 6-13 years old from three local primary and secondary schools. Two 6MWT were performed following ATS guidelines. Weight, height, and TLL were measured. The longer walked distance was selected for statistical analysis. RESULTS: Anthropometric data were similar for both genders into each group of age. Mean (±SD) walked distances in whole group were: boys 704.4?m (77.7); girls 681.6?m (67.9; P?=?0.049). In the univariate regression to predict the distance walked, the adjusted coefficients to TLL and height were in boys: 0.46 and 0.39; and in girls: 0.35 and 0.29, respectively. After adjusting for age and weight, the residuals of the two equations were not significantly different (P?=?0.998). CONCLUSION: The model including TLL to predict the walked distance by healthy children explained more of the variation on the walked distance in the 6MWT than the model using the height but without significant difference between the models. Pediatr Pulmonol. © 2012 Wiley Periodicals, Inc.
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Speech rehabilitation during the first year after total laryngectomy.

Filed under: Rehab Centers

Head Neck. 2012 Nov 20;
Singer S, Wollbrück D, Dietz A, Schock J, Pabst F, Vogel HJ, Oeken J, Sandner A, Koscielny S, Hormes K, Breitenstein K, Richter H, Deckelmann A, Cook S, Fuchs M, Meuret S

BACKGROUND: Gaining a new voice is one of the major aims after total laryngectomy. The objective of this study was to describe the process and results of speech rehabilitation during the first year after surgery. METHODS: Speech intelligibility was measured 6 months (n = 273) and 1 year (n = 225) after total laryngectomy. RESULTS: Objective (23.4 to 47.5 points, p < .0001) and subjective (51.6 to 64.7 points, p < .0001) speech intelligibility improved between 6 months and 1 year after total laryngectomy. Patients who used tracheoesophageal puncture (TEP) had the best results in speech intelligibility 6 months and 1 year after total laryngectomy. In all, 12% of the patients who used TEP initially no longer used it 1 year later. Patients who had received rehabilitation had better objective speech intelligibility than those who did not. CONCLUSIONS: Speech improves considerably between 6 months and 1 year after total laryngectomy. Nonattendance of rehabilitation is associated with a worse functional outcome in speech rehabilitation. Head Neck, 2012. HubMed – rehab


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