1
|
Simon CZ, Du JY, Parel P, Adida S, Miller PM, Qureshi S. Hypoglossal and Glossopharyngeal Nerve Palsy After Anterior Cervical Decompression and Fusion: A Case Report. JBJS Case Connect 2024; 14:01709767-202403000-00028. [PMID: 38340356 DOI: 10.2106/jbjs.cc.23.00372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2024]
Abstract
CASE A 69-year-old man underwent a C3-4 anterior cervical discectomy and fusion and developed postoperative hypoglossal and glossopharyngeal palsies that resolved with symptomatic treatment. CONCLUSION Cranial nerve palsy is a rare and possibly under-reported injury after higher-level cervical spine surgery. Conscientious positioning and awareness of these nerves during surgical exposure are crucial to minimizing cranial nerve palsies. Proper workup to identify these palsies and differentiate them from other complications is necessary to guide proper treatment.
Collapse
Affiliation(s)
- Chad Z Simon
- Hospital for Special Surgery, New York City, New York
| | - Jerry Y Du
- Hospital for Special Surgery, New York City, New York
| | - Philip Parel
- Hospital for Special Surgery, New York City, New York
| | - Samuel Adida
- Hospital for Special Surgery, New York City, New York
| | - Payton M Miller
- Division of General Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | | |
Collapse
|
2
|
Kim J, Ryu B, Kim Y, Choi Y, Lee E. Comparative Analysis of the Prevalence of Dysphagia in Patients with Mild COVID-19 and Those with Aspiration Pneumonia Alone: Findings of the Videofluoroscopic Swallowing Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1851. [PMID: 37893569 PMCID: PMC10608040 DOI: 10.3390/medicina59101851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/11/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Patients recovering from mild coronavirus disease (COVID-19) reportedly have dysphagia or difficulty in swallowing. We compared the prevalence of dysphagia between patients diagnosed with mild COVID-19 and those diagnosed with aspiration pneumonia alone. Materials and Methods: A retrospective study was conducted from January 2020 to June 2023 in 160 patients referred for a videofluoroscopic swallowing study (VFSS) to assess for dysphagia. The cohort included 24 patients with mild COVID-19 and aspiration pneumonia, 30 with mild COVID-19 without aspiration pneumonia, and 106 with aspiration pneumonia alone. We reviewed the demographic data, comorbidities, and VFSS results using the penetration-aspiration scale (PAS) and functional dysphagia scale (FDS). Results: In a study comparing patients with mild COVID-19 (Group A) and those with aspiration pneumonia alone (Group B), no significant differences were observed in the baseline characteristics, including the prevalence of dysphagia-related comorbidities between the groups. Group A showed milder dysphagia, as evidenced by lower PAS and FDS scores, shorter oral and pharyngeal transit times (p = 0.001 and p = 0.003, respectively), and fewer residues in the vallecula and pyriform sinuses (p < 0.001 and p < 0.03, respectively). When Group A was subdivided into those with COVID-19 with (Group A1) and without aspiration pneumonia (Group A2), both subgroups outperformed Group B in terms of specific VFSS metrics, such as oral transit time (p = 0.01), pharyngeal transit time (p = 0.04 and p = 0.02, respectively), and residue in the vallecula (p = 0.04 and p = 0.02, respectively). However, Group B showed improved triggering of the pharyngeal swallowing reflex compared with Group A2 (p = 0.02). Conclusion: Mild COVID-19 patients showed less severe dysphagia than those with aspiration pneumonia alone. This finding was consistent across VFSS parameters, even when the COVID-19 group was subdivided based on the status of aspiration pneumonia.
Collapse
Affiliation(s)
| | | | | | | | - Eunyoung Lee
- Department of Physical Medicine and Rehabilitation, Sahmyook Medical Center, Seoul 02500, Republic of Korea; (J.K.); (B.R.); (Y.K.)
| |
Collapse
|
3
|
Fiszman S, Laguna L. Food design for safer swallowing: focusing on texture-modified diets and sensory stimulation of swallowing via TRP activation. Curr Opin Food Sci 2023. [DOI: 10.1016/j.cofs.2023.101000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
|
4
|
Oda A, Oue K, Oda Y, Taguchi S, Takahashi T, Mukai A, Doi M, Shimizu Y, Irifune M, Yoshida M. Difficult intubation and postoperative aspiration pneumonia associated with Moebius syndrome: a case report. BMC Anesthesiol 2022; 22:316. [PMID: 36221060 PMCID: PMC9552434 DOI: 10.1186/s12871-022-01859-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 10/05/2022] [Indexed: 12/05/2022] Open
Abstract
Background Moebius syndrome is a rare congenital disorder characterized by non-progressive palsy of the abducens (VI) and facial (VII) cranial nerves. Its common features include dysfunctions associated with other cranial nerves, orofacial abnormalities, skeletal muscle hypotonia, and other systemic disorders of differing severities. There are several concerns in the perioperative management of patients with Moebius syndrome. Case presentation We present a report on the management of general anesthesia of a 14-year-old male patient with Moebius syndrome who was scheduled for mandibular cystectomy. The patient was diagnosed with Moebius syndrome at the age of 7 years based on his clinical manifestations of nerve palsy since birth and cranial nerve palsy of the trigeminal (V), facial (VII), glossopharyngeal (IX), vagus (X), and sublingual nerves (XII). The patient’s oral morphological abnormalities made intubation difficult. He also experienced dysphagia and aspiration pneumonia on a daily basis. Oral secretions were frequently suctioned postoperatively. However, after discharge, the patient developed aspiration pneumonia and was readmitted to the hospital. Conclusions The main problem arising when administering general anesthesia to patients with this syndrome is difficult airway management. The oral abnormalities in these patients, such as small jaw and extreme dental stenosis, make mask ventilation and intubation difficult. Furthermore, this syndrome often involves respiratory impairment and dysphagia due to cerebral nerve palsy, so there is a high risk of postoperative respiratory complications. Since multiple organs are affected in patients with Moebius syndrome, appropriate perioperative management strategies must be prepared for these patients.
Collapse
Affiliation(s)
- Aya Oda
- Department of Dental Anesthesiology, Division of Oral and Maxillofacial Surgery and Oral Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8551, Japan
| | - Kana Oue
- Department of Dental Anesthesiology, Division of Oral and Maxillofacial Surgery and Oral Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8551, Japan.
| | - Yuki Oda
- Department of Special Care Dentistry, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8551, Japan
| | - Shima Taguchi
- Department of Anesthesiology and Critical Care, Hiroshima University, Hiroshima, Japan
| | - Tamayo Takahashi
- Department of Dental Anesthesiology, Division of Oral and Maxillofacial Surgery and Oral Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8551, Japan
| | - Akari Mukai
- Department of Dental Anesthesiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Mitsuru Doi
- Department of Dental Anesthesiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yoshitaka Shimizu
- Department of Dental Anesthesiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Masahiro Irifune
- Department of Dental Anesthesiology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Mitsuhiro Yoshida
- Department of Dental Anesthesiology, Division of Oral and Maxillofacial Surgery and Oral Medicine, Hiroshima University Hospital, 1-2-3 Kasumi, Minami-ku, Hiroshima, Hiroshima, 734-8551, Japan
| |
Collapse
|
5
|
Thielhelm TP, Dinh CT, Sargi Z, Ivan ME, Ein L. Haller's Ansa: An Unrecognized Route of Facial Movement After Skull Base Surgery. Laryngoscope 2021; 132:1750-1752. [PMID: 34741465 DOI: 10.1002/lary.29932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/04/2021] [Accepted: 10/14/2021] [Indexed: 11/11/2022]
Abstract
A direct communication between the glossopharyngeal and facial nerves known as Haller's ansa exists in a minority of patients. Clinical manifestations of this anastomosis are not commonly observed. We describe post-operative facial movement with swallowing after facial nerve sacrifice in two patients who underwent surgery for skull base tumors. Patient 1, a 49-year-old male, received a transcochlear approach for resection of endolymphatic sac tumor and intratemporal facial nerve sacrifice without nerve reconstruction. Patient 2, a 23-year-old female, underwent surgery for left jugular paraganglioma, requiring facial nerve sacrifice and cable graft. Both patients had preoperative facial weakness and intraoperative preservation of the glossopharyngeal nerve. A literature review related to Haller's ansa was performed using PubMed, EMBASE, and Scopus from 1920-2021. Post-operatively, both patients demonstrated oral commissure movement with swallowing, suggesting a communication between the glossopharyngeal nerve and the facial nerve (Haller's ansa). Although anatomical references to Haller's ansa exist, there are no reported clinical manifestations of this neural anastomosis. Glossopharyngeal-facial nerve communications may contribute to facial tone and movement. Pre- and post-operative assessment of facial nerve movement with swallowing may help assess for the presence of Haller's ansa. Better understanding of this neural anastomosis may have implications for facial reanimation surgery. Laryngoscope, 2021.
Collapse
Affiliation(s)
- Torin P Thielhelm
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
| | - Christine T Dinh
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
| | - Zoukaa Sargi
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
| | - Michael E Ivan
- Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
| | - Liliana Ein
- Department of Otolaryngology, University of Miami Miller School of Medicine, Miami, Florida, U.S.A
| |
Collapse
|
6
|
Mitani A, Muramatsu M. Development of a Spoon Motion Navigation Algorithm for the Mealtime Assistant Simulator. JOURNAL OF ROBOTICS AND MECHATRONICS 2021. [DOI: 10.20965/jrm.2021.p0768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In aging society like Japan, maintaining the quality of life (QOL) is an important objective. The oral cavity has various significant functions that contribute to the QOL. Elderly people are susceptible to the swallowing disorders owing to various factors associated with advancing age. In such cases, mealtime assistance can provide elderly persons appropriate eating situations. Thus, mealtime assistance skills are essential for students in nursing and caregiver education. Recently, simulation education has attracted attention as an effective educational process for nursing and caregiver students before their clinical practice in a hospital or care house. In this educational process, a patient model that mimics specific symptoms called the simulation model, is used to learn the symptoms and its care process in the same clinical environment as actual. We have attempted to develop several oral care simulation models, and we have earlier developed a prototype of mealtime assistance simulation model. This simulation model had a tongue model with a sensor system to detect spoon motions, and its fundamental functions were evaluated via spoon detection experiments. Based on the earlier achievements, in this study, we develop an evaluation system of feeding skill using a spoon. The pressing force and position by spoon on the tongue model were estimated by transfer functions derived from experiments. In addition, we developed an algorithm that leads students’ spoon position and pressing force in the correct position.
Collapse
|
7
|
Nutritional, Gastrointestinal and Endo-Metabolic Challenges in the Management of Children with Spinal Muscular Atrophy Type 1. Nutrients 2021; 13:nu13072400. [PMID: 34371910 PMCID: PMC8308588 DOI: 10.3390/nu13072400] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 07/08/2021] [Accepted: 07/10/2021] [Indexed: 12/18/2022] Open
Abstract
The management of patients with spinal muscular atrophy type 1 (SMA1) is constantly evolving. In just a few decades, the medical approach has switched from an exclusively palliative therapy to a targeted therapy, transforming the natural history of the disease, improving survival time and quality of life and creating new challenges and goals. Many nutritional problems, gastrointestinal disorders and metabolic and endocrine alterations are commonly identified in patients affected by SMA1 during childhood and adolescence. For this reason, a proper pediatric multidisciplinary approach is then required in the clinical care of these patients, with a specific focus on the prevention of most common complications. The purpose of this narrative review is to provide the clinician with a practical and usable tool about SMA1 patients care, through a comprehensive insight into the nutritional, gastroenterological, metabolic and endocrine management of SMA1. Considering the possible horizons opened thanks to new therapeutic frontiers, a nutritional and endo-metabolic surveillance is a crucial element to be considered for a proper clinical care of these patients.
Collapse
|