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40
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Text
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URL Address
<a href="http://doi.org/10.1007/s00455-017-9832-0" target="_blank" rel="noreferrer noopener">http://doi.org/10.1007/s00455-017-9832-0</a>
Pages
51–62
Issue
1
Volume
33
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
LVC Timing in Infant Pig Swallowing and the Effect of Safe Swallowing.
Publisher
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Dysphagia
Date
A point or period of time associated with an event in the lifecycle of the resource
2018
2018-02
Subject
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*Animal model; *Aspiration; *Deglutition; *Deglutition disorders; *Dysphagia; *Infant; *Laryngeal vestibule closure; *Recurrent laryngeal nerve; Animal; Animal Population Groups; Animals; Aspiration – Etiology; Aspiration/*etiology; Biological; Deglutition – Physiology; Deglutition Disorders – Etiology; Deglutition Disorders/*etiology; Deglutition/*physiology; Disease Models; Humans; Laryngeal Nerve Injuries/*complications; Laryngeal Nerves – Injuries; Larynx; Models; Newborn; Oropharynx; Pneumonia; Questionnaires; Swine
Creator
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Gross Andrew; Ohlemacher Jocelyn; German Rebecca; Gould Francois
Description
An account of the resource
Recurrent laryngeal nerve (RLN) injury in neonates, a complication of head and neck surgeries, leads to increased aspiration risk and swallowing dysfunction. The severity of resulting sequelae range from morbidity, such as aspiration pneumonia, to mortality from infection and failure to thrive. The timing of airway protective events including laryngeal vestibule closure (LVC) is implicated in aspiration. We unilaterally transected the RLN in an infant pig model to observe changes in the timing of swallowing kinematics with lesion and aspiration. We recorded swallows using high-speed video-fluoroscopic swallow studies (VFSS) and scored them using the Infant Mammalian Penetration and Aspiration Scale (IMPAS). We hypothesized that changes would occur in swallowing kinematics (1) between RLN lesion and control animals, and (2) among safe swallows (IMPAS 1), penetration swallows (IMPAS 3), and aspiration swallows (IMPAS 7). We observed numerous changes in timing following RLN lesion in safe and unsafe swallows, suggesting pervasive changes in the coordination of oropharyngeal function. The timing of LVC, posterior tongue, and hyoid movements differed between pre- and post-lesion in safe swallows. Posterior tongue kinematics differed for post-lesion swallows with penetration. The timing and duration of LVC and posterior tongue movement differed between aspiration swallows pre- and post-lesion. After lesion, safe swallows and swallows with aspiration differed in timing of LVC, laryngeal vestibule opening, and posterior tongue and hyoid movements. The timing of thyrohyoid muscle activity varied with IMPAS, but not lesion. Further study into the pathophysiology of RLN lesion-induced swallowing dysfunction is important to developing novel therapies.
Identifier
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<a href="http://doi.org/10.1007/s00455-017-9832-0" target="_blank" rel="noreferrer noopener">10.1007/s00455-017-9832-0</a>
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Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
*Animal model
*Aspiration
*Deglutition
*Deglutition disorders
*Dysphagia
*Infant
*Laryngeal vestibule closure
*Recurrent laryngeal nerve
2018
Animal
Animal Population Groups
Animals
Aspiration – Etiology
Aspiration/*etiology
Biological
Deglutition – Physiology
Deglutition Disorders – Etiology
Deglutition Disorders/*etiology
Deglutition/*physiology
Department of Anatomy & Neurobiology
Disease Models
Dysphagia
German Rebecca
Gould Francois
Gross Andrew
Humans
Laryngeal Nerve Injuries/*complications
Laryngeal Nerves – Injuries
Larynx
Models
NEOMED College of Medicine
Newborn
Ohlemacher Jocelyn
Oropharynx
Pneumonia
Questionnaires
Swine
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Hyperlink
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URL
https://doi.org/10.1002/lary.30070
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Outcomes After Oral Cavity and Oropharyngeal Salvage Surgery
Creator
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Bhavya K Sharma
Kevin J Contrera
Xuefei Jia
Christopher Fleming
Robert R Lorenz
Shlomo A Koyfman
Chengetai Mahomva
Khashayar Arianpour
Brian B Burkey
Michael Fritz
Jamie A Ku
Eric D Lamarre
Joseph Scharpf
Brandon L Prendes
Date
A point or period of time associated with an event in the lifecycle of the resource
2022
Description
An account of the resource
Objectives: Investigate outcomes following oral cavity and oropharyngeal salvage surgery.
Methods: Adult patients who underwent salvage surgery for recurrent squamous cell carcinoma of the oral cavity and oropharynx from 1996 to 2018 were analyzed using multivariable Cox proportional hazards regression. Disease-free survival (DFS), overall survival (OS), associated factors, and basic quality measures were analyzed.
Results: One hundred and eight patients (72% oral cavity, 28% oropharynx) were followed for a median of 17.9 months. Median DFS and OS were 9.9 and 21 months, respectively. Surgery with adjuvant chemoradiotherapy compared to surgery alone (hazard ratio [HR] = 0.15, 95% confidence interval [CI]: 0.03-0.78) and negative margins (HR = 0.36, 95% CI: 0.14-0.90) were associated with better DFS, while lymphovascular space invasion (LVSI) (HR = 2.66, 95% CI: 1.14-6.19) and higher stage (III vs. I-II, HR = 3.94, 95% CI: 1.22-12.71) were associated with worse DFS. Higher stage was associated with worse OS (HR = 3.79, 95% CI: 1.09-13.19). Patients were hospitalized for a median of 8 days with 24% readmitted within 30 days. A total of 72% and 38% of patients, respectively, underwent placement of a feeding tube or tracheostomy.
Conclusions: After oral cavity and oropharyngeal salvage surgery, adjuvant chemoradiotherapy, negative margins, negative LVSI, and lower stage were associated with a lower risk of recurrence. Only lower-stage disease was associated with improved survival. The majority of patients had feeding tubes, half underwent free tissue transfer, a third required tracheostomy, and a quarter was readmitted.
Level of evidence: 3 Laryngoscope, 132:1984-1992, 2022.
Source
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Laryngoscope
. 2022 Oct;132(10):1984-1992. doi: 10.1002/lary.30070. Epub 2022 Feb 22.
Language
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English
2022
Chemotherapy
head and neck
oral cavity
Oropharynx
radiation therapy.