Dysphagia in amyotrophic lateral sclerosis: Quantification of bulbar motor dysfunction.

Background: Dysphagia as a sequel and possible early sign of amyotrophic lateral sclerosis (ALS) is caused by progressive impaired bulbar motor function.

Objective: To evaluate bulbar motor dysfunction in patients suffering from ALS compared to a healthy reference group.

Methods: A clinical study and prospective group comparison was designed.

[Therapeutic success of proton pump inhibitors in the therapy of contact granulomas].

According to the current S2k guideline "Gastroesophageal Reflux Disease (GERD)" of 05/2014, an empirical proton pump inhibitor (PPI) therapy in double standard dose (e. g. Pantoprazole 40 mg 2 ×/day) is recommended for the extraesophageal GERD manifestation (e.

[Speech and Language Disorders in the Elderly].

Cerebrovascular insults and neurodegenerative diseases are the main causes of acquired speech and language disorders. A massive increase in the prevalence of both is evident from the age of 65 years. By the age of 90 years, more than 10 % of the population would have experienced a stroke and 30 % would have suffered from neurodegenerative diseases.

Amyloidosis of the Upper Aerodigestive Tract: Management of a Rare Disease and Review of the Literature.

Amyloidosis in the upper aerodigestive tract is a very rare disease with mainly case reports documented so far. In the pathogenesis, amyloid protein fibers are deposited in organs and tissue. In the upper aerodigestive tract, mostly localized amyloidosis occurs with unspecific symptoms, e.

[Treatment of laryngeal dystonia with botulinum toxin].

The treatment of laryngeal dystonias with botulinum toxin is successful. Every patient suffering from a laryngeal dystonia should be assured of high quality therapeutic intervention. Therefore it is important to establish general standards by experts in this field.

Evaluation of dysphagia by novel real-time MRI.

Objective: To assess safety and feasibility of real-time (RT) MRI for evaluation of dysphagia and to compare this technique to standard assessment by flexible endoscopic evaluation of swallowing (FEES) and videofluoroscopy (VF) in a cohort of patients with inclusion body myositis (IBM).

Methods: Using RT-MRI, FEES, and VF, an unselected cohort of 20 patients with IBM was studied as index disease with a uniform dysphagia. Symptoms of IBM and dysphagia were explored by standardized tools including Swallowing-Related Quality of Life Questionnaire (SWAL-QoL), IBM Functional Rating Scale, Patient-Reported Functional Assessment, and Medical Research Council Scale.

Real-time MRI of swallowing: intraoral pressure reduction supports larynx elevation.

The reduction in intraoral pressure during swallowing has previously been linked to bolus transport, although no such relation has yet been proven. The purpose of this work was to evaluate the time course of intraoral pressure during swallowing using simultaneous real-time magnetic resonance imaging (MRI) and dynamic pressure recordings. Real-time MRI based on highly undersampled radial fast low-angle shot (FLASH) and regularized nonlinear inverse reconstruction was performed at 3 T using a standard head coil and a mid-sagittal section covering the entire oral cavity.

On the physiology of normal swallowing as revealed by magnetic resonance imaging in real time.

The aim of this study was to assess the physiology of normal swallowing using recent advances in real-time magnetic resonance imaging (MRI). Therefore ten young healthy subjects underwent real-time MRI and flexible endoscopic evaluations of swallowing (FEES) with thickened pineapple juice as oral contrast bolus. MRI movies were recorded in sagittal, coronal, and axial orientations during successive swallows at about 25 frames per second.

Intraoral pressure patterns during swallowing.

Swallowing disturbances are common after neurological disease and oropharyngeal tumor resection. In this case the oral stage is often affected. So far the clinical evaluation of the oral phase is limited.

Real-time magnetic resonance imaging of normal swallowing.

Purpose: To evaluate the use of a novel real-time magnetic resonance imaging (MRI) technique for the assessment of normal swallowing dynamics.

Materials And Methods: In a cohort of 10 healthy subjects, real-time MRI movies at 24.3 frames per second were obtained in sagittal, coronal, and axial orientation during self-controlled swallows of 5 mL pineapple juice as oral contrast bolus.

Organ function and quality of life after transoral laser microsurgery and adjuvant radiotherapy for locally advanced laryngeal cancer.

Background And Purpose: Transoral laser microsurgery (TLM) and adjuvant radiotherapy are an established therapy regimen for locally advanced laryngeal cancer at our institution. Aim of the present study was to assess value of quality of life (QoL) data with special regard to organ function under consideration of treatment efficacy in patients with locally advanced laryngeal cancer treated with larynx-preserving TLM and adjuvant radiotherapy.

Patients And Methods: From 1994 to 2006, 39 patients (ten UICC stage III, 29 UICC stage IVA/B) with locally advanced laryngeal carcinomas were treated with TLM and adjuvant radiotherapy.

Cortical sensorimotor control in vocalization: a functional magnetic resonance imaging study.

Background: Verbal communication is a human feature and volitional vocalization is its basis. However, little is known regarding the cortical areas involved in human vocalization.

Methods: Therefore, functional magnetic resonance imaging at 3 Tesla was performed in 16 healthy adults to evaluate brain activations related to voice production.

Successful treatment of autophonia with botulinum toxin: case report.

Objectives: We sought to treat autophonia due to a patulous eustachian tube using botulinum toxin.

Methods: Because we assumed that the patulous eustachian tube was caused by abnormal activity of paratubal muscles (tensor and levator veli palatini muscles and salpingopharyngeus muscle), paralysis was performed via injection of botulinum toxin type A in a 45-year-old female professional musician who had had chronic unilateral autophonia for 20 years. In addition to a patient interview, an endoscopic examination of the nasopharynx (posterior rhinoscopy), ear microscopy, and impedance audiometry were performed to verify the diagnosis and the outcome after treatment.

The supraglottic nerve supply: an anatomic study with clinical implications.

Objectives: To describe the course of the superior laryngeal nerve (SLN) and its branches, in particular, with regard to supraglottic motor and sensory functions.

Methods: In 30 normal human hemilarynges, the SLN with its internal (intSLN) and external branch (extSLN) were dissected under microsurgical conditions and marked with acrylic dye. All anatomic structures of the larynges (muscles, cartilages, and ligaments) were dissected in detail.

Stroboscopy versus high-speed glottography: a comparative study.

Objectives: To evaluate and to compare the diagnostic value of videostroboscopy (VS) and high-speed glottography (HGG) in dysphonic patients.

Study Design: Randomized, prospective study.

Methods: A total of 162 patients underwent indirect laryngoscopy using both methods (VS and HGG).

Functional anatomy of the recurrent and superior laryngeal nerve.

Background And Aims: The purpose of this study was to present the current topographic and anatomical knowledge in neurolaryngology, with special regard to laryngeal paralyses as a major complication in thyroid surgery.

Patients And Methods: Microscopic anatomical preparation of 22 human hemilarynges was accomplished.

Results: Due to their neuroanatomical courses, the following extralaryngeal nerves may be at risk in thyroid surgery: the external branch of the superior laryngeal nerve, the paralaryngeal part of the vagal nerve, the Ansa Galeni, the trunk of the recurrent laryngeal nerve (RLN) and the delicate branches of the RLN to the posterior cricoarytaenoid muscle.

Laser microsurgical bilateral posterior cordectomy for the treatment of bilateral vocal fold paralysis.

Objectives: We performed a prospective study to assess respiratory function and voice quality before and after laser microsurgical bilateral posterior cordectomy performed for chronic airway obstruction in patients with bilateral vocal fold paralysis.

Methods: In 17 patients a laser microsurgical posterior cordectomy was performed as an immediate bilateral approach. Roughness, breathiness, hoarseness, and dyspnea were evaluated both subjectively (on a scale from 0 to 3) and objectively (body plethysmography, computerized voice analysis: Göttingen Hoarseness Diagram).

Human cortical motor representation of the larynx as assessed by transcranial magnetic stimulation (TMS).

Objectives: To analyze characteristic features and details on motor-evoked potentials (MEPs) of the cricothyroid and vocalis muscles from single-pulse cortical transcranial magnetic stimulation (TMS) in normal subjects to characterize cortical motor representation of laryngeal muscles.

Study Design: Prospective, experimental investigation on healthy volunteers.

Method: MEPs of the cricothyroid and vocalis muscles elicited by cortical TMS with a figure-8-shaped coil were investigated in two groups of six healthy subjects each, with special regard to MEP amplitude as a function of the coil position on the head surface along the interaural line.

Assessment of irregular voices after total and laser surgical partial laryngectomy.

Objectives: To assess the merits of computer-aided voice analysis procedures for very irregular voices of patients after total and laser surgical partial laryngectomy, and to characterize qualitative differences in speech and voice function between these 2 groups of patients.

Design: Cross-sectional study.

Setting: University hospital in Göttingen, Germany

Patients: Twenty-nine patients with advanced laryngeal carcinomas (T3-T4; according to the Union Internationale Contre le Cancer, TNM staging system, stages III-IVa) were examined: 18 patients with tracheoesophageal speech (voice prosthesis) after total laryngectomy and 11 patients who underwent partial transoral resection of the larynx (by means of laser microsurgery without surgical voice rehabilitation).

Neuronal nitric oxide synthase-immunoreactivity. A neuromodulating system independent of peripheral nasal gland denervation in guinea pig nasal mucosal tissue after treatment with botulinum toxin type A.

The influence of botulinum toxin type A (BTA) on cellular mechanisms has not been studied in much detail. Since nitric oxide (NO) is of increasing interest as a neuromodulator in the innervation of the nose, its localization was examined in the nasal mucosa of guinea pigs treated with BTA or saline. Neuronal nitric oxide synthase-immunoreactivity (nNOS-IR) was found around vessels and nasal glands.

Neuronal nitric oxide synthase immunoreactivity in the nasal mucosa of patients with idiopathic and allergic rhinitis.

The localization of neuronal nitric oxide synthase (nNOS) in the mucosa of the inferior and middle turbinates of 30 patients with and without allergic rhinitis was examined by immunohistochemical methods. Staining of paraffin sections from allergic and nonallergic patients revealed nNOS immunoreactivity (nNOS-IR) in the muscular layer of vessels, in the basal portion of submucosal glands and in the periost and the osteocytes of the turbinate bones. In contrast to earlier investigations, nNOS-IR was also seen in the nasal respiratory epithelium of allergic and nonallergic patients.