Qualitative and quantitative scintigraphy in sialorrhea before and after botulinum toxin injection.

Objectives/hypothesis: Sialorrhea is excessive saliva production and its usual escape of from the oral cavity. The use of botulinum toxin has been preconized, but its effectiveness until now has been unreliably measured. Our objective was to qualitatively and quantitatively determine the effectiveness of botulinum toxin injection in the reduction of saliva production by the parotid gland.

NEURAL CONTROL OF SWALLOWING.

Background: Swallowing is a motor process with several discordances and a very difficult neurophysiological study. Maybe that is the reason for the scarcity of papers about it.

Objective: It is to describe the chewing neural control and oral bolus qualification.

Dysphagia and sialorrhea: the relationship to Parkinson's disease.

Context: Dysphagia and sialorrhea in patients with Parkinson's disease are both automatically accepted as dependent on this neurological disease.

Objective: The aim were to establish if these two complaints are a consequence or associated manifestations of Parkinson's disease.

Method: Two Parkinson's diseases groups from the same outpatients' population were studied.

Lateral laryngopharyngeal diverticula: a videofluoroscopic study of laryngopharyngeal wall in wind instrumentalists.

Context: This paper analyze healthy musicians who play wind instruments.

Objective: To identify possible diverticular formations on the laryngopharyngeal wall produced by pharyngeal overpressure during the use of these instruments.

Methods: Through a videofluoroscopic method, 22 professional musicians had their pharynx analyzed in frontal face and profile, by swallowing 20 mL of barium sulfate solution and blowing against resistance.

A new hypothesis for fluidification of vocal-fold mucus: scintigraphic study.

Objective: Our aim was to establish a new hypothesis for the fluidification of the mucus of the vocal folds, by using a scintigraphic method to analyze the relationship of the saliva from the oral and pharyngeal cavities to the mucosa of the laryngeal vestibule.

Study Design: We theorized that the saliva that is adsorbed on the oral and pharyngeal mucosa enters the larynx and is also adsorbed on its mucosa, as a natural layer, fluidizing the mucus of the vestibule wall.

Method: A saline solution of sodium pertechnetate (Na(99m)TcO(4)) with radioactivity of 1.

Oral taste recognition in health volunteers.

Context: Taste food recognition has an important role in the nutritional conditions and also allows protection of the organism integrity against foods potentially dangerous.

Objective: To investigate the presence of the selective taste regions on the tongue and also the palate participation in the oral taste definition.

Methods: A standard tongue divided in six regions was exposed with the four basic tastes (sweet, salted, sour and bitter), 10 times each.

Coordination of respiration and swallowing: functional pattern and relevance of vocal folds closure.

Context: Breathing and swallowing coordination, despite the expressive number of study, remain as theme deserving further research.

Objective: To identify a coordination pattern between swallowing and the natural breathing pause that occur in association with it (swallowing apnea) and also the relevance of the vocal folds closure in this process.

Methods: Sixty-six adults, male and female, including normal health people, post-laryngectomy individuals and patients with digestive complaints without dysphagia were analyzed.

Viscosities reproductive patterns for use in videofluoroscopy and rehabilitation therapy of dysphagic patients.

Background: Usually the suitable consistence identified and indicated as safe by videofluoroscopic method has been empirically obtained by association of barium sulfate solution with meals. However, it has been evidenced to be very difficult to reproduce this consistence in nutritional rehabilitation therapy from subjective information.

Aim: To build two reproductive similar crescent viscosities series of solutions, with and without barium sulfate, to be used, the first, as radiological contrasted mean and the second, as base to reproduce the defined safer consistence, in the oral diet rehabilitation of dysphagic patients.

[Mechanical-thermal stimulation of the palatoglossus pillars].

Background: The palatoglossus pillars were admitted as the main receptive responsible area by the pharyngeal swallowing reflex produced by food and tongue posterior progression. This concept sustain the mechanical-thermal maneuver used to recovery the committed pharyngeal function. A pharyngeal motor answer by pillar stimulation is common accepted but not unanimously.

Scintigraphic analysis of the parotid glands in patients with sialorrhea and Parkinson's disease.

Since sialorrhea was initially described, it has been associated with Parkinson's disease (PD) but until now little is known about its pathophysiology. The authors studied parotid gland activity using scintigraphic analysis on 14 PD patients with sialorrhea and in eight healthy persons with matching ages. There was no difference between uptake and intra-glandular distribution by the parotid gland in the two groups but the parotid excretion speed in the PD patients was greater than that observed in healthy individuals.

Esophageal diverticula: pathogenesis, clinical aspects, and natural history.

It has been gradually accepted that esophageal diverticula result from esophageal motor disorders rather than from primary anatomic abnormalities. Twenty-seven patients with these diverticula were evaluated with respect to pathogenesis, clinical aspects, diagnostic tests, therapy, and natural history for a mean of 27 months of followup. Thirteen diverticula were midesophageal, 11 were situated in the distal third of the esophagus, and 3 were in both regions.

Lateral laryngopharyngeal diverticulum: anatomical and videofluoroscopic study.

The aims were to characterize the anatomical region where the lateral laryngopharyngeal protrusion occurs and to define if this protrusion is a normal or a pathological entity. This protrusion was observed on frontal contrasted radiographs as an addition image on the upper portion of the laryngopharynx. We carried out a plane-by-plane qualitative anatomical study through macroscopic and mesoscopic surgical dissection on 12 pieces and analyzed through a videofluoroscopic method on frontal incidence the pharyngeal phase of the swallowing process of 33 patients who had a lateral laryngopharyngeal protrusion.

[The influence of oral and pharyngeal phases on the swallowing dynamic].

Background: The pharyngeal phase of swallowing has received more attention than oral phase although they are presumably interdependent.

Aims: 1. to evaluate, through the videofluoroscopic method, the oral phase of swallowing in order to observe the characteristics organization of the liquid bolus in healthy volunteers and the variations of this organization in exams of patient with dysphagia; 2.

Anatomical investigation of the esophageal and aortic hiatuses: physiologic, clinical and surgical considerations.

Precise knowledge about the anatomical constitution of the diaphragmatic pillars is essential to understand the physiologic, clinical and surgical roles of the esophageal and aortic hiatuses. Because anatomical descriptions found in the literature are dubious, we have decided to investigate this subject. Anatomical dissections and histologic sections of the right and left diaphragmatic pillars (diaphragma crura) from 43 human bodies were analyzed, comprising both non-fixed and fixed specimens.

[Laryngopharyngeal structural analysis and its morphofunctional correlation with cricopharyngeal myotomy, botulinum toxin injection and balloon dilation].

Background: The cricopharyngeal muscle is of the skeletal type and, in this way, unable to sustain continuous contraction for long periods. Despite of this it has been considered as the responsible by the high pressure area, registered by manometry into the pharyngoesophageal transition. For this reason, it has been the object of therapeutics that promote the rupture of its integrity.