Hallmarks in history of esophageal carcinoma.

Esophageal cancer is one of the deadliest cancers due to its aggressive behavior and poor survival. It was mentioned in the works of ancient Chinese and Arabo-islamic physicians, centuries before the recognition of high incidence in the Asian esophageal cancer belt. Till the 19th century the disease was considered incurable and the main goal of the proposed treatments was to alleviate dysphagia and pain. The introduction of esophagoscope in 1868 by Adolf Kussmaul (1822-1902) contributed to the observation of the living esophagus and to the diagnosis of esophageal pathologies, paving the way for new therapeutic approaches. In 1877, Vincenz Czerny (1842-1916) performed the first successful resection of the cervical esophagus for carcinoma, followed by Franz Torek (1861-1938) who carried out in 1913 the first successful subtotal thoracic esophagectomy and Tohru Ohsawa (1882-1984) who performed the world's first esophagectomy with an intrathoracic esophagogastric anastomosis. Nowadays, despite the advent of biomedical technology and the development of operation techniques, the surgical treatment of esophagus still remains a challenge.

25 Years of Dysphagia Rehabilitation: What Have We Done, What are We Doing, and Where are We Going?

As deglutologists, we strive to use the best evidence available in the treatment of swallowing disorders. Evidence-based medicine is a bottom-up approach that thoughtfully combines the best external evidence with individual clinical expertise and the patients' choice reflective of their clinical state and preferences for their specific care plan. Evidence-based medicine is not restricted to randomized clinical trials and meta-analyses; rather, evidence-based medicine includes our ability to discriminate the best external evidence with which to answer clinical questions and then skillfully and appropriately being able to apply this evidence in the care and treatment of our patients (Sackett et al. in BMJ 312:71-72, 1996). Translation of efficient and effective dysphagia rehabilitative clinical practice implies the need to use treatment that has proven therapeutic value, yields measurable physiologic results and most importantly allows appreciable qualitative outcomes for the patient.

History of the Use of Esophageal Stent in Management of Dysphagia and Its Improvement Over the Years.

The art and science of using stents to treat dysphagia and seal fistula, leaks and perforations has been evolving. Lessons learnt from the deficiencies of previous models led to several improvements making stent deployment easier, and with some designs, it was also possible to remove the stents if needed. With these improvements, besides malignant dysphagia, newer indications for using stents emerged. Unfortunately, despite several decades of evolution, as yet, there is no perfect stent that "fits all." This article is an overview of how this evolution process happened and where we are currently with using stents to manage patients with dysphagia and with other esophageal disorders.

Richard Schatzki: a familiar ring.

OBJECTIVE: The Schatzki ring was named for Richard Schatzki, a renowned radiologist who described the entity with his colleague, John E. Gary. The purpose of this article is to shed more light on a man who made such a significant contribution and to chronicle developments concerning this important radiologic finding. CONCLUSION: The Schatzki ring was described long ago, but its cause is poorly understood even today.

History and principles of exercise-based therapy: how they inform our current treatment.

Exercises designed to strengthen muscles involved in respiration, phonation, and articulation play a key role in the remediation of voice and swallowing disorders. This article presents exercise physiology principles that are beginning to be used by a small group of speech and swallowing researchers to undergird their efficacy-based studies of exercise-based therapy. Three principles--contraction type, task specificity, and overload--are used to compare past exercise-based therapies with present therapies. Comparisons are made between today's methods and Oskar Guttmann's (1893) principles for strengthening muscles of respiration, Emil Froeschels' (1944) therapy to improve laryngeal function, and the myofunctional therapy of the 1960s to improve swallowing and articulation.

Disfagia lusória / Dysphagia lusoria

Entre as anomalias do arco aórtico, a artéria subclávia direita anômala é a mais frequente. Os sintomas podem ocorrer dependendo da situaçäo anatômica deste segmento arterial pela compressäo do esôfago, da traquéia ou de ambos.A disfagia lusória devido à compressäoextrínseca do esôfago por esta artéria é uma causa rara de disfagia, mas conhecida desde 1735 quando foi descrita por Hunald.O objetivo deste trabalho é relatar um caso de disfagia lusória, diagnosticado no ambulatório, e uma revisäo da literatura desta doença, cujo sucesso terapêutico baseia-se num diagnóstico correto e intervençäo precoces.

Dysphagia diagnostics and Donner: experiences in the decade of change.

Martin Donner's influence in the area of dysphagia diagnostics has spanned several decades and has provided an impetus for the evolution of advanced dysphagia diagnostics. This article presents an historical perspective of the development of ultrasound imaging and the variety of other imaging procedures to evaluate swallowing. The future of image processing for dysphagia is firmly set.

Speech-language pathology and dysphagia: a brief historical perspective.

In the past decade, speech-language pathologists have taken a leading role in the management of services for patients with oropharyngeal dysphagia. This article presents the historical perspective of this role, the rationale for assuming the responsibility, and suggests directions for continued involvement.

A note on the historical aspects of dysphagia lusoria.

There is a lack of appreciation for the fact that, in less than 1 per cent of the general population, the right subclavian artery has an anomalous origin and course. Fortunately, most of these persons do not have symptoms; however, if they should have neck surgery, they may be at increased risk for damage to the right inferior laryngram nerve. The earliest reported description of an anomalous right subclavian artery was that of Hunald in 1735; 52 years passed before the clinical syndrome of dysphagia lusoria was published by Bayford in 1787. Bayford did not mention the associated displacement of the right inferior laryngeal nerve. In 1823, Stedman described the entire anatomical picture.

David Bayford. His syndrome and sign of dysphagia lusoria.

David Bayford (1739--90) was an unobtrusive medical worthy of the age of William and John Hunter, with each of whom there are documented links. From 1761, when he obtained the Membership of the Company of Surgeons, to 1782 he practised as a surgeon in London, though he was defeated by John Hunter in his bid for election to the staff of St George's Hospital in 1768. In 1782 he proceeded to the MD, granted by the Archbishop of Canterbury, when he removed to Lewes in East Sussex, where he practised as a physician. He later became disfranchised by the Company of Surgeons in order to obtain the Licentiate of the College of Physicians. In 1761, while still an apprentice surgeon, he made his discovery of the unique and bizarre cause--compression of the oesophagus by an aberrant right subclavian artery--of a fatal case of 'obstructed deglutition' for which he coined the term 'dysphagia lusoria' and for which he is eponymously remembered. This discovery remained unrecorded until 1787, when a paper describing the case was read on his behalf before the Medical Society of London.