ABSTRACT
Background: Brachycephalic dogs have several abnormalities in the airways, which generate clinical manifestations that impair the quality of life of these animals. Primary alterations promote airflow obstruction and increase intraluminal negative pressure, causing secondary alterations due to a cycle of inflammation with consequent obstruction. With the onset of inflammation and other alterations in the airways, clinical manifestations can be observed, such as snoring, reverse sneezing, coughing, dyspnea, cyanosis, syncope, and vomiting. Endoscopic examination of the airways allows visualization and diagnosis of morphological changes in these animals. This study aimed to evaluate the endoscopic findings of the airways and determine the quantitative and qualitative assessment of the severity of clinical manifestations in 14 dogs with brachycephalic syndrome (BS). Materials, Methods & Results: Historical and anamnesis data and clinical, respiratory, and digestive manifestations were collected from the owners' reports. The clinical manifestations were classified as mild, moderate, or severe. All animals were subjected to endoscopy of the airways, and image findings were grouped according to the anatomical site where they were observed, then the abnormalities were correlated with the severity of the clinical manifestations. When comparing the frequency of endoscopic abnormalities with the severity of clinical manifestations, it is interesting to observe that animals with severe disease more frequently presented the following alterations: prolongation and thickening of the soft palate, laryngeal changes, presence of hyperemia, lymphoid hyperplasia and polyps in the nasopharynx, hypoplasia and presence of tracheal secretion and thickening of the dorsal tracheal muscle; bronchial collapse, hypoplasia of the main bronchi and bronchial hyperemia and the presence of aberrant nasal turbinates. Comparison between the means of nonparametric variables was performed using the Mann-Whitney test, with a 5% significance level. Discussion: A higher frequency of French Bulldog dogs included in the study was observed, probably due to their greater popularity, although any brachycephalic dog may be affected by BS. Considering that nostril stenosis is a congenital alteration, which is usually diagnosed early, and since the animals included in the study were dogs referred for the rhinoplasty procedure the higher frequency of young dogs in the study was not surprising. The results revealed a significant difference in the endoscopic findings with the severity of the clinical manifestations in different variables, such as prolongation and thickening of the soft palate, eversion of the laryngeal saccules, presence of laryngeal inflammation and collapse, presence of polyps or lymphoid hyperplasia in the nasopharynx, thickening of the dorsal muscle of the trachea, polyps in the trachea and hypoplasia in addition to bronchial hyperemia. The larynx was the most affected anatomical site, with alterations present in 92.8% of the evaluated dogs. Based on these findings, it can be concluded that airway obstruction caused by primary alterations can cause secondary alterations, with consequent clinical manifestations in brachycephalic dogs it is possible to suggest that dogs with this syndrome may present severe manifestations of the disease, regardless of age. Furthermore, it can be concluded that in this study, dogs with BS had frequent laryngeal alterations and that alterations in the main bronchi were present in all animals with severe manifestations of the disease.
Subject(s)
Animals , Dogs , Pharynx/abnormalities , Craniosynostoses/veterinary , Airway Obstruction/genetics , Airway Obstruction/veterinary , Laryngoscopy/veterinaryABSTRACT
La hipertricosis cervical anterior no sindrómica (OMIM N° 600457) es un desorden genético caracterizado por un parche de pelo a nivel de la prominencia laríngea. Se presenta a un niño de 12 años de edad con hipertricosis cervical anterior e hipertricosis generalizada leve, sin alteraciones neurológicas, oftalmológicas ni esqueléticas, en seguimiento clínico por un lapso de 10 años.
The non-syndromic anterior cervical hypertrichosis (OMIM N° 600457) is a genetic disorder characterized by a patch of hair at the level of the laryngeal prominence. We present a 12-year-old boy with anterior cervical hypertrichosis and mild generalized hypertrichosis. He has no neurological, ophthalmological or skeletal anomalies. The clinical follow up is 10 years.
Subject(s)
Humans , Male , Child , Pharynx/abnormalities , Cervix Uteri/abnormalities , Hypertrichosis/diagnosis , Time Factors , Follow-Up StudiesABSTRACT
The non-syndromic anterior cervical hypertrichosis (OMIM N° 600457) is a genetic disorder characterized by a patch of hair at the level of the laryngeal prominence. We present a 12-year-old boy with anterior cervical hypertrichosis and mild generalized hypertrichosis. He has no neurological, ophthalmological or skeletal anomalies. The clinical follow up is 10 years.
La hipertricosis cervical anterior no sindrómica (OMIM N° 600457) es un desorden genético caracterizado por un parche de pelo a nivel de la prominencia laríngea. Se presenta a un niño de 12 años de edad con hipertricosis cervical anterior e hipertricosis generalizada leve, sin alteraciones neurológicas, oftalmológicas ni esqueléticas, en seguimiento clínico por un lapso de 10 años.
Subject(s)
Cervix Uteri/abnormalities , Hypertrichosis , Pharynx/abnormalities , Child , Follow-Up Studies , Humans , Hypertrichosis/diagnosis , Male , Time FactorsABSTRACT
Background: Identifying the craniofacial abnormalities that cause snoring and the narrowest area of the upper airway creating obstructions can help to determine the proper method of treatment. Aim: To identify the factors that can cause snoring and the areas of the airway that are the most likely to collapse with upper airway imaging. Material and Methods: Axial pharynx examinations with CT (computerized tomography) and magnetic resonance imaging (MRI) were performed to 38 patients complaining of snoring and 12 patients who did not complain of snoring. The narrowest areas of nasopharynx, hypophraynx, oropharynx, bilateral para-pharyngeal fat pad and para-pharyngeal muscle thickness were measured. Results: In snoring patients, the narrowest part of the upper airway was the retro-palatal region in the oropharynx, as measured with both imaging methods. When patients with and without snoring were compared, the former that a higher body mass index and neck diameter and a narrower oropharynx area. In dynamic examinations, we determined that as para-pharyngeal muscle thickness increased, medial-lateral airway diameter and the oropharynx area decreased. Conclusions: The narrowest section of the airway is the retro-palatal region of the oropharynx, measured both with CT and MRI.
Antecedentes: La identificación de las anomalías craneofaciales que causan el ronquido es importante para decidir la terapia adecuada. Objetivo: Identificar los factores que causan el ronquido y las zonas de la vía aérea superior que son más susceptibles de colapsar, usando imágenes. Material y Métodos: Se efectuaron exámenes axiales de la faringe con tomografía computada (TC) y resonancia magnética (RM) en 38 pacientes que roncaban y 12 que no lo hacían. Se determinaron las zonas más estrechas de la nasofaringe, hipofaringe, orofaringe y el grosor del tejido adiposo y musculatura parafaríngeos. Resultados: En los pacientes que roncaban la zona más estrecha de la vía aérea superior fue la zona retro-palatal en la orofaringe. Los pacientes roncadores tenían un índice de masa corporal y diámetro cuello mayores y un área orofaríngea menor. En los exámenes dinámicos observamos que a medida que el grosor de los músculos parafaríngeos aumentó, disminuyó el área medial y lateral de la vía aérea y el área de la orofaringe. Conclusiones: La zona más estrecha de la vía aérea superior es la región retropalatal de la orofaringe, medida tanto con TC como con RM.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Oropharynx/abnormalities , Snoring/diagnostic imaging , Magnetic Resonance Imaging/methods , Tomography, X-Ray Computed/methods , Oropharynx/diagnostic imaging , Pharynx/abnormalities , Pharynx/diagnostic imaging , Snoring/physiopathology , Body Mass Index , Femur Neck/anatomy & histologyABSTRACT
BACKGROUND: Identifying the craniofacial abnormalities that cause snoring and the narrowest area of the upper airway creating obstructions can help to determine the proper method of treatment. AIM: To identify the factors that can cause snoring and the areas of the airway that are the most likely to collapse with upper airway imaging. MATERIAL AND METHODS: Axial pharynx examinations with CT (computerized tomography) and magnetic resonance imaging (MRI) were performed to 38 patients complaining of snoring and 12 patients who did not complain of snoring. The narrowest areas of nasopharynx, hypophraynx, oropharynx, bilateral para-pharyngeal fat pad and para-pharyngeal muscle thickness were measured. RESULTS: In snoring patients, the narrowest part of the upper airway was the retro-palatal region in the oropharynx, as measured with both imaging methods. When patients with and without snoring were compared, the former that a higher body mass index and neck diameter and a narrower oropharynx area. In dynamic examinations, we determined that as para-pharyngeal muscle thickness increased, medial-lateral airway diameter and the oropharynx area decreased. CONCLUSIONS: The narrowest section of the airway is the retro-palatal region of the oropharynx, measured both with CT and MRI.
Subject(s)
Magnetic Resonance Imaging/methods , Oropharynx/abnormalities , Snoring/diagnostic imaging , Tomography, X-Ray Computed/methods , Adolescent , Adult , Body Mass Index , Female , Femur Neck/anatomy & histology , Humans , Male , Middle Aged , Oropharynx/diagnostic imaging , Pharynx/abnormalities , Pharynx/diagnostic imaging , Snoring/physiopathology , Young AdultABSTRACT
Se presenta una descripción de las estructuras involucradas en el Síndrome de Eagle o síndrome la apófisis estiloides y sus manifestacionesclínico-radiográficas en referencia a un caso clínico, su diagnóstico diferencial y tratamiento. El objetivo de esta presentación es identificar al Síndrome de Eagle o Síndrome de la apófisis estiloides, mostrando sus características anatómicas, fisiológicas, su diagnóstico por imágenes y su tratamiento...
Subject(s)
Humans , Female , Pharynx/abnormalities , Syndrome , Hyoid Bone/abnormalities , Argentina , Skull/anatomy & histology , Dental Prosthesis , Diagnosis, Differential , Schools, Dental , Vertical DimensionABSTRACT
La mayoría de las infecciones profundas del cuello se originan a partir de un foco en la mucosa aerodigestiva superior o a partir de un foco dental, las anomalías congénitas corresponden sólo a 2 por ciento de las causas. La presentación clínica es bastante similar independientemente de la etiología y en muchas ocasiones no basta con la clínica para llegar a un correcto diagnóstico etiológico. La presencia de una infección del espacio profundo del cuello (IEPC) a repetición es altamente sugerente de una anomalía congénita de las cuales aproximadamente el 58 por ciento derivan del aparato faríngeo. De éstas, las provenientes del IV aparato faríngeo son extremadamente raras siendo más frecuentes en la niñez, en el lado izquierdo del cuello y en pacientes de sexo femenino. Estas IEPC de causa congénita también tienen una buena respuesta a la terapia antibiótica y/o al drenaje por lo tanto ello lo enmascara como un factor etiológico. Realizar el diagnóstico de anomalía del desarrollo del IV aparato faríngeo es difícil. Ellas son poco frecuente (1-2 por ciento de las anomalías congénitas) y clínicamente se presentan como abscesos recurrentes del espacio profundo del cuello, al lado Izquierdo, generalmente en la niñez, acompañados o no de una tiroiditis aguda supurada izquierda asociado al hallazgo del orificio persistente (seno) en el ápex del seno piriforme. Se comunican 3 pacientes con absceso cervical izquierdo secundario a una anomalía en el desarrollo del IV aparato faríngeo.
Subject(s)
Humans , Female , Child, Preschool , Child , Adult , Retropharyngeal Abscess/diagnosis , Retropharyngeal Abscess/therapy , Neck/pathology , Pharyngeal Diseases/complications , Pharynx/abnormalities , Bacterial Infections/diagnosis , Bacterial Infections/therapy , Retropharyngeal Abscess/etiology , Bacterial Infections/etiology , Soft Tissue Infections/diagnosis , Soft Tissue Infections/etiology , Soft Tissue Infections/therapy , RecurrenceABSTRACT
OBJECTIVES: To delineate feeding dysfunction in a population of children with a 22q11.2 deletion and report the associated findings noted during the modified barium swallow (MBS). STUDY DESIGN: Seventy-five children with a chromosome 22q11.2 deletion and history of persistent feeding difficulty received a feeding evaluation, including an MBS for those children for whom there was concern about airway penetration. RESULTS: A consistent pattern of feeding difficulty, independent of palatal or cardiac involvement, emerged from the evaluations. This group typically has trouble coordinating the suck/swallow/breath pattern, resulting in slow nipple feedings interrupted by gagging or regurgitation. Recurrent vomiting and constipation are common. With advancement to chewable table foods, gagging or refusal develops, related to an immature oral transport pattern. The MBS studies demonstrate pharyngeal hypercontractility, cricopharyngeal prominence, and/or diverticula. CONCLUSIONS: Because of the consistency of dysphagic symptoms and MBS findings, we propose that dysmotility, especially through the pharyngoesophageal segment, is central to the dysphagia affecting this group. Dysphagia related to dysmotility may be underdiagnosed in this population or erroneously attributed to cardiac disease. Therefore attention to feeding status and investigation with MBS and gastrointestinal studies as warranted are recommended for all patients with a 22q11.2 deletion and feeding problems.
Subject(s)
Abnormalities, Multiple , Chromosome Deletion , Chromosomes, Human, Pair 22 , Deglutition Disorders/physiopathology , DiGeorge Syndrome/complications , Abnormalities, Multiple/diagnostic imaging , Adolescent , Child , Child, Preschool , Deglutition , Deglutition Disorders/diagnostic imaging , Deglutition Disorders/etiology , Esophagus/abnormalities , Esophagus/diagnostic imaging , Female , Humans , Infant , Infant, Newborn , Male , Pharynx/abnormalities , Pharynx/diagnostic imaging , Radiography , SyndromeABSTRACT
Os autores realizam uma avaliçäo dos efeitos imediatos da prótese obturadora faríngica na fala e voz de 10 pacientes portadores de fissura palatina já submetidos à cirurgia plástica reparadora, mas que apresentavam insuficiência velofaríngica. A observaçäo dos dados permitiu concluir que a prótese obturadora faríngica eliminou a hipernasalidade e promoveu uma reduçäo quantitativa do escape de ar nasal durante o sopro e a fala, melhorando a qualidade da voz