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Sungwon Na - One of the best experts on this subject based on the ideXlab platform.
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rigid laryngoscope assisted insertion of transesophageal echocardiography probe reduces oropharyngeal mucosal injury in anesthetized patients
Anesthesiology, 2009Co-Authors: Sungwon NaAbstract:Background: Intraoperative transesophageal echocardiography has become a routine part of monitoring in patients with cardiac disease. However, insertion of a transesophageal echocardiography probe can be associated with oropharyngeal, esophageal, and gastric injuries. The purpose of this study was to determine whether insertion of a transesophageal echocardiography probe under direct laryngoscopic visualization can reduce the incidence of oropharyngeal mucosal injury. Methods: Eighty patients undergoing surgery with general anesthesia were randomly allocated to either the conventional group, in which the probe was inserted blindly, or the laryngoscope group, in which a rigid laryngoscope was used to visualize the passage of the probe. The incidence of oropharyngeal mucosal injury, the number of insertion attempts, and Odynophagia were assessed. Results: There was no significant difference in demographic and hemodynamic parameters between the 2 groups. The incidence of oropharyngeal mucosal injury was higher in the conventional group than in the laryngoscope group (55% vs. 5%, P < 0.05). The incidence of Odynophagia was higher in the conventional group than in the laryngoscope group (32.5% vs. 2.5%, P < 0.05). The number of insertion attempts was also higher in the conventional group than in the laryngoscope group. Conclusion: Rigid laryngoscope-assisted insertion of the transesophageal echocardiography probe reduces the incidence of oropharyngeal mucosal injury, Odynophagia, and the number of insertion attempts.
K Besherdas - One of the best experts on this subject based on the ideXlab platform.
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PTU-051 Odynophagia – A Symptom Worth Asking About?
Gut, 2014Co-Authors: S Subramaniam, G Goodchild, K BesherdasAbstract:Introduction Odynophagia can be defined as a painful sensation in the oesophageal region that occurs in relation to swallowing. Unlike dysphagia, which has historically been an alarm symptom or warning sign of oesophageal cancer, Odynophagia is not classified as an alarm symptom and does not form part of the suspected upper gastrointestinal (GI) cancer referral form in the UK. Endoscopy is the gold standard imaging modality for the diagnosis of mucosal lesions in the oesophagus. However, there is no clear data regarding the findings at endoscopy in patients scoped for Odynophagia. Mucosal abnormalities even in the presence of typical symptoms of gastro-oesophageal reflux disease, namely heartburn and regurgitation are absent in up to 70%. We hypothesise that the presence of Odynophagia has a high predictive value of mucosal abnormality at endoscopy and aimed to assess the findings at endoscopy for patients scoped for Odynophagia. Methods A retrospective analysis of all patients who underwent upper GI endoscopy for Odynophagia as a primary symptom over an 8-year period (2005–2013) within an NHS Trust in north London was performed. Data was obtained from the Unisoft Endoscopy reporting software. The findings at endoscopy in patients with Odynophagia were scrutinised. Results 50 patients were endoscoped for Odynophagia during the study period. 34 of 50 patients (68%) had oesophageal mucosal lesions (4 Barrett’s mucosa, 2 candida oesophagitis, 14 reflux oesophagitis, 6 malignant tumour, 5 oesophageal stricture, 3 oesophageal ulcers). 12% (6 of 50) had oesophageal cancer. A further 10 had hiatus hernia, 1 had a motility disorder and 1 had oesophageal diverticulum. Conclusion From this study, 68% of patients endoscoped for Odynophagia have a positive endoscopic mucosal abnormality. Odynophagia as a symptom has a high sensitivity for abnormal endoscopy. 12% of patients endoscoped for Odynophagia had oesophageal cancer. This prevalence is similar to the diagnosis of cancer in patients referred on the ‘two week wait upper GI cancer referral form’. We recommend the symptom of Odynophagia be classified as an alarm symptom and those presenting with Odynophagia all undergo upper GI endoscopy to define the exact mucosal abnormality and exclude oesophageal cancer. Disclosure of Interest None Declared.
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ptu 051 Odynophagia a symptom worth asking about
Gut, 2014Co-Authors: S Subramaniam, G Goodchild, K BesherdasAbstract:Introduction Odynophagia can be defined as a painful sensation in the oesophageal region that occurs in relation to swallowing. Unlike dysphagia, which has historically been an alarm symptom or warning sign of oesophageal cancer, Odynophagia is not classified as an alarm symptom and does not form part of the suspected upper gastrointestinal (GI) cancer referral form in the UK. Endoscopy is the gold standard imaging modality for the diagnosis of mucosal lesions in the oesophagus. However, there is no clear data regarding the findings at endoscopy in patients scoped for Odynophagia. Mucosal abnormalities even in the presence of typical symptoms of gastro-oesophageal reflux disease, namely heartburn and regurgitation are absent in up to 70%. We hypothesise that the presence of Odynophagia has a high predictive value of mucosal abnormality at endoscopy and aimed to assess the findings at endoscopy for patients scoped for Odynophagia. Methods A retrospective analysis of all patients who underwent upper GI endoscopy for Odynophagia as a primary symptom over an 8-year period (2005–2013) within an NHS Trust in north London was performed. Data was obtained from the Unisoft Endoscopy reporting software. The findings at endoscopy in patients with Odynophagia were scrutinised. Results 50 patients were endoscoped for Odynophagia during the study period. 34 of 50 patients (68%) had oesophageal mucosal lesions (4 Barrett’s mucosa, 2 candida oesophagitis, 14 reflux oesophagitis, 6 malignant tumour, 5 oesophageal stricture, 3 oesophageal ulcers). 12% (6 of 50) had oesophageal cancer. A further 10 had hiatus hernia, 1 had a motility disorder and 1 had oesophageal diverticulum. Conclusion From this study, 68% of patients endoscoped for Odynophagia have a positive endoscopic mucosal abnormality. Odynophagia as a symptom has a high sensitivity for abnormal endoscopy. 12% of patients endoscoped for Odynophagia had oesophageal cancer. This prevalence is similar to the diagnosis of cancer in patients referred on the ‘two week wait upper GI cancer referral form’. We recommend the symptom of Odynophagia be classified as an alarm symptom and those presenting with Odynophagia all undergo upper GI endoscopy to define the exact mucosal abnormality and exclude oesophageal cancer. Disclosure of Interest None Declared.
Yan Xiansh - One of the best experts on this subject based on the ideXlab platform.
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rigid laryngoscope assisted insertion of transesophageal echocardiography probe in reducing oropharyngeal mucosal injury
Chinese General Practice, 2010Co-Authors: Yan XianshAbstract:Objective To observe the role of rigid laryngoscope-assisted insertion of transesophageal echocardiography(TEE) probe in reducing the incidence of oropharyngeal mucosal injury.Methods Eighty patients receiving uterine myoma surgery under general anesthesia were divided into groups routine,laryngoscope,40 in each.In routine group,TEE probe was blindly intubated under general anesthesia,while in laryngoscope group TEE probe intubated into esophagus after laryngoscope was seen at esophageal entrance.The attempts of TEE probe insertion,oropharyngeal mucosal injury and Odynophagia were recorded in 2 groups during operation.Results Routine group were significantly different from laryngoscope group in TEE probe insertion attempts(1.4±0.5,1.1±0.4,respectively),incidence of bloody TEE probe(37.5%,2.5%,respectively),oropharyngeal mucosal injury(55.0%,5.0%,respectively),Odynophagia(32.5%,2.5%,respectively)(P0.05).Conclusion Rigid laryngoscope-assisted insertion of transesophageal echocardiography probe reduces the incidence of oropharyngeal mucosal injury,Odynophagia,and TEE probe insertion attempts.
Chinchen Chang - One of the best experts on this subject based on the ideXlab platform.
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subcutaneous emphysema after dental procedure
QJM: An International Journal of Medicine, 2011Co-Authors: Chinchen ChangAbstract:A previously healthy 59-year-old woman presented to the emergency department with facial swelling and tenderness around the left eye, which developed 1 h after a root canal treatment of the lower third molar teeth under local anesthesia. She denied dysphagia, Odynophagia, chest tightness or respiratory distress. A non-contrast enhanced …
S Subramaniam - One of the best experts on this subject based on the ideXlab platform.
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PTU-051 Odynophagia – A Symptom Worth Asking About?
Gut, 2014Co-Authors: S Subramaniam, G Goodchild, K BesherdasAbstract:Introduction Odynophagia can be defined as a painful sensation in the oesophageal region that occurs in relation to swallowing. Unlike dysphagia, which has historically been an alarm symptom or warning sign of oesophageal cancer, Odynophagia is not classified as an alarm symptom and does not form part of the suspected upper gastrointestinal (GI) cancer referral form in the UK. Endoscopy is the gold standard imaging modality for the diagnosis of mucosal lesions in the oesophagus. However, there is no clear data regarding the findings at endoscopy in patients scoped for Odynophagia. Mucosal abnormalities even in the presence of typical symptoms of gastro-oesophageal reflux disease, namely heartburn and regurgitation are absent in up to 70%. We hypothesise that the presence of Odynophagia has a high predictive value of mucosal abnormality at endoscopy and aimed to assess the findings at endoscopy for patients scoped for Odynophagia. Methods A retrospective analysis of all patients who underwent upper GI endoscopy for Odynophagia as a primary symptom over an 8-year period (2005–2013) within an NHS Trust in north London was performed. Data was obtained from the Unisoft Endoscopy reporting software. The findings at endoscopy in patients with Odynophagia were scrutinised. Results 50 patients were endoscoped for Odynophagia during the study period. 34 of 50 patients (68%) had oesophageal mucosal lesions (4 Barrett’s mucosa, 2 candida oesophagitis, 14 reflux oesophagitis, 6 malignant tumour, 5 oesophageal stricture, 3 oesophageal ulcers). 12% (6 of 50) had oesophageal cancer. A further 10 had hiatus hernia, 1 had a motility disorder and 1 had oesophageal diverticulum. Conclusion From this study, 68% of patients endoscoped for Odynophagia have a positive endoscopic mucosal abnormality. Odynophagia as a symptom has a high sensitivity for abnormal endoscopy. 12% of patients endoscoped for Odynophagia had oesophageal cancer. This prevalence is similar to the diagnosis of cancer in patients referred on the ‘two week wait upper GI cancer referral form’. We recommend the symptom of Odynophagia be classified as an alarm symptom and those presenting with Odynophagia all undergo upper GI endoscopy to define the exact mucosal abnormality and exclude oesophageal cancer. Disclosure of Interest None Declared.
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ptu 051 Odynophagia a symptom worth asking about
Gut, 2014Co-Authors: S Subramaniam, G Goodchild, K BesherdasAbstract:Introduction Odynophagia can be defined as a painful sensation in the oesophageal region that occurs in relation to swallowing. Unlike dysphagia, which has historically been an alarm symptom or warning sign of oesophageal cancer, Odynophagia is not classified as an alarm symptom and does not form part of the suspected upper gastrointestinal (GI) cancer referral form in the UK. Endoscopy is the gold standard imaging modality for the diagnosis of mucosal lesions in the oesophagus. However, there is no clear data regarding the findings at endoscopy in patients scoped for Odynophagia. Mucosal abnormalities even in the presence of typical symptoms of gastro-oesophageal reflux disease, namely heartburn and regurgitation are absent in up to 70%. We hypothesise that the presence of Odynophagia has a high predictive value of mucosal abnormality at endoscopy and aimed to assess the findings at endoscopy for patients scoped for Odynophagia. Methods A retrospective analysis of all patients who underwent upper GI endoscopy for Odynophagia as a primary symptom over an 8-year period (2005–2013) within an NHS Trust in north London was performed. Data was obtained from the Unisoft Endoscopy reporting software. The findings at endoscopy in patients with Odynophagia were scrutinised. Results 50 patients were endoscoped for Odynophagia during the study period. 34 of 50 patients (68%) had oesophageal mucosal lesions (4 Barrett’s mucosa, 2 candida oesophagitis, 14 reflux oesophagitis, 6 malignant tumour, 5 oesophageal stricture, 3 oesophageal ulcers). 12% (6 of 50) had oesophageal cancer. A further 10 had hiatus hernia, 1 had a motility disorder and 1 had oesophageal diverticulum. Conclusion From this study, 68% of patients endoscoped for Odynophagia have a positive endoscopic mucosal abnormality. Odynophagia as a symptom has a high sensitivity for abnormal endoscopy. 12% of patients endoscoped for Odynophagia had oesophageal cancer. This prevalence is similar to the diagnosis of cancer in patients referred on the ‘two week wait upper GI cancer referral form’. We recommend the symptom of Odynophagia be classified as an alarm symptom and those presenting with Odynophagia all undergo upper GI endoscopy to define the exact mucosal abnormality and exclude oesophageal cancer. Disclosure of Interest None Declared.
