REFLUXO GASTROESOFAGICO E SINTOMAS OTORRINOLARINGOLOGICOS

Gastroesophageal reflux and other gastroesophageal diseases produce symptoms in head and neck region leading individuals to search for ear nose and throat consultation. Otolaryngologist may incorporate investigation of reflux in your daily practice. Comments of gastroesophageal reflux and head and neck complaints are done. To illustrate handling of patients suspected of reflux authors relates a case of a dysphagia patient. Close relationship between otolaryngologist and gastroenterologist in reflux investigation is emphasized.

MANIPULANDO A DISFAGIA DE ORIGEN FARINGOESOFAGICA

Non-neoplastic dysphagia originated from motor deficit in the pharynx and from several disorders in the upper esophagus is studied taking into account the basic mechanisms of deglutition in the pharingoesophageal segment. Three groups of patients with dysphagia were investigated with the purpose of discussing the causes of ths symptom. Clinical examinations and electromanometry of the upper digestive tree, test of the laringeal elevation and clinical test of the bolus propulsion through pharynx were carried out. Emotional alterations, gastroesophageal lesions and motor disturbances in the digestive tree, among other, may cause dysphagia and other associated and secondary symptoms. This study points out the role of Otolaryngology in the investigation of swallowing disorders.

Histoplasmose do esôfago: Relato de caso

The authors report a case of a patient with complaint of progressive disphagia. Stenoses of lower third of esophagus was revealed by radiological and endoscopic examinations. Fungi were showed in biopsy of lesion, with demonstration of Histoplasm capsulate by tissue culture. Endoscopic dilatation was performed because especific medical treatment failed but esophageal rupture was observed. Partial esophagectomy was performed with symptoms remission.

Disfagia e alterações emocionais

Swallowing function may be impaired by a number of conditions involving primary or associated emotional distress. When psychogenic dysphagia is suspected, routine investigation using radiological and manometric examination is inappropriate. These cases demand an evaluation of the individual as a whole, interesting the disease as well as the patient's personal problems and concerns. Five cases of patients complaining of swallowing difficulty and showing concurrent emotional distress were studied. Four individuals were anxious and one was depressed. Because of our approach, a close medical-patient-relationship was established. Afterwards, an explanation about the normal swallowing mechanisms and the role of the emotions on it was provided. All patients showed improvement of the symptom in the following 24 hours. Dysphagia can be found in anxiety, depression and conversion hysteria, with high incidence in the urban population of the third world countries. However, several professionals are unaware of these disorders. Our results suggest that this plain approach is an useful tool in managing dysphagic patients and it has validity even in individuals bearing dysphagia due to comproved organic disease. The results also emphasize the importance of the medical patient relationship and the utility of a hollistic evaluation of the disease.

Investigacao clinica da disfagia orofaringea

The accurate investigation of the oropharyngeal dysphagia demands a systematic sequence of physical examinations. The aim of the present work is to propose a practical rule to facilitate the clinical investigation and the management of dysphagic patients. After a detailed anamnesis, an endoscopic examination is carried out and several manouvers to observe the oral, pharyngeal and laryngeal functions are performed by the patient. Following, a second endoscopy is performed during swallows of several consistencies of food, to verify the impairment of the laryngeal and or pharyngeal activities. The elevation of the laryngeal cartilage is also evaluated.