Posterior Cricoid Region Fluoroscopic Findings: The Posterior Cricoid Plication

The region posterior to the cricoid cartilage is challenging to assess fluoroscopically. The purpose of this investigation is to critically evaluate the posterior cricoid (PC) region on fluoroscopy and describe patterns of common findings. This was a case control study. All fluoroscopic swallowing studies performed between June 16, 2009, and February 9, 2010, were reviewed for features seen in the PC region. These findings were categorized into distinct patterns and compared to fluoroscopic studies performed in a cohort of normal volunteers. Two hundred patient studies and 149 healthy volunteer studies were reviewed. The mean age of the referred patient cohort and the volunteer cohort was 57 years (±19) and 61 years (±16), respectively (p > 0.05). The patient cohort was 53% male and the control cohort was 56% female (p > 0.05). Four groups were identified. Pharyngoesophageal webs were seen in 7% (10/149) of controls and 14% (28/200) of patients (p = 0.03). A PC arch impression was seen in 16% of patients (32/200) and controls (24/149) (p = 1). A PC plication was demonstrated in 23% (34/149) of controls and 30% (60/200) of patients (p = 0.13). No distinctive PC region findings were seen in 54% (81/149) of controls and 42% (84/200) of referred patients (p = 0.02). Four patients (2%) had both a web and a PC plication. Four categories of PC region findings were identified (unremarkable PC region, web, PC arch impression, and PC plication). Both patients referred for swallowing studies and healthy volunteers demonstrated esophageal webs, PC arch impressions, and PC plications. Only webs were more common in patients than in control subjects (p = 0.03). The PC impression and PC plication are likely to represent normal variants that may be identified on fluoroscopic swallow studies.

from Dysphagia

Mental health after laryngectomy and partial laryngectomy: a comparative study

Patients treated for laryngeal cancer are confronted daily with the effects of the operation. The choice of treatment method can have a significant impact on psychosocial adjustment. Three hundred and six out-patients who underwent surgical treatment for laryngeal cancer within the last two decades were interviewed in their own homes using the structured clinical interview for DSM-IV (SCID). Psychiatric disorders were diagnosed among 17.3% of the partial laryngectomy patients (PL) and 22.2% of the patients with total laryngectomy (LE). In comparing four variables (age, time elapsed since diagnosis, gender and subjective speech intelligibility), subjective speech intelligibility and age were the variables with a unique, significant effect on the frequency of psychiatric disorders, albeit only in the case of PL patients. The need for psychosocial rehabilitation for patients with partial laryngectomy tends to be underestimated. It is concluded that screening for psychological variables and subjective speech intelligibility can be beneficial for the identification of out-patients lacking appropriate treatment.

from ORL -Journal for Oto-Rhino-Laryngology and Its Related Specialties

Use of context in the word recognition process by adults with a significant history of reading difficulties

from Annals of Dyslexia

Abstract We examined whether university students who report a significant history of reading difficulties (RD; n = 24) differed from university students with no history of reading difficulties (NRD; n = 31) in how sentence context affects word recognition. Experiment 1 found no differences in how congruent sentence primes or syntactic manipulations of the sentence primes affected the performance of the two groups. However, only the RD group displayed a significant inhibition effect when the target word was preceded by an incongruent sentence prime. Experiment 2 found that the groups differed in how meaning frequency of the target word and context strength of the sentence prime affected word recognition latencies. The results suggest that the RD participants’ performance is context-sensitive and better explained by interactive models of language processing than by modular models.