Preoperative Assessment of Esophageal Function

Purpose The purpose of this tutorial was to describe the surgical management of palate-related abnormalities associated with 22q11.2 deletion syndrome. Craniofacial differences in 22q11.2 deletion syndrome may include overt or occult clefting of the palate and/or lip along with oropharyngeal variances that may lead to velopharyngeal dysfunction. This chapter will describe these circumstances, including incidence, diagnosis, and indications for surgical intervention. Speech assessment and imaging of the velopharyngeal system will be discussed as it relates to preoperative evaluation and surgical decision making. Important for patients with 22q11.2 deletion syndrome is appropriate preoperative screening to assess for internal carotid artery positioning, cervical spine abnormalities, and obstructive sleep apnea. Timing of surgery as well as different techniques, common complications, and outcomes will also be discussed. Conclusion Management of velopharyngeal dysfunction in patients with 22q11.2 deletion syndrome is challenging and requires thoughtful preoperative assessment and planning as well as a careful surgical technique.

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The spectrum of esophageal function disorders in patients suspected to have gastroesophageal reflux disease (GERD): A 3 year experience of an interdisciplinary GI function laboratory

Gastroenterology ◽

10.1016/s0016-5085(01)81091-x ◽

2001 ◽

Vol 120 (5) ◽

pp. A219-A219

Author(s):

U MATSUI ◽

T STRATE ◽

C BLOECHLE ◽

J IZBICKI ◽

T VONSCHRENCK

Keyword(s):

Gastroesophageal Reflux Disease ◽

Gastroesophageal Reflux ◽

Reflux Disease ◽

Esophageal Function

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Esophageal function in normal volunteers and patients with ineffective esophageal motifity (IEM) assessed through combined multichannel intraluminal impedance and manometry (MIL/EM)

Gastroenterology ◽

10.1016/s0016-5085(01)83143-7 ◽

2001 ◽

Vol 120 (5) ◽

pp. A632-A632 ◽

Cited By ~ 1

Author(s):

M VELA ◽

R TUTUIAN ◽

L BAIDOO ◽

M GIDEON ◽

P KATZ ◽

...

Keyword(s):

Multichannel Intraluminal Impedance ◽

Esophageal Function ◽

Normal Volunteers ◽

Intraluminal Impedance

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The role of esophageal function testing in patients with laryngopharyngeal symptoms

Zeitschrift für Gastroenterologie ◽

10.1055/s-0035-1551858 ◽

2015 ◽

Vol 53 (05) ◽

Author(s):

K Gyorgyev ◽

A Rudas ◽

I Wagner ◽

Á Altorjay ◽

F Izbéki

Keyword(s):

Esophageal Function ◽

Esophageal Function Testing ◽

Function Testing

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Open Reduction for Dorsal Dislocation of Second to Fifth Carpometacarpal Joints: A Case Report

Journal of Wrist Surgery ◽

10.1055/s-0040-1715802 ◽

2020 ◽

Author(s):

Hiroo Kimura ◽

Akira Toga ◽

Taku Suzuki ◽

Takuji Iwamoto

Keyword(s):

Closed Reduction ◽

Open Reduction ◽

Delayed Diagnosis ◽

Preoperative Assessment ◽

Radiographic Examination ◽

Clinical Images ◽

Left Hand ◽

Carpometacarpal Joints ◽

Joint Deformity ◽

Poor Outcomes

Abstract Background Fracture-dislocations of all four ulnar (second to fifth) carpometacarpal (CMC) joints are rare hand injuries and frequently overlooked or missed. These injuries can be treated conservatively when closed reduction is successfully achieved, though they are sometimes irreducible and unstable. Case Description We report the case of a 17-year-old boy involved in a vehicular accident. Clinical images showed dorsal dislocation of all four ulnar CMC joints of the left hand associated with a fracture of the base of the fourth metacarpal. Although closed reduction was attempted immediately, the affected joints remained unstable and easily redislocated. Therefore, we performed open reduction and percutaneous fixation of all ulnar CMCs. He showed excellent recovery after 1 year postoperatively, reported no pain, and demonstrated complete grip strength and range of motion of the affected wrist and fingers. Literature Review Accurate clinical diagnosis of this lesion is difficult because of polytrauma, severe swelling masking the dislocated CMC joint deformity, and overlapping of adjacent metacarpals and carpal bones on radiographic examination. As for the treatment strategy, it has yet to obtain a consensus. Some reports value open reduction to guarantee anatomical reduction, and it is definitely needed in the patients with interposed tissues to be removed or with subacute and chronic injuries. Clinical Relevance Delayed diagnosis or treatment could lead to poor outcomes. Therefore, surgeons must be aware that precise preoperative assessment is critical, and anatomical open reduction of interposed bony fragments, like our case, may be required even in an acute phase.

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