Articles: postoperative-complications.
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Manofluorography (mano: manometry, fluoro: videofluoroscopy, graphy: picture) provides a simultaneous display of manometry and fluoroscopy on one video screen. This study uses manofluorography to analyze the swallowing patterns of nine patients who had undergone supraglottic laryngectomy. The results show that during swallowing the pharyngeal mechanism for preventing aspiration depends upon three processes: (1) tight lingual-laryngeal contact, (2) coordination of the swallowing reflex, and (3) tongue base and pharyngeal constrictor clearing of the hypopharynx and laryngeal inlet. ⋯ This close contact during deglutition protects the airway from the bolus and also opens the postcricoid region, aiding bolus passage into the esophagus. Impairment of the swallowing reflex, which can cause severe aspiration before the swallowing reflex is triggered, can be rehabilitated by swallowing therapy. Minor aspiration is commonly caused by impaired clearing of the superior hypopharynx after supraglottic laryngectomy.
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Following anaesthesia with halothane and succinylcholine, a 56-year-old patient relapsed into unconsciousness which was accompanied by an increase of body temperature to 42 degrees C and further symptoms indicative of malignant hyperpyrexia (MH). Although a diagnosis of MH could not be established, during subsequent anaesthesia, the patient was treated as an individual susceptible to MH. The problems of this policy and the need to elucidate the susceptibility to MH are discussed with reference to this case.
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Case Reports
The value of computed tomography in postoperative pneumothorax following open-heart surgery.
Two patients with postoperative pneumothorax following open-heart surgery are described. The diagnostic usefulness of computed tomography and chest roentgenogram in this complication is discussed.