Postswallow aspiration secondary to stenosis of the upper esophageal sphincter.A 73-year-old man came to our center seeking care for dysphagia and aspiration 2 months after he had experienced a cerebrovascular accident. He was dependent on a percutaneous endoscopic gastrostomy percutaneous endoscopic gastrostomy See PEG. tube. A fiberoptic endoscopic evaluation of swallowing with sensory testing revealed pooling in the posterior glottis glottis /glot·tis/ (glot´is) pl. glot´tides [Gr.] the vocal apparatus of the larynx, consisting of the true vocal cords and the opening between them.glot´tal glot·tis n. pl. and pyriform pyriform pear-shaped. pyriform apparatus pair of triangular structures in the eggs of anoplocephalid tapeworms surrounding the oncosphere. sinuses with postswallow aspiration and evidence of outlet obstruction at the level of the cricopharyngeal segment. Laryngeal sensory thresholds were normal (<4 mm Hg). A modified barium swallow examination confirmed the postswallow aspiration and revealed a stenotic cricopharyngeal segment. Figures 1 through 5 are photographs obtained during the barium swallow examination showing the series of events during swallowing. The patient underwent bougie Bougie: see Bejaïa, Algeria. (60 French Maloney) dilation of the upper esophageal sphincter The upper esophageal sphincter (UES) refers to the superior portion of the esophagus. Unlike the lower esophageal sphincter, it is comprised of striated muscle and is under conscious control. . Postoperatively, the patient was treated with transcutaneous electrical stimulation. He is currently tolerating a regular diet by mouth without difficulty. [FIGURES 1-5 OMITTED] |
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