Úvod: Flexibilní endoskopické vyšetření polykání (FEES) je jednou ze základních metod k objektivní diagnostice poruch polykání. Principem je polykání bolusů různých konzistencí pod endoskopickou kontrolou. Z dostupných údajů i našich zkušeností vyplývá, že kvalita a výtěžnost vyšetření závisí na viditelnosti testovaného bolusu. Cíl práce: Ověřit, zda použití fluoresceinu zlepšuje citlivost FEES vyšetření v porovnání se standardním potravinářským barvivem. Metodika: Ve studii jsme u 40 pacientů provedli FEES s polknutím vody obarvené zeleným potravinářským barvivem a vody obarvené fluoresceinem. Hodnocena byla přítomnost predeglutivního leaku, stagnace bolusu v hltanu (valekulách, na stěnách hltanu, piriformních recesech), průnik bolusu do dýchacích cest na základě Penetračně-aspirační škály podle Rosenbeka (PAS), tendence k penetraci přes zadní komisuru a také subjektivní porovnání obou metod ve sledovaných parametrech. Výsledky: Výsledky prokazují statisticky významně vyšší záchyt stagnace bolusu na stěnách hltanu (p < 0,001) a ve valekulách (p = 0,038) v případě tekutiny obarvené fluoresceinem. Při hodnocení průniku bolusu do dýchacích cest dosáhla hodnota reliability (spolehlivosti) statistické významnosti (k = 0,438; p < 0,001) mezi testovanými metodami (zelené barvivo oproti fluoresceinu), což svědčí pro dobrou citlivost obou metod. Na bodové škále podle Rosenbeka (1–8 bodů) se ale metody statisticky významně lišily v hodnocení závažnosti penetrace/aspirace (p = 0,001). Při použití fluoresceinu byla detekována statisticky významně větší hloubka průniku do dýchacích cest (PAS 3,13) než při použití zeleného barviva (PAS 2,10) (p = 0,001). Při subjektivním porovnání obou metod vyšetřujícím lékařem je statisticky významně lepší viditelnost fluoresceinu ve všech hodnocených parametrech. Závěr: Studie prokázala lepší senzitivitu FEES při použití fluoresceinu v porovnání s běžně používaným potravinářským barvivem. Fluorescein se jeví jako vhodné barvivo k vyšetřování poruch polykání.

Background: Flexible endoscopic evaluation of swallowing (FEES) is one of the basic methods for objective diagnostics of swallowing disorders. The principle is to swallow boluses of various consistencies under endoscopic control. According to available data and our experience, the quality and accuracy of the examination depends on the visibility of the tested bolus. Aim of the study: Verify that the use of fluorescein improves the sensitivity of the FEES compared to a standard food colouring. Methods: In the study, we performed FEES on 40 patients using green food colouring and fluorescein dyed water. The presence of pre-deglutive leak, bolus stagnation in the pharynx (valleculas, pharyngeal walls, piriform sinuses), bolus penetration into the airways based on the Rosenbek Penetration-Aspiration Scale (PAS), tendency to penetrate through the posterior commissure and subjective comparison of both methods in parameters mentioned above were evaluated. Results: The results show a statistically significantly higher detection of bolus stagnation on the pharyngeal walls (P <0.001) and in the epiglottic valleculas (P = 0.038) with fluorescein-dyed water. When assessing airway bolus penetration, the reliability value reached statistical significance (k = 0.438; P <0.001) between the tested methods (green food colouring vs. fluorescein), which indicates good sensitivity of both methods. However, on the Rosenbek score scale (1–8 points), the methods differed statistically significantly in the assessment of penetration/aspiration severity (P = 0.001). A statistically significantly greater depth of airway penetration was detected with fluorescein (PAS 3.13) compared to green food colouring (PAS 2.10) (P = 0.001). In a subjective comparison of both methods by the examining physician, the visibility of fluorescein is statistically significantly better in all evaluated parameters. Conclusions: The study showed a better sensitivity of FEES when using fluorescein compared to conventional food colouring. Fluorescein appears to be a good colouring for diagnostics of swallowing disorders.

• MeSH
• Staining and Labeling methods   MeSH
• Diagnostic Imaging methods   MeSH
• Adult MeSH
• Endoscopy classification   methods   MeSH
• Fluorescein * pharmacology   metabolism   MeSH
• Humans MeSH
• Oropharynx diagnostic imaging   pathology   MeSH
• Deglutition Disorders diagnostic imaging   diagnosis   etiology   MeSH
• Prospective Studies MeSH
• Pyriform Sinus diagnostic imaging   pathology   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Publication type
• Research Support, Non-U.S. Gov't MeSH

• MeSH
• Hypopharynx MeSH
• Larynx pathology   MeSH
• Humans MeSH
• Hearing Loss MeSH
• Respiratory Tract Diseases prevention & control   MeSH
• Nasopharyngeal Diseases classification   prevention & control   MeSH
• Nose Diseases * diagnosis   classification   prevention & control   MeSH
• Thyroid Diseases MeSH
• Ear Diseases * diagnosis   classification   prevention & control   MeSH
• Otitis MeSH
• Otolaryngology * MeSH
• Primary Prevention MeSH
• Tinnitus MeSH
• Inflammation MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

INTRODUCTION: Narrow Band Imaging (NBI) is an endoscopic optical imaging enhancement technology that improves the contrast of mucosal surface texture and enhances visualization of mucosal and submucosal vasculature. Due to its properties, it can visualize suspected malignant or precancerous lesions earlier than conventional white light endoscopy. The aim of this study was to analyze the benefit of NBI in visualization of precancerous and malignant lesions in preoperative and intraoperative diagnostics and correlation with histopathologic results. METHODS: A total of 589 patients with suspicious laryngeal or hypopharyngeal lesion were investigated using conventional white light endoscopy (WLE) and NBI endoscopy with high-definition TV (HDTV NBI) from 10/2013 to 12/2019. Patients were divided into two groups based on pre-operative NBI examination (group A, 345 patients) and intraoperative NBI examination (group B, 244 patients). All suspicious lesions were graded to 5 types of Ni classification and correlated with histopathologic results. The SPSS version 8.0.4 statistical software package was used for statistical analysis. In diagnosing premalignant and malignant lesions sensitivity, specificity, positive predictive value, and negative predictive value were calculated. RESULTS: The agreement between NBI endoscopy and histopathological analysis in group A was statistically significant (Қ = 0.76, p < 0.001), with a sensitivity of 86.2% (95% IS: 65.4-95.2) and specificity of 90.9% (95% IS: 70.6-94.1). Moreover, in group B was proven almost perfect agreement between NBI and histopathological analysis (Қ = 0.8461, p < 0.001), with a sensitivity of 84.0% (95% IS: 60.2-92.4) and specificity of 96.0% (95% IS: 87.0-99.2). CONCLUSIONS: Based on our results, NBI using the Ni classification has great potential in improving diagnosis of precancerous and malignant lesions and correlates strongly with histopathologic results. It serves as a useful adjunct to white light endoscopy in the diagnosis of laryngeal and hypopharyngeal lesions, especially using HDTV NBI.

• MeSH
• Diagnosis, Differential MeSH
• Adult MeSH
• Hypopharynx diagnostic imaging   MeSH
• Laryngoscopy MeSH
• Middle Aged MeSH
• Humans MeSH
• Pharyngeal Neoplasms diagnostic imaging   MeSH
• Laryngeal Neoplasms diagnostic imaging   MeSH
• Pharyngeal Diseases diagnostic imaging   MeSH
• Laryngeal Diseases diagnostic imaging   MeSH
• Predictive Value of Tests MeSH
• Precancerous Conditions diagnostic imaging   MeSH
• Prospective Studies MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Sensitivity and Specificity MeSH
• Narrow Band Imaging methods   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

• MeSH
• Respiratory System * anatomy & histology   MeSH
• Pharynx anatomy & histology   MeSH
• Hypopharynx anatomy & histology   MeSH
• Tongue anatomy & histology   MeSH
• Larynx anatomy & histology   blood supply   MeSH
• Humans MeSH
• Mandible anatomy & histology   innervation   blood supply   MeSH
• Maxilla anatomy & histology   innervation   blood supply   MeSH
• Nasopharynx anatomy & histology   MeSH
• Nasal Cavity anatomy & histology   MeSH
• Sleep Apnea, Obstructive physiopathology   MeSH
• Oropharynx anatomy & histology   innervation   blood supply   MeSH
• Paranasal Sinuses anatomy & histology   MeSH
• Check Tag
• Humans MeSH

• MeSH
• Hypopharynx surgery   MeSH
• Tongue anatomy & histology   surgery   MeSH
• Humans MeSH
• Sleep Apnea, Obstructive * surgery   MeSH
• Mouth surgery   MeSH
• Check Tag
• Humans MeSH

Introduction: Human papillomavirus (HPV) causes juvenile-onset recurrent respiratory papillomatosis (JORRP). Although HPV is common in children, the prevalence of JORRP is low. It is likely that other factors contribute to the pathogenesis of JORRP, during either activation or reactivation of a latent HPV infection. There is evidence that laryngopharyngeal reflux (LPR) might be such a risk factor for adult-onset recurrent respiratory papillomatosis. This study investigated if LPR might also be a risk factor for JORRP. Materials and Methods: Children with JORRP of the larynx that required microlaryngoscopy at a tertiary referral hospital were included in this prospective case-series study from November 2015 to November 2017. Using immunohistochemistry, HPV infection and pepsin associated with LPR were diagnosed from laryngeal biopsies. Results: Eleven children (aged 4-14 years) were analyzed. No patient had a history of immunodeficiency or tobacco smoke exposure. All patients underwent at least three previous surgeries due to JORRP and had been vaccinated against HPV in the past. Five children were treated using antivirotics and immunomodulators. The only known maternal risk factor was that three mothers were primiparous. All 11 samples were infected with HPV (type 6 or 11). Pathologic LPR was diagnosed in 5/11 children (45.5%). Conclusion: LPR may be a risk factor for JORRP, contributing to its development by activating or reactivating a latent HPV infection. Results are in accordance with those from our previous study in adults.

• MeSH
• Biopsy MeSH
• Child MeSH
• Adult MeSH
• Hypopharynx physiopathology   virology   MeSH
• Respiratory Tract Infections physiopathology   virology   MeSH
• Papillomavirus Infections physiopathology   virology   MeSH
• Laryngopharyngeal Reflux physiopathology   virology   MeSH
• Humans MeSH
• Adolescent MeSH
• Papillomaviridae pathogenicity   MeSH
• Child, Preschool MeSH
• Risk Factors MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

Polymorbidní 64letý pacient byl plánovaně hospitalizován na Oddělení rekonstrukční chirurgie KPRCH FN Brno. Pacient byl léčen pro neoplazii laryngu, a to chirurgicky laryngektomií, blokovou disekcí krčních uzlin, adjuvantní radioterapií s následným vznikem píštěle hypofaryngu. Nutrice pacienta byla zajištěna perkutánní endoskopickou gastrostomií (PEG), vyhotovena byla i permanentní tracheostomie. Po radikálním debridementu defektu a identifikaci příjmových cév – pravostranných arteria a vena mammaria interna, bylo rozhodnuto o rekonstrukci defektu hypofaryngu a ventrálního defektu krku volným muskulokutánním lalokem anterolateral thigh flap (ALT) ve variantě „tube in tube“. Pacient profitoval z uzavření defektu hypofaryngu, nastalo obnovení funkce hypofaryngu při příjmu potravy a hydratace per os, zvýšila se jeho tělesná hmotnost, byla zrušena PEG a gastrostomie byla uzavřena. V neposlední řadě pak pacient profitoval po stránce psychoemotivní a sociální.

Polymorbid 64 - year old patient was hospitalized at the Department of Reconstructive Surgery, University Hospital Brno. Thepatient was treated for laryngeal neoplasia surgically by laryngectomy and block dissection of cervical lymph nodes, adjuvantradiotherapy with subsequent development of hypopharyngeal fistula. Nutrition of the patient was ensured by percutaneousendoscopic gastrostomy (PEG) and permanent tracheostomy has been drawn. After radical debridement of defect and identificationof vessels – right internal mammary artery and right internal mammary vein the decision was made to reconstruct the defectof the hypopharynx and ventral cervical defect with free musculocutaneus anterolateral thigh flap (ALT) variant "tube in tube".The patient benefited from closure of the hypopharyngeal defect, restoration of hypopharyngeal function in ingestion and oralhydration occured, the body weight increased, PEG was closed. Finally, patient benefited from the procedure psychoemotionalyand socialy.

• Keywords
• ALT laloky,
• MeSH
• Radiotherapy, Adjuvant adverse effects   MeSH
• Esophagus surgery   MeSH
• Hypopharynx * surgery   pathology   MeSH
• Laryngectomy MeSH
• Middle Aged MeSH
• Humans MeSH
• Laryngeal Neoplasms surgery   radiotherapy   MeSH
• Respiratory Tract Fistula etiology   surgery   MeSH
• Postoperative Complications MeSH
• Free Tissue Flaps * MeSH
• Plastic Surgery Procedures methods   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Publication type
• Case Reports MeSH

• MeSH
• Adenoids MeSH
• Pharynx * anatomy & histology   MeSH
• Head MeSH
• Hypopharynx MeSH
• Palatine Tonsil anatomy & histology   MeSH
• Neck MeSH
• Humans MeSH
• Nasopharynx MeSH
• Oropharynx MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

• MeSH
• Diagnostic Techniques and Procedures MeSH
• Endoscopy methods   MeSH
• Pharynx * MeSH
• Hypopharynx MeSH
• Palatine Tonsil MeSH
• Laryngoscopy methods   MeSH
• Humans MeSH
• Nasopharynx MeSH
• Check Tag
• Humans MeSH
• Publication type
• Review MeSH

Diagnostika a léčba mimojícnových projevů refluxní choroby jícnu zaznamenaly v posledních dvou desetiletích významný rozvoj, který je v této knize popsán.

• MeSH
• Gastroesophageal Reflux MeSH
• Vocal Cords physiopathology   MeSH
• Hypopharynx physiopathology   MeSH
• Hydrogen-Ion Concentration MeSH
• Voice Disorders MeSH
• Signs and Symptoms, Digestive MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Fields
• gastroenterologie
• NML Publication type
• kolektivní monografie