The results indicate that unilateral stroke of either cerebral hemisphere can produce dysphagia. Effective recovery is associated with cerebral activation related to cortical swallowing representation in the compensating or recruited areas of the intact hemisphere. Functional MRI is a useful method for exploring the spatial localisation of changes in neuronal activity during tasks that may be related to recovery. Therefore, the subsequent information gleaned from changes in neural plasticity could be useful for assessing the prognosis of dysphagic stroke.

Our results indicate that dysphagia secondary to stroke is associated with disruptive functional and structural integrity in the large-scale brain networks involved in motor control, thus providing new insights into the neural remodeling associated with this disorder.

The purpose of this study was to explore cerebral structural and functional changes in amyotrophic lateral sclerosis (ALS) patients with or without dysphagia compared with healthy adults. In total, five ALS patients with dysphagia, five ALS patients without dysphagia and 10 healthy controls were evaluated using diffusion tensor magnetic resonance imaging (DTI) and event-related functional magnetic resonance imaging (fMRI) while laryngeal swallow-related movements were recorded. The fMRI data were analysed using the general linear model to gain the differential statistical map (two-sample t-test) for each group. Maps of fractional anisotropy (FA) and mean diffusivity (MD) were calculated within the masks that corresponded to the different statistical functional maps of intergroup comparisons. During the voluntary saliva swallowing, prominent activation of foci corresponded to the primary sensorimotor (SM) cortex in both ALS and controls, while decreased activation of the SM cortex was observed in ALS patients with dysphagia. DTI analysis revealed that FA was significantly reduced and MD was typically increased in the posterior limb of the internal capsule, thalamus, and anterior cingulate gyrus, as well as in the insula of ALS patients compared with controls. However, in ALS patients with dysphagia, FA and MD were more sensitive to these changes than ALS patients without dysphagia. This study highlights the potential of DTI and fMRI for monitoring structural degeneration and functional changes in patients with ALS. This study is the first to demonstrate that cerebral activation map changes correspond to distribution patterns of diffusion abnormalities. Combined non-invasive neuroimaging techniques may be useful tools to assess prognosis and study rehabilitation strategies for dysphagic ALS patients, especially for patients who are MRI-negative by conventional methods.

Purpose. To present the safety and effect of endoscopic transethmosphenoid optic canal decompression (ETOCD) for indirect traumatic optic neuropathy (ITON) patients with no-light-perception (NLP). Methods. A retrospective study performed on 96 patients (96 eyes) with NLP after ITON between June 1, 2010, and June 1, 2015, who underwent ETOCD, was reviewed. Visual outcome before and after treatment was taken into comparison. Results. The overall visual acuity improvement rate after surgery was 46.9%. The improvement rates of visual acuity of patients who received treatment within 3 days of injury, 3–7 days after injury, and later than 7 days were 63.6%, 42.9%, and 35.7%, respectively. Statistically significant difference was detected between the effective rates of within-3-day group and later-than-7-day group (χ 2 = 5.772, P = 0.016). The effective rate of atrophy group and nonatrophy group was 25.0% and 51.3%, respectively. The effective rate was significantly higher in nonatrophy group (χ 2 = 4.417, P = 0.036). Conclusion. For patients suffering from ITON with NLP, time to medical treatment within 3 days is an influential factor for visual prognosis. Optic nerve atrophy is an important predictor for visual prognosis. Treatment should still be recommended even for cases of delayed presentation to hospital.

Objectives: To compare the results of immediate endoscopic dacryocystorhinostomy (En-DCR) and delayed En-DCR in the treatment of new-onset acute dacryocystitis (AD).Study Design: This report describes a prospective randomized controlled interventional case series. Methods: Between April 2009 and May 2019, 176 adults presenting at a tertiary eye care center with new-onset AD manifesting within the last 48 hours were randomized into two groups. Altogether, 160 patients (48 male, 112 female) were included in this study, with a median age of 52.8 years (range: 18-82). Patients in group A underwent urgent En-DCR, although those in group B underwent a delayed En-DCR after 2 to 5 days of systematic antibiotic treatment. Variables compared between these two groups included the time for resolution of acute external inflammation, free lacrimal passage reconstruction (LPR) success rates, and complication rates.Results: Postoperative data were collected from 86 patients in group A and 74 patients in group B. Patients that underwent immediate En-DCR exhibited a quicker resolution of acute inflammation (P < .05). Patients that underwent delayed surgery experienced compilations of acute inflammation, with 10 ultimately developing skin fistulization and 4 exhibiting orbital cellulitis before surgery. The success rate of LPR at 12 months after surgery was higher in group A (81/86 94.2%) relative to group B (62/74 83.8%; P < .05).Conclusions: Immediate En-DCR is associated with quicker disease resolution and a higher long-term success rate, although reducing the incidence of complications including skin fistulization and the spread of infection.

No abstract

No abstract

AIM: To establish the necessity of silicone tube intubation in acute dacryocystitis (AD) patients undergoing endonasal endoscopic dacryocystorhinostomy (En-DCR). METHODS: Patients presenting with unilateral AD were randomly assigned to two treatment groups. En-DCR procedures were performed following lacrimal abscess formation, with the operation being performed with silicone intubation for patients in group B but not group A. Functional success was defined by an absence of additional AD episodes, no epiphora, and ostium patency as established via endoscopic evaluation or fluorescein irrigation. Operative success rates and demographic variables were compared between treatment groups. RESULTS: In total, 66 patients were analyzed in the present study (33 per group), with complete postoperative data having been successfully collected from 27 and 22 patients in group A and group B, respectively. All patients exhibited complete resolution of acute inflammation. Upon follow-up, granulation tissue was detected around the ostium at higher rates in group B (9/22, 40.9%) relative to group A (4/27, 14.8%). At the 12-month follow-up time point, patients in group A exhibited higher success rates (25/27, 92.6%) relative to patients in group B (20/22, 90.9%), but this difference was not significant. Cases of lacrimal passage reconstruction failure in both groups were attributed to excessive fibrous and/or granulation tissue formation proximal to the intranasal ostium. CONCLUSION: Given that these two operative approaches are associated with similar rates of operative success and in light of differences in granulation tissue formation, cost, and operative duration, these data do not support the routine silicone intubation of AD patients following En-DCR surgery.