This study aimed to determine the efficacy of carbonated and sweetened drinks added to thickened liquids, which are routinely used for patients with dysphagia to improve dysphagia. Patients swallowed thin liquid (Thin), thickened liquid (Thick), carbonated thin drink (C-Thin), and carbonated thickened drink (C-Thick) in random order. Penetration and/or aspiration were scored using the Penetration–Aspiration Scale (PAS). The residue was scored using the Yale Pharyngeal Residue Severity Rating Scale (YPR-SRS). Swallowing reflex initiation was scored using the Hyodo score. The subjective difficulty of swallowing was scored on a face scale. We analyzed 13 patients with a mean age of 79.6 ± 9.6 years. PAS was significantly lower in the C-Thick group than the Thin group (p < 0.05). Swallowing reflex initiation was significantly different between the Thin and Thick (p < 0.01) groups; moreover, post hoc analysis revealed that it was significantly lower in the C-Thick group than the Thin group (p < 0.01). The subjective difficulty of swallowing in the C-Thick was significantly lower than the Thick group (p < 0.05). C-Thick was easier to swallow than Thick and may improve penetration and/or aspiration in older patients with dysphagia with complex diseases.
Primary nasopharyngeal Hodgkin lymphoma (HL) is a rare, but important differential diagnosis of nasopharyngeal tumors. If not diagnosed early and correctly, it may cause life-threatening complications and be difficult to treat. We report the case of a patient with nasopharyngeal tumor, in whom the diagnosis of primary nasopharyngeal HL was established by partial resection. We also provide a review of published reports on primary nasopharyngeal HL. A 32-year-old Japanese man presented to us with the chief complaint of nasal obstruction, which was diagnosed as being caused by a nasopharyngeal tumor. The nasopharyngeal tumor biopsy was negative, therefore, partial resection of the nasopharyngeal tumor was performed. Histopathological examination of the resected specimen showed Reed-Sternberg cells and immunohistochemistry showed positive staining for CD30, which confirmed the diagnosis of classical HL, mixed cellularity type. He was treated by involved field radiation therapy (IFRT) alone, to avoid azoospermia. Until now, 10 months since the completion of treatment, good local control is maintained. Nasopharyngeal HL should be included in the differential diagnosis of a nasopharyngeal mass and may be diagnosed by partial resection in the event of failure of diagnosis at the initial biopsy.
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