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[Dysphagia] Re: Clivus meningioma
Message: 3
Date: Tue, 2 Aug 2005 12:43:09 +0100
From: Paula leslie
Subject: FWD: RE: [Dysphagia] Clivial meningeoma & resultant swallow
problems
To: Dysphagia List
Message-ID: <42EF5596@webmail.ncl.ac.uk>
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***
A number of questions come to mind in this case:
1) What is the patient?s age?
2) What, if any, comorbidities?
3) What medications?
4) Was the resection total or partial?
5) Is there possibility of regrowth?
6) Did the patient experience the usual CRN deficits of V, VI, VII and/or gait disturbance?
7) Any evidence of pontocerebellar pathology?
8) Any signs of LPR?
9) Was AP view obtained in VFSS? What is te source of the identification of pharyngeal hemiparesis ? absence of laterla movement, unilateral failure of epiglottic descent?
10) Any role for UES dilatation ? keeping in mind the GER problem?
11) Indications from the literature are that hyolaryngeal movement could be permanently affected by pathological/surgical/medication effects on V, VII and pons/cerebellum because of the difficulty of surgical approach. Mayberry and Simon found that 60% were worst on the immediate post surgical period but that 70% have permanent cranial nerve deficit.
12) Any persistent cerebral edema?
Sorry if these have already been addressed - I may be coming in at the middle.
Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com
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