This guidance is aimed at outlining the steps that can be taken by ENT / Head & Neck Surgeons to best protect themselves and minimise aerosol generation when called on to perform open tracheostomies on COVID patients
Curso sobre Ronco e Apnéia do sono com a Dra. Yasmin Frazão/SP. Docente certificada pela ABS em Fonoaudiologia na Medicina do Sono. Um diferencial na sua formação e que conta pontos para sua certificação! Curso Inédito em MG!
*Fga Yasmin Frazão/SP*
CRFa 2 3933
– Graduada e Mestre em Fonoaudiologia pela PUC/SP.
– Doutoranda no Programa de Pós-Graduação em Fonoaudiologia na FOB/USP.
– Especialista em Motricidade Orofacial pelo CFFa.
– Certificada em Fonoaudiologia do Sono pela Associação Brasileira do Sono/ABS.
✔Data e horário:
20/03 – 18 às 22h
21/03 – 08 às 17h
✔Programação: 1. Anatomo fisiologia da respiração
2. Inter-relação complexo oro-crânio-cervical
3. Etiologia dos distúrbios da respiração
4. Consequências funcionais da respiração oral
5. Equipe de intervenção na Respiração Oral
6. Metodologias, abordagens e técnicas de intervenção na respiração Oral
7. Classificação dos distúrbios do sono
8.Etiologia dos Distúrbios Respiratórios do Sono
9. Causas multifatoriais–tratamento com equipe multiprofissional
10.Tratamento interdisciplinar x multidisciplinar
11.Avaliação Fonoaudiológica – protocolos de avaliação
12.Critérios para eleição do paciente para o tratamento fonoaudiológico – possibilidades e limites da intervenção
Lingual resistance training has been proposed as an intervention to improve decreased tongue pressure strength and endurance in patients with dysphagia. However, little is known about the impact of lingual resistance training on swallow physiology. This systematic review scrutinizes the available evidence regarding the effects of lingual resistance training on swallowing function in studies using Videofluoroscopic Swallowing Studies (VFSS) with adults. Seven articles met the inclusion criteria and underwent detailed review for study quality, data extraction, and planned meta-analysis. Included studies applied this intervention to a stroke and brain injury patient populations or to healthy participants, applied different training protocols, and used a number of outcome measures, making it difficult to generalize results. Lingual resistance training protocols included anterior and posterior tongue strengthening, accuracy training, and effortful press against hard palate with varying treatment durations. VFSS protocols typically included a thin barium stimulus along with one other consistency to evaluate the effects of the intervention. Swallowing measures included swallow safety, efficiency, and temporal measures. Temporal measures significantly improved in one study, while safety improvements showed mixed results across studies. Reported improvements in swallowing efficiency were limited to reductions in thin liquid barium residue in two studies. Overall, the evidence regarding the impact of lingual resistance training for dysphagia is mixed. Meta-analysis was not possible due to differences in methods and outcome measurements across studies. Reporting all aspects of training and details regarding VFSS protocols is crucial for the reproducibility of these interventions.
Future investigations should focus on completing robust analyses of swallowing kinematics and function following tongue pressure training to determine efficacy for swallowing function.
Rainer Wirth, Rainer Dziewas, Anne Marie Beck, Pere Clavé, Shaheen Hamdy, Hans Juergen Heppner, Susan Langmore,9 Andreas Herbert Leischker, Rosemary Martino, Petra Pluschinski, Alexander Rösler, Reza Shaker, Tobias Warnecke, Cornel Christian Sieber and Dorothee Volkert
Oropharyngeal dysphagia (OD) is a highly prevalent and growing condition in the older population. Although OD may cause very severe complications, it is often not detected, explored, and treated. Older patients are frequently unaware of their swallowing dysfunction which is one of the reasons why the consequences of OD, ie, aspiration, dehydration, and malnutrition, are regularly not attributed to dysphagia. Older patients are particularly vulnerable to dysphagia because multiple age-related changes increase the risk of dysphagia. Physicians in charge of older patients should be aware that malnutrition, dehydration, and pneumonia are frequently caused by (unrecognized) dysphagia. The diagnosis is particularly difficult in the case of silent aspiration. In addition to numerous screening tools, videofluoroscopy was the traditional gold standard of diagnosing OD. Recently, the fiberoptic endoscopic evaluation of swallowing is increasingly utilized because it has several advantages. Besides making a diagnosis, fiberoptic endoscopic evaluation of swallowing is applied to evaluate the effectiveness of therapeutic maneuvers and texture modification of food and liquids. In addition to swallowing training and nutritional interventions, newer rehabilitation approaches of stimulation techniques are showing promise and may significantly impact future treatment strategies.
Objectives: Dysfunction of the pharyngoesophageal segment (PES) is a common cause of oropharyngeal dysphagia. Surgi- cal dilation of the PES uses cylindrical dilators that expand radially in a circular shape. Animal studies, however, suggest that the PES is kidney-shaped. The purpose of this investigation was to evaluate the 3D shape of the human PES with a novel cast- ing method.
Methods: A platinum-cured liquid silicone polymer was infused under pressure into the upper aerodigestive tract of nine fresh human cadavers to construct 3D casts of the maximally distended PES. Cross-sectional and volumetric analysis were per- formed using computed tomography and serial sectioning of the models. Canonical variate analysis was used to identify the shape features that best distinguishes the PES from the cervical esophagus.
Results: The mean age of the cadavers was 77.9 (SD 10.6) years, with 67% women. Analysis of the casts confirms that the human PES possesses a kidney-shaped structure at maximal distention, which is discretely different from the adjacent esophagus (P < 0.001). The posterior body of the cricoid cartilage formed the anterior wall of the PES, which provided a rigid structure responsible for preservation of the kidney shape during distention. The diameter of the maximally distended PES at the cricopharyngeus was highly variable (range = 0.86–4.68 cm2; SD = 1.33 cm2).
Conclusion: The data suggest that the human PES is not round and that targeted expansion at the level of the cricopharyngeus with an eccentrically shaped dilator may provide improved distention.
O curso visa desenvolver o raciocínio clínico para adequação da dosimetria laser baseada em evidências; detalhar os diferentes tipos de laser e as estruturas que os absorvem; apresentar e discutir os efeitos fisiológicos e terapêuticos da laserterapia baseados evidências nas diversas áreas da Fonoaudiologia.
Ftp. Alexandre Cavallieri Gomes/Portugal
Fgª Vanessa Mouffron/MG
Fgª Tatiana Chaves/MG
Curso teórico e prático!
1. Laserterapia como facilitadora do exercício e redutor da fadiga muscular;
2. Interação da FBM com os tecidos;
3. lesões nervosas periféricas (paralisias faciais e parestesias);
5. tratamento de fraturas;
6. prevenção e tratamento de mucosites (oncologia);
7. cicatrização de feridas e incisões;
8. como agente analgésico e modulador da inflamação;
9. Laserterapia na amamentação;
10. Disfunções neurológicas;
12. Estética Facial;
14. Fonoaudiologia Hospitalar;
15. Fotobiomodulação e o cérebro: perspectivas futuras e evidências científicas (AVC, TCE, Alzheimer, Parkinson, demências).
Associação Médica de Minas Gerais: Avenida João Pinheiro, 161 – Centro