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The purpose of this study is to clarify whether swallowing function can be inferred from grip strength. Based on the diagnostic criteria of sarcopenia, patients were divided into two groups according to grip strength, and it was analyzed whether there was a difference in the evaluation index for swallowing function between the two groups. Among the cases requesting evaluation of swallowing function from June 10, 2020 to October 28, 2020, 83 cases (mean age: 71.7 years, 59 males and 24 females) who received assessment tests and swallowing endoscopy were included. According to the diagnostic criteria for grip strength in the Asian working group in Sarcopenia, less than 28 kgf and 18 kgf were defined as the weak group for men and women, respectively. Hyodo scores, repeated salivary swallowing tests (RSST), maximum vocalization time (MPT), and dysphagia severity classification (DSS) were compared between the two groups. Of the 83 patients, 29 and 54 were in the normal group and weak group, respectively. In all indicators, the normal group showed significantly better results than the weak group: Hyodo score (2.4 vs. 4.0, p < 0.01), RSST (4.1 times vs. 2.4 times, p < 0.01), MPT (12.1 s vs. 5.9 s, p < 0.001), DSS (4.5 vs. 5.9, p < 0.001), respectively. In multiple regression analysis with DSS as the dependent variable, grip strength was a significant independent variable of DSS even after adjusting for age, gender, and body mass index. Grip strength assessment based on sarcopenia criteria can be a useful tool for estimating swallowing function. [ABSTRACT FROM AUTHOR]

Background: Clinical manifestations of Kimmerle’s anomaly are detected in 5.5 to 20% of patients. The main reason for the development of symptoms is prolonged compression of the V3 (atlantic) segment of the vertebral artery in the bone ring as a result of the atlantooccipital membrane’s exostosis. To date, the final tactics for treating patients with Kimmerle’s anomaly has not been determined. The effectiveness of conservative methods of therapy does not exceed 40%. The aim Of this study was to evaluate the results of a minimally invasive surgical treatment of patients with symptomatic Kimmerle’s anomaly using video endoscopic assistance. Methods: In the period from 2020 to 2022, 15 patients were operated on. The indication for the surgical treatment was the lack of the conservative therapy’s effect for 1 year from the onset of the disease, aggravation of the disease symptoms, a decrease in the blood flow through the vertebral artery at the Kimmerle’s anomaly side when turning the head. The vertebral artery decompression was performed using video endoscopy through a posterior median approach in two (13%) patients and through a paravertebral intermuscular approach (4 cm incision in the occipitocervical region in the projection of the Kimmerle’s anomaly) in thirteen (87%) patients. Results: The outcome of the disease was assessed at the time of discharge from the hospital, as well as in 6 and in 12 months after the operation. Following the surgical treatment, all the patients showed the complete regression of symptoms and restoration of the blood flow velocities in the vertebral artery. There were no complications after the operation. The use of video endoscopy made it possible to reduce the size of the surgical wound from 12 cm to 4 cm, which contributed to a decrease in the intensity of pain in the postoperative period, early activation and a decrease in the duration of the inpatient treatment. Conclusion: With the proper selection of patients with Kimmerle’s anomaly, decompression of the V3 segment of the VA using video endoscopy is a safe and effective method of treatment.

Abstract Objective Videoendoscopic evaluation of swallowing is an objective swallowing function evaluation method used in dysphagia rehabilitation. However, it is anatomically difficult to detect the entry of foreign substances through the posterior tracheal wall using a conventional endoscope (CE). In this study, we developed an endoscope that can observe the posterior tracheal wall and investigated its reliability and validity in healthy adults. Methods Twenty healthy adults were included. The trachea was observed from inside the larynx using a CE and a portable, flexible two‐step angulation endoscope (two‐AE) with a two‐step curved shaft tip. The visibility of the anterior and posterior walls was recorded. The time from the endoscope tip entering the larynx to the posterior tracheal wall was measured. Additionally, discomfort events were assessed after the examination. McNemar's test and a paired t‐test were used for statistical analysis. Kappa coefficients and concordance rates were calculated. Results The anterior tracheal wall was observed using both endoscopes. The posterior tracheal wall was significantly observed in 18 participants with the two‐AE (p

Purpose: Post-stroke dysphagia (PSD) is the most common type of dysphagia. Stroke patients with sustained dysphagia have poorer outcomes. The severity of PSD is assessed using miscellaneous scales with unknown consistencies. We aim to investigate the consistencies among miscellaneous scales, which could aid in the assessment of PSD. Methods: A total of 49 PSD patients were enrolled. Functional Oral Intake Scale (FOIS), Dysphagia Severity Scale (DSS), Ohkuma Questionnaire, Eating Assessment Tool-10, and Repetitive Saliva Swallowing Test were performed. FOIS was performed by physicians, and DSS was conducted by both the physicians and nurses; the physicians used either videofluoroscopy (VF) or videoendoscopy (VE) for evaluation; while, the nurses assessed PSD by observation and subjective judgment. Results: When using VF (VF-DSS and VF-FOIS) as the gold standard for the evaluation, VE-FOIS (κ = 0.625, 95% CI 0.300–0.950, p < 0.001) has a substantial agreement with VF-FOIS, and VE-DSS (κ = 0.381, 95% CI 0.127–0.636, p = 0.007) has a fair agreement with VF-DSS. The weighted kappa of FOIS to DSS in VE (weighted κ = 0.577, 95% CI 0.414–0.740, p < 0.001) is not lower than that in VF (weighted kappa = 0.249, 95% CI 0.136–0.362, p < 0.001). Conclusion: For both DSS and FOIS, only VE has a statistically significant agreement with VF. Though VF has been viewed as the traditional gold standard of dysphagia screening, it has the limitations of being invasive and equipment dependent. For PSD, VE could be considered as a substitution when VF is not available or suitable. [ABSTRACT FROM AUTHOR]

Objective: Videoendoscopic evaluation of swallowing is an objective swallowing function evaluation method used in dysphagia rehabilitation. However, it is anatomically difficult to detect the entry of foreign substances through the posterior tracheal wall using a conventional endoscope (CE). In this study, we developed an endoscope that can observe the posterior tracheal wall and investigated its reliability and validity in healthy adults. Methods: Twenty healthy adults were included. The trachea was observed from inside the larynx using a CE and a portable, flexible two‐step angulation endoscope (two‐AE) with a two‐step curved shaft tip. The visibility of the anterior and posterior walls was recorded. The time from the endoscope tip entering the larynx to the posterior tracheal wall was measured. Additionally, discomfort events were assessed after the examination. McNemar's test and a paired t‐test were used for statistical analysis. Kappa coefficients and concordance rates were calculated. Results: The anterior tracheal wall was observed using both endoscopes. The posterior tracheal wall was significantly observed in 18 participants with the two‐AE (p <.001), compared to only three of 20 participants with the CE. The time to observation of the posterior tracheal wall for examiners 1 and 2 was 13.3 ± 6.5 and 12.0 ± 6.7 s, respectively, with no difference between groups (p =.400). The kappa coefficients of examiners 1 and 2 and between the examiners were 0.444, 0.643, and 0.643, respectively, with concordance rates of 90%, 95%, and 95%, respectively. Conclusion: Regardless of the examiner's years of experience, we observed that the two‐AE could observe the posterior tracheal wall. Level of Evidence: Step 5. [ABSTRACT FROM AUTHOR]

Graves' disease is a recurrent syndrome often accompanied by depression. I report a rare case in which dysphagia and bulbar myopathy indicated a relapse of Graves' disease, accompanied by recurrent depression. [ABSTRACT FROM AUTHOR]

Abstract Background Several studies have reported a strong association between the presence of oropharyngeal secretions in the laryngeal vestibule and the likelihood of aspiration of food or liquid. However, no previous studies have evaluated the accumulation of saliva and swallowing dynamics. Objective The objective of this study was to examine the factors related to decreased function that result in saliva accumulation based on images from videofluoroscopic examination of swallowing (VF) performed on the same day as videoendoscopic examination of swallowing (VE). Methods This retrospective study investigated 47 patients with dysphagia who underwent VF and VE on the same day. Saliva accumulation in the pharynx was assessed on VE and classified by the Murray secretion scale. Pharyngeal residue was assessed on VF. In addition, displacement of the hyoid bone and larynx on swallowing and the opening size of the esophageal orifice were measured, and contact between the base of the tongue and the posterior pharyngeal wall was examined on VF. Results Moderate correlations were found between saliva accumulation and perpendicular displacement of the larynx and upper esophageal sphincter opening. The percentage of patients showing contact between the base of the tongue and the posterior pharyngeal wall was significantly greater in those with a saliva accumulation score of 0 or 1. Conclusion Less laryngeal elevation and upper esophageal sphincter opening and absence of contact between the base of the tongue and the posterior pharyngeal wall when swallowing tended to result in accumulation of saliva in the pharynx.

This study focused on the Kuchikara Taberu Balance Chart (KTBC) as a tool for swallowing function evaluation. To clarify the relationship between videoendoscopic (VE) examination of swallowing function and the KTBC, we compared median KTBC scores with and without laryngeal penetration identified by VE. Sixty-five patients with a mean age of 84.3 ± 7.9 years were examined at the Towada City Hospital. The patients were classified into groups based on laryngeal penetration, including 28 patients with and 37 patients without penetration. We found no significant differences in patient backgrounds. The median KTBC score (interquartile range) was 36.5 (31–44.5) in the group with laryngeal penetration and 42 (35–48.5) in the group without penetration, but the scores were not significantly different (level of statistical significance at α = 0.0036 determined by the Bonferroni correction method) when compared with the Mann–Whitney U test (36.5 vs. 42, z = -2.33, p = 0.020). The median respiratory condition (3 vs. 4, z = − 3.23; p < 0.0036), oral preparatory and propulsive phases (3 vs. 4, z = − 2.96; p < 0.0036), and position and endurance (1 vs. 3, z = − 3.25; p < 0.0036) scores were significantly lower in the group with laryngeal penetration. This study revealed a correlation between laryngeal penetration confirmed by VE and KTBC scores. Consequently, respiratory condition, oral preparatory and propulsive phases, and position and endurance may be useful as tools for the assessment of swallowing. In particular, we recommend adding respiratory status to dysphagia screening. [ABSTRACT FROM AUTHOR]

Introduction: Rhinoplasty is an esthetic and functional surgery that reshapes the nose and improves breathing. The nasal valve area is the area with the maximum flow resistance in the nose. The borders of the internal nasal valve area are the lower end of the upper lateral cartilage, pyriform aperture, nasal septum, and anterior end of the inferior turbinate. External nasal valve is the area at the entrance of the nostrils. The aim of this study was to compare the changes in internal and external nasal valve area and internal nasal valve angles with videoendoscopic images of patients in a standardized position using a rigid endoscope, which was taken before the surgery using current rhinoplasty techniques and at least 3 months after the surgery. Method: The changes in the cross sections of the valve regions of the 30 volunteer patients who will undergo primary rhinoplasty were analyzed using the ImageJ program. The effects of the current rhinoplasty techniques on the internal nasal valve angles and the dimensions of the nasal valve areas and VAS values were examined. Results: Eleven patients who were able to return for postoperative follow-up were evaluated to compare the sections of the valve region before and after nasal surgery. Assessments show that while rhinoplasty shrinks the internal and external nasal valve areas and angles, breathing improves. Conclusion: The results obtained from 11 patients show that current rhinoplasty techniques are effective for improving nasal valve areas and angles for better breathing. Patients reported that their breathing problems resolved and improved 2 points according to VAS analysis. [ABSTRACT FROM AUTHOR]

Purpose: Pharyngeal symptoms related to amyloidosis are quite rare, and there are no reports demonstrating videoendoscopic (VE) or videofluorographic (VF) swallowing examinations. We report a case of systemic light chain amyloidosis with dysphagia at the pharyngeal phase of swallowing revealed by VE and VF, and discuss the causative mechanisms. Case: A 77-year-old man presented with a 6-month history of dysphagia. An oral cavity examination revealed normal findings. Laryngofiberscopy did not show space-occupying lesions or laryngeal nerve palsy. VE revealed a crystal violet-pigmented bolus that flowed into the pharynx toward the glottis before laryngeal elevation, and then pooled in the piriform recess of the hypopharynx and was aspirated into the trachea. VF using barium sulfate showed delayed onset and poor laryngeal elevation, aspiration during swallowing, poor pharyngeal contraction, and bolus residue in the piriform recess of the hypopharynx. Opening of the upper esophageal sphincter was adequate. Flow in the esophagus was normal. The number of swallowings was increased to clear the bolus from the pharynx. VE and VF indicated impairment during the pharyngeal phase of swallowing. Histopathological analysis of the lower lip demonstrated degeneration of the minor salivary glands and hypertrophic basal membranes due to amyloid deposits; the acini and ducts had been replaced by amyloid deposits of λ light chain (AL) amyloidosis. Discussion: The possible mechanisms of pharyngeal phase impairment are peripheral neuropathy of the swallowing-related nerves and amyloid myopathy. Conclusion: Systemic amyloidosis may cause pharyngeal phase dysphagia.

Background: Several studies have reported a strong association between the presence of oropharyngeal secretions in the laryngeal vestibule and the likelihood of aspiration of food or liquid. However, no previous studies have evaluated the accumulation of saliva and swallowing dynamics. Objective: The objective of this study was to examine the factors related to decreased function that result in saliva accumulation based on images from videofluoroscopic examination of swallowing (VF) performed on the same day as videoendoscopic examination of swallowing (VE). Methods: This retrospective study investigated 47 patients with dysphagia who underwent VF and VE on the same day. Saliva accumulation in the pharynx was assessed on VE and classified by the Murray secretion scale. Pharyngeal residue was assessed on VF. In addition, displacement of the hyoid bone and larynx on swallowing and the opening size of the esophageal orifice were measured, and contact between the base of the tongue and the posterior pharyngeal wall was examined on VF. Results: Moderate correlations were found between saliva accumulation and perpendicular displacement of the larynx and upper esophageal sphincter opening. The percentage of patients showing contact between the base of the tongue and the posterior pharyngeal wall was significantly greater in those with a saliva accumulation score of 0 or 1. Conclusion: Less laryngeal elevation and upper esophageal sphincter opening and absence of contact between the base of the tongue and the posterior pharyngeal wall when swallowing tended to result in accumulation of saliva in the pharynx. [ABSTRACT FROM AUTHOR]

(1) Background: Postoperative nerve root injury with dysesthesia is the most frequent sequela following lumbar endoscopic transforaminal discectomy. At times, it may be accompanied by transient and rarely by permanent motor weakness. The authors hypothesized that direct compression of the exiting nerve root and its dorsal root ganglion (DRG) by manipulating the working cannula or endoscopic instruments may play a role. (2) Objective: To assess whether intraoperative neurophysiological monitoring can help prevent nerve root injury by identifying neurophysiological events during the initial placement of the endoscopic working cannula and the directly visualized video endoscopic procedure. (3) Methods: The authors performed a retrospective chart review of 65 (35 female and 30 male) patients who underwent transforaminal endoscopic decompression for failed non-operative treatment of lumbar disc herniation from 2012 to 2020. The patients’ age ranged from 22 to 86 years, with an average of 51.75 years. Patients in the experimental group (32 patients) had intraoperative neurophysiological monitoring recordings using sensory evoked (SSEP), and transcranial motor evoked potentials (TCEP), those in the control group (32 patients) did not. The SSEP and TCMEP data were analyzed and correlated to the postoperative course, including dysesthesia and clinical outcomes using modified Macnab criteria, Oswestry disability index (ODI), visual analog scale (VAS) for leg and back pain. (4) Results: The surgical levels were L4/L5 in 44.6%, L5/S1 in 23.1%, and L3/L4 in 9.2%. Of the 65 patients, 56.9% (37/65) had surgery on the left, 36.9% (24/65) on the right, and the remaining 6.2% (4/65) underwent bilateral decompression. Postoperative dysesthesia occurred in 2 patients in the experimental and six patients in the control group. In the experimental neuromonitoring group, there was electrodiagnostic evidence of compression of the exiting nerve root’s DRG in 24 (72.7%) of the 32 patients after initial transforaminal placement of the working cannula. A 5% or more decrease and a 50% or more decrease in amplitude of SSEPs and TCEPs recordings of the exiting nerve root were resolved by repositioning the working cannula or by pausing the root manipulation until recovery to baseline, which typically occurred within an average of 1.15 min. In 15 of the 24 patients with such latency and amplitude changes, a foraminoplasty was performed before advancing the endoscopic working cannula via the transforaminal approach into the neuroforamen to avoid an impeding nerve root injury and postoperative dysesthesia. (5) Conclusion: Neuromonitoring enabled the intraoperative diagnosis of DRG compression during the initial transforaminal placement of the endoscopic working cannula. Future studies with more statistical power will have to investigate whether employing neuromonitoring to avoid intraoperative compression of the exiting nerve root is predictive of lower postoperative dysesthesia rates in patients undergoing videoendoscopic transforaminal discectomy.

Summary Rhinoplasty is a common procedure in cosmetic surgery all over the world. Patients desire enhancement of their facial beauty by the correction of preexisting nasal deformities. Precisely performed operations lead to better results, and enhancing technical accuracy accordingly results in more successful outcomes. Endoscopy helps us visualize the closed parts of the body with the aid of an illuminated optical device. The objective behind the present case series was to bring the advantages of open and closed rhinoplasty together by using endoscopic vision systems. A total of 312 patients with unoperated nasal deformities from private practice were operated, and videoendoscopic closed rhinoplasty was performed on each patient. Postoperative patient satisfaction was assessed using the Rhinoplasty Outcome Score; the level of satisfaction was found to be excellent. In the present case series, it was hypothesized that trocar mobility under the skin flap allows virtual binocular vision that eventually leads to stereoptic depth perception. This allows virtual three-dimensional (3D) vision on the screen of the endoscope with a regular trocar. The mobility of the tip in the transverse axis created a virtual 3D appearance. Our experiences with videoendoscopic closed rhinoplasty are shared in this report. [ABSTRACT FROM AUTHOR]

Over the past 50 years, per season pregnancy rate in Thoroughbred mares have risen from 70 to >90% and foaling rates from 55 to >80%. Some of the significant pharmacological treatments and diagnostic methods which have driven this marked improvement in breeding efficiency are reviewed. They include the application of artificial lighting to hasten the onset of ovulatory oestrous cyclicity in early Spring, rapid steroid hormone assays to aid in determining the stage and normality of the mare's cycle, prostaglandin analogues, synthetic progestagens and Gonadotrophin-releasing Hormone (Gn RH) analogues to better control and manipulate her cycle to good effect, transrectal ultrasound scanning to monitor follicle growth, endometrial architecture and ovulation and to allow accurate, early pregnancy diagnosis thereby enabling successful ablation of one of twin conceptuses. Also, flexible videoendoscopy to monitor physiological and pathological changes in the uterine endometrium and rigid laparoscopy to apply prostaglandin to the oviducts to dislodge and clear suspected blockages of them to restore fertility. The outbreak of Contagious Equine Metritis in Newmarket in the spring of 1977 and the swabbing-related changes to mare and stallion management, plus the improved veterinary hygiene methods, which followed are also recounted. The past half century has witnessed many technical and therapeutic advances that have enhanced tremendously the diagnostic and treatment capabilities of studfarm veterinary surgeons. They, in turn, have improved greatly the efficiency of breeding Thoroughbreds and other types of horses. [ABSTRACT FROM AUTHOR]

Aspiration pneumonia is a cause of mortality in the elderly. Evaluating swallowing function is important. Videofluoroscopy and flexible endoscopic evaluation of swallowing are comparable; however, observing all swallowing dynamics is impossible using the latter approach. We examined the significance of flexible endoscopic evaluation of swallowing using videofluoroscopy. Thirty-seven patients with dysphagia [70.0 ± 8.9 (range 49-84) years] were included. In random order, patients underwent videofluoroscopy with 10 cc contrast material, once without, and once with an endoscope inserted. Laryngeal elevation delay time, Penetration-Aspiration Scale score, and Pharyngeal Residue Severity Rating Scale score were evaluated. Laryngeal elevation delay time without or with endoscope insertion was similar (0.35 ± 0.16 s vs. 0.36 ± 0.16 s, P = 0.29). The Penetration-Aspiration Scale (3.59 ± 2.71 vs. 4.41 ± 2.85; P < 0.001) and Pharyngeal Residue Severity Rating Scale (0.97 ± 0.93 vs. 1.46 ± 1.10; P < 0.001) scores differed significantly. The cases that showed no aspiration without endoscope insertion showed greater aspiration with endoscope insertion, and the cases that did not show aspiration with an endoscope inserted also showed no aspiration without an endoscope. Flexible endoscopic insertion resulted in more severe aspiration and residue than non-insertion, as assessed using videofluoroscopy. [ABSTRACT FROM AUTHOR]

Endotracheal intubation of laboratory animals is a common procedure shared by several research fields for different purposes, such as mechanical ventilation of anaesthetized animals, instillation of cytotoxic nanoparticles, infectious agents or tumour cells for induction of disease models, and even for diagnostic and therapeutic purposes. These different research purposes, achieved in different animal models, require technical expertise and equipment that suits every research need from animal facilities. In this short report we propose a videoendoscopic intubation station that could be shared among the most common laboratory animals, namely the mouse, rat, guinea pig and rabbit, from neonates to adult animals. This report aims to contribute to the reduction of animals excluded from experiments due to false paths during direct and blind intubations and to the refinement of procedures by replacing surgical approaches such as tracheotomy. [ABSTRACT FROM AUTHOR]

Objective: Currently, various tools have been introduced for the assessment of vocal fold vibration: laryngeal videolaryngoscopy (LV), videokymography (VKG), high speed videoendoscopy (HSV), digital videokymography (DKG), and 2D scanning videokymography (2D VKG). Among these, the authors have recently designed a dual modality examination system using LV and 2D VKG for more detailed information regarding the vibrations of the vocal folds. The clinical availability of this hybrid system offers medical imaging departments a range of potential advantages in the evaluation of vocal fold vibration. The obvious benefit of simultaneous acquisition is the improved integration of information that allows not only optimal anatomic localization, but also physical movement patterns. Other advantages include the lessened inconvenience to patients due to no longer requiring repeated examinations and shortening the examination time, and increased profitability. The purpose of study was to identify the efficacy of real-time dual examination of two different modalities for the evaluation of vocal fold vibration in human subjects and vocal fold vibration simulator.Methods: One vocally healthy subject and three patients with vocal fold nodules, a vocal cyst, and vocal fold paralysis took part in this study. The vibratory patterns of the vocal folds were visualized using simultaneous real-time examination of two different modalities. Additionally, qualitative and quantitative analyses of the dual LV and 2D VKG images were performed.Results: Real-time dual examination using a two modality system provided high definition images of the vibratory movements of the vocal folds. By assessing the obtained images, we confirmed that the dual modality examination method was useful in the evaluation of pathologic vibratory patterns, even in non-periodic phonation.Conclusion: The present system might improve the understanding of the processes of vocal fold vibration and make a contribution to pathologic voice research, as well as clinical practice. [ABSTRACT FROM AUTHOR]

Background : The objective of this retrospective analysis was to assess the treatment of endoscope abdominoplasty for diastasis recti deformity patients. Methods : From January 1999 to January 2011, 88 patients ranging from 35 to 46 years in age were treated with videoendoscopy-assisted minimally invasive surgery. All patients were Asian. Early (< 3 months) and late (> 6 months) complications were assessed throughout a follow-up period of up to 66 months. Results : Observations were conducted at the end of three weeks, six months, and 66 months. Early on, all patients experienced numbness with local paresthesia (100%) closely after treatment, and reported the feelings to subside by six months post-treatment. Four patients (4.5%) experienced ecchymosis, and three patients (3.4%) were affected by seroma. One patient (1.1%) had dyspnea immediately after surgery, which recovered after oxygen (O 2 ) administration. Only one patient (1.1%) experienced minimal skin loss, which recovered after 3 months of surgery, and there were no further complications. Hypertrophic scars were apparent in three patients (3.4%) who showed no unwanted signs or further complications after post-operative scar care. No hematoma had been reported. All complications subsided (> 6 months) postoperatively. Conclusions : Videoendoscopy-assisted abdominoplasty can be used for diastasis recti deformity with minimal excess skin. Our study demonstrated effects against the formation of seroma and other complications.

Objectives/hypothesis: Describe the relationship between the magnitude of eustachian tube (ET) dilation during swallowing observed on transnasal videoendoscopy and quantified by sonotubometry.Study Design: Descriptive observational study.Methods: Simultaneous transnasal videoendoscopic and sonotubometric recordings were done on 33 adults with no middle ear disease. Briefly, microphones were placed in the ear canals, a 45° telescope introduced through one side of the nose to visualize and record ipsilateral ET movements, and the probe from a sound generator placed in the opposite nostril. At a generated nasopharyngeal sound level, ET movements and ipsilateral microphone signals were continuously recorded while the subject performed a series of three swallows. For each swallow, relational movements among ET structures observed on video recordings and characteristics of the sonotubometry signal envelope at the ear canal were quantified at three times: swallow onset (T1), maximum soft-palate elevation (T2), and maximum ET luminal dilation (T3).Results: A total of 99 swallows were analyzed. The average medial rotation of the ET cartilage and lateral wall over the T1-T2 interval were -32.7 ± 14.9° and 7.2 ± 25.1°, and over the T2-T3 interval were 4.6 ± 7.7° and 6.2 ± 14.6°, respectively. The transtubal sound transmission during a swallow peaked at an amplitude of 30.5 ± 35.7 mV during the 572.5 ± 292.6 ms of elevated sound-pressure time. Correlational analysis documented significant linear associations between the relational measures of ET component movements from videoendoscopy and the signal envelope measures from sonotubometry.Conclusions: There is a direct linear relationship between the degree of ET luminal dilation visualized on videoendoscopy and represented in the sonotubometry signal envelope.Level Of Evidence: NA Laryngoscope, 126:2778-2784, 2016. [ABSTRACT FROM AUTHOR]

Clinically, reclining posture has been reported to reduce risk of aspiration. However, during involuntary swallow in reclining posture, changes in orofacial and pharyngeal movement before and during pharyngeal swallow should be considered. Further, the mechanisms underlying the effect of body posture on involuntary swallow remain unclear. The aim of the present study was to determine the effect of body posture on activity patterns of the suprahyoid muscles and on patterns of bolus transport during a natural involuntary swallow. Thirteen healthy male adults participated in a water infusion test and a chewing test. In the water infusion test, thickened water was delivered into the pharynx at a very slow rate until the first involuntary swallow was evoked. In the chewing test, subjects were asked to eat 10 g of gruel rice. In both tests, the recording was performed at four body postures between upright and supine positions. Results showed that reclining changed the location of the bolus head at the start of swallow and prolonged onset latency of the swallowing initiation. Muscle burst duration and whiteout time measured by videoendoscopy significantly increased with body reclining and prolongation of the falling time. In the chewing test, reclining changed the location of the bolus head at the start of swallow, and the frequency of bolus residue after the first swallow increased. Duration and area of EMG burst and whiteout time significantly increased with body reclining. These data suggest that body reclining may result in prolongation of pharyngeal swallow during involuntary swallow. [ABSTRACT FROM AUTHOR]

Videoendoscopy is newly used in breast and axillary surgery. Single-port surgery is one of the newest methods of minimally invasive surgery. This report describes the first case of videoendoscopic single-port axillary dissection. In histopathological evaluation, 24 lymph nodes were identified and one node was infiltrated by the cancer cells. Videoendoscopic single-port axillary dissection is a precise and improvable technique. Single-port videoendoscopic axillary dissection could be more feasible with individual tools that will be designed for minimally invasive breast surgery.

Objective: This study aimed to classify sequential swallowing types using videoendoscopy (VE) avoiding radiation exposure and compare the results using videofluoroscopy (VF). Design: Twenty-one healthy adults simultaneously underwent VF and VE during sequential straw drinking. Each discrete swallow was classified into an L-segmental type (laryngeal vestibule opens after swallow) or L-continuous type (laryngeal vestibule closure continues after swallow) using VF and a V-segmental type (velopharynx opens after swallow) or V-continuous type (velopharynx closure continues after swallow) using VE. Test-retest reproducibility and interrater and intrarater reliability were evaluated in ten healthy adults. Results: Of 128 swallows, 94 were L-segmental and 34 were L-continuous types as per VF, whereas 95 were V-segmental and 33 were V-continuous types as per VE. The leading edge of the bolus at swallow onset was significantly deeper in L-continuous types (P = 0 001 ) . Laryngeal vestibule closure on VF images corresponded to velopharyngeal closure on VE images for 127 of 128 swallows (k = 0.9 8 , P < 0.001 ) . All subjects showed the same types of swallows in the first and the second studies. Both interrater and intrarater reliability were high. Conclusion: VE showed high reproducibility and reliability in the classification of sequential swallowing types. [ABSTRACT FROM AUTHOR]

Purpose : Wireless capsule endoscopy (WCE) is commonly used for noninvasive gastrointestinal tract evaluation, including the detection of mucosal polyps. A new embeddable method for polyp detection in wireless capsule endoscopic images was developed and tested. Methods : First, possible polyps within the image were extracted using geometric shape features. Next, the candidate regions of interest were evaluated with a boosting based method using textural features. Each step was carefully chosen to accommodate hardware implementation constraints. The method's performance was evaluated on WCE datasets including 300 images with polyps and 1,200 images without polyps. Hardware implementation of the proposed approach was evaluated to quantitatively demonstrate the feasibility of such integration into the WCE itself. Results : The boosting based polyp classification demonstrated a sensitivity of 91.0 %, a specificity of 95.2 % and a false detection rate of 4.8 %. This performance is close to that reported recently in systems developed for an online analysis of video colonoscopy images. Conclusion : A new method for polyp detection in videoendoscopic WCE examinations was developed using boosting based approach. This method achieved good classification performance and can be implemented in situ with embedded hardware. [ABSTRACT FROM AUTHOR]

Narrow Band Imaging (NBI) is an endoscopic method used for the diagnostics of mucosal changes that accompany the development and growth of epithelial tumors. The method helps to see the mucosal surface with greater contrast between epithelium and mucosal blood vessels than in white light. This is achieved by using specially filtered light. Even tiny millimeter changes not observable in white light can be visualized using NBI. The method is used in otorhinolaryngology in the outpatient setting as a screening method, or in the follow-up of patients with a history of cancer treatment, as well as during surgical procedures for targeting biopsies and for precise identification of the resection margins during cancer surgery. [ABSTRACT FROM AUTHOR]

When eating food containing both liquid and solid phases (two-phase food), the liquid component frequently enters the hypopharynx before swallowing, which may increase the risk of aspiration. We therefore tested whether preswallow bolus transport and swallow initiation would change as the viscosity of two-phase food was increased. Fiberoptic endoscopy was recorded while 18 adult subjects ate 5 g of steamed rice with 3 ml of blue-dye water. Liquid viscosity was set at four levels by adding a thickening agent (0, 1, 2, and 4 wt%, respectively). We measured the timing of the leading edge of the food reaching the base of the epiglottis, as well as the location of the leading edge at swallow initiation. As viscosity increased, the leading edge of the food reached the epiglottis significantly later during chewing and was higher in the pharynx at swallow onset. The time after the leading edge reached the epiglottis did not vary among the viscosities of the two-phase food. This study found that the initial viscosity of two-phase food significantly altered oropharyngeal bolus flow and the timing of swallow initiation. Accordingly, increased two-phase food viscosity may delay food entry into the pharynx and be of use in dysphagic diets. [ABSTRACT FROM AUTHOR]

Reasons for performing study: Two genetically and phenotypically distinct horse breeds are used for harness racing in Scandinavia: the Standardbred (SB) and Coldblooded Trotter. These racehorses have identical environmental, management and racing conditions. Therefore, this study was undertaken to identify and compare the relative prevalence of upper respiratory tract (URT) obstructive disorders in these 2 breeds. Objectives: To determine whether these 2 phenotypically different breeds of harness racehorses have different predispositions for URT disorders. Methods: Retrospective study of 88 Norwegian Coldblooded Trotters (NCT) and 97 SBs referred to this hospital for URT evaluation between 1998 and 2006. Case records of all horses diagnosed with an URT disorder during resting endoscopy, and all horses undergoing high-speed treadmill videoendoscopy (HSTV) with one or more periods of induced poll flexion were evaluated. The relative prevalence of URT disorders between the 2 breeds was analysed using a Fisher's exact test. Results: There was a significant (P<0.05) breed predisposition regarding 6 URT disorders. Bilateral dynamic laryngeal collapse associated with poll flexion and flaccid epiglottis was significantly more frequent in the NCT. Alar fold collapse and nasopharyngeal collapse were significantly more frequent in SBs. Epiglottic entrapment and nasal flutter were only diagnosed in the SBs. Dynamic disorders were more common than resting disorders in both breeds. Conclusion: URT obstructive disorders (dynamic laryngeal collapse associated with poll flexion, flaccid epiglottis, pharyngeal collapse, alar fold collapse, nasal flutter and epiglottic entrapment) are breed related, indicating an anatomic or functional cause. Periods of induced poll flexion during HSTV was essential to declare harness racehorses free of URT disorders. Potential relevance: Further anatomic or physiological studies comparing these breeds could potentially provide insight into the pathogenesis of certain URT obstructive disorders. Induced poll flexion should be included in routine HSTV examinations of all harness racehorses. [ABSTRACT FROM AUTHOR]

Reasons for performing study: Many horses demonstrate dynamic collapse of more than one upper respiratory tract (URT) structure during high-speed treadmill videoendoscopy (HSTV). Objectives: To report the frequency of complex dynamic URT collapse in harness racehorses and determine if an association exists between occurrence of certain disorders. Methods: Retrospective study of 99 Standardbreds and Coldblooded trotters that had one or more dynamic URT disorders identified during HSTV between 1998 and 2006. The horses underwent HSTV using a protocol that included periods of free head carriage and poll flexion until fully fatigued. Dynamic abnormalities were classified as: dynamic laryngeal collapse (DLC) associated with poll flexion; axial deviation of the aryepiglottic folds (ADAF); dynamically flaccid epiglottis (FE); caudal palatal instability (PI); intermittent dorsal displacement of the soft palate (iDDSP); pharyngeal collapse (PC); alar fold collapse (AFC) and nasal flutter (NF). Cluster analysis and Fisher's exact test was performed between groups. Significance was set at P<0.05. Results: The overall incidence of complex dynamic URT collapse was 69.7%. Axial deviation of the aryepiglottic folds was significantly associated with PI (P<0.0001) and FE (P<0.0001); iDDSP was significantly associated with PI (P = 0.004) only. Dynamic laryngeal collapse associated with poll flexion was significantly associated with FE (P = 0.002). Cluster analysis confirmed strong associations between the above diagnosis groups and weaker associations between others. Conclusion: Caudal PI seems to result in 2 diagnosis groupings: one that leads to ADAF and the other to iDDSP. Dynamic collapse of the margins of the epiglottis was a common finding in this study strongly associated with DLC, PI and ADAF. Potential clinical relevance: The associations between certain dynamic diagnoses identified in this study seems best explained as due to local anatomic and functional weaknesses that influence other structures through the Bernouilli principle, rather than being due to a generalised neurological disorder. [ABSTRACT FROM AUTHOR]

The purpose of the present study was to examine what dysphagic signs identified by videoendoscopy (VE) could predict the incidence of pneumonia and body weight loss in elderly patients living in nursing homes. This study was performed at six nursing care facilities in Japan from March 2007 to February 2009. The 148 subjects (85·1 ± 8·0 years, male/female: 43/105) were evaluated for their feeding and swallowing movements by clinical and VE examinations during the consumption of a regular meal. The VE examination items included the existence/absence of pharyngeal residue, laryngeal penetration, and aspiration of food and saliva. The patients were followed-up for 3 months with individualized feeding therapy based on the results of the clinical/VE examination at baseline, and the incidence of pneumonia was examined as the primary outcome. In patients without pneumonia, the body weight change was also measured as a secondary outcome. The risk factors for pneumonia and body weight loss (of 3% or more) were identified among the clinical/VE examination items by a Cox proportional hazard analysis. Even with elaborative feeding therapy, 12 (8·1%) of the 148 patients developed pneumonia during the 3 months follow-up period. The existence of signs of 'silent aspiration of saliva' or 'aspiration of saliva' detected by VE examination was a significant risk factor for both pneumonia and a body weight loss of 3% or more. This study shows that 'aspiration of saliva' detected by VE is a significant risk factor for both pneumonia and body weight loss in elderly patients living in nursing homes. [ABSTRACT FROM AUTHOR]

Introduction: Compared to rigid arthroscopic optics, a flexible camera system offers theoretically significant advantages: It has the potential to adapt to the naturally curved surface of joints, to move within the joint without stress to the cartilage or capsule and thereby to reduce the number of portals needed. Former studies evaluated flexible fiberoptic systems which were insufficient regarding image resolution. This is the first report on a new flexible videoendoscope with the so called "chip-on-the-tip" technology used in human joints. Methods: With a plasma sterilized 3.9 diameter flexible video endoscopy system (Visera ENF V, OLYMPUS) commonly used in diagnostic rhino-laryngoscopy, we performed preliminary testing in cadaveric knee joints. After successful feasibility testing we utilized the tool in two qualitative diagnostic knee and five hip arthroscopies in combination with conventional rigid 30° and 70° arthroscopes (STORZ). Results: Qualitative evaluation showed superior visualisation of the posterior aspects of the knee joint as insertion of the posterior medial and lateral meniscal horn, tibial insertion of the posterior cruciate ligament and the posterolateral capsulo-ligamentous corner with acceptable image resolution and clarity compared to the rigid arthroscope. In the hip, it was possible to pass around the femoral neck, avoiding additional portals. There seemed to be virtually no risk for cartilage damage at all. Difficulties of the system were scope handling, navigation and orientation within the joint as well as potential damage to the tool itself. Conclusion: This is to our knowledge the first report on flexible videoarthroscopy. Some of the expectations were met, such as to reach virtually every corner the joint with minimal risk for the cartilage or other joint structures and with acceptable image quality. However, there are many significant disadvantages which question the routine use of such a videoendoscopic system with its present technical features. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to evaluate the severity of upper airway obstruction at the retropalatal and retroglossal regions in obstructive sleep apnea (OSA) patients. Methodology: This is a descriptive cross-sectional study at the Sleep Clinic, Department of Otorhinolaryngology-Head and Neck Surgery. Flexible nasopharyngolaryngoscopy was performed in seated erect and supine position. Retropalatal and retroglossal regions were continuously recorded during quiet breathing and Mueller's maneuver in both positions. Captured images were measured using Scion Image software and narrowing rate was calculated. Level of each site was classified based on Fujita classification and severity of obstruction using Sher scoring system for Mueller's maneuver. Results: A total of 59 patients participated in this study. Twenty-nine (49.2%) participants had type 1 (retropalatal) obstruction, 23 (38.9%) had type 2 (retropalatal and retroglossal), and seven (11.9%) in type 3 (retroglossal) obstruction. Fifty (84.7%) of the patients have severe obstruction at the retropalatal region in supine position (SRP) followed by 35 (59.3%) at retropalatal region in erect position (ERP), 27 (45.8%) at retroglossal region in supine position (SRG) and eight (13.5%) at retroglossal region in erect position (ERG). The average oxygen saturation showed significant association in ERP ( P = 0.012) and SRP ( P < 0.001), but not significant in ERG and SRG. Conclusions: Videoendoscopy utilizing flexible nasopharyngolaryngoscopy and Scion Image software is reliable, minimally invasive, and useful as an office procedure in evaluating the multilevel obstruction of upper airway in OSA patients. The retropalatal region has more severe obstruction compared with retroglossal region either in erect or supine position. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: In the field of prosthodontics, many methods for evaluating the masticatory function involve ejection of the food bolus from the mouth. In addition, these methods could not evaluate mastication and swallowing function comprehensively. The present study aimed to quantitatively evaluate masticatory functions during a series of masticatory and swallowing movements by using videoendoscopy. Methods: Subjects are ten healthy dentulous adults without dysphagia. The test foods used were 2-colored (green and white) molded rice and uirou (rice cake). The test foods were consumed under the restriction on the number of mastication (10, 15, 20, and 30), and under the instruction to “chew normally” or “chew well”. The masticatory function was evaluated by observing the food bolus in the oropharynx with a videoendoscope. The bolus formation index (BFI), in terms of the degree of mixing of the green and white parts, was quantitatively determined using an image measurement software. Results: The BFI of the rice and uirou increased significantly with increase in the number of mastication times (p <0.01). A significantly correlation coefficient was observed between the BFI and the number of mastication (0.84 for rice and 0.89 for uirou). The BFI obtained by “chewing well” was significantly higher than that obtained by “chewing normally” (p <0.01). Conclusions: The results of this study confirm that the endoscopic measurement of food bolus formation by mastication in terms of the color tones of 2-colored test foods enables quantitative evaluation of the masticatory function during a series of masticatory and swallowing movements. [Copyright &y& Elsevier]

This paper presents the study of vocal videostroboscopic videos to detect morphological pathologies using an active contour segmentation and objective measurements. The ad-hoc designed active contour algorithm permits to obtain a robust and fast segmentation using vocal folds images in RGB format. In this work, we have employed connected component analysis as a post-processing tool. After the segmentation process the image is analyzed and the pathology can be localized automatically and we can extract some features of each fold (such as the size of the polyp or cyst, the glottal space, the position...). Experimental results demonstrate that the proposed method is effective. Our proposal segments correctly the 95% of database test videos and it shows a great advance in design. The objective measurements complete a new method to diagnose vocal folds pathologies. [ABSTRACT FROM AUTHOR]

Extraordinary developments have occurred in the field of endoscopy over the past 40 years. The era that began with the fiberoptic endoscope (fiberscope) has now moved to the videoscope and, more recently, to the capsule endoscope. Videoendoscopy will remain the major form of endoscopy for the next 5–10 years but, thereafter, diagnostic procedures including colonoscopy will increasingly be performed by capsule endoscopy. This change will be largely driven by patient preference rather than superior results from capsule studies. Image analysis of capsule studies will be accelerated by software that highlights abnormal areas and, by 2025, capsule studies will be ‘read’ by computer. For the next decade, more complex therapeutic procedures will be performed by a new group of therapeutic endoscopists using advanced videoscopes. Several new therapeutic procedures will emerge but natural orifice transluminal approaches will need to compete with advances in laparoscopic techniques. It is also likely that health administrators faced with escalating medical costs will demand that new and more expensive procedures not only facilitate patient care but result in superior health outcomes. [ABSTRACT FROM AUTHOR]

The patient was a 78-year-old man with a chief complaint of dysphagia. Extrinsic displacement of the posterior hypopharyngeal wall was observed on upper endoscopy. The patient was diagnosed with ossification of the anterior longitudinal ligament (OALL) of the cervical spine according to lateral cervical spine radiographic findings. The OALL caused dysphagia. In swallowing endoscopic assessments of patients with dysphagia, OALL of the cervical spine should be differentiated from other possible diagnoses by using radiography when extrinsic displacement of the posterior oropharyngeal or hypopharyngeal wall is observed. [ABSTRACT FROM AUTHOR]

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Summary: Part 1 of this paper compared fiber optic (FO) and distal chip (DC) flexible technologies in the diagnosis of vocal fold masses and mucosal wave abnormalities. Part 2 of this study was designed to evaluate the usefulness of FO and DC flexible imaging in the diagnosis of laryngopharyngeal reflux (LPR) disease. Thirty-four consecutive patients were examined with either FO or DC flexible stroboscopy followed immediately by rigid stroboscopy. Rigid stroboscopy was considered the “gold-standard” for this study. All stroboscopy segments were evaluated by two laryngologists, an otolaryngologist, a laryngology fellow, and an otolaryngology resident for physical findings of LPR using the Reflux Finding Score (RFS) and Posterior Erythema Grade (PE grade). Both flexible systems underrepresented the physical findings of LPR compared to the rigid examination, but the FO system was frequently more accurate than the DC system. For PE grade, agreement with the rigid endoscope was 95% for the FO system and 73% for the DC system. Total RFSs for both flexible systems were significantly different than RFSs from the corresponding rigid examinations (P =0.001). Raters who used the RFS more often were more consistent. More severe PE grade scores correlated well with increasing RFSs. The number of patients diagnosed with LPR (RFS>7) showed that despite differences in the category scores, the FO and DC were almost identical in how much LPR was diagnosed compared with their matched rigid examination. Because both flexible platforms significantly underrepresented reflux signs, we recommend that a rigid laryngeal telescope be used when examining the larynx for signs of LPR. If this is not available, these data suggest that a high-quality FO endoscope may be more accurate than a DC endoscope for most otolaryngologists. [Copyright &y& Elsevier]

The subject matter of this paper concerns advanced techniques of imaging used in diagnosis and minimally invasive procedures applied in non-operable cases of the digestive tract tumour therapy. The role of optical techniques in current medical imaging is significant. Optical properties of transilluminated or illuminated tissues and organs depend on strong light absorption and scattering. Numerous issues related to the result interpretation still remain unsolved. Effectiveness and precision can be especially improved when some combined methods of imaging are used. Videoendoscopy imaging, X-ray imaging, and endoscopic ultrasound imaging are three complementary methods applied during the interventions described in this work. All interventions have concerned with the upper part of the digestive tract. Especially, interdisciplinary issues of combined medical imaging are presented using some examples of a modern approach to imaging of esophagus and biliary stenting. The selected examples of effects obtained during interventions assisted by combined imaging of the operation site are presented. The operator can have great control over the appearance of desirable effects as well as undesirable complications in order to work comfortably and safe. [ABSTRACT FROM AUTHOR]

Objective: To validate the technique of the Muller maneuver (MM) using videoendoscopy and to quantify the correlation between its clinical results and variables of polysomnography. Study Design: Prospective, controlled study. Methods: Videoendoscopy with MM was performed in 70 patients who were categorized into two groups, with 35 patients giving a history suggestive of snoring and 35 patients without such history. The snoring group underwent further examination with polysomnography. Cross-sectional areas at the retropalatal (RP) and retrolingual (RL) levels during quiet respiration (RP0 or RL0) and the maximal effort of MM (RP1 or RL1) were calculated with the digital measurement software 'Image J.' One hundred forty pairs of data were acquired. The collapsing ratio (CR) was defined as the difference of RP0 (or RL0) between RP1 (or RL1) divided by RP0 (or RL0) to compare the difference between the two phases. These results were compared with each other and correlated to the variables obtained from polysomnographic studies. Results: There were significant differences in the CR of RP (CRRP), the CR of RL (CRRL), and body mass index (BMI) when comparing the two groups. In snoring patients, BMI was positively related to the respiratory disturbance index (RDI) and obstructive sleep apnea (OSA) staging but not to CRRP and CRRL. CRRP had a significant positive relationship with RDI and OSA rather than CRRL. Conclusion: MM with videoendoscopy can be a simple, cost-effective, quantitative, and even predictable technique. This method allows us to examine the dynamic upper airway for more precise preoperative planning. [ABSTRACT FROM AUTHOR]

This paper is devoted to a modern diagnostic method called the endoscopic ultrasonography (EUS). In many countries, the diagnostic attributes of the EUS still need to be more widely spread among physicians and clinical engineers in health-care fields. This method is based on two-imaging techniques: videoendoscopy and ultrasonography (USG), making a possible effective aiding of diagnostics as well as evaluating possibilities of performing a radical surgical therapy. Rotating the USG probes enables acquiring images vertical to an axis for the round angle area. Small diameters and adequate frequencies of these miniprobes make it possible for their deep penetration into such difficult sites as the biliary and pancreatic ducts. In this paper, the EUS advantages and limitations are discussed on the basis of several examples of real interventions practiced by the authors. All images reported in this paper are concerned in using the EUS to assist the minimally invasive diagnostics and surgery processes made on the upper parts of the intestinal tract. Real interventions were assisted by the EUS, which were performed with a rotating minihead inserted through the endoscopic operating channel. Improving a combined imaging of the operation site allowed evaluating the degree to which the cancer formation has spread beyond the tract wall and detecting lesions as small as 1 to 3 mm. Utilization of the EUS has allowed precise diagnostics without disturbances occurring at the conventional ultrasound imaging [ABSTRACT FROM PUBLISHER]

Background: Laparoendoscopic surgery has emerged as a new method for the management of iliac and aortoiliac occlusive disease. This article describes a combined retroperitoneal and pelvic extraperitoneal approach to aorta and iliac arteries.Methods: A review was performed for 15 patients who underwent videoendoscopically assisted vascular bypass procedures between January 1999 and June 2003. A minimal access approach was used for access to the proximal anastomotic site (proximal common iliac or distal aorta) and creation of a tunnel for the prosthetic graft placement up to the distal anastomotic site. Altogether, 11 iliofemoral bypasses, 2 iliobifemoral bypasses and 2 aortobifemoral bypasses were performed. Patients with diffuse stenosis/long-segment occlusion and multiple lesions for whom percutaneous transluminal angioplasty with stenting proved to be unsuitable were included. The outcome parameters measured were intraoperative time, intraoperative blood loss, skin incision length, length of hospital stay, postoperative pain and analgesia requirement, and patency of graft.Results: Videoendoscopy was used to complete 14 procedures. The mean operating time was 258 +/- 49 min (range, 180-300 min) and the mean blood loss was 124 +/- 28.23 ml (range, 80-150 ml). The mean hospital stay was 6.7 +/- 4.46 days (range, 4-9 days). After a mean follow-up period of 14.4 +/- 3.55 months (range, 6-20 months), all grafts were patent.Conclusion: Videoendoscopically assisted vascular surgery for iliac and aortoiliac occlusive disease by a combined retroperitoneal and pelvic extraperitoneal approach is feasible and appears to confer many advantages of minimal access surgery. However, prospective randomized trials are needed to define clearly any advantages of this approach over conventional surgery. [ABSTRACT FROM AUTHOR]

Summary: The purpose of this study was to develop and evaluate a method for automatic endoscopic motion compensation (MC) specialized for laryngeal high-speed videoendoscopy (HSV) of sustained phonation. Specifically, the left-right and posterior-anterior endoscopic shifts were addressed. The method is based on the hypothesis that the difference between endoscopic and vocal fold dynamics is sufficient for accurate estimation of the endoscopic motion relative to the vocal folds. The research questions of particular interest were as follows: is MC of laryngeal HSV possible at the subpixel level, and what are the validity, reliability, and accuracy of the proposed MC method? First, the MC accuracy was assessed on simulated HSV data with exactly known motion trajectories. Then, the accuracy and reliability of MC were evaluated on real HSV data. Finally, the validity of MC was established by correlating objective to perceptual ratings. The method demonstrated subpixel accuracy and reliable performance when tested on both simulated and real data. Perceptual ratings of the endoscopic motion demonstrated high intrarater and interrater reliabilities. Perceptual and quantitative assessments of endoscopic motion were in agreement. The reported result is encouraging for resolving a persistent problem toward building better methods for visual and quantitative voice assessment. [Copyright &y& Elsevier]