The aortic arch normally causes no symptomatic physiological constriction of the esophagus. Symptoms of dysphagia are generally observed in the presence of specific conditions, such as an aortic aneurysm. In the present case, during a videofluoroscopic swallowing study (VFSS), the authors incidentally found that despite the absence of an aortic lesion, the dysphagia observed in a stroke patient was caused by compression from the aortic arch. The patient complained of discomfort when swallowing, similar to a bolus lodged in the chest, which was consistent with compression by the aortic arch found on the VFSS and chest computed tomography (CT). After undergoing dysphagia therapy, the VFSS after 52 days revealed improved swallowing function; however, the sensation of food lodging in the chest due to compression by the aortic arch persisted. We conclude that although the physiological constriction of the esophagus by the aortic arch is usually asymptomatic, the constriction can be a factor that exacerbates the swallowing function in patients with dysphagia, and should therefore be considered during the differential diagnosis.

In cases of inadequate nutrition among individuals with dysphagia, nasogastric tube insertion is considered for nutritional supplementation. Typically, the complications of nasogastric tube insertion are not severe. In rare cases, however, nasal or nasopharyngeal injury caused by the self-knotting of nasogastric tubes can occur. This paper presents a case of spontaneous knotting of a nasogastric tube and its removal in a patient with aspiration pneumonia caused by dysphagia. This case shows that self-knotting must be considered when there is strong resistance during the removal of a nasogastric tube.

An intraneural ganglion in the peripheral nerve and the resulting ulnar neuropathy at the elbow are uncommon and may show various symptoms ranging from local pain to motor and sensory impairment. We report a case of a 76-year-old man who was diagnosed with ulnar neuropathy caused by an intraneural ganglion derived from the elbow. We also discuss the pathophysiology, treatment, prognosis, and diagnostic value of ultrasonography in neuropathy caused by a ganglion.

An intraneural ganglion in the peripheral nerve and the resulting ulnar neuropathy at the elbow are uncommon and may show various symptoms ranging from local pain to motor and sensory impairment. We report a case of a 76-year-old man who was diagnosed with ulnar neuropathy caused by an intraneural ganglion derived from the elbow. We also discuss the pathophysiology, treatment, prognosis, and diagnostic value of ultrasonography in neuropathy caused by a ganglion.

The aortic arch normally causes no symptomatic physiological constriction of the esophagus. Symptoms of dysphagia are generally observed in the presence of specific conditions, such as an aortic aneurysm. In the present case, during a videofluoroscopic swallowing study (VFSS), the authors incidentally found that despite the absence of an aortic lesion, the dysphagia observed in a stroke patient was caused by compression from the aortic arch. The patient complained of discomfort when swallowing, similar to a bolus lodged in the chest, which was consistent with compression by the aortic arch found on the VFSS and chest computed tomography (CT). After undergoing dysphagia therapy, the VFSS after 52 days revealed improved swallowing function; however, the sensation of food lodging in the chest due to compression by the aortic arch persisted. We conclude that although the physiological constriction of the esophagus by the aortic arch is usually asymptomatic, the constriction can be a factor that exacerbates the swallowing function in patients with dysphagia, and should therefore be considered during the differential diagnosis.

Since dysphagia is a common occurrence after a stroke, assessing the swallowing function in stroke patients is important. Killian-Jamieson diverticulum is a rare esophageal diverticulum that leads to various complications.However, few studies have reported the presence of the Killian-Jamieson diverticulum subsequent to a cerebral infarct. A 66-year-old woman diagnosed with left periventricular white matter infarction complained of dysphagia.A suspected diverticulum observed in the first videofluoroscopic swallowing study (VFSS) was thought to be unrelated to the patient’s symptoms. However, since the patient continued to complain of dysphagia, computed tomography was performed to detect any anatomical abnormalities that could cause dysphagia. An approximately 12 mm-sized Killian-Jamieson diverticulum was found on the left side of the esophagus at the C5-6 level. A reversed flow from the diverticulum was observed in the following VFSS. No treatment was administered as the caregiver disagreed with the patient’s aggressive treatment options, which included surgical procedures such as diverticulectomy and cricopharyngeal myotomy. Only periodic VFSS follow-up was continued. The association between Killian-Jamieson diverticulum and cerebral infarction remains unclear. This case underlines the importance of considering an esophageal diverticulum in patients with aggravated swallowing difficulties after cerebral infarction.

The cricopharyngeus muscle (CPM), an important anatomical component of the upper esophageal sphincter (UES), is controlled by reflexive contraction and relaxation movements that are coordinated with swallowing and breathing.In cricopharyngeal dysfunction (CPD) the CPM does not relax to allow food to enter the esophagus or it relaxes in an uncoordinated manner, causing dysphagia. Prolonged CPD may lead to malnutrition, dehydration, weight loss, or aspiration, and therefore, prompt treatment is essential. A 41-year-old female diagnosed with left lateral medullary infarction demonstrated relative improvement in cognitive, language, and motor dysfunctions following acute treatment. However, her swallowing disorder continued from time of onset of symptoms. Balloon dilatation was performed at various frequencies, and gradually the patient was trained to perform the procedure on her own. The effects of balloon dilatation were evaluated continuously through repetitive videofluoroscopic swallowing studies. While balloon dilatation is a widely used method for treating CPD, its use has not yet been standardized. The diameter, pressure, and extension time of the balloon depend greatly on the operator’s personal experience. This case is valuable because we determined the optimal frequency of balloon dilatation for the patient through a series of attempts at various frequencies. Furthermore, performing balloon dilatation on her own helped with her early recovery and discharge. Due to this individualized treatment, the patient could safely progress to a regular diet from being fed through a tube.

The cricopharyngeus muscle (CPM), an important anatomical component of the upper esophageal sphincter (UES), is controlled by reflexive contraction and relaxation movements that are coordinated with swallowing and breathing.In cricopharyngeal dysfunction (CPD) the CPM does not relax to allow food to enter the esophagus or it relaxes in an uncoordinated manner, causing dysphagia. Prolonged CPD may lead to malnutrition, dehydration, weight loss, or aspiration, and therefore, prompt treatment is essential. A 41-year-old female diagnosed with left lateral medullary infarction demonstrated relative improvement in cognitive, language, and motor dysfunctions following acute treatment. However, her swallowing disorder continued from time of onset of symptoms. Balloon dilatation was performed at various frequencies, and gradually the patient was trained to perform the procedure on her own. The effects of balloon dilatation were evaluated continuously through repetitive videofluoroscopic swallowing studies. While balloon dilatation is a widely used method for treating CPD, its use has not yet been standardized. The diameter, pressure, and extension time of the balloon depend greatly on the operator’s personal experience. This case is valuable because we determined the optimal frequency of balloon dilatation for the patient through a series of attempts at various frequencies. Furthermore, performing balloon dilatation on her own helped with her early recovery and discharge. Due to this individualized treatment, the patient could safely progress to a regular diet from being fed through a tube.

The cricopharyngeus muscle (CPM), an important anatomical component of the upper esophageal sphincter (UES), is controlled by reflexive contraction and relaxation movements that are coordinated with swallowing and breathing.In cricopharyngeal dysfunction (CPD) the CPM does not relax to allow food to enter the esophagus or it relaxes in an uncoordinated manner, causing dysphagia. Prolonged CPD may lead to malnutrition, dehydration, weight loss, or aspiration, and therefore, prompt treatment is essential. A 41-year-old female diagnosed with left lateral medullary infarction demonstrated relative improvement in cognitive, language, and motor dysfunctions following acute treatment. However, her swallowing disorder continued from time of onset of symptoms. Balloon dilatation was performed at various frequencies, and gradually the patient was trained to perform the procedure on her own. The effects of balloon dilatation were evaluated continuously through repetitive videofluoroscopic swallowing studies. While balloon dilatation is a widely used method for treating CPD, its use has not yet been standardized. The diameter, pressure, and extension time of the balloon depend greatly on the operator’s personal experience. This case is valuable because we determined the optimal frequency of balloon dilatation for the patient through a series of attempts at various frequencies. Furthermore, performing balloon dilatation on her own helped with her early recovery and discharge. Due to this individualized treatment, the patient could safely progress to a regular diet from being fed through a tube.

The cricopharyngeus muscle (CPM), an important anatomical component of the upper esophageal sphincter (UES), is controlled by reflexive contraction and relaxation movements that are coordinated with swallowing and breathing.In cricopharyngeal dysfunction (CPD) the CPM does not relax to allow food to enter the esophagus or it relaxes in an uncoordinated manner, causing dysphagia. Prolonged CPD may lead to malnutrition, dehydration, weight loss, or aspiration, and therefore, prompt treatment is essential. A 41-year-old female diagnosed with left lateral medullary infarction demonstrated relative improvement in cognitive, language, and motor dysfunctions following acute treatment. However, her swallowing disorder continued from time of onset of symptoms. Balloon dilatation was performed at various frequencies, and gradually the patient was trained to perform the procedure on her own. The effects of balloon dilatation were evaluated continuously through repetitive videofluoroscopic swallowing studies. While balloon dilatation is a widely used method for treating CPD, its use has not yet been standardized. The diameter, pressure, and extension time of the balloon depend greatly on the operator’s personal experience. This case is valuable because we determined the optimal frequency of balloon dilatation for the patient through a series of attempts at various frequencies. Furthermore, performing balloon dilatation on her own helped with her early recovery and discharge. Due to this individualized treatment, the patient could safely progress to a regular diet from being fed through a tube.