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Pharyngeal stability is ensured by both anatomical and non-anatomical factors. In addition to the anatomical width, functional factors are also significant in determining the degree of obstruction of the upper airway. The functionality of the pharyngeal muscles depends on an undisturbed sensorimotor system. In patients with rhonchopathy or obstructive sleep apnea (OSA), sensorimotor function and muscle morphology change progressively. It is hypothesised that long-term snoring leads to vibration-induced sensorimotor neuropathy, resulting in the loss of function and structure of the pharyngeal muscles. Pharyngeal mechanoreceptors lose their sensitivity, and due to neural damage, information can no longer be adequately translated into motor responses. This raises the question of the timeframe within which irreversible vibration-induced receptor damage occurs due to snoring., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

Objective: Head-and-neck cancer patients run a high risk of peri- or post-treatment malnutrition that can severely affect the therapy outcome. However, little is known about malnutrition under the pre-treatment condition. Therefore, this study aimed to provide a systematic description of the pre-treatment nutritional status and risk of malnutrition in this population., Material and Methods: Before the onset of the oncological therapy, nutritional status of 102 head-and-neck cancer patients was assessed by body mass index (BMI), their risk of malnutrition by "Nutritional Risk Screening" (NRS). Tumour stage and site, patients' age and sex as well as oropharyngeal dysphagia were analysed as possible influence factors. The latter was quantified by the Flexible Endoscopic Evaluation of Swallowing (FEES)., Results: According to BMI, malnutrition (undernutrition) was found in 6% of patients, a risk of malnutrition (NRS) in 27% of patients, and oropharyngeal dysphagia in 15%. In a linear regression, only oropharyngeal dysphagia was identified as a significant influence factor for the risk of malnutrition ( β = 0.380/3.776; p < .001)., Conclusions: Pre-treatment risk of malnutrition was found in a quarter of head-and-neck cancer patients. For the early identification of this risk and for the introduction of measures that would help to avoid it, a pre-treatment examination of swallowing functions and a systematic malnutrition screening by means of NRS are recommended., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

We present the case of an otherwise healthy 19-year-old student who has been affected by vocal cord dysfuntion (VCD) since she is fourteen. 3 years after that diagnosis she has also been coughing blood at an increasing rate (1-3 times per week). We postulate that the haemoptoe is the result of breathing against a closed airway which can lead to excessively high negative intrathoracic pressures. Which, in turn, rapture alveolar capillaries. After bilateral injection of Botulinum toxin injection into the muscles vocalis, VCD as well as haemoptoe episodes ceased for three months., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Objective:  Dysphagia constitutes a frequent post-operative functional impairment in head-and-neck cancer patients. This impairment can result in aspiration/penetration and limitations of oral intake. Therefore, often it requires a therapeutic intervention. In this study, prevalence of post-operative dysphagia and its associations with the tumour stage, localisation, patients' age, and biological sex were analysed for the inpatient treatment setting., Material and Methods:  A total of 201 adult head-and-neck cancer patients (mean age 63 years) were analysed prospectively by FEES in two university hospitals in regard to their penetration/aspiration, limitations of oral intake, and need for therapeutic interventions directly after the operative tumour treatment. Additionally, the influence of the same patients' characteristics on these three parameters were analysed by means of univariate and multivariate statistical methods., Results:  Out of 201 patients, 66.7 % needed a therapeutic intervention because of their dysphagia, 57.2 % needed a nasogastral or PEG tube due to limitations of oral intake, 45.3 % had an aspiration. In the latter subgroup, 38.5 % had a silent aspiration. Higher tumour stage, patients' higher age and male sex were shown to be significant influence factors for dysphagia, tumour localisation showed only a marginally significant result., Conclusions:  The study demonstrated a clinical importance and relevance of the consequent and systematic treatment of post-operative dysphagia in head-and-neck cancer patients in the acute care units as a constituent of a modern oncological therapy., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.

In the presented study video-head impulse test (vHIT) was performed in 72 patients with complaints of dizziness for more than 3 months who did not show any pathology in rotatory chair testing or caloric test, in order to analyzed high frequency vestibular-ocular-reflex (VOR). Retrospective data analyzed of rotatory chair testing, caloric tests and vHIT results were accomplished in 72 patients. Gain, gain variance and the occurrence of catch-up saccades were measured. 10 patients (n=10; 13.8%) showed pathologic vHOR results with reduced gain. In the remaining 62 patients, a median gain of 0.85 when tested to the right respectively 0.87 when tested to the left side was assed. Especially in patients with normal results in rotatory chair testing and caloric testing, who complain of persistent dizziness and imbalance, high frequency hVOR should also be evaluated using vHIT in order to objectify and document an isolated high frequency hVOR lesion., Competing Interests: Interessenkonflikt: Kein Interessenkonflikt angegeben., (© Georg Thieme Verlag KG Stuttgart · New York.)

The NOS3-786 T/C polymorphism (rs2070744) is a candidate to explain individual variations in sports related phenotypes. We determined the genotype and allele frequency of NOS3-786 T/C in a group of 60 male professional elite soccer players. Their results were compared with those of 100 world-class endurance athletes, 53 elite power athletes, and 100 sedentary, healthy men (controls) of the same Caucasian (Spanish) origin. There were significant differences in genotype frequencies between soccer players, controls, endurance and power elite athletes (all P ≤ 0.02). These results were confirmed when we analysed allelic frequencies (all P<0.01). The likelihood of having the C allele was higher in soccer players compared with (i) controls [odds ratio (OR), 2.165, 95% confidence interval (CI): 1.362-3.441], (ii) endurance athletes (OR: 1.879, 95%CI: 1.184-2.984), and (iii) power athletes (OR: 4.032, 95%CI: 2.307-7.047). In conclusion, the -786C allele is associated with the status of being an elite soccer player, compared with non-athletic controls and also with elite endurance and power athletes. More research is needed in other groups of elite soccer players in order to replicate the results of the present study., (© Georg Thieme Verlag KG Stuttgart · New York.)