Charlie Myer

24 timestamped statements across 1 topic — auto-found in recorded discussions, each timestamp jumps to the exact moment. Summaries Charlie gave as host are listed separately below.

Featured statements

▶ Ep 5 · 3:05
I do what I call the poor man's feast where I actually just take my 2.2 mm scope and touch various points around the larynx and see if I elicit a cough or a swallow or a very unhappy child.
quote · Aspiration
▶ Ep 5 · 1:15
Most of the kids that have injuries to the recurrent laryngeal nerve are not high vagal injuries.
quote · Aspiration

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Charlie's statements about Aspiration 24 statements

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QUAD #19: Laryngeal Sensory Reinnervation with Dr. Charles Myer IV

▶ Ep 5 · 0:44
clinical Swallowing is not just a motor issue, it's also a sensory issue requiring combined focus on both components. ↗
▶ Ep 5 · 0:44
quote We know that swallowing is not just a motor issue, it's also a sensory issue. It's a combined focus of both, and so we need to look at both of those things when we move along. ↗
▶ Ep 5 · 1:00
clinical Laryngeal sensation is a vagal function that comes in through the ipsilateral internal branch of the superior laryngeal nerve. ↗
▶ Ep 5 · 1:15
epidemiological Most children with recurrent laryngeal nerve injuries do not have high vagal injuries; the etiology is often iatrogenic from cardiac procedures or thyroid surgery. ↗
▶ Ep 5 · 1:15
quote Most of the kids that have injuries to the recurrent laryngeal nerve are not high vagal injuries. ↗
▶ Ep 5 · 1:50
clinical FEES plus sensory testing uses a calibrated air pulse by a generator to stimulate the laryngeal adductor reflex for objective assessment of laryngeal sensation. ↗
▶ Ep 5 · 2:20
clinical The laryngeal adductor reflex is an involuntary reflection that can be observed as a brief break in respiration or stimulation of a swallow or laryngeal squeeze on video. ↗
▶ Ep 5 · 3:05
clinical A clinical examination technique involves using a 2.2 mm scope to touch various points around the larynx to elicit a cough, swallow, or response in the child. ↗
▶ Ep 5 · 3:05
quote I do what I call the poor man's feast where I actually just take my 2.2 mm scope and touch various points around the larynx and see if I elicit a cough or a swallow or a very unhappy child. ↗
▶ Ep 5 · 5:15
quote The results you're going to see are really going to happen between 9 to 12 months. ↗
▶ Ep 5 · 5:15
clinical Results of sensory reinnervation are expected to occur between 9 to 12 months post-operatively. ↗
▶ Ep 5 · 5:25
opinion Sensory reinnervation should be considered for patients with sensory deficits, high degree of aspiration, and when at the end of other treatment options to improve swallowing or protect lungs. ↗
▶ Ep 5 · 6:30
quote What really pushed us to move forward was that he was having early bronchiectatic changes on a CT scan. ↗
▶ Ep 5 · 6:50
clinical Combined ansa to recurrent laryngeal nerve and greater auricular to internal branch of the superior laryngeal nerve anastomosis can be performed simultaneously. ↗
▶ Ep 5 · 7:05
clinical Bilateral submandibular gland excision and parotid duct ligation can be combined with sensory reinnervation procedures. ↗
▶ Ep 5 · 7:25
quote And so at this point now several years later, he's tolerating a full oral diet, he's decannulated. He's not had progression of any of his pulmonary changes. No pneumonias and is doing great. ↗
▶ Ep 5 · 8:10
epidemiological There is a lack of publications on laryngeal sensory reinnervation and no pediatric outcome data in the literature. ↗
▶ Ep 5 · 8:10
quote But then Dr. Myer points out that the problem they have is the lack of publications on this matter. There's not any pediatric wards when I talk to the folks who are doing this, we're seeing variable results. ↗
▶ Ep 5 · 8:25
clinical Clinicians performing sensory reinnervation are seeing variable results in practice. ↗
▶ Ep 5 · 8:35
opinion Swallowing is a combined neurological function of both motor and sensation, and while motor issues are often addressed, sensation may be ignored. ↗
▶ Ep 5 · 8:35
quote In summary, we need to remember that swallowing is a combined neurological function of both motor and sensation. While we often times address the motor piece, we may ignore the sensation. ↗
▶ Ep 5 · 8:50
opinion If a patient displays signs of poor sensation beyond isolated recurrent laryngeal nerve injury, reinnervating the sensory component should be considered. ↗
▶ Ep 5 · 9:05
clinical Long-term results for large populations and optimal timing for sensory reinnervation are not yet clear. ↗
▶ Ep 5 · 9:20
opinion Sensory reinnervation is an emerging technique that can be useful in salvage cases. ↗

Summaries Charlie gave as host · 9 summaries

Recaps of what the experts said, with Charlie as narrator — not Charlie's own clinical position, and never cited in answers.

Summaries Charlie gave as host · Aspiration 9 summaries

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QUAD #19: Laryngeal Sensory Reinnervation with Dr. Charles Myer IV

▶ Ep 5 · 2:50
host summary Charlie Myer summarizing a resource: Dr. Thompson's work in pediatric FEES found a correlation between pooled hypopharyngeal secretions and sensory testing thresholds. ↗
▶ Ep 5 · 3:40
host summary Charlie Myer summarizing a resource: Dr. Jonathan Aviv described microneurorraphy between the greater auricular nerve and the internal branch of the superior laryngeal nerve in 1997 with two patients. ↗
▶ Ep 5 · 4:00
host summary Charlie Myer summarizing a resource: Dr. Aviv's patients had central nervous system injuries and strokes with motor and sensory deficits in the larynx and significant aspiration pneumonia burden. ↗
▶ Ep 5 · 4:15
host summary Charlie Myer summarizing a resource: Dr. Aviv combined internal branch of the superior laryngeal nerve reanastomosis with the greater auricular nerve with CP myotomy and mandibular hyoid suspension. ↗
▶ Ep 5 · 4:35
host summary Charlie Myer summarizing a resource: In Dr. Aviv's study, improvement in sensation was not seen until around 6 to 12 months post-operatively when tested with FEES. ↗
▶ Ep 5 · 4:35
host summary Charlie Myer summarizing a resource: They had good results in the swallowing and aspiration outcomes, but it wasn't until around 6 to 12 months that he saw an improvement in the sensation when he tested with feast. ↗
▶ Ep 5 · 4:50
host summary Charlie Myer summarizing a resource: And people describe that it's a tingling sensation in the upper neck or in the earlobe during swallowing. ↗
▶ Ep 5 · 4:50
host summary Charlie Myer summarizing a resource: Patients describe a tingling sensation in the upper neck or earlobe during swallowing after sensory reinnervation, providing a sensory cue to help protect the airway. ↗
▶ Ep 5 · 7:55
host summary Charlie Myer summarizing a resource: In Dr. Aviv's work, two out of two patients had improvement in sensation at 12 months with significant improvement. ↗