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ワカバヤシ ヒデタカ
Wakabayashi Hidetaka
若林 秀隆 所属 医学部 医学科（東京女子医科大学病院） 職種 教授・基幹分野長 |
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| 論文種別 | 症例報告 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Glottal Closure Surgery for Dysphagia Associated with Cerebral Hemorrhage, Tongue Defect, and Sarcopenia: A Case Report |
| 掲載誌名 | 正式名：Progress in rehabilitation medicine 略 称：Prog Rehabil Med ISSNコード：24321354/24321354 |
| 掲載区分 | 国内 |
| 巻・号・頁 | 3,pp.20180020 |
| 著者・共著者 | Kishima Masako, Wakabayashi Hidetaka, Kanazawa Hideaki, Itoda Masataka, Nishikimi Toshio, Kishima Masako, Wakabayashi Hidetaka, Kanazawa Hideaki, Itoda Masataka, Nishikimi Toshio |
| 担当区分 | 2nd著者 |
| 発行年月 | 2018 |
| 概要 | Background: Dysphagia occurs often after oral cancer surgery. However, no case of dysphagia in combination with cerebral hemorrhage, tongue defect, and sarcopenia has been reported. We describe the case of a 70-year-old man with dysphagia associated with a cerebral hemorrhage, tongue defect, and sarcopenia who received rehabilitation nutrition and underwent glottal closure. Case: At age 48 years, the patient had the left part of his tongue removed because of cancer. Twenty-two years later, he developed dysphagia and right hemiplegia after a cerebral hemorrhage. The patient was diagnosed with sarcopenia based on a low left handgrip strength (10 kg) and reduced calf circumference (26.5 cm). The patient’s Functional Oral Intake Scale (FOIS) score was 1, and his tongue muscle mass indicated atrophy, making the maximum tongue pressure difficult to measure. Palatal augmentation prostheses (PAP) were made to increase swallowing and tongue pressures, and nutritional intake was changed from nasal tube feeding to a gastric fistula. Nutritional intake was increased to 2400 kcal/day and protein intake to 96 g/day. Although rehabilitation nutrition using PAP improved the patient’s nutritional status, the dysphagia did not improve, and therefore he underwent glottal closure. This resulted in a weight gain of 13.7 kg and increased tongue muscle strength and volume. The patient’s FOIS score increased to 7 (i.e., total oral diet with no restrictions) at 5 months after discharge. Discussion: Glottic closure surgery may be useful for improving oral ingestion, nutritional status, and activities of daily living. |
| DOI | 10.2490/prm.20180020 |
| PMID | 32789245 |