Katoh J, Hayakawa M, Ishihara K, Kazumi T
Department of Internal Medicine, Hyogo Rehabilitation Center Hospital, Kobe.
Nihon Ronen Igakkai Zasshi. 2000 Jun;37(6):490-4. doi: 10.3143/geriatrics.37.490.
A 65-year old man was admitted with severe dysphagia, ataxia and aspiration pneumonia. Dysphagia and ataxia were caused by lateral medullary infarction (Wallenberg's syndrome). The swallowing abnormality was assessed by videofluorography and we attempted the balloon dilatation method for cricopharyngeal dysphagia. Three months after initiation of swallowing training, videofluorography (VF) showed that the magnitude of aspiration to the trachea had decreased and the patient began taking food by mouth. The balloon dilatation method is successful for chronic stage cricopharyngeal dysphagia and the VF test is useful for quantitative assessment of dysphagia and for deciding when to start oral intake in elderly patients.
一名65岁男性因严重吞咽困难、共济失调和吸入性肺炎入院。吞咽困难和共济失调由延髓外侧梗死(Wallenberg综合征)引起。通过电视荧光吞咽造影评估吞咽异常情况,并尝试用球囊扩张法治疗环咽肌吞咽困难。吞咽训练开始三个月后,电视荧光吞咽造影(VF)显示气管吸入量减少,患者开始经口进食。球囊扩张法对慢性期环咽肌吞咽困难治疗有效,VF检查有助于对吞咽困难进行定量评估,并有助于确定老年患者何时开始经口进食。