Jiang Yu-Er, Lyu Qian-Qian, Lin Feng, You Xue-Ting, Jiang Zhong-Li
Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing 211100, Jiangsu Province, China.
World J Clin Cases. 2020 Mar 26;8(6):1142-1149. doi: 10.12998/wjcc.v8.i6.1142.
A swallowing disorder may occur following a brainstem stroke, especially one that occurs in the swallowing centers. Lateral medullary syndrome (referred to as LMS), a rare condition in which a vascular event occurs in the territory of the posterior inferior cerebellar artery or the vertebral artery, has been reported to lead to more severe and longer lasting dysphagia.
We report two patients with dysphagia due to LMS and propose a novel technique named hyoid-complex elevation and stimulation technique (known as HEST). The two patients had no other functional incapacity back into life, but nasogastric feeding was the only possible way for nutrition because of severe aspirations. Swallowing function was evaluated by functional oral intake scale, modified water swallow test, surface electromyographic signal associated with video fluorography swallowing study to assess the situation of aspiration, pharyngeal residue, pharyngeal peristalsis, upper esophageal opening and the ability of deglutition. Both patients were treated with the HEST method for dysphagia and recovered quickly.
HEST is effective for shortening the in-hospital time and improving the quality of life for patients with dysphagia who suffer from LMS and likely other strokes.
脑干卒中后可能会出现吞咽障碍，尤其是发生在吞咽中枢的卒中。外侧延髓综合征（简称LMS）是一种罕见的疾病，后下小脑动脉或椎动脉供血区域发生血管事件，据报道会导致更严重、持续时间更长的吞咽困难。
我们报告了两名因LMS导致吞咽困难的患者，并提出了一种名为舌骨复合体抬高与刺激技术（简称HEST）的新技术。这两名患者恢复生活后没有其他功能障碍，但由于严重误吸，鼻饲是唯一可行的营养途径。通过功能性经口摄食量表、改良水吞咽试验、与视频荧光吞咽造影研究相关的表面肌电信号来评估吞咽功能，以评估误吸、咽部残留、咽部蠕动、食管上括约肌开口及吞咽能力的情况。两名患者均采用HEST方法治疗吞咽困难，恢复迅速。
HEST对于缩短LMS及可能的其他卒中所致吞咽困难患者的住院时间和提高生活质量有效。
