Hashimoto Yuu, Umemoto Yasunori, Suzuki Shigeru, Miyazaki Yuri, Nishimura Yukihide, Kouda Ken
Department of Rehabilitation Medicine, Wakayama Medical University Hospital, Wakayama, Japan.
Department of Rehabilitation Medicine, Yokohama City University School of Medicine, Yokohama, Japan.
J Prosthodont Res. 2025 Jan 10;69(1):76-81. doi: 10.2186/jpr.JPR_D_23_00158. Epub 2024 Aug 16.
Acute stroke often leads to dysphagia. In the oral stage of dysphagia, there is a potential for immediate benefit from using a palatal augmentation prosthesis (PAP). We investigated whether our quickly fabricated, simple, and expedited version of PAP would result in an immediate improvement in swallowing function after an acute stroke.
We analyzed the records of stroke patients that were hospitalized between October 2019 and March 2022 and met the following criteria: they had a rehabilitation prescription and had paralysis of facial or hypoglossal nerves and either repeated salivary swallowing test ≤2 times or modified water swallow test ≤3, they were fasting, were within 3 weeks of onset, and had a simple PAP made for them. Outcomes included with/without PAP, maximum tongue pressure, repeated salivary swallowing test, and modified water swallow test on the day after starting to wear PAP was started. In addition, within one week, a videofluoroscopic examination was performed to measure the oral transit time, pharyngeal transit time, and penetration aspiration scale. Statistical analyses were performed using Wilcoxon signed-rank tests. Statistical significance was set at P < 0.05.
Fifteen patients met the inclusion criteria and were included in this study. The mean age of the subjects was 76.9 ± 9.0 years. The use of PAP significantly increased maximum tongue pressure (P < 0.0001*) and shortened oral transit time (P < 0.0091*). There were no significant differences among the other items.
Simple PAP immediately increased the maximum tongue pressure and improved swallowing function during the oral stage.
急性中风常导致吞咽困难。在吞咽困难的口腔期，使用腭部增强假体（PAP）可能会立即带来益处。我们研究了快速制作、简单且加速版的PAP是否会使急性中风后吞咽功能立即得到改善。
我们分析了2019年10月至2022年3月期间住院的中风患者记录，这些患者符合以下标准：有康复处方，面部或舌下神经麻痹，重复唾液吞咽试验≤2次或改良水吞咽试验≤3次，处于禁食状态，发病在3周内，且为他们制作了简单PAP。结果包括佩戴PAP前后的最大舌压、重复唾液吞咽试验、改良水吞咽试验。此外，在一周内进行视频荧光透视检查以测量口腔通过时间、咽部通过时间和渗透误吸量表。使用Wilcoxon符号秩检验进行统计分析。统计学显著性设定为P < 0.05。
15名患者符合纳入标准并纳入本研究。受试者的平均年龄为76.9±9.0岁。使用PAP显著增加了最大舌压（P < 0.0001*）并缩短了口腔通过时间（P < 0.0091*）。其他项目之间无显著差异。
简单的PAP可立即增加最大舌压并改善口腔期的吞咽功能。
