舌癌術後嚥下障害患者に対する姿勢調節法の効果 : 健側傾斜姿勢の奏効例と非奏効例との比較 Effects of the postural technique on postoperative dysphagia in patients with tongue cancer : A comparison of improved cases with unimproved cases on head tilting toward the stronger side

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著者

    • 深澤 美樹 FUKASAWA Miki
    • 昭和大学歯学部顎口腔疾患制御外科学教室 Department of Oral and Maxillofacial Surgery, School of Dentistry, Showa University
    • 高橋 浩二 TAKAHASHI Koji
    • 昭和大学歯学部口腔リハビリテーション科 Department of Oral Rehabilitation, School of Dentistry, Showa University
    • 宇山 理紗 [他] UYAMA Risa
    • 昭和大学歯学部口腔リハビリテーション科 Department of Oral Rehabilitation, School of Dentistry, Showa University
    • 平野 薫 HIRANO Kaoru
    • 昭和大学歯学部口腔リハビリテーション科 Department of Oral Rehabilitation, School of Dentistry, Showa University
    • 中山 裕司 NAKAYAMA Hiroshi
    • 昭和大学歯学部顎口腔疾患制御外科学教室 Department of Oral and Maxillofacial Surgery, School of Dentistry, Showa University
    • 関 健次 SEKI Kenji
    • 昭和大学歯学部歯科放射線学教室 Department of Oral Radiology, School of Dentistry, Showa University
    • 南雲 正男 NAGUMO Masao
    • 昭和大学歯学部顎口腔疾患制御外科学教室 Department of Oral and Maxillofacial Surgery, School of Dentistry, Showa University

抄録

Postoperative dysphagia is often improved by postural compensatory techniques in patients with head and neck cancer. This study was done to evaluate the effects of postural technique on postoperative dysphagia in patients with tongue cancer. We compared improved cases with unimproved cases on head tilting toward the stronger side.<BR>Fifteen patients with dysphagia were subjects. All subjects swallowed 5ml of the contrast medium in both an upright position and with the head tilted toward the stronger side during videofluorographic (VF) examination. Eight patients (improved cases) showed aspiration in the upright position and no aspiration during head tilting. Seven patients (unimproved cases) showed aspiration in both the upright position and on head tilting.<BR>Tilting magnitude, vallecular angle, and epiglottic angle were measured on video prints. Pharyngeal delay time, pharyngeal passing time, and pharyngo-esophageal (PE) segment opening time were measured using a video motion analyzer. Retention amounts (intraoral, valleculae, and pyriform sinuses) were qualitatively evaluated on video prints.<BR>The results were as follows:<BR>1) Vallecular angle in the tilting posture was greater than that in the upright posture in 6 of the 8 improved cases.<BR>2) Vallecular angle in the tilting posture was smaller than that in the upright posture in 6 of the 7 unimproved cases.<BR>3) As compared with the upright position, pharyngeal delay time and pharyngeal passing time in the tilting posture were shorter in both the improved and the unimproved cases. The time difference between pharyngeal passing time and pharyngeal delay time in the tilting posture was a positive value in all improved case.<BR>4) PE segment opening time in the tilting posture was longer than that in the upright position in 5 of the 8 improved cases.<BR>5) PE segment opening time in the tilting posture was shorter than that in the upright position in 6 of the 7 unimproved cases.<BR>6) Intraoral retention amount after barium swallow during the tilting posture was mild in 7 of the 8 improved cases and in 6 of the 7 unimproved cases.<BR>7) Retention amounts in the valleculae and pyriform sinuses after barium swallow during the tilting posture were less in the improved cases than in the unimproved cases.

収録刊行物

  • 日本口腔外科学会雑誌  

    日本口腔外科学会雑誌 52(4), 225-233, 2006-04-20 

    Japanese Society of Oral and Maxillofacial Surgeons

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各種コード

  • NII論文ID(NAID)
    10018860048
  • NII書誌ID(NCID)
    AN00189163
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    00215163
  • NDL 記事登録ID
    7941637
  • NDL 雑誌分類
    ZS44(科学技術--医学--歯科学・口腔外科学)
  • NDL 請求記号
    Z19-145
  • データ提供元
    CJP書誌  CJP引用  NDL  J-STAGE 
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