学童期に発症した小児嚥下障害の4症例

Four school-aged children with dysphagia

Ⅰ　はじめに

　小児の嚥下障害に関する報告の多くは，脳性麻痺にかかわるものであり，経口摂取方法，栄養管理，嚥下性肺炎の防止などが取り上げられることが多い^1～4）。筆者らが渉猟した範囲では，1983年以降，学童期の脳血管障害や外傷，自己免疫性筋疾患による嚥下障害の報告は散見されるものの^5～7），脳性麻痺に伴う嚥下障害以外の嚥下障害の治療やリハビリテーションに関する詳細な報告はない。今回われわれは脳血管障害や外傷により嚥下障害を起こした学童期小児症例を治療する機会を得たので若干の文献的考察を加えて報告する。

　This report dealed with 4 school-aged children with dysphagia. The subjects consisted with 2 children with arteriovenous malformation,one with cerebral thrombosis and the one with traffic brain injury.

　In conclusion,stability of the trunk was important in treatments of dysphagia. Children at school age who were expected growth and development did not have enough mental ability to understand their disability and rehabilitation as was expected in adults. Rehabilitation approaches in children were quite different from those in adults. Cooperation with pediatricians and otolaryngologists is necessary in treatment of children's dysphagia combined with multiple disabilities.