Case report on the effectiveness of balloon-guided rehabilitation and chemical stimulation in the reacquisition of swallowing movements after total laryngectomy Minoru Toyama 1 , Akiko Tsuyama 2 , Junichi Mori 1 , Kouji Satou 1 , Hiroshi Etou 1 1Department of Rehabilitation Medicine, Yufuin Kouseinenkin Hospital 2Department of Rehabilitation, Shida Hospital Keyword: 嚥下障害 , 誤嚥性肺炎 , 喉頭全摘出術 , 化学刺激 , バルーン訓練法 , dysphagia , deglutition pneumonia , total laryngectomy , chemical stimulation , balloon-guided rehabilitation pp.45-52
Published Date 2009/3/15
DOI https://doi.org/10.11477/mf.6001100190
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 We encountered a case of cerebral vascular disturbance in which aglutition developed after total laryngectomy. In this case, the postoperative esophageal sphincter function remained intact, but the dilation of the esophageal inlet and esophageal transit, which are necessary for oral ingestion, were compromised. Therefore, for the remaining esophageal sphincter function, balloon training was conducted in an attempt to enhance the deglutition reflex induced by sensory impulses (hereafter called induction of the deglutition reflex). As a result, the deglutition reflex was induced by balloon dilation between the cricopharyngeal part and the hypopharynx, and confirmation of the deglutition state using VF and direct deglutition training became possible. Furthermore, by adding chemical stimulants to the food to facilitate deglutition training, the delay in the deglutition reflex decreased and the patient finally regained oral ingestion function. It is suggested that the balloon training and chemical stimulation are useful techniques to promote postoperative deglutition reflex. It is also suggested that when introducing postsurgical direct swallowing training, attention should be given to food selection in consideration of dysgeusia and the presence of permanent tracheostomy, as well as the effective application of chemical stimuli.

Copyright © 2009, Japanese Association of Speech-Language-Hearing Therapists. All rights reserved.


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