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A case of severe dysphagia following the removal of a parapharyngeal space tumor Nami Noto 1 , Rumi Ueha 2 , Yuki Saito 2 , Takaharu Nito 2 , Haruhi Inokuchi 3 , Nobuhiko Haga 1,3 1Rehabilitation Center, The University of Tokyo Hospital 2Department of Otolaryngology, The University of Tokyo Hospital 3Department of Rehabilitation Medicine, Graduate School of Medicine, The University of Tokyo Keyword: 副咽頭間隙腫瘍 , 下位脳神経障害 , 嚥下障害 , 摂食嚥下リハビリテーション , parapharyngeal space tumors , hypostatic cranial nerve disorder , dysphagia , dysphagia rehabilitation pp.104-112
Published Date 2015/6/15
DOI https://doi.org/10.11477/mf.6001200041
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 Tumors arising in the parapharyngeal space are relatively rare. Surgical treatment carries a risk of postoperative dysphagia caused by hypostatic cranial nerve disorder. We report a patient who experienced severe dysphagia following the removal of a parapharyngeal space tumor.

 A woman in her 50s with multiple neurogenic tumors which were caused by neurofibromatosis type 1 had been diagnosed with right vocal cord paralysis upon removal of a mediastinal tumor. After the parapharyngeal space tumor resection, severe dysphagia was recognized. Delay of the pharyngeal phase, reduced laryngeal elevation and dysfunction of the pharyngeal constriction, velopharyngeal closure and upper esophageal sphincter were observed in videofluorography(VF). The patient has undergone rehabilitation involving indirect therapy, head rotation during swallowing and voluntary airway protection from the seventh postoperative day. Approximately two months later, the patient was able to achieve full oral intake.

 Rehabilitation based on functional evaluation with periodic VF assessment was effective for our patient without causing aspiration pneumonia.


Copyright © 2015, Japanese Association of Speech-Language-Hearing Therapists. All rights reserved.

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電子版ISSN 印刷版ISSN 1349-5828 日本言語聴覚士協会

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