SP-3-02-E-04
EFFECT OF LINGUAL NERVE ANESTHESIA ON SWALLOWING
Keiji Tanimoto, Yoshikazu Suei, Toshikazu Yamada, Tomiko Fukuda (Hiroshima University, Hiroshima, Japan), Tatsuya Fujiki (Okayarea University, Okayama, Japan)
Purpose: To know the effect on oral and pharyngeal phases of swallowing by lingual nerve anesthesia.
Subject & Method: Five volunteers were participated with informed consent. A lateral cinematographic examination of swallowings was executed at the speed of 1/30 S. The subjects were examined twice, three swallowings each. 10 ml Barium sulphate solution was used as a swallowing material. The first examination was done as controls. In the second examination, bilateral lingual nerves were anesthetized with 2 % xylocaine by conductive anesthesia. A dentist examined the sensation on lingual surface by touching a pair of tweezers, and additional anesthesia was given in the case ineffective.
The developed cinefilms were analyzed using the angiogram projection system. Motion observation and time measurement were done.
Result: The holding pattern of bolus was changed in 3 subjects. Laryngeal penetration was observed in 1 subject in control. In 3 subjects, laryngeal penetration appeared 1, 2, 3 times respectively. No aspiration occurred. The position of the tongue tip was changed in all subjects.
Conclusion: The relationship between oral and pharyngeal swallowing was thought to be very important. The result of this experiment may indicate that oral phase sensation may effect on the pharyngeal function.
SP-3-02-E-05
PROGNOSIS OF POSTSTROKE DYSPHAGIA
Mana Yamori (Komagome Hospital, Tokyo, Japan), Hiromi Oka, Noriko Sano (Otsuka Hospital), Keiko Nojima (Neurological Hospital), and Jun Hasegawa (Hiroshima Prefectural College, Hiroshima)
Purpose: The purpose of this investigation is to determine the prognosis factors of poststroke dysphagia, and the effectiveness of swallowing therapy. After detection, we can make a decision concerning the duration and contents of the treatment for poststroke dysphagic patients.
Method: We evaluated 197 stroke patients by means of videofluoroscopic study (VFS) from 1989 to 1995. The videotapes of VFS, medical charts and therapy records were reviewed using the following variables: 1) Extent of improvements, 2) age, 3) months after onset, 4) duration of treatment, 5) mobility, 6) speech and/or language symptom(s), 7) speech intelligibility, and 8) type and timing of aspiration.
Results: The swallowing therapy can improve a patient's oral movement and timing of the swallow reflex. However, these patients with the following symptom(s) showed poor improvement: 1) More than 80 years old, 2) less than 3 months after onset and duration of treatment, 3) difficulty to maintain the sitting position, 4) non-fluent aphasia, 5) speech intelligibility below the 3rd grade, 6) silent aspirator, 7) dysfunction of cricopharyngeal muscle.
Conclusion: Poststroke dysphagia should be treated by a multidisciplinary team for sufficient period.
