A Case of Dysphagia after Operation on a Large Cerebellar-Pontine Angle Tumor

Abstract

We reported a 20-year-old female with dysphagia after operation on a large cerebellar-pontine angle tumor, who achieved successful results with conservative therapy by a physical therapist. The patient had diplopia, light palsy of the soft palate and vocal folds, hemiplegia on the right side and light ataxia; however, she was independent in ADL except for eating. She was alimentated by noso-gastric tube. At standing and sitting, her neck flexed anteriorly to the left. Evaluation by the physical therapist showed that the extensors of the neck and trunk were overactivated continuously, causing the neck and trunk to be locked in extended position. In a pharyngoesophagogram, the neck flexed anteriorly as in the chin-down method. The pharyngoesophagogram showed aspiration, and disorder of hyoid bone movement and laryngeal cartilages during swallowing. She was taught self-insertion of the naso-gastric tube. Physical therapy was performed mainly to adjust muscle tone. Her neck posture changed four weeks after the physical therapy. The pharyngoesophagogram at that time showed her symptom were almost normal. These findings suggest that direct therapy by physical therapists to patients with dysphagia is effective.