A case study of the patient who suffered from dysphagia because of pontine hemorrhage

Abstract

Case study of a 58 year-old male who suffered from a hemorrhage of the right pons. He complained of dysphagia. After the hemorrhage the patient complained of dysphagia. The patient underwent 8 months of rehabilitative therapy however his symptom did not improve. A laryngoscopy revealed poolings of secretions in the vallecula and hypopharynx. A video fluoroscopy showed that the larynx wasn't elevated enough, and when the patient tried to swallow the upper esophageal sphincter didn't relax so aspiration of the secretions in the larynx occurred. The VF and the laryngoscopy were useful for evaluating the patient's swallowing process. Eventually it was decided to perform a laryngeal elevation and tracheostoma plasty. Though laryngeal elevation is usually combined with cricopharyngeal myotomy, and though cricopharyngeal myotomy might have shortened the required time for rehabilitation, the laryngeal elevation was only performed in this case, because a tracheostoma plasty was needed for the patient's rehabilitation after the operation. The laryngeal elevation improved the patient's dysphagia. Approximately one year's retraining was necessary for the patient to learn to swallow again.