筋萎縮性側索硬化症39例の検討

主に気管切開と滲出性中耳炎について

抄録

From 1989 to 2005, we investigated 39 cases of amyotrophic lateral sclerosis (ALS) that were first examined by an otolaryngologist at this hospital.
As a background of ALS patients, we investigated the following items: onset type, chief complaints and diagnosis at the time of the first examination by an otolaryngologist. In addition, the following items were examined to investigate the time from intervention of an otolaryngologist to ALS treatment, the term before the first examination by an otolaryngologist to tracheotomy, and the one before contracting otitis media with effusion (OME) from the onset of ALS.
Patients were often first seen for a tracheostomy. The chief complaints of half of the patients were breathing difficulties. An otolaryngologist was consulted about two years after the appearance of ALS. Moreover, tracheostomy was performed at the time of the first medical examination. Few patients had undergone evaluation of swallowing function. After tracheostomy, OME was contracted three to four years after the appearance of disease.
It is preferable in ALS treatment for otolaryngologists to evaluate the swallowing function and explain the operations that prevent aspiration to the patient and family, while building up a closer connection with a neurologist about six to twelve months after the appearance of disease.
Over the natural terminal course, when coming to use a respirator, there is a possibility of contracting OME three to four years after onset, and positive examinations by otolaryngologists are necessary.