Abstract
Problems associated with frequent pneumonia and excessive suction accompanying aspiration are the patient's own pain and the resulting burden on the family and care staff. Even if speech communication is not possible due to severe sensory aphasia, so long as the patient can utter vocalizations with emotion or quick voice, those important functions should be preserved. Therefore, surgical prevention for aspiration that will cause permanent vocal loss is not desirable even if it would enable recovery of oral intake. Here we report on the progress of our treatment of a patient with sensory aphasia accompanying severe dysphagia who recovered vocal communication and oral intake.
The case was a 48-year-old female. One year ago she underwent clipping of a left middle cerebral artery aneurysm. Two months later her cerebellar artery ruptured during cranioplasty. She underwent a decompressive craniectomy for the posterior fossa, but this was followed by severe dysphagia, and as those symptoms continued, she then underwent a tracheostomy and gastrostomy. She took home care after that but needed frequent suction all day long, so she was introduced to us for surgery to prevent aspiration. We elucidated the disease state of dysphasia in this case and undertook thorough treatment. Ultimately we were able to close the tracheal stoma and she recovered oral intake and vocal communication.
