Four Cases in Which Dysphagia Rehabilitation Was Efficacious in Improving Recurrent Wheezing in Infancy

Abstract

Four patients exhibited improved airway responsiveness with medical examinations and dysphasia rehabilitation, among cases with poor improvement of symptoms despite early intervention for infantile asthma.

Case 1: A male infant with Down syndrome received the first examination at the age of 1 year and 8 months after being treated for infantile asthma at the age of 10 months without improvement. The patient swallowed chopped food without mastication by tongue thrusting. Counseling on assistance with eating meals was provided. Wheezing was improved and the dose of drug for disease control was tapered.

Case 2: A male infant with unilateral cleft lips did not obtain symptomatic relief following treatment for infantile asthma at the age of 5 months. The first medical examination was at the age of 11 months. The chief complaint was choking during meals. Dysphagia rehabilitation was provided. Airway responsiveness was improved, and the dose of drug for asthma control was tapered.

Case 3: A female infant without underlying diseases had RS virus infection and gastroesophageal reflux disease from 1 month of age. Even after treatment for infantile asthma at 6 months old, there was no symptomatic improvement. Despite counseling on assistance with eating meals from the initial examination at the age of 4 months, counseling methods were not sufficiently complied with at home. The dose of drug for symptom control was not reduced. However, the frequency of seizures progressively decreased.

Case 4: A male infant was first examined at the age of 1 year and 4 months, because symptoms did not improve after taking thickened milk on suspicion of gastroesophageal reflux disease and nasal regurgitation at the age of 4 months and provision of treatment for infantile asthma at the age of 11 months. A tendency to refuse food and dysfunction of mastication were observed. A blowing exercise with a whistle was provided to improve velopharyngeal function failure and counseling on assistance with eating meals was provided. Wheezing and food intake were improved.

Dysphagia due to inappropriate food style and assistance with meals was noted at the first examination in all cases. Three patients exhibited a tendency to refuse food. It appeared that dysphagia rehabilitation can help improve recurrent wheezing in infants with or without underlying diseases, since airway responsiveness with dysphagia rehabilitation was improved and the frequency of asthmatic attacks and doses of drugs for controlling symptoms were reduced. It is suggested that dysphagia examinations should be conducted, given the possibility of dysphasia, in resistant cases of infantile asthma.