Abstract
Aspiration pneumonia is caused by the aspiration of food due to dysphagia as well as saliva aspiration during the night. As a countermeasure for saliva aspiration, low-pressure continuous salivary suction using a suction tube is used. However, this method has some shortcomings, including accidental swallowing or ingestion of the suction tube by biting and difficulty holding the suction tube within the oral cavity. There- fore, this method may be difficult to use in patients who move excessively or overnight while the patients are sleep. To solve these problems, we developed a simple method to fabricate a mouthpiece for continu- ous salivary suction by integrating a suction tube and a mouthpiece. In this report, we describe its clinical application in two patients with dysphagia.
Case 1: The patient was a man in his 70s. He had dysphagia and left hemiplegia due to a right frontal lobe infarction. He started dysphagia rehabilitation after being transferred to a convalescent hospital. Saliva aspiration was confirmed using a fiberoptic endoscopic evaluation of swallowing. The patient had increased phlegm production at night due to saliva aspiration. A continuous saliva suction mouthpiece was fabricated to suction this overnight phlegm. The frequency of sputum suction at night (midnight to 6:00 am) decreased from eight times per night on average during the two weeks prior to beginning the use of the mouthpiece to zero during the two weeks while the mouthpiece was used.
Case 2: The patient was a man in his 60s. Due to bulbar palsy caused by amyotrophic lateral sclerosis, saliva was retained in his oral cavity, and his family had difficulty suctioning his phlegm while he slept. A saliva continuous suction mouthpiece was fabricated and worn while the patient slept, and suctioning decreased from an average of three times per night to zero with the use of our mouthpiece.
Discussion: Saliva aspiration not only causes aspiration pneumonia but also increases the care burden as frequent phlegm suctioning is required. Our saliva continuous suction mouthpiece is simple to fabricate and can help reduce the burden on caregivers. Further interventional study is needed to clarify the effects of saliva suction using this device to promote its widespread use.
