Abstract
We report on a 67-year-old male with severe swallowing disorder after stroke．He had not taken food orally for about 18 months after the onset．Intensive dysphagia treatments were applied including rehabilitation therapy and a palatal augmentation prosthesis (PAP)．After 2.5 months，he became able to take food orally．One of the main factors contributing to improvement of swallowing was effective training with the PAP．The PAP was constructed by a dentist in cooperation with a speech language therapist．To evaluate the effect of PAP，the tongue pressure was measured using two types of sensor．After training，the posterior tongue pressure was markedly increased with PAP and also without the device．We concluded (it is obvious) that tongue pressure was facilitated by training with PAP．There are few reports about applying PAP to a patient with severe swallowing disorder after stroke．In our case， it was effective to apply the PAP to stroke patient．The important factors indicating the potential usefulness of a PAP are considered to be (1) dysarthria of lingtial sounds； (2) oral residue of food and vertical distance between the tongue dorsum and the palate during swallowing demonstrated by videofluoroscopic study； and (3) the anatomical form of the palate such as a highly arched palate．
