喉頭
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当科での誤嚥防止手術症例 —その適応と術後状態の検討—
宇野 敦彦長井 美樹山本 佳史坂田 義治宮原 裕
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29 巻 (2017) 1 号 p. 8-13

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We reviewed 51 patients that underwent surgery to prevent respiratory aspiration. Neurodegenerative disease(48%)and encephalopathy(22%)were frequent underlying pathologies. All cases had episodes of aspiration pneumonia. Seventy percent of the cases were bedridden and required total assistance in daily life. Despite the significance of the decision to undergo surgery, as the laryngeal function, including phonation, would be permanently lost following surgery, the medical stuff was not unable to directly confirm the will of the patient in 35% of cases. A tracheal cannula was used pre-operatively in 76% of cases and post-operatively in 53%. Pre-operatively, 94% of patients received total alimentation through a catheter without any oral ingestion, but this proportion decreased to 37% post-operatively.

In addition to preventing aspiration, surgery allowed for relief from a tracheal cannula(29% of cases)and the recovery of oral ingestion, albeit only to a slight degree in some instances(57% of cases). In some of cases, oral ingestion successfully recovered even after years without phonation or oral intake. In these cases, earlier surgery would have helped improve the quality of life even further.

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© 2017 日本喉頭科学会
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