The purpose of this study is to investigate the outcome of patients with tracheostomy in a convalescence rehabilitation ward. Of 3,179patients who were discharged from our hospital in 4 years, 78subjects who had tracheostomy tubes at admission were included in the study. Forty-six of those patients (59%) were decannulated during hospitalization. The number of days required for decannulation was 35days on average. While all of the 78subjects had no oral intake at admission, upon discharge, 51subjects (65%) were able to take some kind of oral intake, and 38 of those were able to take oral nutrition fully. Additionally, those patients with consciousness disorders or severe physical impairments often had difficulty with decannulation. However, some cases with severe consciousness disorders or patients who were totally dependent for their physical care were successfully decannulated. Patients who require tracheostomy at the acute stage should be further evaluated for its necessity during the recovery phase. Some of the important aspects to consider in convalescence rehabilitation include evaluating the possibility of changing the type of tracheostomy tubes, examining the possibility of removing the tracheostomy tubes altogether, and performing dysphagia rehabilitation.

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Hyperlexia and ambient echolalia are rare conditions, and investigations into their clinical course have not been reported in the literature thus far. Here we report the case of a 69-year-old woman with cerebral infarction of the left anterior cingulate cortex and corpus callosum, on whom we performed an echo induction test for studying her long-term hyperlexia and ambient echolalia. Her clinical features included symptoms of complex disorders such as visual groping, compulsive manipulation of tools and callosal disconnection syndrome. The patient did not have dementia or aphasia. Her most outstanding behavioral traits were the hyperlexia and ambient echolalia. We investigated the induction of her hyperlexia and ambient echolalia by subjecting the patient to 10 verbal questions using a background of visual (bookshelves were placed in front of her) and auditory (imitated hospital announcements) stimuli at periods of 1, 2 and 6 months after the stroke. Hyperlexia was induced at 1 and 2 months after stroke, whereas ambient echolalia was only induced at 1 month after stroke. The disappearance of the hyperlexia and ambient echolalia in this case might be due to a reduction in the disinhibition of response to external stimuli caused by damage sustained in the stroke to the left anterior cingulate cortex and corpus callosum.

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