Tracheostomy affects swallowing and increases the risk of aspiration. We attempted to prevent aspiration using the speech valve for tracheostomy patients with severe physical and mental disorders. Here, we report the results on changes in swallowing before and after using the speech valve.

The study subjects were four patients who had tracheostomy and underwent repeated aspiration pneumonia. Laryngoscopy was performed before and after the attachment of the speech valve. Laryngeal clearance, laryngeal elevation, and aspiration were reported. The revised water bottle test was performed and the occurrence of aspiration pneumonia was investigated.

The laryngeal clearance before fitting the speech valve showed low values in all subjects, and occurrence of aspiration pneumonia was reported. After wearing the speech valve, the laryngeal clearance and modified water bottle test results were improved, and no aspiration pneumonia was reported. Installation of the speech valve prevented aspiration pneumonia.

This study investigated swallowing function and its prognosis in postoperative congenital heart disease children who were late to start taking food orally. We showed that the decrease in swallowing function was mainly due to the muscle weakness associated with long-term rest and delayed development of the body and swallowing and malnutrition. Of the four patients who were followed, one refused to eat, while the remaining three patients had an improved ability to eat safely and smoothly with the appropriate intervention. Their prognoses were good.

In the videofluoroscopic swallowing study (VFSS) descent of the hyoid bone was a useful indicator of decreased pharyngeal contractility, poor esophageal opening, and risk of laryngeal invasion. Since the risk of suffocation is high in cases with descent of the hyoid bone, it is important to understand the causes and pathological conditions, provide guidance on eating styles in accordance with the development of the body, oropharynx, and larynx, and adjust the posture of the neck and bend forward slightly. Aggressive intervention, such as stimulation and toy licking to increase tongue muscle strength, is required.

We report the case of a hearing loss improvement after treatment in a patient with asymptomatic cytomegalovirus (CMV) infection. The patient was diagnosed early with delayed hearing loss by a simple hearing test using automatic auditory brainstem response (AABR) monitoring. The patient was a 2-year-old male infant. A CMV-DNA qualitative test using urine at birth revealed 1,320 copies/μl; however, AABR results were PASS bilaterally. In subsequent AABR evaluations at 3 months of age, the left side showed Refer, and at 119 days of age, the right and left sides ABR threshold were 50 dBnHL and 70 dBnHL, respectively. The ABR evaluation performed 24 days after the administration of 16 mg/kg/dose of valganciclovir hydrochloride (VGCV)—which was initiated from the age of 123 days—revealed 30 dBnHL on the right side and 40 dBnHL on the left side, thus showing a rapid improvement. The hearing of the patient is still normal to date. Early diagnosis and treatment were useful for improving delayed hearing loss caused by congenital CMV.

Airway management, as well as diagnosis, are essential for pediatric patients with rapidly progressive dyspnea. We reported a 15-month female patient with a subglottic cyst who underwent tracheostomy for emergency airway management. She was admitted to our hospital because of dyspnea with stridor. The subglottic stenosis was identified by CT scan, although it was not detected using flexible laryngoscopy. Tracheostomy was performed for progressive dyspnea in collaboration with the anesthesiologists and pediatrists. The subglottic cyst was then diagnosed by direct laryngoscopy. Recurrence was not observed nine months after marsupialization of the cyst.