頭頚部癌術後えん下障害患者に対する姿勢調節法の効果―えん下造影画像解析による直立姿勢と健側傾斜姿勢との比較検討―

Abstract

Postsurgical dysphagia in patients with head and neck cancer is often improved by postural techniques, one procedure for compensatory treatment.This study was done to analyze videofluorographic (VF) images of postsurgical patients with head and neck cancer by comparing upright posture with head tilting posture on the stronger side. Twelve postsurgical patients with head and neck cancer whose aspiration was improved by head tilting posture on the stronger side were studied.The tilting magnitude, vallecular angle, and epiglottic angle were measuredon VF prints. Retained amounts of swallowed barium were evaluated in the oral region, vallecular region, and pyriform sinus on VF images.Pharyngeal delay time, pharyngeal passage time, and pharyngo-esophageal (PE) segment opening time were measured on VF images. The results were as follows:1) There was no correlation between any two of the following three variables: tilting magnitude, vallecular angle, and epiglottic angle.2) The retained amount of swallowed barium swallow in tilting posture on the stronger side was less than that in upright posture in 10 of 12 subjects.3) As compared with upright position, pharyngeal delay time and pharyngeal passage time were shorter in tilting posture on the stronger side.