Effectiveness of the Self-Balloon Dilatation Treatment Dysphagia in Lateral Medullary Infarction: A Case Report
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초록
The cricopharyngeus muscle (CPM), an important anatomical component of the upper esophageal sphincter (UES), is controlled by reflexive contraction and relaxation movements that are coordinated with swallowing and breathing. In cricopharyngeal dysfunction (CPD) the CPM does not relax to allow food to enter the esophagus or it relaxes in an uncoordinated manner, causing dysphagia. Prolonged CPD may lead to malnutrition, dehydration, weight loss, or aspiration, and therefore, prompt treatment is essential. A 41-year-old female diagnosed with left lateral medullary infarction demonstrated relative improvement in cognitive, language, and motor dysfunctions following acute treatment. However, her swallowing disorder continued from time of onset of symptoms. Balloon dilatation was performed at various frequencies, and gradually the patient was trained to perform the procedure on her own. The effects of balloon dilatation were evaluated continuously through repetitive videofluoroscopic swallowing studies. While balloon dilatation is a widely used method for treating CPD, its use has not yet been standardized. The diameter, pressure, and extension time of the balloon depend greatly on the operator’s personal experience. This case is valuable because we determined the optimal frequency of balloon dilatation for the patient through a series of attempts at various frequencies. Furthermore, performing balloon dilatation on her own helped with her early recovery and discharge. Due to this individualized treatment, the patient could safely progress to a regular diet from being fed through a tube.
Abstract
The cricopharyngeus muscle (CPM), an important anatomical component of the upper esophageal sphincter (UES), is controlled by reflexive contraction and relaxation movements that are coordinated with swallowing and breathing. In cricopharyngeal dysfunction (CPD) the CPM does not relax to allow food to enter the esophagus or it relaxes in an uncoordinated manner, causing dysphagia. Prolonged CPD may lead to malnutrition, dehydration, weight loss, or aspiration, and therefore, prompt treatment is essential. A 41-year-old female diagnosed with left lateral medullary infarction demonstrated relative improvement in cognitive, language, and motor dysfunctions following acute treatment. However, her swallowing disorder continued from time of onset of symptoms. Balloon dilatation was performed at various frequencies, and gradually the patient was trained to perform the procedure on her own. The effects of balloon dilatation were evaluated continuously through repetitive videofluoroscopic swallowing studies. While balloon dilatation is a widely used method for treating CPD, its use has not yet been standardized. The diameter, pressure, and extension time of the balloon depend greatly on the operator’s personal experience. This case is valuable because we determined the optimal frequency of balloon dilatation for the patient through a series of attempts at various frequencies. Furthermore, performing balloon dilatation on her own helped with her early recovery and discharge. Due to this individualized treatment, the patient could safely progress to a regular diet from being fed through a tube.
참고문헌 (13)
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