• Title/Summary/Keyword: 삼킴

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Anatomy and physiology of swallowing process (삼킴(연하) 과정에 관련된 해부생리학적 고찰)

  • Lee, Jina
    • The Journal of the Korean dental association
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    • v.56 no.5
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    • pp.278-286
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    • 2018
  • Food intake and swallowing are complicated and intriguing series of movements involving voluntary and involuntary activities of cranial and spinal nerves and muscles. They have two most important functions, that is, food passage from the oral cavity to stomach and airway protection. Tongue, buccinators, and hyoid bone and its muscular attachments are anatomic structures for swallowing of special interests. The swallowing process of liquid is commonly divided into oral preparatory, oral propulsive, pharyngeal, and esophageal stages according to the location of the bolus. The movement of the food in the oral cavity and to the oropharynx differs between eating solid food and drinking liquid.

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Schwannoma of the Esophagus - A case report- (식도의 신경집종 -1예 보고-)

  • 백종현;이장훈;이동협;정태은;김미진;이정철
    • Journal of Chest Surgery
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    • v.37 no.11
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    • pp.963-966
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    • 2004
  • A rare case of schwannoma involving lower thoracic esophagus is presented. A 64-year-old male was seen with slowly progressing dysphagia for 2 years. Large sized submucosal tumor was found by endoscopy and chest CT. On surgery, tumor was very solid and tightly adherent to the adjacent tissue. Esophagectomy and esophagogastrostomy was done.

The Importance of Video Fluoroscopy Swallowing Study for Nasogastric Tube Removal in Rehabilitation Patients (재활치료환자의 비위관(nasogastric tube)제거에 따른 비디오 투시연하검사(VFSS)의 중요성 평가)

  • Jung, Myoyoung;Choi, Namgil;Han, Jaebok;Song, Jongnam;Kim, Weonjin
    • Journal of the Korean Society of Radiology
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    • v.9 no.1
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    • pp.1-7
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    • 2015
  • Acute phase patients who are unconscious and are suffering from cerebral infarction, cranial nerve disorders, or cerebral apoplexy are susceptible to aspiration pneumonia due to dysphagia. In these cases, a nasogastric tube is inserted to supply nutrients. Although bedside screening tests are administered during recovery after rehabilitation, clinical examinations may not be able to ascertain asymptomatic aspiration. Therefore, a video fluoroscopy swallowing study (VFSS) was performed in 10 patients with dysphagia after rehabilitation therapy; these patients had nasogastric tubes inserted, and a rehabilitation specialist assessed the degree of swallowing based on the patients' diet and posture. If aspiration or swallowing difficulties were observed, dysphagia rehabilitation therapy was administered. The patients were reassessed approximately 30-50 days after administration of therapy, based on the patients' condition. If aspiration is not observed, the nasogastric tube was removed. A functional dysphagia scale was used to analyze the VFSS images, and the scores were statistically calculated. The mean score of patients with nasogastric tubes was $49.79{\pm}9.431$, thereby indicating aspiration risk, whereas the group without nasogastric tubes showed a mean score of $11.20{\pm}1.932$, which indicated low risk of aspiration. These results demonstrated that a significantly low score was associated with nasogastric tube removal. Mann-Whitney's test was performed to assess the significance of both the groups, and the results were statistically significant with a P value <0.001. In conclusion, VFSS can effectively assess the movements and structural abnormalities in the oral cavity, pharynx, and esophagus. It can also be used to determine the aspiration status and ascertain the appropriate diet or swallowing posture for the patient. Therefore, VFSS can potentially be used as a reliable standard test to assess swallowing in order to determine nasogastric tube removal.

Presence and characteristics of dysphagia in stroke patients without awareness of dysphagia (연하장애에 대한 병식이 없는 뇌졸중 환자들의 연하장애 유무와 양상)

  • Shin, Joong-Il;Kam, Kyung-Yoon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.1
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    • pp.294-300
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    • 2011
  • This study was performed to examine the presence of dysphagia and analyze characteristics of the symptoms in cerebrovascular accident(CVA) patients without awareness of dysphagia. A questionnaire for this study was given to CVA patients who had visited P rehabilitation medical center in Busan. Eleven patients (4 males and 7 females) who answered no awareness of dysphasia were given to VFSS, functional dysphasia scale, and NCSE. Descriptive statistics and Pearson correlation analysis were performed by SPSS 12.0. All of subjects without awareness of dysphasia showed characteristics of dysphasia symptoms. Prominent dysfunctions were problems in oral phase and delay of swallowing reflex in pharyngeal phase. For the aspect of cognition, they showed lower score in construction, memory, and similarity than other NCSE items. There was highly significant correlation between orientation, judgment and delay of swallowing reflex. Verbal comprehension and residual materials in oral cavity showed closed correlation. CVA patients without awareness had dysphagia with high probability. The early evaluation of dysphagia should be performed in CVA patients in order to prevent complications due to CVA, so it is necessary to increase the effectiveness of rehabilitation therapy.

Analyses of Studies on Swallowing Rehabilitation Program for Stroke patients in Korea (뇌졸중 환자 대상의 연하재활프로그램에 대한 국내 연구 논문 분석)

  • Kwak, Hye-Weon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.11
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    • pp.7394-7402
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    • 2015
  • The purpose of this study was to investigate the status of studies on swallowing rehabilitation interventions for stroke patients that had been conducted in the past 5 years (2010-2014) in Korea and to examine their findings. A literature search was conducted through RISS, National Assembly Library, and KISS, and 12 papers were analyzed. Four articles were from nursing science, and 8 from other disciplines. Qualitative evaluation of the articles was conducted by using an evaluation framework that was designed by the researcher, which took into account the checklist presented by the Scottish Intercollegiate Guideline Network (2013). In the results of the qualitative evaluation on the papers, 4 studies scored 7 out of 10 points, 6 studies scored between 5 and 6 points, and 2 studies scored 4 points. Intervention sessions were conducted for 25 minutes, on average, each at a frequency of 4.1 sessions per week, for a total of 33.7 sessions. This study found that direct swallowing training and comprehensive intervention of respiratory and oral, including pharyngeal were effective in relieving difficulties in swallowing. In the future, such findings are expected to be used in nursing interventions for establishment of the basis for evidence-based nursing practice.

A Survey About Awareness and Necessity of Community Based Dysphagia Therapy of Community Dwelling Older Adults (지역사회 거주 노인들의 연하장애 인식과 중재 필요성)

  • Min, Kyoung Chul;Kim, Eun Hee;Woo, Hee-Soon
    • Therapeutic Science for Rehabilitation
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    • v.11 no.2
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    • pp.39-51
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    • 2022
  • Objective : This study aimed to investigate the awareness and experience of community-based dysphagia therapy and related education in community-dwelling older adults. Methods : A total of 89 older adults were recruited from a public health center in Gyeonggi-do. Awareness, experience, and related education regarding community-based dysphagia therapy were analyzed using descriptive statistics. Results : We analyzed 89 questionnaires. Awareness, treatment experience, and education regarding dysphagia were low; however, the importance and intention to participate were high. Respondents wanted education about proper chewing and safe swallowing, oral health, oral motor exercise, and participation in community-based dysphagia programs in public health centers. The reason for the lack of experience in dysphagia education and therapy is insufficient information and opportunities. The respondents had a good understanding of dysphagia symptoms. Conclusion : Dysphagia therapy maintains swallowing and eating functions as a life-long Activity of Daily Living, and is a very important area in community rehabilitation. Based on the results of this survey, the necessity and importance of community-based dysphagia were identified. It is time to provide correct information and develop a systematic education program for community-based dysphagia therapy. Occupational therapists need to play an active role in improving quality of life by early detection and providing proper intervention.

Effect of Oral Motor Facilitation Technique (OMFT) and Neuromuscular Electrical Stimulation (NMES) Applied to a Patient With Wallenberg's Syndrome: A Case Study (발렌버그 증후군(Wallenberg's Syndrome) 환자에게 적용한 구강운동촉진기술(OMFT)과 신경근전기자극치료(Neuromusclular Electrical Stimulation; NMES) 효과: 단일 사례 연구)

  • Son, Yeong Soo;Min, Kyoung Chul;Woo, Hee-Soon
    • Therapeutic Science for Rehabilitation
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    • v.11 no.4
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    • pp.69-83
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    • 2022
  • Objective : This study aimed to confirm the possibility of the clinical application of oral motor facilitation technique (OMFT) protocol and neuromuscular electrical stimulation (NMES) in patients with Wallenberg syndrome. Methods : One patient with Wallenberg syndrome was treated with OMFT and NMES applied 40 times each, 5 days a week, twice a day for 4 weeks. The Comprehensive Oral-Facial Function Scale (COFFS), Korean-Mann Swallowing Ability Assessment (K-MASA), and Penetration-Aspiration Scale (PAS) were used to compare the changes before and after the intervention. Data analysis was used to compare the score changes before and after the intervention. Results : Orofacial function and swallowing ability improved after the intervention in the individual who participated in this study. Among oral motor functions, relatively greater functional improvement was observed in tongue movement compared to other functions, which was evaluated to the extent that pharyngeal swallowing was possible. Conclusions : Early swallowing rehabilitation using systematic OMFT and NMES of exercise intensity confirmed the possibility of improving oral motor function and dysphagia. In the future, complementary studies on the effects of interventions applying the OMFT and NMES will be needed.

The Effects of Short Neck Flexion Exercise in Proprioceptive Neuromuscular Facilitation and Neuromuscular Electrical Stimulation on Swallowing Function in Patients with Chronic Stroke (고유수용성신경근촉진법의 짧은 목 굽힘 운동과 신경근전기자극치료가 만성 뇌졸중 환자의 삼킴 기능에 미치는 효과)

  • Kim, Kyoungdon
    • Journal of The Korean Society of Integrative Medicine
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    • v.5 no.4
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    • pp.31-39
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    • 2017
  • Purpose : The purpose of this study was to examine the effects of short neck flexor strengthening in proprioceptive neuromuscular facilitation and neuromuscular electrical stimulation on swallowing function in patients with chronic stroke and to provide basic data for swallowing rehabilitation in stroke patients. Method : The study involved 30 chronic stroke patients who visited ${\bigcirc}{\bigcirc}$ General Hospital in Daegu Metropolitan City between March and July, 2017. The subjects were randomly assigned to either an experimental group (n=15) or a control group (n=15). Both groups underwent traditional swallowing rehabilitation therapy for 30 minutes five times a week over a six-week period. The experimental group performed short neck flexor exercises, which are part of the proprioceptive neuromuscular facilitation, for 30 minutes three times a week over a six-week period. The control group performed neuromuscular electrical stimulation for 30 minutes three times a week over a six-week period. Based on its results, changes in the patients' swallowing function and degree of food intake were analyzed. Result : In terms of the ASHA NOMS scale and new VFSS scale, the experimental group and the control group showed statistically significant changes in ten sub-items and six sub-items, respectively. Statistically significant differences in one sub-item were found between the groups. Conclusion : PNF-based short neck flexion exercise appear to be effective at improving swallowing function of stroke patients with dysphagia.

A Case of Herpes simplex Esophagitis in an Immunocompetent Boy (건강했던 남아에서 발생된 헤르페스 식도염 1예)

  • Yeo, Joong-Suk;Jeon, Je-Deok;Chang, Soo-Hee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.1
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    • pp.70-74
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    • 2008
  • Herpes simplex virus has rarely been identified as a cause of esophagitis in immunocompetent children. This virus affects predominantly males presenting with symptoms of fever, odynophagia, dysphagia, and retrosternal pain of acute onset. Esophagoscopy typically reveals exudative well-circumscribed ulcerations of the distal and/or mid-esophagus. Further investigations using biopsy, viral culture, polymerase chain reaction (PCR), and seroconversion of antibodies to Herpes simplex are recommended to assist with a definitive diagnosis. This esophagitis is often a self-limited infection in immunocompetent children. Nevertheless, antiviral treatment may expedite symptom relief with Herpes simplex virus infection. It is imperative to document herpes esophagitis in cases with subsequent severe odynophagia in immunocompetent children. Here we present the case of a 12-year-old immunocompetent boy with herpes esophagitis.

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