• Proceedings of the KOR-BRONCHOESO Conference
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• 1983.05a
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• pp.14.2-14
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• 1983

Complications and sequelae of the laryngeal trauma are respiratory difficulties, edema or swelling, cellulitis or abscess, fistula, perichondrium and chondritis, chronic laryngeal stenosis, vocal cord paralysis, decannulation difficulty, and impaired voice production etc. Generally, the treatment of laryngeal injuries consists of initial tracheostomy for adequate airway and later surgical intervention for its complications and sequelae. Recently, authors experienced a case of closed laryngeal injury with thyroid cartilage fracture, left vocal cord paralysis, swallowing difficulty and right clavicular fracture owing to automobile accident. With reconstructive surgery for thyroid cartilage fracture, we established an adequate airway, improved swallowing function and better voice production.

• PNF and Movement
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• v.13 no.4
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• pp.169-174
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• 2015

Purpose: This study aimed to investigate the effect of neck exercises using proprioceptive neuromuscular facilitation (PNF) on dysphagia and neck pain in stroke patients. Methods: This study included 20 patients with stroke who performed the following neck exercises using PNF: flexion, lateral flexion, and rotation. The PNF technique was repeated under the guidance of verbal commands from a physical therapist. The exercise program consisted of 5 times, 30-minute sessions each week for four weeks. The Mann Assessment of Swallowing Ability (MASA) and the visual analogue scale (VAS) were used to evaluate the patients before and after the training. Swallowing ability was evaluated using MASA, and the patients' pain was evaluated using VAS. All data were analyzed using SPSS 21.0. Results: Significant differences were observed for the MASA and VAS in the subjects: MASA was significantly improved (p<0.00) and VAS was significantlyincreased (p<0.00). Conclusion: The neck is a very important part of the body in stroke patients. Neck exercises using PNF are effective for improving dysphagia and decreasing neck pain in patients with stroke. Thus, neck exercises using PNF are very effective for stroke patients, and this approach would be effective in clinical practice.

• Journal of International Academy of Physical Therapy Research
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• v.12 no.2
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• pp.2365-2369
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• 2021

Background: Patients with dysphagia after stroke are treated with neuromuscular electrical stimulation (NMES), but its effect on masseter muscle thickness and bite force in the oral phase is not well known. Objectives: To investigated the effect of NMES on masseter muscle thickness and occlusal force in patients with dysphagia after stroke. Design: Two group, pre-post design. Methods: In this study, 25 patients with dysphagia after stroke were recruited and allocated to either the experimental or the control groups. Patients in the experimental group were treated with NMES to the masseter muscle at the motor level for 30 minutes and were additionally treated with traditional swallowing rehabilitation for 30 minutes. In contrast, patients in the control group were only treated with traditional swallowing rehabilitation for 30 minutes. Masseter muscle thickness was measured using ultrasonography before and after intervention, and bite force was measured using an bite force meter. Results: The experimental group showed significant improvement in masseter muscle thickness and bite force compared to the control group. Conclusion: NMES combined with traditional dysphagia rehabilitation is effective in improving masseter muscle thickness and bite force in patients with dysphagia after stroke.

• Journal of International Academy of Physical Therapy Research
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• v.12 no.1
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• pp.2267-2271
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• 2021

Background: Recently, a new home-based dysphagia rehabilitation method using information and communications technology (ICT) has been reported, but clinical evidence is still lacking. Objectives: To investigate the effects of home-based dysphagia rehabilitation using ICT on tongue muscle strength and volume in patients with developed dysphagia after stroke. Design: Randomized controlled trial design. Methods: Twenty patients who developed dysphagia after stroke were enrolled. The experimental group received dysphagia rehabilitation in the form of ICT-based home care. In contrast, the control group received traditional rehabilitation based on swallowing under the supervision of occupational therapists. All interventions were conducted five times a week for four weeks. Results: Both groups showed statistically significant increases in tongue muscle strength and volume after the intervention (P<.05, both). However, there were no significant differences in tongue strength or volume between the two groups after the intervention (P>.05, both). Conclusion: Home-based dysphagia rehabilitation using ICT showed effects similar to those of conventional swallowing rehabilitation in patients who developed dysphagia after stroke. These findings suggest that dysphagia rehabilitation can be conducted at home without the help of a therapist.

• Archives of Craniofacial Surgery
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• v.23 no.4
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• pp.139-151
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• 2022

Reconstructive surgery in the management of head and neck cancer has evolved to include structure-specific approaches in which organ-specific treatment algorithms help optimize outcomes. Tongue cancer management and reconstruction are surgical challenges for which well-executed reconstructive plans should be completed promptly to avoid delaying any subsequently planned oncologic treatment. Crucial considerations in tongue cancer resection are the significant functional morbidity associated with surgical defects, particularly in terms of speech and swallowing, and the consequent negative impact on patients' quality of life. With the evolution of microsurgical techniques and the development of the perforator flap concept, flap options can be tailored to the characteristics of various tongue defects. This has allowed the implementation of pliable flaps that can help restore tongue mobility and yield subsequent functional outcomes. Using an evolutional framework, we present this series of reviews related to tongue reconstruction. The first part of the review summarizes flap options and flap-related factors, such as volume and tissue characteristics. Related functional aspects are also presented, including tongue mobility, speech, and swallowing, as well as ways to evaluate and optimize these outcomes.

• The korean journal of orthodontics
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• v.22 no.1
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• pp.253-271
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• 1992

The purpose of this study was to investigate the difference of EMG activity of the Orbicularis oris and Mentalis muscle between normal occlusion and class III malocclusion group during various lip position and to find out whether any correlations exist between the muscular activity and craniofacial morphology. In this study, 50 subjects with a mean age of 22.9 Years (range 20.0-26.0) were investigated (25 subjects were normal occlusion, and 25 subjects were class III malocclusion). EMG data were recorded from the Orbicularis oris and Mentalis muscle during rest lip posture, lip position at maximum biting, lip position at maximum sealing effort, lip position at chewing, swallowing and phonation with the Medelec MS-25 electromyographic machine. Lateral cephalometric radiographs was taken with the mandible in intercuspal position on all subjects. All data were recorded and statistically processed. The findings of this study can be summerized as follows: 1. In normal occlusion, the maximal mean amplitude of upper lip during the lip position at chewing was lower than that of lower lip and mentalis muscle. But the maximal mean amplitude of orbicularis oris and mentalis muscle during the other lip position was not statistically different. 2. In Class III malocclusion, the maximal mean amplitude of upper lip during the lip position at chewing, swallowing and phonation was lower than that of lower lip and mentalis muscle. But the maximal mean amplitude of orbicularis oris and mentalis muscle during the other lip position was not statistically different. 3. Compare to normal occlusion, the Class III malocclusion was showed low maximal mean amplitude of upper lip during rest lip posture and the lip position at swallowing of saliva, and showed great maximal mean amplitude of lower lip and meantalis muscle during the lip position at chewing and phonation. 4. In normal occlusion, the maximal mean amplitude of upper lip during various lip position was not correlated with the length and thickness of upper lip, but the maximal mean amplitude of lower lip during the lip position at chewing and swallowing was positively correlated with the thickness of lower lip. 5. In Class III malocclusion, the maximal mean amplitude of upper lip during rest lip posture was negatively correlated with the thickness of upper lip, and the maximal mean amplitude of lower lip and mentalis muscle during the lip position at chewing and swallowing was positively correlated with the thickness of lower lip and mentalis muscle. But the maximal mean amplitude of orbicularis oris and mentalis muscle during the other lip position was not correlated with the cephalometric measurements of soft tissue. 6. The correlation between the maximal mean amplitude of orbicularis oris and mentalis muscle and cephalometric measurements of incisors was not nearly present. 7. In normal occlusion, the maximal mean amplitude of lower lip and mentalis muscle during the lip position at maximum biting was negatively correlated with the angle between palatal plane and mandibular plane. In Class III malocclusion, the maximal mean amplitude of upper lip, lower lip and mentalis muscle during function was negatively correlated with the length of maxilla, the maximal mean amplitude of upper lip and lower lip during function was negatively correlated with the SNA and SNPo, and the maximal mean amplitude of lower lip during the lip position at chewing was negatively correlated with the ANB.

• 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.

• The Journal of the Korea Contents Association
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• v.14 no.6
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• pp.288-297
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• 2014

The purpose of this study was to investigate the quality of life related to swallowing through Swallowing-Quality Of Life(SWAL-QOL) and examine the impact of SWAL-QOL on overall quality of life measured by Short-Form Health Survey(SF-36) and Geriatric Quality of Life(GQOL). For this purpose, the SWAL-QOL, SF-36 and GQOL have been conducted on 140 old people who were all over 60 years of age and physically and mentally normal. The collected data have been analyzed using a Windows SPSS 21.0 program. The results show that the SWAL-QOL are significant differences according to age(F=7.76, p<.01) and aspiration(t=-4.44, p<.01) and aspiration is ouly factor affecting the SW AL-QOL in elderly people. There are significant correlations between SF-36, GQOL and SW AL-QOL and the pearson product moment correlation coefficient is .39(p<.01) and .33(p<.01) respectively. The SWAL-QOL can predict approximately 36% and 25% of quality of life measured by SF-36 and GQOL. Therefore, this result will be able to utilize as basic data to improvement of quality of life related swallowing and overall quality of life related to health in normal elderly people.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.11
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• pp.421-431
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• 2016

The purpose of this study was to identify the influence of depression, social isolation, and meaning in life on the swallowing related quality of life in patients with dysphagia. In this study, 87 the dysphagia patients diagnosed with stroke, degenerative disease, and neurological disorder in a general or rehabilitation hospital in Seoul, Gyeonggi, and Incheon were assessed. The data were collected between February and April, 2015 using CES-D, RULS, PIL, SWAL-QOL. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation, and stepwise multiple regression with SPSS 22.0. Of the participants, 20.7% reported having had depression, 92.0% middle-high social isolation and 64.4% existential vacuum. The mean scores were SWAL- QOL 158.89(35.97). Stepwise multiple regression revealed that tube feeding to have the greatest effect on SWAL-QOL(${\beta}=-0.57$, p<.001), followed in order by age (${\beta}=0.26$, p=.001), lower MIL (${\beta}=0.19$ p=.014), and education (${\beta}=0.17$, p=.032). The most influential factor to SWAL-QOL was tube feeding. These variables accounted for 50.7% of SWAL-QOL in dysphagia patients (F=28.84 p=.031). Therefore, it is essential to develop the intervention that can improve the meaning in life in patients with dysphagia. In addition there is a need to study the psychological factors and quality of life of tube feeding.

• Korean Journal of Bronchoesophagology
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• v.5 no.2
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• pp.191-197
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• 1999

Background and Objective : Soft palate plays a great role in function of speech and swallowing. Ablation of tonsil cancer results in multi-demensional defect including soft palate in most cases and restoration of the postoperative oral cavity function is a continuing surgical challenge. Although a variety of techniques are available, radial forearm free flap has been known as an effective method for these defect, which offers a thin, pliable, and relatively hairless skin, and a long vascular pedicle. The aim of the present study is to report the speech and swallowing function test results of our 5 consecutive radial forearm free flaps used for tonsil cancers. Materials and Methods : We reviewed the medical records of 5 patients who were offered intraoral reconstruction with a radial forearm free flap after ablative surgery for tonsil cancers, from Dec. 1997 to Oct. 1998, and analyzed the surgical methods, complications, and speech and swallowing function test results. We have examined with modified barium swallow to evaluate postoperative wallowing function and articulation and resonance test for speech. Results : The tumor sizes by TNM stage(AJCC, 1997) were T1(1), T2(2), and T4(3). The paddles of flaps were tailored in multilobed designs from oval shape to pentalobed design and in variable size from 24$cm^2$ to 108$cm^2$(average size = 78.4$cm^2$), according to the defect after ablation. This procedures resulted in satisfactory flap success and functional results all but 1 case of flap contracture in 2 postoperative week, achieved early oral diet until 16-57 postoperative day(average, 28 days) and social speech. The oropharyngeal defect including soft palate reconstruction with radial forearm free flap might be an excellent method for the maximal functional results, after ablative surgery of tonsil cancer that results in multidimensional defect.