• Journal of Korean Critical Care Nursing
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• v.14 no.3
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• pp.73-86
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• 2021

Purpose : This study aimed to investigate the effects of oropharyngeal sensory stimulation using low-temperature capsaicin on dysphagia, dietary level, aspiration pneumonia, and nutritional status in acute stroke patients with dysphagia admitted to a stroke intensive care unit. Methods : This study used a randomized controlled trial design and 43 participants were randomly assigned to the experimental group (n=21) or control group (n=22). An oropharyngeal sensory stimulation intervention program was constructed based on previous studies. The intervention was provided before meals twice a day for seven days and started with the first meal after hospitalization. In the control group, a solution was made using only bottled water without adding capsaicin solution, and the intervention was provided at the same time, method, and number of times as the experimental group. Results : As a result of the study, dysphagia and dietary level improved in the experimental group that received oropharyngeal sensory stimulation using capsaicin. There were no effects on the nutritional status or aspiration pneumonia. Conclusion : This study provides basic data for the development of an intervention program for patients with dysphagia by presenting a theoretical basis that oropharyngeal sensory stimulation intervention using capsaicin improves dysphagia and dietary levels.

• Journal of Trauma and Injury
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• v.35 no.2
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• pp.115-117
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• 2022

"Whiplash"-type injuries are commonly encountered and often cause neck pain, neck stiffness, and headaches. However, these injuries can have rare and poorly recognized complications, such as the development of a prevertebral hematoma leading to acute respiratory failure in the emergency department, followed by severe, life-threatening dysphagia and recurrent aspirations. In the patient described herein, a whiplash injury was accompanied by vocal cord paralysis and dysphonia (vagus nerve), dysgeusia (glossopharyngeal nerve, vagus nerve), and upper esophageal spasm (cricopharyngeal muscle, vagus nerve). It is unlikely that this was a complication of cervical fusion surgery. Instead, a combined stretch-induced lower cranial nerve injury, possibly on the exit of these nerves through the jugular foramen, seems to be a likely, but underappreciated mechanism occurring in rare instances of whiplash injuries.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.32 no.1
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• pp.39-42
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• 2021

Granuloma is an uncommon benign disease that develops in the process of wound healing. Pharyngeal or laryngeal granuloma can be associated with gastric reflux, mechanical injury or trauma including intubation, voice abuse, or foreign body. 50-year-old female was transferred to our institute with a huge mass occupying the upper aerodigestive tract causing dysphagia. The patient has been suffering from a brain hemorrhage for several months and was kept in bed due to the quadriplegia with stuporous mental status, and was tracheotomized. On examination, the whole oropharynx and hypopharynx was covered by a smooth-surfaced soft big diffuse granular mass, which extended down to the upper trachea through the larynx. The huge granuloma was successfully removed with surgery and was found to have a pedunculating stalk on the oropharyngeal posterior wall with a small mucosal defect, suggestive of the origin of the mass. The defect was closed primarily after the cauterization. The patient is now followed up regularly without any recurrence of the disease.

• The Korean Journal of Rehabilitation Nursing
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• v.5 no.1
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• pp.38-48
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• 2002

The purpose of this study is to identify the effects of a nursing intervention using sensory stimulation in dysphagic patients. Quasi-experimental with a nonequivalent control group pretest-posttest design was used. 15 patients of each group were assigned for this study, who were hospitalized in the oriental medicine hospital of K. University. Specific stimulation plans were devised based on a dysfunctional area of the subjects. For each modality, subjects were systematically stimulated for 30 minutes, in the experimental group prior to each meal and 3 times per day for a week. The data were analyzed by SPSS PC program using $X^2$-test, Wilcoxon Signed Rank test and Mann-Whitney U test. The results of this study are as follows : 1. The tongue control score of the experimental group is greater than that of the control group(u=52.0, p=.007). 2. The score of chewing ability, lip control, swallowing ability of the experimental group is greater than that of the control group. But no difference is statistically seen between the experimental group and control group. Therefore, this study shows that sensory stimulation using icing, quick stretch, etc., was effective in improving or oropharyngeal function in patients with dysphagia.

• Korean Journal of Bronchoesophagology
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• v.4 no.1
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• pp.52-58
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• 1998

BACKGROUND： Aspiration is defined as the laryngeal penetration of secretions below the level of the true vocal cords. Aspiration can result in life-threatening complications, such as bronchospasm, airway obstruction, pneumonia, pulmonary abscess, sepsis, and death. The patient with high vagal palsy had significant aspiration and dysphagia OBJECTIVE： To formulate a step-by-step management paradign for the patients with high vagal palsy MATERIALS AND METHODS : The medical records of 23 patients who were diagnosed as high vagal palsy from September, 1995 to April, 1998 in Seoul National University Hospital were reviewed retrospectively. Eleven patients were managed conservatively and 12 patients were operated to treat chronic aspiration. RESULTS : The main etiologies of high vagal palsy were mass lesions of the skull base such as neurogenic tumor, pseudotumor, meningioma or nasopharyngeal carcinoma. Aspiration and dysphagia improved in 7 out of 11 patients who were managed conservatively after 2.2 months on the average. The patients who were refractory to the conservative management underwent surgery and showed improvement in 10 out of 12 patients. The employed surgical modalities were vocal cord medialization combined with cricopharyngeal myotomy in 7 patients, laryngotracheal separation in 3 patients and arytenoid adduction only in 2 patients. Two patients still had gastrostomy tube due to the persistent symptoms. Two patients had improved after surgery, but died of underlying disease. CONCLUSION : The patients with high vagal palsy are recommended to be managed conservatively for the first 2 months. If aspiration and dysphagia are persisting after conservative management, vocal cord medialization combined with or without cricopharyngeal myotomy should be considered. If failed, laryngotracheal separation or gastrostomy will be the next option based on the control of the oropharyngeal secretion.

• Journal of Chest Surgery
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• v.31 no.4
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• pp.432-435
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• 1998

Idiopathic cricopharyngeal achalasia is a rare condition that produces oropharyngeal dysphagia. It is caused by spasm of the cricopharyngeus and inability to relax with swallowing. A prominent muscle bar at the upper esophageal sphincter is a typical finding of the esophagogram. Cricopharyngeal myotomy is the treatment of choice. We report a case of cricopharyngeal myotomy for 61-year-old female patient.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.7
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• pp.36-44
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• 2019

Swallowing impairment is a frequent complication following stroke. The characteristics of swallowing impairment with stork patient can facilitate identification of individuals at risk of dysphagia would be of great helpful. The present study examined oropharyngeal swallowing impairment with subacute stroke patients using the Modified Barium Swallowing Impairment Profile(MBSImP). The 49 consecutive patients with the supratentorial stroke met inclusion criteria for the present study. A retrospective review was performed of patients who underwent the videofluoroscopic swallowing study(VFSS). Of Stroke patients, 95.9% exhibited abnormal function of lip closure. 98% and 57.1 % shown abnormal tongue function and lingual motion, respectively. Oral residue was present in 51% and delayed pharyngeal response was present in 89.9%. In addition, abnormal laryngeal and hyoid excursion was seen in 42.9% and 87.8%, respectively. Abnormal function of soft palate elevation was present in 18.4% and abnormal epiglottic movement was seen in 4.1%. 30.6% of 30.6% of these patients exhibited abnormal laryngeal closure. All of the stroke patients(100%) in this study exhibited abnormal pharyngeal stripping wave and pharyngoesophageal segment opening. Abnormal tongue base retraction and oral reside were present 91.8%, respectively. The results suggest that stroke patient is more likely to exhibit reduced swallowing functions including lip closure, tongue control, initiation of pharyngeal swallow, anterior hyoid motion, tongue base retraction, pharyngeal residue and pharyngoesophageal contraction. Therefore, these data could provide valid and precise information regarding physiological evidence to delineate symptoms of dysphagia in this stroke cohort. Future studies should explore the bolus effect in the swallowing impairment.

• Korean Journal of Head & Neck Oncology
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• v.11 no.2
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• pp.173-177
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• 1995

Multiple primary malignant neoplasms occur relatively frequently today and are important especially in the head and neck area for they usually carry a bad prognosis. Detection of a synchronous primary tumor at the time of initial work-up is crucial both for management and final outcome. The first case was a T1 hypopharyngeal cancer with a mid-esophageal second primary who complained of a huge neck node. The second case was a T3 hypopharyngeal cancer who was initially seen by the chest surgeons for a large lower esophageal tumor. The third case was a patient previously operated for stomach adenocarcinoma three years ago, who had newly developed symptoms like dysphagia and hoarseness, and was diagnosed as hypopharyngeal T3 with oropharyngeal second primary cancer. Three cases were all heavy smokers and had histories of heavy alcohol consumption. They were all treated at the same sitting by en-block resection of the involved organs and postoperative radiation therapy. The authors have recently experienced 3 cases of synchronous second primary cancers in association with hypopharyngeal cancer and a report is made.

• Korean Journal of Bronchoesophagology
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• v.6 no.1
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• pp.38-43
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• 2000

The reconstruction for the pharynx and cervical esophagus after wide resection in essential procedures and the several methods have the reported. Each method has advantages and disadvantages relatively. Five cases of free jejunal graft were analyzed retrospectively for the reconstruction of pharynx and cervical esophagus at Chungbuk National University Hospital from May 1996 through December 1998. Primary sites were one oropharyngeal cancer, three hypopharyngeal cancers and one subglottic cancer involved the cervical esophagus. Two grafts had necrosis. Postoperative minor complications were dysphagia, fistula, stricture of anastomosis site, and pneumonia in the order. There were not possible voice rehabilitation in three success cases.

• Medical Lasers
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• v.9 no.1
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• pp.71-75
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• 2020

Eagle syndrome is relatively uncommon with an incidence of abnormal stylohyoid length being 4% to 7.3%. A vast majority of individuals with elongation of the styloid process are asymptomatic. It is a syndrome marked by the clinical signs and symptoms of facial pain, ear pain, throat pain, dysphagia and a globus sensation in the throat. The cause of Eagle syndrome is believed to be a congenital or hormonal change and reactive osseus hyperplasia of the styloid process in response to pharyngeal trauma or surgical intervention, such as tonsillectomy. We present here a case of a 37-year-old female with a twelve-month history of both sided oropharyngeal pain and globus sensation which has no trauma or surgical intervention. The patient presented with a long, slender, bony intraoral projection that was found to be an elongated styloid process. We removed this elongated styloid process with a CO₂ laser, and her symptoms disappeared.