Diagnosis and evaluation of 100 dysphagia patients using videoendoscopy at a core hospital of a local city in Japan
Odontologyに「Diagnosis and evaluation of 100 dysphagia patients using videoendoscopy at a core hospital of a local city in Japan」(Yonenaga K, Majima H, Oyama S, Ishibashi K, Tanno H.)が掲載されている。
Abstract
Japan has entered an era of a super-aging population, and given the importance of oral nutrition, the need to evaluate swallowing function has increased.
Herein, we contribute to continued developments in evaluating eating and swallowing functions by describing current videoendoscopy (VE) usage and trends to evaluate and diagnose causes of dysphagia. In all, 100 patients (58 men and 42 women; mean age: 79 years) with suspected dysphagia were enrolled; 15 of these were re-examinations.
Examinations were conducted according to the Japanese Society of Dysphagia Rehabilitation VE examination guidelines for swallowing.
In this study, several patients (77.8 %) with poor vocalization and a saliva reservoir were unable to eat. While evaluating the relationship between aspiration and pharyngeal or laryngeal influx, we found that when pharyngeal and laryngeal influx were present, the risk of aspiration was high.
Some patients (38.9 %) were able to eat despite lacking a cough reflex; thus, the absence of a cough reflex does not necessarily equate to an inability to eat, even in patients unable to ingest nutrition orally.
One case could ingest nutrition, even with no cough reflex.
The 6-month survival rate after the examination of patients on nil per os status was 57.1 %, specifically in patients unable to ingest nutrition orally.
These results suggest that decreased eating and swallowing functions indicate a poor prognosis for the patient's quality of life, as eating and swallowing require smooth passage in the oral phase.
Therefore, actively requesting a dental intervention and oral rehabilitation is important for a patient presenting these issues.
経口摂取困難が続くと6か月後で半分以上（57.1％）予後不良になることが述べられている。
そのための歯科介入の重要性について触れている。
経口摂取を達成するために歯科介入は大事であるが、口腔ケアのみしていれば経口摂取につながるものではなく、口腔ケア後に摂食嚥下リハ介入をすることでより経口摂取の可能性が高まると考える。
今後も患者さんに器質的口腔ケアと機能的口腔ケア両方提供できるよう研鑚していきたい。
Abstract
Japan has entered an era of a super-aging population, and given the importance of oral nutrition, the need to evaluate swallowing function has increased.
Herein, we contribute to continued developments in evaluating eating and swallowing functions by describing current videoendoscopy (VE) usage and trends to evaluate and diagnose causes of dysphagia. In all, 100 patients (58 men and 42 women; mean age: 79 years) with suspected dysphagia were enrolled; 15 of these were re-examinations.
Examinations were conducted according to the Japanese Society of Dysphagia Rehabilitation VE examination guidelines for swallowing.
In this study, several patients (77.8 %) with poor vocalization and a saliva reservoir were unable to eat. While evaluating the relationship between aspiration and pharyngeal or laryngeal influx, we found that when pharyngeal and laryngeal influx were present, the risk of aspiration was high.
Some patients (38.9 %) were able to eat despite lacking a cough reflex; thus, the absence of a cough reflex does not necessarily equate to an inability to eat, even in patients unable to ingest nutrition orally.
One case could ingest nutrition, even with no cough reflex.
The 6-month survival rate after the examination of patients on nil per os status was 57.1 %, specifically in patients unable to ingest nutrition orally.
These results suggest that decreased eating and swallowing functions indicate a poor prognosis for the patient's quality of life, as eating and swallowing require smooth passage in the oral phase.
Therefore, actively requesting a dental intervention and oral rehabilitation is important for a patient presenting these issues.
経口摂取困難が続くと6か月後で半分以上（57.1％）予後不良になることが述べられている。
そのための歯科介入の重要性について触れている。
経口摂取を達成するために歯科介入は大事であるが、口腔ケアのみしていれば経口摂取につながるものではなく、口腔ケア後に摂食嚥下リハ介入をすることでより経口摂取の可能性が高まると考える。
今後も患者さんに器質的口腔ケアと機能的口腔ケア両方提供できるよう研鑚していきたい。
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