嚥下障害の臨床的観察

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The purpose of present investigation was to clarify the contributory factors for dysphagia.In a series of 331 patients, who were confirmed radiologically to be affected either functional or organic disturbances in the proxismal part of the alimentary tract, dysphagia was the present symptom in 116 patients. Etiologically, these disorders included two main groups, neurogenic diseases and local structual lesions. Twenty eight patients with pharyngeal paralysis associated with central and peripheral nervous diseases, had been investigated. Of these, all had complained of dysphagia, including 6 patients whose chief complaint was aspiration. Radiological examina-tions revealed cricopharyngeal dysfunction in 6 patients. The local structual lesions were divided into intrinsic lesion and extrinsic one. In a group of 188 patients with intrinsic lesions, 78 complained of dysphagia. Forty seven of them had carcinoma of the hypopharynx and esophagus, being the most common causes of dysphagia in this series. Achalasia of the upper esophageal sphincter and of cardia, esophageal stricture, and hiatus hernia were observed in 18 patients. Esophageal diverticulum and esophagitis were rare.In 115 patients with extrinsic lesions, only 16 had complained dysphagia. Of 10 patients in whom dysphagia were related to malignant thyroid tumor and mediastinal tumors, 4 showed direct invasion of tumor to the esophagus. Another 6 showed external compression of the esophagus.
社団法人日本耳鼻咽喉科学会の論文

嚥下障害の臨床的観察

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