A case of severe dysphagia after excision of a brain stem tumor.
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概要
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We experienced a case, where a patient who underwent surgical removal of a hemangioblastoma of the brain stem, only to be left with trismus, dysmasesis, dysphonia, dysphemia and severe dysphagia after the operation. This patient was totally unable to ingest food or drink. We treated this patient by means of rehabilitation, and surgical procedures involving the fields of otorhinolaryngology, plastic and reconstructive surgery and dentistry.<BR>The patient was a 38-year-old female who underwent surgical removal of a hemangioblastoma of the brain stem in November of 1989. During the surgery, the glossopharyngeal nerve and the vagus nerve were inadvertently severed. In addition, Wallenberg's syndrome developed due to vascular occlusion. These conditions resulted in postoperative unilateral paralysis of 5th through 12th nerves, and oral intake was totally impossible. Surgical therapy was carried out in the form of cricopharyngeal myotomy, chalioplasty, adhesiotomy of temporomandibullar joint and rehabilitation was performed. As a result, the patient became capable of oral intake.<BR>Accordingly, we surmised that, for patients such as the one reported here, with severe dysfunction of head and neck area as a sequela of brain surgery, it is essential that multidisciplinary countermeasures be taken soon after the onset of the dysfuncion. Those countermeasures include education of the patient, physical rehabilitation and the cooperation of various medical specialties.
- 耳鼻咽喉科展望会の論文
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