@article{oai:niigata-u.repo.nii.ac.jp:02000538,
 author = {鈴木, 拓 and Suzuki, Taku and 神田, 知佳 and Kanda, Chika and 辻村, 恭憲 and Tsujimura, Takanori and 堀, 一浩 and Hori, Kazuhiro and 井上, 誠 and Inoue, Makoto},
 issue = {2},
 journal = {新潟歯学会雑誌},
 month = {Dec},
 note = {We report a case of dysphagia following resection of cerebellopontine angle meningioma in a 57-years old woman. She underwent an operation on January 9th, 2015 in our hospital. Results of swallowing functional evaluation at first visit (January 13th) showed insufficient oral hygiene, loss of occlusal support, impairment of respiratory force and symptoms of the cranial nerve (Ⅴ, Ⅶ, Ⅸ, Ⅹ and Ⅻ) palsy on the left side. Repetitive saliva swallowing test score was 0 and cough reflex was observed after swallowing 0.5 ml water, diagnosed as dysphagia with oral and oropharyngeal disorders. We started oral care and indirect therapy. On videoendoscopic examination on the 18th day after the operation, we found that swallowing function was improved, in that obvious aspiration was not observed although pharyngeal residue remained after swallowing. We started direct therapy using paste and jelly foods. We found that right lateral decubitus with head rotation to the left was a safe posture at meal by videofluoroscopic examination on the 27th day, a meal started. Food form was changed several times depending on the functions. In addition, wearing denture contributed to the recovery of oral and chewing function and she could take steamed rice and soft side dishes on neutral position. Finally, she was discharged on the 86th day., 小脳橋角部髄膜腫摘出術後に嚥下障害を認めた一例を報告する。症例は57歳女性。2015年1月9日，疼痛の制御困難につき，当院脳神経外科入院下にて摘出術施行された。同月13日(術後4日目)，嚥下機能評価目的に当科初診。口腔衛生状態は不良で，残根歯多数認め，臼歯部の咬合支持はほぼ無い状態。安静時より湿性嗄声を認め，自己喀痰は困難。左側三叉・顔面・舌咽・迷走・舌下神経領域の運動・感覚不全麻痺あり。反復唾液嚥下テストは0回，唾液誤嚥の疑いを認めたために0.5mlの水飲みテストを行ったところむせを認めた。以上より，準備期から嚥下咽頭期にわたる機能的嚥下障害と診断して，まずは口腔ケア，間接訓練より介入開始。術後18日目，嚥下内視鏡検査を実施。検査食の咽頭部残留を認めるも明らかな誤嚥を認めなかったことから，翌日より直接訓練を開始。術後27日目，嚥下造影検査実施。右側臥位・左側頚部回旋位では，中間位に比して嚥下後の咽頭部残留が減少したことから，姿勢調整により経口摂取可能と判断して同日より食事開始。経過に応じ食上げを行い，並行して新義歯作製および咀嚼訓練実施。最終的に中間位にて米飯・軟々菜食まで摂取可能となり，術後86日目に自宅退院に至った。},
 pages = {81--85},
 title = {小脳橋角部髄膜腫摘出術後に嚥下障害を認めた一例},
 volume = {45},
 year = {2015}
}