{"_buckets": {"deposit": "db579e61-7350-424a-95ed-64ba2b95f6f0"}, "_deposit": {"id": "25522", "owners": [], "pid": {"revision_id": 0, "type": "depid", "value": "25522"}, "status": "published"}, "_oai": {"id": "oai:niigata-u.repo.nii.ac.jp:00025522", "sets": ["456", "1303"]}, "item_7_alternative_title_1": {"attribute_name": "その他のタイトル", "attribute_value_mlt": [{"subitem_alternative_title": "A case report of combinational approach of surgery and rehabilitation resulting in oral intake in a patient with severe dysphagia"}]}, "item_7_biblio_info_6": {"attribute_name": "書誌情報", "attribute_value_mlt": [{"bibliographicIssueDates": {"bibliographicIssueDate": "2007-12", "bibliographicIssueDateType": "Issued"}, "bibliographicIssueNumber": "2", "bibliographicPageEnd": "204", "bibliographicPageStart": "201", "bibliographicVolumeNumber": "37", "bibliographic_titles": [{"bibliographic_title": "新潟歯学会雑誌"}, {"bibliographic_title": "新潟歯学会雑誌", "bibliographic_titleLang": "en"}]}]}, "item_7_description_4": {"attribute_name": "抄録", "attribute_value_mlt": [{"subitem_description": "今回, 我々は脳幹梗塞後遺症により食道入口部開大不全を伴う嚥下障害を生じ, 2年余りの完全経腸栄養の時期を経て, 耳鼻科での外科手術の後に当科にてリハビリテーションを行い, 経口摂取が可能となった症例を経験したので, その概要について報告する｡患者は56歳男性で椎骨動脈乖離性動脈瘤破裂によりくも膜下出血を来たし, その後右延髄梗塞を合併して球麻痺, 重度左麻痺が残存した｡当初より嚥下造影検査時には食道入口部開大不全が明らかであり, 経口摂取は困難と判断されて発症4ケ月後に胃瘻造設された｡経口摂取やリハビリテーションを希望して発症から1年後に当科を初診された時点でも症状の改善はみられず, リハビリテーションの適応ではないと判断した｡外科的対応を主眼において当院耳鼻科を紹介し, 同科にて発症後約2年後に輪状咽頭筋切断術と喉頭挙上術を行った｡術後8日日より当科にてリハビリテーションを再開した｡その後の嚥下造影検査結果では下顎を上前方に突き出して食道入口部を開く代償法が有効であった｡この代償法の獲得訓練を行い, 全粥半固形食を摂るまでに回復した｡完全経腸栄養の状態から家庭で食事ができるまでに至った意義は非常に大きいと考える｡本症例は耳鼻科による外科手術とその後の当科におけるリハビリテーションによる新たな摂食方法の獲得のどちらが欠けてもこのような改善が期待できなかったケースとして, 多職種連携の重要性を実証したものといえる｡", "subitem_description_type": "Abstract"}, {"subitem_description": "We report a patient who has suffered from severe dysphagia with cricopharyngeal dysfunction, a hypertonic cricopharyngeus muscle, after brain stem infarction. He got nourishment by gastrostomy for two years after the first attack. He had come to be able to take meals by oral attributed to the combination of orofacial and pharyngeal surgery and dysphagia rehabilitation. The 56 years old man caught subarachnoid hemorrhage caused by ruptured neurysm of vertebral artery, and also caught right medulla infarction causing incurable bulbar paralysis and severe left side palsy. The patient visited our clinic one year after the attack. We found that the cricopharyngeal dysfunction was developed in the first videofluoroscopic examination of swallowing (VFG). Since more than a year had past from the attack, it was obvious that this was not the case of dysphagia rehabilitation but the surgical correction should be choused at that time. We, therefore, introduced him to the otolaryngology and he underwent the surgery of cricopharyngeal myotomy and laryngeal suspension two years after the attack. Eight days after the operation the rehabilitation was started since it was found that the upper esophageal sphincter (UES) opened efficiently in the second VFG. Then, in the process of rehabilitaion, it was clarified that chin forward lead to opening the UES by using the VFG and videoendoscopy. As a result of continuous training, he had come to be able to eat foods by oral, taking meals with his family. In this case, both of surgical operation in otolaryngology and rehabilitation were essential for the improvement. This case strongly suggested that multi-occupational cooperation may be important to treat a patient with severe dysphagia.", "subitem_description_type": "Abstract"}]}, "item_7_full_name_3": {"attribute_name": "著者別名", "attribute_value_mlt": [{"nameIdentifiers": [{"nameIdentifier": "150464", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Adachi, Taiga"}]}, {"nameIdentifiers": [{"nameIdentifier": "150465", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Ootaki, Sachiko"}]}, {"nameIdentifiers": [{"nameIdentifier": "150466", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Inoue, Makoto"}]}, {"nameIdentifiers": [{"nameIdentifier": "150467", "nameIdentifierScheme": "WEKO"}], "names": [{"name": "Yamada, Yoshiaki"}]}]}, "item_7_publisher_7": {"attribute_name": "出版者", "attribute_value_mlt": [{"subitem_publisher": "新潟歯学会"}]}, "item_7_select_19": {"attribute_name": "著者版フラグ", "attribute_value_mlt": [{"subitem_select_item": "publisher"}]}, "item_7_source_id_11": {"attribute_name": "書誌レコードID", "attribute_value_mlt": [{"subitem_source_identifier": "AN0018300X", "subitem_source_identifier_type": "NCID"}]}, "item_7_source_id_9": {"attribute_name": "ISSN", "attribute_value_mlt": [{"subitem_source_identifier": "03850153", "subitem_source_identifier_type": "ISSN"}]}, "item_creator": {"attribute_name": "著者", "attribute_type": "creator", "attribute_value_mlt": [{"creatorNames": [{"creatorName": "安達, 大雅"}], "nameIdentifiers": [{"nameIdentifier": "150460", "nameIdentifierScheme": "WEKO"}]}, {"creatorNames": [{"creatorName": "大瀧, 祥子"}], "nameIdentifiers": [{"nameIdentifier": "150461", "nameIdentifierScheme": "WEKO"}]}, {"creatorNames": [{"creatorName": "井上, 誠"}], "nameIdentifiers": [{"nameIdentifier": "150462", "nameIdentifierScheme": "WEKO"}]}, {"creatorNames": [{"creatorName": "山田, 好秋"}], "nameIdentifiers": [{"nameIdentifier": "150463", "nameIdentifierScheme": "WEKO"}]}]}, "item_files": {"attribute_name": "ファイル情報", "attribute_type": "file", "attribute_value_mlt": [{"accessrole": "open_date", "date": [{"dateType": "Available", "dateValue": "2019-08-19"}], "displaytype": "detail", "download_preview_message": "", "file_order": 0, "filename": "NS_37(2)_201-204.pdf", "filesize": [{"value": "852.7 kB"}], "format": "application/pdf", "future_date_message": "", "is_thumbnail": false, "licensetype": "license_free", "mimetype": "application/pdf", "size": 852700.0, "url": {"label": "NS_37(2)_201-204.pdf", "url": "https://niigata-u.repo.nii.ac.jp/record/25522/files/NS_37(2)_201-204.pdf"}, "version_id": "3b987ed0-fbaa-4941-84b1-b870fa1fc377"}]}, "item_keyword": {"attribute_name": "キーワード", "attribute_value_mlt": [{"subitem_subject": "球麻痺(Bulbar paralysis)", "subitem_subject_scheme": "Other"}, {"subitem_subject": "延髄梗塞(Medulla infarction)", "subitem_subject_scheme": "Other"}, {"subitem_subject": "輪状咽頭筋切断術(Cricopharyngeal myotomy)", "subitem_subject_scheme": "Other"}, {"subitem_subject": "摂食･嚥下リハビリテーション(Dysphagia rehabilitation)", "subitem_subject_scheme": "Other"}, {"subitem_subject": "チームアプローチ(Team approach)", "subitem_subject_scheme": "Other"}]}, "item_language": {"attribute_name": "言語", "attribute_value_mlt": [{"subitem_language": "jpn"}]}, "item_resource_type": {"attribute_name": "資源タイプ", "attribute_value_mlt": [{"resourcetype": "departmental bulletin paper", "resourceuri": "http://purl.org/coar/resource_type/c_6501"}]}, "item_title": "食道入口部開大不全に対して手術とリハビリテーションを行い経口摂取に至った一例", "item_titles": {"attribute_name": "タイトル", "attribute_value_mlt": [{"subitem_title": "食道入口部開大不全に対して手術とリハビリテーションを行い経口摂取に至った一例"}, {"subitem_title": "食道入口部開大不全に対して手術とリハビリテーションを行い経口摂取に至った一例", "subitem_title_language": "en"}]}, "item_type_id": "7", "owner": "1", "path": ["456", "1303"], "permalink_uri": "http://hdl.handle.net/10191/22818", "pubdate": {"attribute_name": "公開日", "attribute_value": "2013-07-25"}, "publish_date": "2013-07-25", "publish_status": "0", "recid": "25522", "relation": {}, "relation_version_is_last": true, "title": ["食道入口部開大不全に対して手術とリハビリテーションを行い経口摂取に至った一例"], "weko_shared_id": null}