부산대학교 도서관

A patient with cerebral palsy usually has a disorder of tongue movement, often accompanied by pharyngeal dysphagia. We describe the results of a doctor’s visit dental program for a 36-year-old Japanese male with cerebral palsy at a facility for severely mentally and physically handicapped people in our area. The patient had a disorder of tongue movement and we were asked by a speech therapist to make a palatal augmentation prosthesis because the patient’s accidental swallowing and cyanosis had worsened. We made a PAP and set it to the patient, after which the patient received dysphagia rehabilitation by the speech therapist. We evaluated swallowing function with or without the PAP by videofluoroscopic examination of swallowing. We also evaluated it using the oral function evaluation list according to Hironishi, et al. As a result, his oral function, especially tongue movement, improved sufficiently to enable him to spit out tea that he disliked. The number of times of choking and coughing during meals was decreased. By putting on the PAP, adhesion and residue of alimentary bolus on the posterior wall of the oropharynx were decreased and accidental swallowing was improved according to VF observation. The results of a blood test showed that the number of neutrophils and C-reactive protein had decreased. We conclude that a PAP may be effective for patients with cerebral palsy having pharyngeal dysphagia.