Dysphagia Rehabilitation Through the Use of Palatal Augmentation Protheses

Objectives:As one of the after-effects following surgery for oral cancer, dysphagia often clinically develop. Generally, if the movements of the tongue become impaired, an increased pharyngeal internal pressure are not achieved to a large extent. Conventionally, for such disorders of the tongue movement, the recovery of tongue function has been attempted by Palatal Augmentation Protheses(PAP), but there have been few reports that have previously assessed the actual swallowing movement functionally. This study describes our method for dysphagia rehabilitation and its functional assessment, by means of PAP, in case of patient with dysphagia after surgery for tongue cancer.Methods:The patient was 81-year-old male. On July 25, 2001, a hemitongue resection was performed due to the presence of left tongue cancer. His problems included, 1) dysfunctional transport of bolus, 2) impaired elevation of soft palate and 3) oral saburra were observed. Regarding the treatment strategy for 1), both tongue stretching and tongue muscle-strengthening exercises were carried out, while for 2) and 3), dysphagia rehabilitation through PAP were performed. Both before and after the training, videofluorography (VF) was performed as functional assessment.Results:1. The application of PAP demonstrated, as a result, was thus found to effectively improve the tongue function, while also decreasing the symptoms of oral saburra. 2. The application of PAP caused increasing of elevation of the soft palate, in result, contributed to enhancement of swallow strength.Conclusions:1. It is believed that improving the tongue function and reducing the symptoms of oral saburra were achieved due to PAP being attached to the palate, whereby the tongue comes into close contact with the area corresponding to the palate.2.It is believed that application of PAP caused an improvement of elevation of soft palate due to an acceleration of pharyngeal internal pressure.