Oral Intake in the Complete Lateral Position as a Compensatory Method for a Patient with Severe Dysphagia: A Case Report

Naoki Fukumura, K. Makigami
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Abstract

ABSTRACT Background: We report a patient with severe dysphagia who was successfully treated using our newly developed swallowing rehabilitation method involving a complete lateral position. Case: This case involved a 74-year-old male patient with dysphagia caused by multiple morbidities, including sarcopenia after panperitonitis, Wallenberg syndrome, and Lewy body dementia. We attempted oral feeding in the complete lateral position and observed that the bolus was moving as intended and was swallowed without penetration or aspiration. The patient achieved oral feeding using the complete lateral position, and his physical and cognitive functions improved. He was discharged home and continued feeding orally without alternative means for more than 5 years. Discussion: In the flat (complete) lateral position, the bolus flows and pools as far as possible from the airway opening of the pharynx. Using this method, gravity aids in preventing penetration and aspiration. Therefore, eating in the complete lateral position has immediate effects that are reproducible and not dependent on the cognitive function or motor skills of the patient or the assistance skills of the caregivers.
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以完全侧卧位进食作为严重吞咽困难患者的一种补偿方法:病例报告
摘要 背景:我们报告了一名患有严重吞咽困难的患者,该患者采用我们新开发的完全侧卧位吞咽康复方法获得了成功治疗。病例:该病例涉及一名 74 岁的男性患者,他因多种疾病导致吞咽困难,包括泛腹膜炎后的肌肉疏松症、瓦伦贝里综合征和路易体痴呆症。我们尝试采用完全侧卧位进行口腔喂养,观察到栓剂按预定方向移动,吞咽时没有穿透或吸入。患者采用完全侧卧位实现了口腔进食,其身体和认知功能均有所改善。他出院回家后,在没有其他替代方法的情况下继续口服喂养了 5 年多。讨论:在平卧(完全)侧卧位时,栓剂尽可能远离咽部气道开口流动和汇集。使用这种方法,重力有助于防止渗透和吸入。因此,采用完全侧卧位进食具有立竿见影的效果,且可重复,不依赖于患者的认知功能或运动技能,也不依赖于护理人员的辅助技能。
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