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Case Report

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J Korean Dysphagia Soc 2020; 10(1): 123-129

Published online January 30, 2020

Copyright © The Korean Dysphagia Society.

Improvement of Dysphagia in Traumatic Neurovascular Compression: A Case Report and Collective Review

Yong Kyun Kim, M.D., Ph.D., Yun Jung Lee, M.D., Ph.D., Yong Seob Jo, M.D., Jung Hyun Cha, M.D.

Department of Physical Medicine and Rehabilitation, Myongji Hospital, Goyang, Korea

Abstract

Dysphagia is a relatively rare symptom of neurovascular compression of the lower cranial nerve (CN). Many case reviews of neurovascular compression required surgical treatment to improve the neurological symptoms. This report presents a 75-year-old female patient who complained of dysphagia due to neurovascular compression of CNs IX-XI at the left side after the onset period. The symptom was improved by treating with balloon swallowing rehabilitation (BSR). In a video fluoroscopic swallowing study (VFSS), no significant manifestations were observed in the oral phase. On the other hand, profuse post-swallow residue decreased pharyngeal propulsion were observed without aspiration or penetration during the semisolid portion of the swallowing test. To reduce the pharyngeal remnant and improve pharyngeal propulsion, the BSR protocol was performed and the patient recovered quickly. Follow-up VFSS showed improvement in the post-swallow residue from 42.6 to 7.3%. After discharge, the patient could resume a normal diet without complications. Based on this observed result, it is advantageous to consider the option of a prescribed rehabilitation program over surgical treatment.

Keywords: Dysphagia, Neurovascular compression, Glossopharyngeal nerve, Vagus nerve, Rehabilitation

Article

Case Report

J Korean Dysphagia Soc 2020; 10(1): 123-129

Published online January 30, 2020

Copyright © The Korean Dysphagia Society.

Improvement of Dysphagia in Traumatic Neurovascular Compression: A Case Report and Collective Review

Yong Kyun Kim, M.D., Ph.D., Yun Jung Lee, M.D., Ph.D., Yong Seob Jo, M.D., Jung Hyun Cha, M.D.

Department of Physical Medicine and Rehabilitation, Myongji Hospital, Goyang, Korea

Abstract

Dysphagia is a relatively rare symptom of neurovascular compression of the lower cranial nerve (CN). Many case reviews of neurovascular compression required surgical treatment to improve the neurological symptoms. This report presents a 75-year-old female patient who complained of dysphagia due to neurovascular compression of CNs IX-XI at the left side after the onset period. The symptom was improved by treating with balloon swallowing rehabilitation (BSR). In a video fluoroscopic swallowing study (VFSS), no significant manifestations were observed in the oral phase. On the other hand, profuse post-swallow residue decreased pharyngeal propulsion were observed without aspiration or penetration during the semisolid portion of the swallowing test. To reduce the pharyngeal remnant and improve pharyngeal propulsion, the BSR protocol was performed and the patient recovered quickly. Follow-up VFSS showed improvement in the post-swallow residue from 42.6 to 7.3%. After discharge, the patient could resume a normal diet without complications. Based on this observed result, it is advantageous to consider the option of a prescribed rehabilitation program over surgical treatment.

Keywords: Dysphagia, Neurovascular compression, Glossopharyngeal nerve, Vagus nerve, Rehabilitation

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