Successful Treatment of Dysphagia in Postoperative Medulloblastoma: A Case Study

JOURNAL TITLE: International Journal of Phonosurgery & Laryngology

Author
1. Suman Kumar
2. Nikita Chatterjee
3. Joyanta C Mandal
4. Indranil Chatterjee
ISSN
2230-7508
DOI
10.5005/jp-journals-10023-1167
Volume
9
Issue
1
Publishing Year
2019
Pages
3
Author Affiliations
1. com.mps.common.model.Contributor@3369b84c ,
2. com.mps.common.model.Contributor@6ff983b ,
3. com.mps.common.model.Contributor@6017062b ,
4. com.mps.common.model.Contributor@9dd9164
Article keywords
Aspiration, Dysphagia, Medulloblastoma, Swallowing, Swallowing therapy

Abstract

Aim: The aim of this study was to document the assessment and therapeutic management of dysphagia in a case of postoperative medulloblastoma. Background: Medulloblastoma is a highly malignant and rapidly growing central nervous system (CNS) tumor that arises from the cerebellum, the lower and rear portion of the brain. The tumor causes hydrocephalus and symptoms of increased intracranial pressure (ICP) as well as affected functions like problem in controlling balance, posture, and complex motor functions such as finer hand movement, speech, and swallowing as noted on examination also nystagmus and papilledema. Patients with neurosurgical conditions like medulloblastoma exhibit serious swallowing problem mainly in oral transit, pharyngeal, and esophageal stage such as delayed or even absence of pharyngeal trigger, restricted tongue, and laryngeal movement with no true pharyngeal swallow. Case description: A 35-year-old male was diagnosed with pharyngoesophageal dysphagia and was advised for swallowing therapy. The swallowing therapy including the oromotor exercises included Masako or tongue hold, and Shaker and modified Shaker exercises along with the swallowing maneuvers included effortful swallow, Mendelsohn maneuvers, and super-supraglottic swallow. The therapy was provided twice a week for the duration of 45 minutes. Conclusion: This study concluded that early intervention or early implementation of swallowing therapy plays a significant role in triggering the rate of improvement and helps the patient to experience an improved quality of life. Clinical implication: A combination of swallow therapy techniques with each technique aimed to treat specific impairment has the ability to boost the rate of recovery. In 15 sessions, the feeding tube was removed and the patient was able to swallow safely and efficiently.

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