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[Dysphagia] traumatic fall and tongue mobility
In my experience, I would vote for long intubation and traching. Intubation
of just 3 days has been known as an indicator of dysphagia.
JoAnn
----- Original Message -----
From: <naomislp@aol.com>
To: <dysphagia@b9.com>
Sent: Tuesday, March 08, 2005 11:01 AM
Subject: [Dysphagia] traumatic fall and tongue mobility
> Hello all,
> Recently saw a young patient s/p 3-story fall, currently on trach collar
> and s/p PEG placement. There were multiple fractures but no documented
> head trauma or fractures around skull or face. Oral motor function is
> intact except for what seems to be isolated but significantly impaired
> lingual mobility and strength. This has resolved slightly, with better
> range of motion at tongue tip and front but poorer movement mid-back and
> likely poorest movement at base, given poor swallow function and gross
> aspiration on single trial puree during bedside eval. He was initially
> aphonic (despite cuff deflation, trach occlusion) but vocal function is
> gradually improving.
> What could be causing the isolated impairment of tongue function - is this
> cranial nerve damage? Would that also explain initially poor laryngeal
> function (or is that more likely due to period of intubation prior to
> trach and/or presence of trach currently?)
> He seems to be responding to traditional OM exs - any other suggestions?
> Thanks in advance,
> Naomi
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