ABSTRACT
We present the case of an infant with oral cancer that developed in the 3rd month of life, following which oral feeding became difficult. In the 11th month of life, the right side of the mandible was resected surgically and movement on the right side of the mandible was restricted because of the compression caused by the rectus abdominis myocutaneous flap used for reconstruction. We initiated rehabilitation for the initial acquisition of eating functions so that the patient would be able to ingest baby food despite having an organic disorder in the oral cavity.Postoperative dysphagia in adult oral cancer is an organic disorder that occurs after acquisition of a normal swallowing pattern, whereas postoperative dysphagia in pediatric oral cancer is an organic disorder that occurs during the initial acquisition of eating functions. At present, the rehabilitation approach has not been established.From 12 months of age in this patient, we evaluated training methods that were easily accepted by children, including postoperative oral function evaluation, with the goal of the initial acquisition of eating functions. We approached postoperative wound contracture prevention with a focus on approaches to lip insufficiency, predation, and tongue/mandibular movements. In addition, we focused on family guidance and tried to support the caretaker's correct use of methods established during training.
ABSTRACT
Coronavirus disease 2019 (COVID-19) has been spreading globally since 2019；however, comprehensive rehabilitation of elderly patients with COVID-19 pneumonia remains a challenge. A 76-year-old American woman with COVID-19 pneumonia was admitted to our hospital. Because her disease was complicated by acute respiratory distress syndrome (ARDS), she was treated with intensive care, including invasive ventilation and extracorporeal membrane oxygenation (ECMO). During and after intensive care, she exhibited physical symptoms such as weakness, pain, shortness of breath, and difficulty in movement and exercise. Furthermore, during approximately 3.5 months of hospitalization, she received swallowing and speech therapies along with physical therapy. These rehabilitation therapies enabled her to get home in the United States. Her rehabilitation schedule had to be carefully planned according to her symptoms and infectiousness of COVID-19. This paper highlights few important points regarding the difficulty in rehabilitation including that of physical function, mental health, and cognitive function of patients with COVID-19. Furthermore, this report provides a problem-solving approach for long-term rehabilitation in elderly patients with COVID-19 pneumonia.