A case of Wallenberg syndrome with prolonged dysphagia successfully treated by management of the tracheostoma

Abstract

In patients with severe dysphagia, tracheostomy is a useful intervention for airway management. However, it is accompanied by some disadvantages such as an inhibition of laryngeal elevation. In this paper, we present a case of Wallenberg syndrome with prolonged dysphagia who was successfully treated by minor revision surgery of the tracheostoma. A 70-year-old male presented with severe dysphagia due to brainstem infarction. He had undergone a tracheostomy for airway management and was wearing a cuffed cannula. Despite intensive swallowing rehabilitation, his swallowing function showed insufficient improvement. The subject was treated with adjustment of the tracheostoma to a lower position and alteration of the cannula. These interventions resulted in improvement of laryngeal elevation and decrease in aspiration. He recovered sufficient oral feeding and the tracheostoma was successfully closed. Clinicians should be aware that tracheostoma may cause deterioration in or inhibit recovery of swallowing function.