Evaluation of swallowing function during the perioperative period using fiberoptic endoscopy in a patient with myasthenia gravis: a case report.

IF 0.8 Q3 ANESTHESIOLOGY

JA Clinical Reports Pub Date : 2025-04-02 DOI:10.1186/s40981-025-00783-y

Kunihiro Mitsuzawa, Takashi Ishida, Mariko Ito, Satoshi Tanaka, Mikito Kawamata

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引用次数: 0

Abstract

Background: General anesthesia causes postoperative dysphagia, and myasthenia gravis also impairs swallowing function. Thus, managing general anesthesia in patients with myasthenia gravis requires special attention to swallowing function. Fiberoptic endoscopic evaluation of swallowing (FEES) has the potential to provide precise perioperative assessment and management of swallowing in these patients.

Case presentation: A 35-year-old woman with myasthenia gravis was scheduled for laparoscopic ileocolic resection. FEES was performed before anesthesia, after extubation, and on postoperative day 1. General anesthesia was performed with endotracheal intubation, and extubation was performed uneventfully. Post-extubation FEES revealed salivary pooling, decreased glottal closure reflex, and redness of right arytenoid, likely caused by the endotracheal intubation and nasogastric tube. However, FEES performed on postoperative day 1 showed improvement of these findings.

Conclusions: FEES effectively identified transient swallowing impairments related to intubation and confirmed the absence of dysphagia specific to myasthenia gravis, thereby contributing to safe perioperative care.

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纤维内镜对重症肌无力患者围手术期吞咽功能的评价：1例报告。

背景：全身麻醉引起术后吞咽困难，重症肌无力也会损害吞咽功能。因此，在重症肌无力患者的全身麻醉管理中，需要特别注意吞咽功能。光纤内镜吞咽评估（FEES）有可能为这些患者提供精确的围手术期吞咽评估和管理。病例介绍：一名35岁重症肌无力妇女计划行腹腔镜回结肠切除术。在麻醉前、拔管后和术后第1天分别进行FEES检查。气管插管全麻，拔管顺利。拔管后检查发现唾液淤积，声门关闭反射减弱，右侧杓状关节发红，可能是气管内插管和鼻胃管所致。然而，术后第1天进行的FEES显示这些结果有所改善。结论：FEES可有效识别与插管相关的短暂性吞咽障碍，并确认没有重症肌无力特有的吞咽困难，从而有助于安全的围手术期护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JA Clinical Reports ANESTHESIOLOGY-

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： JA Clinical Reports is a companion journal to the Journal of Anesthesia (JA), the official journal of the Japanese Society of Anesthesiologists (JSA). This journal is an open access, peer-reviewed, online journal related to clinical anesthesia practices such as anesthesia management, pain management and intensive care. Case reports are very important articles from the viewpoint of education and the cultivation of scientific thinking in the field of anesthesia. However, submissions of anesthesia research and clinical reports from Japan are notably decreasing in major anesthesia journals. Therefore, the JSA has decided to launch a new journal, JA Clinical Reports, to encourage JSA members, particularly junior Japanese anesthesiologists, to publish papers in English language.