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已发表论文
间歇性经口食管管饲调节出血后吞咽障碍中的咽部炎症
Authors An D, Zhang Y, Hou X, Dou Z, Tang ZM, Wen H
Received 13 May 2025
Accepted for publication 18 December 2025
Published 13 January 2026 Volume 2026:19 538664
DOI https://doi.org/10.2147/IMCRJ.S538664
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Thomas E Hutson
Delian An,1,* Yaowen Zhang,1,* Xingyue Hou,1 Zulin Dou,1 Zhi-Ming Tang,2 Hongmei Wen1
1Department of Rehabilitation Medicine, The Third Affiliated Hospital Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of China; 2Department of Rehabilitation Medicine, The First People’s Hospital of Foshan, Guangzhou, Guangdong, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Hongmei Wen, Department of Rehabilitation Medicine, The Third Affiliated Hospital Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong Province, 510630, People’s Republic of China, Email wenhongmei@mail.sysu.edu.cn Zhi-Ming Tang, Department of Rehabilitation Medicine, The First People’s Hospital of Foshan, 600 Tianhe Road, Guangzhou, Guangdong, 510630, People’s Republic of China, Tel/Fax +86 20 85256013, Email tgzhiming@hotmail.com
Abstract: Dysphagia may be caused by stroke, cranial trauma, head and neck tumor surgery, and neurodegeneration. The overall prevalence of dysphagia in China is 38.7%, which can lead to aspiration pneumonia and malnutrition, increasing mortality rates and prolonging hospitalization. As an independent predictor of death, post-stroke dysphagia mortality ranges from 29% to 37%. Indwelling nasogastric tube feeding is widely used for dysphagic patients, but complications include mucosal bleeding, tumefaction, pneumonia, and acid regurgitation. Intermittent nasogastric tubes are an alternative option, though rarely reported. This paper describes a stroke patient with dysphagia and tracheotomy who received intermittent oroesophageal tube feeding. Notably, epiglottis tumefaction caused by the indwelling nasogastric tube disappeared after switching to intermittent oroesophageal tube feeding, with concurrent improvements in nutritional indicators, gastrointestinal tolerance, and swallowing function. To avoid side effects of indwelling nasogastric tubes in dysphagic patients, intermittent oroesophageal tube feeding deserves clinical consideration.
Plain Language Summary: A 34-year-old male with post-cerebral hemorrhage quadriplegia developed persistent dysphagia and pharyngeal edema after six months of indwelling nasogastric tube feeding. Serial fiberoptic bronchoscopy demonstrated progressive epiglottic and left piriform sinus swelling correlating with prolonged tube placement. Transition to intermittent oroesophageal feeding (Ch14 tube, 6 times/day protocol) led to complete resolution of mucosal edema within 12 days, documented through three endoscopic examinations. Nutritional status improved with 2160 kcal/day enteral nutrition (35 kcal/kg/day), accompanied by 5% weight gain. Successful tracheostomy decannulation occurred on February 24, 2020, with stable vital signs post-extubation. Key clinical insights include the association between indwelling tube duration and pharyngeal inflammation severity, the therapeutic role of feeding interval adjustment in mucosal recovery, and the value of serial endoscopic monitoring when videofluoroscopic swallowing studies are unavailable. This protocol demonstrates effective dysphagia management in post-neurosurgical rehabilitation settings.
Keywords: intermittent oroesophageal tube feeding, nutrition, stroke, dysphagia, epiglottis tumefaction
1Department of Rehabilitation Medicine, The Third Affiliated Hospital Sun Yat-sen University, Guangzhou, Guangdong, People’s Republic of China; 2Department of Rehabilitation Medicine, The First People’s Hospital of Foshan, Guangzhou, Guangdong, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Hongmei Wen, Department of Rehabilitation Medicine, The Third Affiliated Hospital Sun Yat-sen University, 600 Tianhe Road, Guangzhou, Guangdong Province, 510630, People’s Republic of China, Email wenhongmei@mail.sysu.edu.cn Zhi-Ming Tang, Department of Rehabilitation Medicine, The First People’s Hospital of Foshan, 600 Tianhe Road, Guangzhou, Guangdong, 510630, People’s Republic of China, Tel/Fax +86 20 85256013, Email tgzhiming@hotmail.com
Abstract: Dysphagia may be caused by stroke, cranial trauma, head and neck tumor surgery, and neurodegeneration. The overall prevalence of dysphagia in China is 38.7%, which can lead to aspiration pneumonia and malnutrition, increasing mortality rates and prolonging hospitalization. As an independent predictor of death, post-stroke dysphagia mortality ranges from 29% to 37%. Indwelling nasogastric tube feeding is widely used for dysphagic patients, but complications include mucosal bleeding, tumefaction, pneumonia, and acid regurgitation. Intermittent nasogastric tubes are an alternative option, though rarely reported. This paper describes a stroke patient with dysphagia and tracheotomy who received intermittent oroesophageal tube feeding. Notably, epiglottis tumefaction caused by the indwelling nasogastric tube disappeared after switching to intermittent oroesophageal tube feeding, with concurrent improvements in nutritional indicators, gastrointestinal tolerance, and swallowing function. To avoid side effects of indwelling nasogastric tubes in dysphagic patients, intermittent oroesophageal tube feeding deserves clinical consideration.
Plain Language Summary: A 34-year-old male with post-cerebral hemorrhage quadriplegia developed persistent dysphagia and pharyngeal edema after six months of indwelling nasogastric tube feeding. Serial fiberoptic bronchoscopy demonstrated progressive epiglottic and left piriform sinus swelling correlating with prolonged tube placement. Transition to intermittent oroesophageal feeding (Ch14 tube, 6 times/day protocol) led to complete resolution of mucosal edema within 12 days, documented through three endoscopic examinations. Nutritional status improved with 2160 kcal/day enteral nutrition (35 kcal/kg/day), accompanied by 5% weight gain. Successful tracheostomy decannulation occurred on February 24, 2020, with stable vital signs post-extubation. Key clinical insights include the association between indwelling tube duration and pharyngeal inflammation severity, the therapeutic role of feeding interval adjustment in mucosal recovery, and the value of serial endoscopic monitoring when videofluoroscopic swallowing studies are unavailable. This protocol demonstrates effective dysphagia management in post-neurosurgical rehabilitation settings.
Keywords: intermittent oroesophageal tube feeding, nutrition, stroke, dysphagia, epiglottis tumefaction