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This study focused on the Kuchikara Taberu Balance Chart (KTBC) as a tool for swallowing function evaluation. To clarify the relationship between videoendoscopic (VE) examination of swallowing function and the KTBC, we compared median KTBC scores with and without laryngeal penetration identified by VE. Sixty-five patients with a mean age of 84.3 ± 7.9 years were examined at the Towada City Hospital. The patients were classified into groups based on laryngeal penetration, including 28 patients with and 37 patients without penetration. We found no significant differences in patient backgrounds. The median KTBC score (interquartile range) was 36.5 (31-44.5) in the group with laryngeal penetration and 42 (35-48.5) in the group without penetration, but the scores were not significantly different (level of statistical significance at α = 0.0036 determined by the Bonferroni correction method) when compared with the Mann-Whitney U test (36.5 vs. 42, z = -2.33, p = 0.020). The median respiratory condition (3 vs. 4, z = - 3.23; p < 0.0036), oral preparatory and propulsive phases (3 vs. 4, z = - 2.96; p < 0.0036), and position and endurance (1 vs. 3, z = - 3.25; p < 0.0036) scores were significantly lower in the group with laryngeal penetration. This study revealed a correlation between laryngeal penetration confirmed by VE and KTBC scores. Consequently, respiratory condition, oral preparatory and propulsive phases, and position and endurance may be useful as tools for the assessment of swallowing. In particular, we recommend adding respiratory status to dysphagia screening.

Tuberous sclerosis complex (TSC) is an autosomal dominant disorder in which benign nodular tumors form in the cerebral cortex, cerebellum, and throughout the body causing various symptoms. In this study, we summarized the incidence of dental findings in patients with TSC at our hospital and its association with diseases in various organs. Patients diagnosed with TSC at our hospital between January 2013 and September 2017, and who were examined in the dental and oral surgery department were included in this study. The presence of intraoral manifestations (central cusps, enamel pits, oral fibromas) was examined by means of visual inspection, intraoral photography, and X-ray photography. In addition, the relationship with associated diseases (neurological, cutaneous, cardiac, renal, and pulmonary) according to organ and disease severity was examined. The mean age (± SD) of the 42 TSC patients (19 men and 23 women) was 27.8 ± 14.6 years, of which 24 patients (11 men and 13 women) presented with oral manifestations. Of these patients, seven had central cusps, 10 had enamel pits, and 17 had oral fibromas. The group with central cusps had significantly higher neurological issues in the relationship between intraoral manifestations and associated disease based on the involved organ. The prevalence of central cusps in TSC was 16.7%, which is significantly higher than the 2.6% reported in healthy Japanese subjects. The central cusp is a diagnostic factor alongside the presence of enamel pits and oral fibromas, which can aid in the early diagnosis of TSC by dentists.

Japan has entered an era of a super-aging population, and given the importance of oral nutrition, the need to evaluate swallowing function has increased. Herein, we contribute to continued developments in evaluating eating and swallowing functions by describing current videoendoscopy (VE) usage and trends to evaluate and diagnose causes of dysphagia. In all, 100 patients (58 men and 42 women; mean age: 79 years) with suspected dysphagia were enrolled; 15 of these were re-examinations. Examinations were conducted according to the Japanese Society of Dysphagia Rehabilitation VE examination guidelines for swallowing. In this study, several patients (77.8 %) with poor vocalization and a saliva reservoir were unable to eat. While evaluating the relationship between aspiration and pharyngeal or laryngeal influx, we found that when pharyngeal and laryngeal influx were present, the risk of aspiration was high. Some patients (38.9 %) were able to eat despite lacking a cough reflex; thus, the absence of a cough reflex does not necessarily equate to an inability to eat, even in patients unable to ingest nutrition orally. One case could ingest nutrition, even with no cough reflex. The 6-month survival rate after the examination of patients on nil per os status was 57.1 %, specifically in patients unable to ingest nutrition orally. These results suggest that decreased eating and swallowing functions indicate a poor prognosis for the patient's quality of life, as eating and swallowing require smooth passage in the oral phase. Therefore, actively requesting a dental intervention and oral rehabilitation is important for a patient presenting these issues.

Background: The branching patterns of the external carotid artery vary among individuals, and consideration of the proximity of nerves is important during catheter insertion in superselective intra-arterial infusion via the superficial temporal artery. We aimed to evaluate the anatomy of the external carotid artery and its surrounding nerves for safe and accurate administration of superselective intra-arterial chemotherapy via the superficial temporal artery., Methods: We analyzed the external carotid artery and its branches morphometrically in 28 Japanese cadavers (56 sides)., Results: Vascular tortuosity in the preauricular region of the catheter insertion site was observed in 42.9% of the sides; the main trunk of the external carotid artery was excessively tortuous in 25.0% of the sides, primarily in the preparotid region. Faciolingual and superior thyrolingual trunks were observed in 28.6 and 1.8% of the sides, respectively. The superior thyroid, lingual, facial, occipital, and maxillary arteries branched from the external carotid artery above the carotid bifurcation in 41.1% of the sides. The mean distance between the insertion site and maxillary artery was 39.5 mm, indicating the extent of catheter insertion. The auriculotemporal nerve was observed near the superficial temporal artery in the preauricular region in 44.6% of the sides; however, the clearly identifiable nerves in the exposed area were difficult to avoid., Conclusion: Because of the branching variations observed in individuals and sides, preoperative angiography is extremely important for avoiding complications.