Rinsho Shinkeigaku (Clinical Neurology)

Original Article

Analysis of resting salivation rate in patients with amyotrophic lateral sclerosis using tracheostomy invasive ventilation

Chiharu Matsuda, R.N., M.N.S.1)2), Toshio Shimizu, M.D., Ph.D.3), Yuki Nakayama, R.N., Ph.D.1), Michiko Haraguchi, R.N., Ph.D.1), Yoko Mochizuki, M.D., Ph.D.4), Chiyoko Hakuta, D.D.S., Ph.D.5), Masato Taira, D.D.S., Ph.D.6), Takaya Numayama, M.D., Ph.D.7) and Masanobu Kinoshita, M.D., Ph.D.2)

1)ALS Nursing Care Project, Tokyo Metropolitan Institute of Medical Science
2)Department of Frontier Health Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University
3)Department of Neurology, Tokyo Metropolitan Neurological Hospital
4)Department of Neurology, Tokyo Metropolitan Kita Medical and Rehabilitation Center for the Disabled
5)Department of Preventive Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
6)Department of Cognitive Neurobiology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University
7)Department of Neurology, Sayama Neurological Hospital

Patients with amyotrophic lateral sclerosis (ALS) often suffer from salivation problems such as drooling and dry mouth. We examined resting salivation rate cross-sectionally in 66 advanced ALS patients with tracheostomy invasive ventilation using a cotton roll method, and investigated clinical factors associated with salivation rate. Resting salivation rate in the patients was well preserved (median value 0.6 g/min), and was significantly more increased in patients with impairment of jaw movement (P = 0.007) or mouth opening (P = 0.003) than in patients with less impairment, and in patients with the mouth being constantly open ≥ 10 mm in rostrocaudal length than in patients with < 10 mm. These data indicate that salivation rate was increased with progression of dysfunction of voluntary jaw movement. Appropriate oral care is required in advanced ALS patients to maintain their oral hygiene and to avoid penetration of saliva into the airway.
Full Text of this Article in Japanese PDF (427K)

(CLINICA NEUROL, 56: 465|471, 2016)
key words: amyotrophic lateral sclerosis, tracheostomy invasive ventilation, resting salivation rate, oral myofunction, oral hygiene

(Received: 23-Nov-15)