アブストラクト（44巻1号：神奈川歯学）

神奈川歯学

Japanese

Title　： 舌喉頭矯正術による哺乳トラブル改善の評価
Subtitle　： 原著
Authors　： 西崎靖仁, 山本伊佐夫, 北川有華, 中川貴美子, 大平寛, 向井將*
Authors（kana）　：
Organization　： 神奈川歯科大学社会歯科学講座法医学分野, *向井診療所
Journal　： 神奈川歯学
Volume　： 44
Number　： 1
Page　： 16-23
Year/Month　： 2009 / 6
Article　： 原著
Publisher　： 神奈川歯科大学学会
Abstract　： 「緒言」母乳の利点は栄養面, 免疫面, 母子関係, 母体回復など科学的根拠に基づいて広く一般に認められている1,2). ユニセフ/WHOは, 1989年, 「母乳育児を成功させるための10か条」3)を, 厚労省は, 2007年, 「授乳・離乳の支援ガイド」4)を発表し母乳育児を推進している. 妊娠中に母乳で育てたいと思っている母親の割合は96.0%と高いが, 厚生労働省の2005年度乳幼児栄養調査によると, 母乳のみを与える母乳栄養の割合は生後1ヶ月42.4%, 3ヶ月38.0%といずれも10年前と比較して減少傾向にある5). 母乳継続を困難にする要因の一つに乳頭痛・乳房痛・しこり・残乳感・乳腺炎などの哺乳トラブルが挙げられ, 母親が授乳時に苦痛を伴うため母乳を断念するケースが報告されている6,7). 舌喉頭偏位症(ADEL)は, 舌小帯の有無にかかわらず舌および喉頭の前上方への偏位による呼吸抑制と上気道抵抗の増加のため, 乳児では, チアノーゼ・睡眠時無呼吸・寝つきが悪い・哺乳障害・夜泣き・喘泣・抱き癖・反返り・腹部膨満・向き癖・身体が硬い・手足が冷たいなど多様な症状を呈する.
Practice　： 歯科学
Keywords　： 舌喉頭偏位症, 舌喉頭矯正術, 哺乳障害, 母乳

English

Title　： Evaluation of improvement on breast-feeding troubles by the correction of the glosso-larynx
Subtitle　：
Authors　： Yasuhito NISHIZAKI, Isao YAMAMOTO, Yuka KITAGAWA, Kimiko NAKAGAWA, Hiroshi OHIRA, Susumu MUKAI*
Authors（kana）　：
Organization　： Division of Forensic Medicine, Department of Dental Sociology, Kanagawa Dental College, *Mukai Clinic
Journal　： Kanagawa Shigaku
Volume　： 44
Number　： 1
Page　： 16-23
Year/Month　： 2009 / 6
Article　： Original article
Publisher　： Kanagawa Odontological Society
Abstract　： [Abstract] Ankyloglossia with Deviation of the Epiglottis and Larynx (ADEL) is not only the forward displacement of the tongue, but it is also accompanied by an upper-forward displacement of the epiglottis and larynx. This condition is independent of the existence of the frenum linguae or not. This condition not only increases the resistance of the upper airflow, but also inhibits respiratory function. ADEL presents various symptoms. Those in babies are cyanosis, sleep apnea, difficult to fall asleep, crying hard and/or cry over the night, dakiguse, or the babies wanted always someone's arms, they bend backward, swollen abdomen, their body are tense, cold extremities and so on. Treatment of ADEL is achieved by cutting the frontal bundles of the genioglossus muscle. It is named Correction of the glosso-larynx (CGL). The tongue, epiglottis and larynx move backward and downward by the CGL. As the results the epiglottis and larynx stand strait to the epipharynx, or post-nasal cavity. Symptoms of ADEL disappear just after the CGL. We studied about the ameliorations of breast-feeding problems after CGL by questionnaire for one hundred forty one breast-feeding mothers. The amelioration rates after one month were as follows (parenthesis): breast pain (100%), blisters on the nipple (100%), mastitis (94.1%), nipple pain (93.0%), stopping breathing during suckling (93.0%), gulping of the breast milk (92.5%), stiffness in the breast (89.0%), suffocating while suckling (88.3%), white debris on the tongue (85.9%), detaching from the nipple while feeding (85.6%), feeling of milk remaining after feeding (85.3%), vomiting (85.1%), and cracks of the nipple (84.6%). Significant relationships were observed between post total operative ameliorated conditions of suckling problems, such as gulping of the breast milk, detaching from the nipple while feeding, stopping breathing during suckling, vomiting and suffocating while suckling, and both the amelioration rate of average SpO2 during suckling and minimum Sp02. The causes of these results were thought that they could easily suckle their mothers' breasts, for the larynx located normal straight position and the respiratory tract was maintained after the CGL. The ameliorated rate of mothers' comments after the CGL were as follows (parenthesis); babies suckle tight (74.9%), suckling became soft and smooth (70.1%), feeding time became short (64.4%) and breast-feeding became their joy (68.7%). All studied ameliorated after the CGL and the mothers were content with the results. The conclusions of this study are as follows; The CGL increases the breast-feeding rate. The CGL released them from their stresses of both feeding and of child-care. It can be said that CGL prevented child abuse. In addition, there were high rates of suffocation, vomiting and inability to continue suckling during feeding. These problems were remarkably diminished after CGL. CGL may prevent choking to death.
Practice　： Dentistry
Keywords　：