A Study ofPreventive Management ofAspiration Pneumonia Establishment of Diagnosing Method and Preventive Method against Aspiration Pneumonia-

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1. The improvement of the precision of swallow and respiratory sound analyzing system was attempted. Microphone system that could control the noise and gather the high quality target sound was built.2. The sites where the swallowing sounds were produced and acoustic characteristics of the swallowing sound in each site were investigated. The bolus passing sounds at tongue base, epiglottis, and UES and the acoustic characteristics of swallow sounds at each site were revealed.3. The critical values of acoustic signals were set in order to differentiate dysphagic swallows from safe swallows by analyzing the swallowing and expiratory sounds obtained from the post-surgical head and neck cancer patients with dysphagia. Comparison of the acoustic analysis with the differentiations from the VF findings showed significant agreement.4. The effectiveness of the postural technique on post-surgical head and neck cancer patients with dysphagia was investigated comparing improved cases with unimproved cases using head tilting posture toward the stronger side. An increase in vallecular angle, positive value in the time difference between pharyngeal passing time and pharyngeal delay time, and prolonged UES opening time were recognized in relation to the head tilting posture.5. The effectiveness of the management of psychiatric patients with dysphagia was investigated. The total number of choking incidents was almost halved after the management program started. Respiratory function, oral function and QOL of these patients were improved after the breathing exercise.6. Clinico-statistical analysis of patients at the department of oral rehabilitation was done.7. The effectiveness of the Showa swallow maneuver on post-surgical head and neck cancer patients with dysphagia was investigated. The airway was closed and pharyngeal delay time was shortened with the Showa swallow maneuver.8. Subjective evaluation of postoperative function in head and neck cancer patients was investigated.