Atuação fonoaudiológica em disfagia orofaríngea na paralisia supranuclear progressiva: um estudo de caso

Abstract

Progressive Supranuclear Palsy (PSP) is a neurodegenerative disease often classified as atypical Parkinsonism. Among the serious complications of the disease is oropharyngeal dysphagia, which impairs the safety and efficiency of swallowing due to neuromuscular failures responsible for swallowing. In view of this, a multidisciplinary approach is essential to meet the needs of individuals with PSP, especially speech therapy. The aim of this study is to describe the speech therapy intervention and its effect on a patient with PSP, with a view to providing information on how the procedures helped improve her dysphagia. To this end, the case of a 50-year-old patient diagnosed with PSP with a medical history of hypertension, severe dysarthrophonia, vertical gaze paralysis, bradykinesia, axial rigidity, apraxia of eye opening, postural instability, emotional alterations and dysphagia for liquids was reported. The descriptive qualitative analysis considered the phonoaudiological and instrumental evaluations using the fiberoptic endoscopic evaluation of swallowing before and after the phonoaudiological intervention. The study of the speech therapy intervention procedures considered the records of the care sessions carried out in the years 2022 to 2023. The discussion of the results sought to highlight the most successful approaches to the biomechanics of swallowing. Improvements in posture, mobility of orofacial structures and stability of structures related to intraoral pressure and hyolaryngeal excursion indicated a therapeutic course that proved favorable to reducing his swallowing disorder, especially for level 0 consistency (thin liquid), according to the international classification of consistencies (IDDSI - International Dysphagia Diet Standardization Initiative).