Nasopharyngeal cancer is one of the highly prevalent malignant tumors in China, especially in Guangdong Province, which is also known as Guangdong cancer. Radiation therapy is the main treatment for nasopharyngeal cancer. While treating tumors well, some patients may suffer from post-radiation neurological damage, including post-radiation cerebral edema and cranial nerve damage.
If the nerves of swallowing and voice formation are involved, radiation injury will cause difficulty in swallowing, hoarseness, tongue atrophy, and gradually worsen to speech blurred and hard to hear, and difficulty in eating. Severe cases often choke food into the lungs during eating and cause recurrent pneumonia and fever, requiring a gastric tube or gastrostomy tube to assist in eating. When these symptoms occur, in addition to timely hospital consultation, the patient himself needs to strengthen the corresponding rehabilitation exercises. Of course, patients who do not have the above symptoms after radiotherapy for nasopharyngeal carcinoma should also take precautions and strengthen the corresponding exercises in their daily life to prevent the occurrence of these symptoms.
I. Swallowing training (for swallowing difficulty and tongue muscle atrophy)
1, do cheek puffing, tongue extension and bilateral facial massage movements. Commercially available electric massager can be used to strengthen rehabilitation exercises, massage the tongue, oral muscles, etc.
2.Sucking training: The patient wears a rubber sleeve on the index finger and puts it in the mouth, imitates the sucking action, and experiences the sensation of sucking 20 times, more than 2 times a day.
3.Improve the perception of oral mucosa: clean the mouth, brush the teeth and massage the gums several times a day. Also, the perceptual massage brush can be used to perform this exercise, as follows.
4.Passive movement of the tongue: fix the tongue with a tongue sucker and pull the tongue in different directions with your hands.
5.Active movement of the tongue: stretch the tongue forward and backward by yourself, lick the left and right corners of the mouth; also use a spoon or tongue depressor to give the tongue a resistance movement.
6.Laryngeal training: Ask the patient to inhale deeply through the nose, hold the breath for 5 seconds with the lips closed, then pronounce the long “a” sound, repeat several times, then ask the patient to repeatedly pronounce the long “a” sound 5 times, hold the breath for 5 seconds, then cough.
7. “Gargling” training: ice water over 3 ml, gargling for more than 5 seconds.
Second, sound training (for slurred speech, hoarseness)
1, whistle training: nasal inhalation, mouth whistle, gradually increase the whistle time, try to pronounce fricatives, vowels in the whistle; can also use the commercially available whistle trainer to strengthen the whistle training, as shown, practice 3-6 times a day, 15-20 minutes each time, from the first ball to start practicing, need to deep whistle, step by step, deep inhalation volume normal adult 1200 ML. need to pay attention to choose fresh air place Practice, in the use of if you feel dizzy or tired, then temporarily stop training, take a break can be.
2, vocal training: try to make a guttural sound, and raise the pitch until a loud stabbing sound, and try to maintain the maximum volume for a few seconds. You can also use the vocal flute as shown below to assist in training.
Three, mouth opening training (for mouth opening restrictions)
1.Mouth opening exercise: slowly open the mouth and then slowly close it.
2.Lateral jaw movement: Open your mouth slightly, move your jaw slowly to the left to the end, return to the center line, and do the same to the right.
3.Bailing exercise: stretch the jaw forward to the end and then return to the original position.
4.Finger mouth opening exercise: Roll your index finger and middle finger in gauze and place them between your upper and lower teeth, then separate your index finger and middle finger as far as possible to pull your mouth open. Do it for 5 seconds at the beginning, and then gradually increase the time of stretching exercise.
5. Use mouth opener for mouth opening exercise: The opener can be purchased at a general pharmacy or replaced by a small spoon or cork. Put an appropriately sized mouth opener into the mouth and do it for 5 minutes at first, then gradually increase the number and time. Stretching the oral muscles to relax.
Fourth, the neck training (for neck pain, turning neck difficulties)
1.Neck forward flexion, backward tilt and left and right rotation, do 3 to 5 times.
2.Chin reduction exercise: bring the chin inward to the chest, then slowly return to the original position, do 3 to 5 times.
3.Neck rotation exercise: turn the neck slowly in the direction of the clock, and then turn in the direction of the counterclock; or do the “rice” movement, do 3 to 5 times.
4.Neck stretching exercise.
(1) the back of the neck stretching exercise, the head down, crossed fingers on the top of the head, hands and head natural drooping, with the weight of the hands naturally pulling the back of the neck.
(2) Side neck stretching exercise, bring the left ear towards the left shoulder, place the left hand on the top of the head, and use the weight of the hand to stretch the right side of the neck muscles; then do the same to the right.
Do 3 to 5 times each of the neck joint movement exercises, with each movement lasting about 3 seconds; do 2 times each of the neck stretching exercises, with each lasting 5 to 10 seconds.
On the shores of Saranac Lake in northeastern New York, USA, is engraved the inscription of a Western physician, Trudeau: “Sometimes to heal; often to help; always to comfort.” Even today, with such advanced technology, there is still much helplessness in the face of disease. We hope our patients will insist on self-rehabilitation in their daily lives, especially for swallowing, diction, mouth opening and neck training!