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Year: 2013  Vol. 17   Num. Suppl. 1  - Print:
SPEECH THERAPY INTERVENTION IN FAT EMBOLISM SYNDROME: A CASE REPORT
Author(s):
Joyce Gonçalves dos Santos, Fabiana Akemi Yamamoto, Kalil Garcia do Nascimento Silva, Milena Vaz Bonini
Abstract:

INTRODUCTION: Fat embolism is defined as a blockage of a vascular lumen by fat droplets, typically originating from bone fractures. The condition is considered a syndrome in the presence of lesions involving one or more organs, with lungs and brain being the most commonly affected. OBJECTIVE: To report the progress of a patient with post-traumatic fat embolism syndrome who received speech therapy intervention. CASE REPORT: The patient was a 21-year-old man with polytrauma of the lower limbs due to a motorcycle accident, tracheostomy, and exclusively nasoenteral-tube feedings. He had a history of prolonged intubation (20 days), exhibited searching and bite reflexes, spontaneous swallowing with frequent coughing on swallowing assessment, and a positive result on the Blue Dye test. He was initially classified as level 0 (severe dysphagia) on the swallowing rating scale (ASHA) with absence of phonation. Speech therapy was initiated, focusing on swallowing and voice functions. The patient progressed to asthenic and breathy voice quality. Tracheobronchoscopy exams and fiberoptic nasendoscopy revealed left vocal-fold paresis. The patient had 10 speech therapy sessions during the hospital stay, and was discharged from the hospital with exclusive oral feedings, multiple consistencies (ASHA level 6), improved voice intensity and quality, and return of airflow through the upper airways (weaned from tracheostomy). CONCLUSION: Speech therapy in fat embolism syndrome proved to be of utmost importance in recovery from impairments of organs involved in swallowing and phonation. Conducting objective exams helps to confirm the clinical findings and aids in follow-up during speech therapy.

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