Auricular Stimulation with Capsaicin Ointment as Prophylaxis Against Aspiration Pneumonia

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  • カプサイシン軟膏による外耳道刺激を用いた誤嚥と嚥下性肺炎の予防法の開発
  • カプサイシン ナンコウ ニ ヨル ガイジドウ シゲキ オ モチイタ ゴエン ト エンカセイ ハイエン ノ ヨボウホウ ノ カイハツ

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Abstract

<p>Dysphagia increases the risk of aspiration pneumonia. Cough reflex plays an important role in protecting the respiratory tract against inhalation of foreign particles. However, the sensitivity of the cough reflex is reduced in elderly subjects and patients with aspiration pneumonia. Capsaicin is the main component of red pepper, and stimulation of the pharyngolaryngeal mucosa with capsaicin induces the cough reflex by activating the sensory C-fibers. Stimulation of the auricular branch of the vagus nerve, the Arnold’s nerve, with 0.025% capsaicin ointment applied to the external auditory canal also improves glottal closure and the cough reflex via stimulating the Arnold-cough reflex in elderly patients with dysphagia. Repeated alternative application of 0.025% capsaicin ointment to each external auditory canal once a day for 2 weeks improved glottal closure and the cough reflex in a sustained manner in elderly patients with dysphagia, without the development of capsaicin defunctionalization. Moreover, a reduced incidence of pneumonia was observed in elderly dysphagic patients during the 6 months of daily alternative application of 0.025% capsaicin ointment to each external auditory canal, as compared with that recorded during the 6 months prior to the intervention. These findings suggest that daily auricular stimulation with capsaicin ointment is a potentially safe and promising intervention for prevention of aspiration pneumonia in elderly patients with dysphagia.</p>

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