We experienced therapy of a 68-year-old male patient who developed vocal cord paralysis and dysphagia after esophagectomy. His symptoms were weight loss and excessive uneasiness during feeding treatment. He was very nervous in the course of rehabilitation and needed mental support as well as nutritional support.
　Intervention by nutritional support team (NST) improved his nutritional status,body weight and anxiety about weight loss. Maximum phonation time extended from 2 seconds to 7 seconds by speech therapy and he regained self-confidence in his voice, visually understanding his recovery with a speech analyzer. We recommended him to use a diary to take notes about his symptoms and what he thought during meal. That procedure made us easily to evaluate his functional disturbance and to support his rehabilitation successfully.
　食道癌術後に両側反回神経麻痺と嚥下障害を生じ,摂食訓練中に体重減少と摂食に過度の不安を訴えた症例を経験した。
　患者は68歳,男性で,神経質な性格であった。本症例に対し,精神・心理的サポートを含めた摂食・嚥下リハビリテーションとNutrition Support Team(以下,NST)が介入し治療を進めた。
　1.NSTの介入により正確な栄養評価が行われ,体重減少の不安軽減が図れた。2.発声持続時間は2秒以下から7秒に延長し,音響分析結果を視覚的に呈示することによって,声に対する自信につながった。3.「食べることがこわい」,「全く食べられない」という消極的な反応から「つぎはこのようにして食べてみよう」との積極的な発言に変化した。
　摂食後に日記形式で自由にコメントをつけてもらうことにより,嚥下機能面のみならず,効果的な精神・心理的サポートが可能であった。