Successful Continuation of Oral Intake in a Dysphagic and Tetraplegic Patient With Alternate Right and Left Complete Lateral Decubitus Positions in Rehabilitation

This case report describes a 76-year-old man with tetraplegia and dysphagia after a cervical spinal cord injury who had difficulty swallowing safely. He developed aspiration pneumonia while attempting to eat in an elevated position. The patient was then evaluated using FEES, which revealed that he could swallow jelly safely in the right complete lateral decubitus position. After two months, he could also swallow jelly and paste-like food safely in the left complete lateral decubitus position. To prevent shoulder pain from staying in one position, the patient alternated between the right and left complete lateral decubitus positions for oral intake for six months without developing aspiration pneumonia.

• 1
  Oral intake in an elevated head position was not safe for the patient, as it led to aspiration pneumonia.
• 2
  The right complete lateral decubitus position allowed the patient to swallow jelly safely, as confirmed by FEES.
• 3
  Alternating between right and left complete lateral decubitus positions allowed for continuous oral intake for six months without recurrent aspiration pneumonia and helped manage shoulder pain.