Hyoid-complex elevation and stimulation technique restores swallowing function in patients with lateral medullary syndrome: Two case reports

Table 1 Clinical course and treatment timeline

	Case 1	Case 2
Chief complaint	Aphagosis for 20 d accompanying salivation and emaciation	Dysphagia for 24 d
MRI examination	Left lateral medullary infarction	Right lateral medullary infarction
Admission evaluation	Fois: Level 1	Fois: Level 1
	MWST: Grade 1	MWST: Grade 4
	Semg: Imperfect swallowing motion and delayed pharyngeal transit time	sEMG: Imperfect swallowing waves especially when swallowing at the left side
	VFSS: Leakage or aspiration, pharyngeal residue, incomplete epiglottic closure and UES dysfunction	VFSS: Leakage or aspiration, pharyngeal residue, decreased laryngeal elevation and impaired opening of UES
	FEES: Epiglottis insufficiency
Start times of HEST	The 2nd wk (After 2 wk, the patient was able to resume oral feeding)	The 1st d (After 3 d, the patient was able to resume normal oral feeding)
Discharge evaluation	FOIS: Level 7	FOIS: Level 7
	MWST: Grade 5	MWST: Grade 5
	sEMG: Normal	sEMG: Normal
Follow-up	FOIS: Level 7	FOIS: Level 7
	Oral feeding (Each meal could be finished within 30 min)	Oral feeding (Each meal could be finished within 30 min)

FOIS: Functional oral intake scale; MWST: Modified water swallow test; sEMG: Surface electromyography; VFSS: Video fluorography swallowing study; FEES: Fiberoptic endoscopic evaluation of swallowing examination; MRI: Magnetic resonance imaging.