Dysphagia in Open Partial Horizontal Laryngectomy Type IIa: Quantitative Analysis of Videofluoroscopy using the ASPEKT Method.
Dysphagia in Open Partial Horizontal Laryngectomy Type IIa: Quantitative Analysis of Videofluoroscopy using the ASPEKT Method.
复制标题
IIa 型开放性部分水平喉切除术中的吞咽困难：使用 ASPEKT 方法对视频荧光镜检查进行定量分析。
DOI：
10.1007/s00455-024-10677-3
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发表时间：
2024
期刊：
影响因子：
2.6
通讯作者：
Steele,CatrionaM
中科院分区：
文献类型：
--
作者：
daCostaMirandaBarbosa,Raphaela;deFreitas,AndressaSilva;Cerqueira,RayaneBeltrãoAlves;Mancopes,Renata;Dias,FernandoLuiz;Steele,CatrionaM
开放性水平喉部分切除术(OPHL)IIa手术是一种用于治疗喉癌的保守手术技术。在这项初步研究中，我们旨在通过与视频透视定量测量的健康参考值进行比较，来表征OPHL IIa型手术后一系列患者的吞咽功能和生理特征。我们对10名男性患者的初步样本进行了视频荧光透视记录的回顾性定量分析。每个视频透视片段由训练有素的盲评分员根据ASPEKT方法(吞咽生理学分析：事件、运动学和计时)评定一式三份。这份先前接受过OPHL手术的患者的初步样本显示了功能性的呼吸道保护，只有2名患者表现出不完全的喉前庭闭合(LVC)和相关的呼吸道侵犯。然而，大多数患者(90%)表现出LVC潜伏期延长和上食道括约肌(UES)开放。还注意到LVC和UES开放的持续时间延长，但这些都是补偿而不是减损。70%的样本显示静息时咽部面积缩小，所有患者都表现出较差的咽部收缩。吞咽后残留物是这些患者中75%的 ≥ 的突出发现。特别是，梨状窦区域的下咽收缩减轻或消失是本样本吞咽的特征。来自这些患者的数据表明，尽管有功能性的呼吸道保护，但OPHL手术后可能会出现严重的吞咽功能障碍，包括咽部收缩和团剂清除不良。
Open Partial Horizontal Laryngectomy (OPHL) Type IIa surgery is a conservative surgical technique used in the treatment of laryngeal carcinomas. In this pilot study, we aimed to characterize swallowing function and physiology in a series of patients after OPHL Type IIa surgery through comparison to healthy reference values for quantitative measures for videofluoroscopy. We performed retrospective quantitative analysis of videofluoroscopy recordings of thin liquid swallows for a preliminary sample of 10 male patients. Each videofluoroscopy clip was rated in triplicate by trained blinded raters according to the ASPEKT Method (Analysis of Swallowing Physiology: Events, Kinematics and Timing). This preliminary sample of patients with previous OPHL surgery showed functional airway protection, with only 2 patients showing incomplete laryngeal vestibule closure (LVC) and associated airway invasion. However, the majority of patients (90%) showed prolonged latencies to LVC and upper esophageal sphincter (UES) opening. Prolonged durations of LVC and UES opening were also noted, but these were in the direction of compensation rather than impairment. Reduced pharyngeal area at rest was seen in 70% of the sample, and all patients showed poor pharyngeal constriction. Post-swallow residue was a prominent finding in ≥ 75% of these patients. In particular, reduced or absent constriction of the hypopharynx in the region of the pyriform sinuses was noted as a characteristic of swallowing in this sample. The data from these patients suggest that despite functional airway protection, severe swallowing dysfunction involving poor pharyngeal constriction and bolus clearance may be likely after OPHL surgery.