Initiation and Duration of Laryngeal Closure During the Pharyngeal Swallow in Post-Stroke Patients
Initiation and Duration of Laryngeal Closure During the Pharyngeal Swallow in Post-Stroke Patients
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DOI：
10.1007/s00455-009-9237-9
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发表时间：
2010-09-01
期刊：
影响因子：
2.6
通讯作者：
McCullough, Gary
中科院分区：
文献类型：
--
作者：
Park, Taeok;Kim, Youngsun;McCullough, Gary
吞咽时，当食团进入咽部时，气道受到喉闭合的保护，这一过程的特征是声带接近加上杓状软骨接近会厌底部。本研究的目的是测量三组受试者的喉闭合开始（ILC）和喉闭合持续时间（LCD）：（1）10名在吞咽前和吞咽过程中进行抽吸的卒中患者（抽吸器），（2）10名未进行抽吸的卒中患者（非抽吸器）和（3）10名正常对照受试者。在随后的视频透视吞咽检查分析中，使用100 ms计时器分析5 ml和10 ml稀液体推注的ILC和LCD的平均值和标准差。在ILC和LCD方面，抽吸者与对照受试者之间存在显著差异，在ILC方面，抽吸者与非抽吸者之间存在显著差异。有吸引器和无吸引器之间的LCD无显著差异。延迟的ILC和减少的LCD都与卒中后误吸有关。延迟ILC是吸入总体风险的重要指标。这些研究结果的临床意义进行了讨论。
As a bolus enters the pharynx during the swallow, the airway is protected by laryngeal closure, a process characterized by approximation of the vocal folds plus approximation of the arytenoid cartilages to the base of the epiglottis. The purpose of this study was to measure initiation of laryngeal closure (ILC) and laryngeal closure duration (LCD) in three groups of subjects: (1) ten stroke patients who aspirated before and during the swallow (aspirators), (2) ten stroke patients who did not aspirate (nonaspirators), and (3) ten normal control subjects. Means and standard deviations of ILC and LCD were analyzed for both 5-ml and 10-ml thin-liquid boluses using a 100-ms timer during subsequent analysis of videofluoroscopic swallowing examinations. There were significant differences between aspirators and control subjects for both ILC and LCD, and significant differences between aspirators and nonaspirators for ILC. There were no significant differences between aspirators and nonaspirators for LCD. Both delayed ILC and reduced LCD were associated with post-stroke aspiration. Delayed ILC is a significant indicator of overall risk of aspiration. Clinical implications for these findings are discussed.