Relationship Between Tongue Base Region Pressures and Vallecular Clearance
Relationship Between Tongue Base Region Pressures and Vallecular Clearance
复制标题
DOI：
10.1007/s00455-015-9688-0
复制
发表时间：
2016-06-01
期刊：
影响因子：
2.6
通讯作者：
Thibeault, Susan
中科院分区：
文献类型：
--
作者：
Knigge, Molly A.;Thibeault, Susan
舌根压力被认为在吞咽过程中通过咽部提供主要的推注清除。团注驱动压力与吞咽后残留量之间的关系尚未确定。在威斯康星大学语音和吞咽结果数据库中，37名吞咽困难患者接受了视频透视(VFSS)和高分辨率测压(HRM)的评估。根据VFSS上存在或不存在血管分子停滞以及舌头不完全或完全回缩的二元分级对患者进行分类。用HRM测量1ml和10ml容量生理盐水吞咽时的舌根部压力，并将其与血管分子停滞或舌根退缩的分级进行比较。当存在或不存在瓣膜淤滞时，平均HRM峰值压力之间没有显著差异(1ml生理盐水：P=.1886；10ml生理盐水：P=.7354)。当按完全或不完全舌后缩分类时，完全舌后缩组的平均HRM峰值压力显著高于不完全舌后缩组(1ml生理盐水：P=0.0223；10ml生理盐水：P=0.0100)。研究结果表明，导致膜分子间隙降低的因素有很多。在缺乏HRM措施的情况下，在计划吞咽困难治疗时，判断VFSS的舌根完全或不完全缩舌可能是比VFSS清除更有效的舌根区压力的量度。
Tongue base pressures have been thought to provide primary bolus clearance through the pharynx during swallowing. The relationship between bolus driving pressures and residue remaining in the valleculae after the swallow has not been defined. Thirty-seven dysphagic patients who were evaluated with both videofluoroscopy (VFSS) and high-resolution manometry (HRM) were identified within the University of Wisconsin Voice and Swallowing Outcomes database. Patients were categorized according to binary ratings of presence or absence of vallecular stasis as well as incomplete or complete tongue retraction on VFSS. Tongue base region pressures measured with HRM during saline swallows of 1 and 10 ml volumes were compared to ratings of vallecular stasis or tongue base retraction. No significant difference could be identified among mean peak HRM pressures when compared to presence or absence of vallecular stasis (1 ml saline: p = .1886; 10 ml saline: p = .7354). When categorized according to complete or incomplete tongue retraction, mean peak HRM pressures were significantly greater in the complete tongue retraction group as compared to incomplete tongue retraction (1 ml saline: p = .0223; 10 ml saline: p = .0100). Findings suggest there are multiple factors that lead to reduced vallecular clearance. In the absence of HRM measures, judging complete or incomplete tongue retraction on VFSS may be a more valid gauge of tongue base region pressures than vallecular clearance when planning dysphagia treatment.