Oropharyngeal accommodation to swallow volume
Oropharyngeal accommodation to swallow volume
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DOI：
10.1053/gast.1996.v111.pm8690194
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发表时间：
1996-08-01
期刊：
影响因子：
29.4
通讯作者：
Logemann, JA
中科院分区：
文献类型：
--
作者：
Kahrilas, PJ;Lin, SZ;Logemann, JA
背景和目的：口咽吞咽可容纳一系列的食团体积，尽管这是一个近乎反射的序列，但对其动态放射线外观有重大影响。本研究的目的是分析容量调节的机制。方法：通过双平面电视荧光镜吞咽研究，对 8 名志愿者在 1 和 20 mL 吞咽过程中测量舌腭交界处、腭咽交界处、喉前庭和上食管括约肌 (UES) 的协调性以及腔内咽部尺寸。这些测量应用于咽部吞咽的三维重建，从而可以分析它们对腔内体积和推进功能的影响。结果：将咽部吞咽分为重构期、持续重构期和重构偏移期，通过0.2秒的重构延长来发生容量调节，保持起始事件和偏移事件的协调。增强的重构增加了咽腔的尺寸，导致更快的团块排出，并增加了 UES 膨胀。然而，穿过 UES 的每单位面积的最大经括约肌流量是恒定的，显示出其顺应性。结论：容量调节是通过增强和延长咽部从呼吸途径到吞咽途径的重构来实现的。这种神经介导事件时间的改变被其机械后果放大，导致大容量和小容量吞咽的不同电影放射学外观和推进属性。
Background & Aims: The oropharyngeal swallow accommodates a range of bolus volumes with substantial impact on its dynamic radiographic appearance despite being a nearly reflexive sequence. The aim of this study was to analyze the mechanism of volume accommodation. Methods: Coordination of the glossopalatal junction, velopharyngeal junction, laryngeal vestibule, and upper esophageal sphincter (UES) and intraluminal pharyngeal dimensions were measured from biplane videofluoroscopic swallowing studies in 8 volunteers during 1- and 20-mL swallows. These measurements were applied to three-dimensional reconstructions of the pharyngeal swallow, permitting analysis of their effect on intraluminal volume and propulsive function. Results: Dividing the pharyngeal swallow into periods of reconfiguration, sustained reconfiguration, and offset of reconfiguration, volume accommodation occurred by a 0.2-second prolongation of reconfiguration, preserving the coordination of the onset and offset events. Augmented reconfiguration increased the dimensions of the pharyngeal chamber, caused more rapid bolus expulsion, and increased UES distention. However, maximal transphincteric flow per unit area across the UES was constant, showing its compliance. Conclusions: Volume accommodation is accomplished by augmenting and prolonging pharyngeal reconfiguration from a respiratory to deglutitive pathway. This modification in the timing of neurally mediated events is amplified by its mechanical consequences, resulting in the different cineradiographic appearance and propulsive attributes of large and small volume swallows.