Evaluation of Dysphagia After Cervical Surgery Using Laryngeal Electromyography
Evaluation of Dysphagia After Cervical Surgery Using Laryngeal Electromyography
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DOI：
10.1007/s00455-011-9368-7
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发表时间：
2012-09-01
期刊：
影响因子：
2.6
通讯作者：
Shin, Dong Ah
中科院分区：
文献类型：
--
作者：
Ryu, Ju Seok;Lee, Ji Hyun;Shin, Dong Ah
本研究的目的是利用喉肌电图（LEMG）探讨颈椎手术后吞咽困难的原因，以及喉神经病变对吞咽困难严重程度的影响。包括 17 名颈椎手术后出现明显吞咽困难的患者。视频透视吞咽研究 (VFSS) 评估的参数包括谷囊和梨状窦中残留物的体积、Rosenbek 穿透-误吸量表 (PAS) 和吞咽功能评分系统 (SFSS)。根据 VFSS 结果，患者被分为轻度或重度吞咽困难组。 17 名患者中有 9 名出现声音变化。 2 名患者的 SFSS 评分为 0，1 名患者的 SFSS 评分为 3，1 名患者的 SFSS 评分为 4，1 名患者的 5 分，12 名患者的 6 分。 PAS 评分为 8 名患者中 1 分、5 名患者中 2 分、3 名患者中 7 分、1 名患者中 8 分。七名患者（41.2%）有明显的喉神经病变。其中，所有患者均出现复发性喉神经病变，28.6%的患者出现喉上神经病变。当我们评估 LEMG 结果与吞咽困难严重程度的关系时，严重吞咽困难组显示出与喉神经病变存在显着相关性 (p = 0.006)。尽管谷囊中的残留物水平与喉神经病变的存在无关（p = 0.442），但梨状窦中的残留物量确实显示出显着的相关性（p = 0.020）。
The purpose of this study was to investigate the causes of dysphagia after cervical surgery using laryngeal electromyography (LEMG), and the effect of laryngeal neuropathy on the severity of dysphagia. Seventeen patients with dysphagia evident after cervical surgery were included. Video fluoroscopic swallow study (VFSS) parameters evaluated included the volume of residue in the vallecular pouch and the pyriform sinus, the Rosenbek penetration-aspiration scale (PAS), and the swallowing function scoring system (SFSS). By VFSS findings, patients were classified into a mild or severe dysphagia group. Nine of 17 patients showed voice change. SFSS scores were 0 in 2 patients, 3 in 1 patient, 4 in 1 patient, 5 in 1 patient, and 6 in 12 patients. PAS scores were 1 in 8 patients, 2 in 5 patients, 7 in 3 patients, and 8 in 1 patient. Laryngeal neuropathy was evident in seven patients (41.2%). Of these, all patients exhibited recurrent laryngeal neuropathy and 28.6% had superior laryngeal neuropathy. When we evaluated LEMG findings with respect to the severity of dysphagia, the severe dysphagia group showed significant association with the presence of laryngeal neuropathy (p = 0.006). Although the level of residue in the vallecular pouch was not associated with the presence of laryngeal neuropathy (p = 0.442), the amount of residue in the pyriform sinus did show a significant association (p = 0.020).