Involvement of hypoglossal and recurrent laryngeal nerves on swallowing pressure
Involvement of hypoglossal and recurrent laryngeal nerves on swallowing pressure
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DOI：
10.1152/japplphysiol.00944.2017
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发表时间：
2018-05-01
影响因子：
3.3
通讯作者：
Inoue, Makoto
中科院分区：
文献类型：
--
作者：
Tsujimura, Takanori;Suzuki, Taku;Inoue, Makoto
吞咽压力的产生对于确保摄入的药丸的安全运输非常重要，而不会吸入或在咽部留下残留物。为了阐明这一机制，我们在麻醉大鼠的口咽部(OP)、上食道括约肌(UES)和颈部食道(CE)处使用了一种特殊设计的测压导管来测量吞咽压。通过肌电(EMG)记录舌骨上和甲状腺舌骨上肌的激活来识别由点状机械刺激喉部诱发的吞咽。来自两个试验的OP、UES和CE的吞咽压力曲线下的区域表明，受试者内具有很高的重复性。本文观察了横断舌下神经(12N)和喉返神经(RLN)对吞咽功能的影响。双侧舌下神经切断(Bi12Nx)后，OP压显著降低，甲状舌骨肌电爆发峰值与OP压之间的时间间隔明显缩短。用丙烯酸材料覆盖硬腭和软腭后，经Bi12Nx处理后，降低的OP压显著增加，甲状舌骨肌电爆发峰值与OP压的峰间时间缩短，OP压缩短。双侧喉返神经切断后UES压力较切断前显著降低。这些结果表明，12N和RLN分别在吞咽时的OP和UES压力中起重要作用。我们推测，用假体覆盖腭部可以逆转12N患者吞咽压降低或舌损伤的情况。值得注意的是，舌下神经横断术降低了口咽部的吞咽压。用丙烯酸材料覆盖软硬上颚可能会逆转舌下神经损伤导致的吞咽功能下降的情况。喉返神经切断可降低吞咽时上食道括约肌负压。
Swallowing pressure generation is important to ensure safe transport of an ingested bolus without aspiration or leaving residue in the pharynx. To clarify the mechanism, we measured swallowing pressure at the oropharynx (OP), upper esophageal sphincter (UES), and cervical esophagus (CE) using a specially designed manometric catheter in anesthetized rats. A swallow, evoked by punctate mechanical stimulation to the larynx, was identified by recording activation of the suprahyoid and thyrohyoid muscles using electromyography (EMG). Areas under the curve of the swallowing pressure at the OP, UES, and CE from two trials indicated high intrasubject reproducibility. Effects of transecting the hypoglossal nerve (12N) and recurrent laryngeal nerve (RLN) on swallowing were investigated. Following bilateral hypoglossal nerve transection (Bi-12Nx), OP pressure was significantly decreased, and time intervals between peaks of thyrohyoid EMG bursts and OP pressure were significantly shorter. Decreased OP pressure and shortened times between peaks of thyrohyoid EMG bursts and OP pressure following Bi-12Nx were significantly increased and longer, respectively, after covering the hard and soft palates with acrylic material. UES pressure was significantly decreased after bilateral RLN transection compared with that before transection. These results suggest that the 12N and RLN play crucial roles in OP and UES pressure during swallowing, respectively. We speculate that covering the palates with a palatal augmentation prosthesis may reverse the reduced swallowing pressure in patients with 12N or tongue damage by the changes of the sensory information and of the contact between the tongue and a palates.NEW & NOTEWORTHY Hypoglossal nerve transection reduced swallowing pressure at the oropharynx. Covering the hard and soft palates with acrylic material may reverse the reduced swallowing function caused by hypoglossal nerve damage. Recurrent laryngeal nerve transection reduced upper esophageal sphincter negative pressure during swallowing.