High-resolution manometry of pharyngeal swallow pressure events associated with effortful swallow and the Mendelsohn maneuver.
High-resolution manometry of pharyngeal swallow pressure events associated with effortful swallow and the Mendelsohn maneuver.
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DOI：
10.1007/s00455-011-9385-6
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发表时间：
2012-09
期刊：
影响因子：
2.6
通讯作者：
McCulloch, Timothy M.
中科院分区：
文献类型：
--
作者：
Hoffman, Matthew R.;Mielens, Jason D.;Ciucci, Michelle R.;Jones, Corinne A.;Jiang, Jack J.;McCulloch, Timothy M.
关键词：
努力吞咽和门德尔松动作是改善吞咽障碍的两种常用策略。我们使用高分辨率测压（HRM）来量化这些动作对压力和时间特性的影响。14名正常受试者使用三种技术吞咽多个5 ml的水丸：正常吞咽;用力吞咽;和门德尔松动作。最大压力，速率，持续时间，面积积分，和线积分确定的咽喉和舌根。记录上食管括约肌（UES）的最小压力、压力相关变化的持续时间、最低压力的持续时间、最大打开前和关闭后压力、面积积分和线积分。咽部压力曲线的面积和线积分随着门德尔松动作而显著增加;线积分随着用力吞咽而增加。对于门德尔松，打开前UES压力显著降低，而对于两种操作，关闭后压力倾向于增加不显著。UES面积和线积分以及最低点UES压力持续时间随着两种机动而增加。主要在腭咽和UES观察到动作依赖性变化。这些区域对于安全吞咽至关重要，因为咽部在推注尾部提供正压，而UES允许推注进入食管而没有反流风险。积分比最大压力或持续时间更敏感，应进一步研究。
Effortful swallow and the Mendelsohn maneuver are two common strategies to improve disordered swallowing. We used high-resolution manometry (HRM) to quantify the effects of these maneuvers on pressure and timing characteristics. Fourteen normal subjects swallowed multiple, five ml water boluses using three techniques: normal swallow; effortful swallow; and Mendelsohn maneuver. Maximum pressure, rate, duration, area integral, and line integral were determined for the velopharynx and tongue base. Minimum pressure, duration of pressure-related change, duration of nadir pressure, maximum pre-opening and post-closure pressure, area integral, and line integral were recorded for the upper esophageal sphincter (UES). Area and line integrals of the velopharyngeal pressure curve significantly increased with the Mendelsohn maneuver; the line integral increased with the effortful swallow. Pre-opening UES pressure decreased significantly for the Mendelsohn, while post-closure pressure tended to increase insignificantly for both maneuvers. UES area and line integrals as well as nadir UES pressure duration increased with both maneuvers. Maneuver-dependent changes were observed primarily at the velopharynx and UES. These regions are critical to safe swallowing, as the velopharynx provides positive pressure at the bolus tail while the UES allows a bolus to enter the esophagus without risk of regurgitation. Integrals were more responsive than maximum pressure or duration and should be investigated further.
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DOI：
10.1177/000348941011900602
发表时间：
2010-06
期刊：
The Annals of otology, rhinology, and laryngology
影响因子：
--
作者：
McCulloch TM;Hoffman MR;Ciucci MR
通讯作者：
Ciucci MR
影响因子：
4.3
作者：
Hind, JA;Nicosia, MA;Robbins, J
通讯作者：
Robbins, J
DOI：
10.1044/1092-4388(2008/07-0016
发表时间：
2008-10-01
影响因子：
2.6
作者：
Wheeler-Hegland, Karen M.;Rosenbek, John C.;Sapienza, Christine M.
通讯作者：
Sapienza, Christine M.
影响因子：
1
作者：
Logemann, JA
通讯作者：
Logemann, JA
影响因子：
1
作者：
Lazarus, C;Logemann, JA;Kahrilas, PJ
通讯作者：
Kahrilas, PJ