PHARYNGEAL CLEARANCE DURING SWALLOWING - A COMBINED MANOMETRIC AND VIDEOFLUOROSCOPIC STUDY
PHARYNGEAL CLEARANCE DURING SWALLOWING - A COMBINED MANOMETRIC AND VIDEOFLUOROSCOPIC STUDY
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DOI：
10.1016/0016-5085(92)91105-d
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发表时间：
1992-07-01
期刊：
影响因子：
29.4
通讯作者：
ERGUN, GA
中科院分区：
文献类型：
--
作者：
KAHRILAS, PJ;LOGEMANN, JA;ERGUN, GA
吞咽性咽部收缩的分析同时使用视频荧光镜和测压研究8名志愿者。在吞咽5和10 mL液体钡的过程中，测量咽表面相对于颈椎的前、后和纵向运动。在通过咽的食团传输期间，咽部显著缩短，消除了进入喉部的通道，并将上食管括约肌提升至舌后咽1.5 cm以内。通过咽部的团注头部运动先于传播的咽部收缩，并在主要压力复合体之前以压力计记录为轻微的团注内压力。在水平平面中的收缩开始于丸头通过之后，并且随着丸尾通过咽的剥离而达到高潮。上括约肌开放时间延长，吞咽量更大，这是由于咽部水平收缩的延迟发作而不是传播改变。它的结论是传播咽部收缩促进咽部间隙，但在吞咽过程中丸推进的作用很小。传播性收缩与深度咽缩短协同工作，以最大限度地减少吞咽后的下咽残留物。
The deglutitive pharyngeal contraction was analyzed using simultaneous videofluoroscopic and manometric studies of eight volunteers. Anterior, posterior, and longitudinal movements of the pharyngeal surfaces, relative to the cervical vertebrae, were measured during swallows of 5 and 10 mL of liquid barium. Profound pharyngeal shortening during bolus transit through the pharynx eliminated access to the larynx and elevated the upper esophageal sphincter to within 1.5 cm of the retrolingual pharynx. Bolus head movement through the pharynx preceded the propagated pharyngeal contraction and registered manometrically as a slight intrabolus pressure before the major pressure complex. Contraction in the horizontal plane began after bolus head transit and culminated with stripping of the bolus tail through the pharynx. Prolonged upper sphincter opening with the larger-volume swallows resulted from a delayed onset rather than altered propagation of the horizontal pharyngeal contraction. It is concluded that the propagated pharyngeal contraction facilitates pharyngeal clearance but has a minimal role in the process of bolus propulsion during swallowing. The propagated contraction works in concert with profound pharyngeal shortening to minimize hypopharyngeal residue after a swallow.