The Effect of the Cervical Orthosis on Swallowing Physiology and Cervical Spine Motion During Swallowing
The Effect of the Cervical Orthosis on Swallowing Physiology and Cervical Spine Motion During Swallowing
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DOI：
10.1007/s00455-015-9660-z
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发表时间：
2016-02-01
期刊：
影响因子：
2.6
通讯作者：
Ito, Yasuo
中科院分区：
文献类型：
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作者：
Mekata, Kojiro;Takigawa, Tomoyuki;Ito, Yasuo
颈椎矫形器是用于固定颈部的各种疾病，如创伤和术后。然而，颈椎矫形器在吞咽过程中如何限制颈椎的活动程度以及如何影响吞咽生理，目前尚不清楚。本研究的目的是使用费城(R)项圈来评估这些问题。我们对39名健康受试者（23名男性，16名女性，平均年龄34.3岁）进行了吞咽显像检查，其中有和没有颈椎矫形器。为了比较两种情况下颈椎运动，我们测定了枕骨（C0）和每个颈椎（C1-C7）从口腔期到咽部期的角度和位置变化。同样，为了比较吞咽生理学，我们评估了软腭抬高、舌骨前上快速运动、会厌内翻、喉前庭关闭和咽食管段（PES）打开的开始和结束时间和持续时间。最后，我们比较了两种情况下造影剂的传递时间。有颈椎矫形器时，C1、C2、C3的屈曲度分别为0.31度、0.07度、0.05度（平均）；无颈椎矫形器时，C1、C2、C3的屈曲度分别为0.98度、1.42度、0.85度（平均）。这些结果表明颈椎矫形器限制了C1-C3的屈曲。吞咽生理分析显示，舌骨前上仰、会厌内翻和PES开口的平均持续时间分别延长0.09、0.19和0.05 s。综上所述，颈椎矫形器限制了吞咽过程中颈椎的运动，改变了吞咽生理。
Cervical orthosis is used to immobilize the neck in various disorders such as trauma and post-operation. However, it is still uncertain how cervical orthosis restricts the degree of movement of the cervical spine during swallowing and how they affect swallowing physiology. The purpose of this study was to evaluate these issues using the Philadelphia (R) Collar. We conducted videofluorography of swallowing in 39 healthy subjects (23 men, 16 women; mean age of 34.3 years) with and without cervical orthosis. To compare the two conditions regarding the cervical spine motion, we determined the angular and positional changes of the occipital bone (C0) and each cervical vertebra (C1-C7) from the oral phase to the pharyngeal phase. Similarly, to compare swallowing physiology, we assessed the start and end times and the durations of soft palate elevation, rapid hyoid anterosuperior movement, epiglottis inversion, closure of the laryngeal vestibule, and pharyngoesophageal segment (PES) opening. Finally, we compared the transit times of contrast agent in the two conditions. The respective extensions of C1, C2, and C3 were 0.31 degrees, 0.07 degrees, and 0.05 degrees (mean) with cervical orthosis, and the respective flexions of C1, C2, and C3 were 0.98 degrees, 1.42 degrees, and 0.85 degrees (mean) without. These results suggested that cervical orthosis restricted the flexion of C1-C3. Analysis of swallowing physiology revealed that the average durations of hyoid anterosuperior elevation, epiglottic inversion, and PES opening were prolonged by 0.09, 0.19, and 0.05 s, respectively. In conclusion, the cervical orthosis restricted the movement of the cervical spine during swallowing and changed swallowing physiology.