EFFECT OF SWALLOWED BOLUS VARIABLES ON ORAL AND PHARYNGEAL PHASES OF SWALLOWING
EFFECT OF SWALLOWED BOLUS VARIABLES ON ORAL AND PHARYNGEAL PHASES OF SWALLOWING
复制标题
DOI：
10.1152/ajpgi.1990.258.5.g675
复制
发表时间：
1990-05-01
影响因子：
--
通讯作者：
LANG, IM
中科院分区：
文献类型：
--
作者：
DANTAS, RO;KERN, MK;LANG, IM
在这项调查中，我们研究了丸量和粘度的定量特征的口腔和咽吞咽。在10名健康志愿者中同时进行了视频透视和测压研究，这些志愿者在侧位投影中成像。以30帧/秒的速度进行视频荧光造影，同时使用5个跨咽和上食管括约肌（UES）的腔内传感器进行测压。同时记录颏下肌电图。记录2-20 ml低粘度液体钡和高粘度糊状钡的吞咽量。分析表明，推注量增加的主要影响是前舌根运动、上级腭运动、前喉运动和UES打开的提前发生。这些事件提供了用于接收吞咽丸剂的接受性适应。早期UES开放与括约肌开放时间和括约肌直径增加相关。与推注量无关的高推注粘度的主要影响是延迟口腔和咽部推注传输，增加咽部蠕动波的持续时间，延长和增加UES开放。因此，大剂量粘度本身的具体影响与大剂量体积的具体影响有很大不同。我们得出结论：1）吞咽的特定变量受到吞咽丸剂变量（如体积和粘度）的显著影响; 2）总体而言，丸剂体积和粘度以不同的方式影响吞咽; 3）研究结果对控制吞咽的神经控制机制以及异常口咽吞咽患者的诊断和治疗具有影响。
In this investigation, we studied the effects of bolus volume and viscosity on the quantitative features of the oral and pharyngeal phases of swallowing. Concurrent videofluoroscopic and manometric studies were done in 10 healthy volunteers who were imaged in lateral projection. Videofluorography was done at 30 frames/s while concurrent manometry was done with 5 intraluminal transducers that straddled the pharynx and upper esophageal sphincter (UES). Submental electromyography was recorded also. Swallows of 2-20 ml were recorded for low-viscosity liquid barium and high-viscosity paste barium. Analysis indicated that the major effect of increases in bolus volume was an earlier onset of anterior tongue base movement, superior palatal movement, anterior laryngeal movement, and UES opening. These events provide receptive adaptation for receiving a swallowed bolus. Earlier UES opening was associated with an increase in the duration of sphincter opening and sphincter diameter. The major effects of high bolus viscosity, unrelated to bolus volume, were to delay oral and pharyngeal bolus transit, increase the duration of pharyngeal peristaltic waves, and prolong and increase UES opening. Thus the specific effect of bolus viscosity per se differs substantially from that of bolus volume. We conclude that 1) specific variables of swallowing are affected significantly by the variables of the swallowed bolus such as volume and viscosity; 2) overall, bolus volume and viscosity affect swallowing in a different manner; and 3) the study findings have implications about the neural control mechanisms that govern swallowing as well as about the diagnosis and treatment of patients with abnormal oral-pharyngeal swallowing.