EFFECTS OF MANEUVERS ON SWALLOWING FUNCTION IN A DYSPHAGIC ORAL-CANCER PATIENT
EFFECTS OF MANEUVERS ON SWALLOWING FUNCTION IN A DYSPHAGIC ORAL-CANCER PATIENT
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DOI：
10.1002/hed.2880150509
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发表时间：
1993-09-01
影响因子：
2.9
通讯作者：
GIBBONS, P
中科院分区：
文献类型：
--
作者：
LAZARUS, C;LOGEMANN, JA;GIBBONS, P
本研究检查了三种吞咽动作的效果：（1）声门上吞咽（吞咽前自愿关闭声带）； (2) 超声门上吞咽（气道闭合在杓状软骨到会厌基部的水平）； (3)门德尔松动作（吞咽时自愿延长喉部抬高和环咽开口）对一名 47 岁患者吞咽功能的影响，该患者因右侧磨牙后三角区鳞状细胞癌接受了右侧复合切除术。所有操作均在患者手术后 6 个月进行的同一视频荧光摄影 (VFG) 吞咽研究中进行。对 3 mL 吞咽的生物力学分析确定了吞咽时有或没有动作时舌根回缩至咽后壁、喉部抬高、喉部闭合和环咽张开的程度和时间。声门上和超声门上吞咽期间气道关闭时间延长，但误吸并未消除。门德尔松动作的使用改善了咽部吞咽事件的协调性和时间安排，包括舌根向后移动至咽壁与气道闭合和环咽张开相关的时间安排，并消除了误吸。门德尔松疗法补偿了口咽部吞咽的解剖和生理变化，并使这位接受手术治疗的头颈癌患者恢复了安全的口服摄入，该患者以前无法口服营养。 (C) 1993 约翰威利父子公司
This study examined the effects of three swallow maneuvers: (1) the supraglottic swallow (voluntary closure of the vocal folds prior to the swallow); (2) the super-supraglottic swallow (airway closure at the level of the arytenoid to base of epiglottis); and (3) the Mendelsohn maneuver (voluntary prolongation of laryngeal elevation and cricopharyngeal opening during swallow) on swallow functioning in a 47-year-old patient who underwent right composite resection for a squamous cell carcinoma of the right retromolar trigone. All maneuvers were employed during the same videofluorographic (VFG) swallow study conducted 6 months after the patient's surgery. Biomechanical analysis of 3-mL swallows defined the extent and timing of tongue base retraction to the posterior pharyngeal wall, laryngeal elevation, laryngeal closure and cricopharyngeal opening during swallows with and without maneuvers. Airway closure duration was prolonged during supraglottic and super-supraglottic swallows, but aspiration was not eliminated. Use of the Mendelsohn maneuver improved coordination and timing of pharyngeal swallow events, including timing of posterior movement of the tongue base to the pharyngeal wall in relation to airway closure and cricopharyngeal opening, with elimination of aspiration. The Mendelsohn maneuver compensated for anatomic and physiologic changes in the oropharyngeal swallow and enabled reinstatement of safe oral intake in this surgically treated head and neck cancer patient who was previously unable to take nutrition orally. (C) 1993 John Wiley & Sons, Inc.