Vocal Fold Immobility and Aspiration Status: A Direct Replication Study
Vocal Fold Immobility and Aspiration Status: A Direct Replication Study
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DOI：
10.1007/s00455-011-9362-0
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发表时间：
2012-06-01
期刊：
影响因子：
2.6
通讯作者：
Judson, Benjamin L.
中科院分区：
文献类型：
--
作者：
Leder, Steven B.;Suiter, Debra M.;Judson, Benjamin L.
这项直接重复研究的目的是确认声带不动（VFI）的发生率及其与咽部吞咽困难和误吸的关系。使用单组连续转诊病例系列，2003年8月至2007年12月期间，共有2，650名参与者接受了吞咽的光纤内窥镜评价。主要结局指标包括VFI的总体发生率和抽吸状态，特别强调年龄、性别、病因和咽期团注流特征以及VFI的侧（右侧、左侧或双侧）。将这些数据与原始研究（= 1，452）进行比较，然后将其与总共4，102名参与者相结合。结果表明，VFI的发生率为4.3%（112/2,650），即，27%（31/112）单侧右侧，58%（65/112）单侧左侧，14%（16/112）双侧。误吸发生率为22%（580/2，650）。在VFI患者中，40%（45/112）为吸气，即，单侧右侧42%（13/31），单侧左侧37%（24/65），双侧50%（8/16）。VFI患者的误吸率是非VFI患者的2.50倍（95% CI = 1.86-3.37）。液体吸入的OR = 2.41（95%CI = 1.77-3.28），果泥吸入的OR = 2.08（95%CI = 1.47-2.93）。左侧VFI最常发生于手术创伤。液体比果泥更常被吸出。男性比女性更常表现出VFI。VFI侧别和年龄不是误吸发生率的显著增加因素。经证实，VFI在吞咽困难测试期间并不罕见，并且与已接受吞咽困难评价的人群相比，当存在时，会增加误吸的几率。
The purpose of this direct replication study was to confirm the incidence of vocal fold immobility (VFI) and its relationship to pharyngeal dysphagia and aspiration. Using a single-group consecutively referred case series, a total of 2,650 participants underwent fiberoptic endoscopic evaluation of swallowing between August 2003 and December 2007. Main outcome measures included overall incidence of VFI and aspiration status, with specific emphasis on age, gender, etiology and pharyngeal phase bolus flow characteristics, and side of VFI (right, left, or bilateral). These data were compared to and then combined with the original study ( = 1,452) for a total of 4,102 participants. Results indicated that the incidence of VFI was 4.3% (112/2,650), i.e., 27% (31/112) unilateral right, 58% (65/112) unilateral left, and 14% (16/112) bilateral. Incidence of aspiration was 22% (580/2,650). Of those with VFI, 40% (45/112) aspirated, i.e., 42% (13/31) unilateral right, 37% (24/65) unilateral left, and 50% (8/16) bilateral. An individual with VFI had 2.50 times the odds of aspirating as someone without VFI (95% CI = 1.86-3.37). For liquid aspiration, the odds ratio (OR) = 2.41 (95% CI = 1.77-3.28), and for puree aspiration, OR = 2.08 (95% CI = 1.47-2.93). Left VFI occurred most frequently due to surgical trauma. Liquid was aspirated more often than a puree. Males exhibited VFI more often than females. Side of VFI and age were not factors that increased the incidence of aspiration significantly. It was confirmed that VFI is not an uncommon finding during dysphagia testing and, when present, increased the odds of aspiration compared to a population already being evaluated for dysphagia.