Validation of the Normalized Laryngeal Constriction Ratio in Normal and Disordered Swallowing.
Validation of the Normalized Laryngeal Constriction Ratio in Normal and Disordered Swallowing.
复制标题
正常和吞咽障碍时标准化喉部收缩比率的验证。
DOI：
10.1002/lary.28161
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Humbert,Ianessa
中科院分区：
文献类型：
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作者：
Miller,Melissa;Vose,Alicia;Rivet,Alycia;Smith-Sherry,May;Humbert,Ianessa
目的喉前庭关闭的时机对吞咽时的气道保护非常重要。然而，目前尚不清楚LVC的程度是否有助于气道保护。本研究的目的是验证LVC的程度，通过一项措施，称为喉缩比（LCR）。MethodsA回顾性分析的videofluoroscopic吞咽38中风参与者和40名健康对照。通过从1）最大闭合喉前庭和2）最大开放喉空域（静止时）推导尺寸归一化的空域面积来计算LCR。气道侵犯的严重程度，通过渗透抽吸量表score.Results649视频透视吞咽进行了分析。混合模型分析显示，健康个体（平均值（m）= 0.003）与老年吞咽困难患者（m = 0.026）（P= 0.001）的标准化喉收缩率之间存在统计学显著性平均差异，量化了老年吞咽困难患者的闭合程度较低。此外，吞咽与气道妥协有统计学意义上更糟糕的LCR相比，吞咽没有气道compromise（P= 0.001）。ConclusionThe normalized LCR可能是一个有效的荧光透视替代测量LVC，此外，在吞咽过程中的气道妥协。通过调查安全和不安全吞咽期间喉前庭的空间测量，LCR为进一步研究提供了方向，允许对与闭合程度相关的生理学进行关键检查，以精确检测和治疗吞咽期间的异常。证据等级4喉镜，130：E190-E198，2020
PurposeThe timing of laryngeal vestibule closure (LVC) is important for airway protection during swallowing. However, it is unknown whether the extent of LVC contributes to airway protection. The goal of this study is to validate the extent of LVC via a measure called laryngeal constriction ratio (LCR).MethodsA retrospective analysis of videofluoroscopic swallows was conducted on 38 stroke participants and 40 healthy controls. The LCR was calculated by deriving a size‐normalized area of airspace from a 1) maximum closed laryngeal vestibule and a 2) maximum open laryngeal airspace (at rest). Airway invasion severity was derived via the Penetration–Aspiration Scale score.ResultsSix hundred forty‐nine videofluoroscopic swallows were analyzed. A mixed model analysis revealed a statistically significant mean difference between the normalized laryngeal constriction ratios of healthy individuals (mean (m) = 0.003) versus older dysphagic patients (m = .026) (P= 0.001), quantifying less closure in older patients with dysphagia. Additionally, swallows with airway compromise had a statistically worse LCR when compared to swallows without airway compromise (P= 0.001).ConclusionThe normalized LCR might be a valid fluoroscopic surrogate measure for LVC and, furthermore, airway compromise during swallowing. By investigating spatial measurements in the laryngeal vestibule during safe and unsafe swallows, the LCR provides a direction for further research to allow for critical examination of the physiology relating to closure degree in order to precisely detect and treat abnormalities during swallowing.Level of Evidence4Laryngoscope, 130:E190–E198, 2020