Evaluating Method for Swallowing Function at Chair-Side

目的：本研究的目的是建立一种客观的椅子侧吞咽评估方法。方法：研究1：受试者；10例健康，牙齿发育完全（平均年龄28.6±3.5岁）。研究2：受试者；5例健康，牙齿发育完全（平均年龄：30.6±5.9岁）。研究3：受试者；5例健康，牙齿发育完全（平均年龄：29.0±2.4岁）。研究4：受试者；5例健康，牙齿发育完全（平均年龄：29.5±3.6岁）。研究5：受试者；无牙全口义齿5例（平均年龄：68.4±7.3岁）。采用通用超声诊断设备，采用5 MHz电子凸扇形扫描探头，观察舌部吞咽试验食物时的运动。为了记录吞咽声，心音麦克风通过生理信号单元连接到超声波诊断设备上。在录音纸上同时记录舌部运动和吞咽音，用数字化仪绘制舌部运动曲线的5个拐点（T1、T2、T3、T4、T5）和吞咽音的2个起点（S1、S2）进行分析。受试者被引导吞下测试食物（一种与水混合的淀粉化合物）结果：研究1：确认10名受试者的数据均具有可重复性。T4与S1的相关性有统计学意义。S1总是领先于T4。研究2：通过vf影像确认，S1与会厌刚刚关闭的时间点重合，T4与试验食物尾部刚刚到达食道的时间点重合。研究3：腭板和咬板厚度对吞咽功能的影响。研究四：体位对吞咽功能的影响。研究5：义齿植入对吞咽功能有明显的改善作用。结论：本方法对椅侧吞咽的诊断有一定的指导意义。

Objectives :The purpose of this study was to develop an objective evaluation method for swallowing at Chair-Side.Methods :Study 1 : Subjects ; Ten healthy, fully dentate (Mean age : 28.6±3.5yo.)Study 2: Subjects ; Five healthy, fully dentate (Mean age : 30.6±5.9yo.)Study 3 : Subjects ; Five healthy, fully dentate (Mean age : 29.0±2.4yo.)Study 4 : Subjects ; Five healthy, fully dentate (Mean age : 29.5±3.6yo.)Study 5 : Subjects ; Five edentulous patients with complete denture (Mean age : 68.4±7.3yo.)To observe tongue movements in swallowing the test food, general-purpose ultra-sound diagnostic equipment was used with a 5 MHz electronic convex sector scanning probe. To record swallowing sounds, a heart sound microphone was connected to the ultra-sound diagnostic equipment through a physiologic signal unit. The tongue movements and swallowing sounds were simultaneously recorded on recording paper and analyzed by plotting five inflection points (T1, T2, T3, T4 and T5) of the movement curve and two beginning points of swallowing sounds (S1 and S2) using a digitizer. Subjects were directed to swallow the test food (a starch compound mixed with water)Results :Study 1 : It was confirmed that all the data of 10 subjects had repeatability. There was statistically significant correlation between T4 and S1. S1 were always ahead of T4.Study 2 : From the VF-image, it was confirmed that S1 coincided with the point of time that the epiglottis was just going to shut, and T4 coincided with the point of time that the tail of test food has just got to the esophagus.Study 3 : Thickness of palatal plate and biteplate influence on swallowing function.Study 4 : The body positions influence on swallowing function.Study 5 : Denture insertion was effective for swallowing function.Conclusion :From this investigation, it is suggested that our evaluating method could be useful for the diagnosis of swallowing at chair-side.