DSA study on evaluation of the aspiration prevention posture in dysphagic patients

本研究的目的是确定用于测量吞咽困难患者的参考线，特别是体位改变技术的使用。视频透视是吞咽困难患者最常用的检查方法。该设备的两个主要部件是X射线管和图像增强器(I.I.)。由于I.I.的失真本质上称为假脱机失真，因此有必要对I.I.失真进行纠正。应用该程序对对照组(74例)、患者组(150例)、针刺敷贴患者组(40例)进行了研究。使用这些视频荧光图像，我们检查了参考线。作为水平指标的腭平面在患者组中不能确定42%的患者的喉部已经拉长。如果用鼻底代替腭面，不能确定水平指数的病例减少到29%。将颈椎线确定为垂直，虽然第4颈椎几乎全部可见，但第5颈椎因位于暴露范围外而约10%未见，我们利用这些水平和垂直指标来研究吞咽姿势改变的影响。牵引前后的角度变化测量平均为13度。舌面与咽面的T2-P2和T3-P3距离比分别由习惯位的0.82增加到0.86和从0.76增加到0.81。这意味着向下拉下巴会使咽部的宽度变窄。综上所述，本研究建议1.在确定颈椎线时，连接C2和C4的下端可能比C2和C5更好。2.可用鼻腔代替腭面。

The purpose of this study was to determine the reference lines for measurement of dyphagic patients, especially the usage of posture change technique. Videofluorography is most popular examination for dysphagic patients. The two main components of the equipment is X-ray tube and Image Intensifier (I.I.). Since the I.I. has distortion essentially called spool distortion, the correction of the I.I. distortion is necessary. We developed the program for distortion compensation of I.I. which corrected the distortion satisfactory.Using this program we studied Control group (74 cases), Patient group (150 cases), and Chin tack application patient group (40 cases). Using these videofluorographic images, we examined reference lines. The palatal plane as a horizontal index was not able to determine 42 % in patient group when their larynx have elongated. If we used nasal floor instead of the palatal plane, the cases cannot determine the horizontal index were reduced to 29 %. Determining the cervical vertebral line as a vertical, although, almost all the cases of the 4^<th> vertebra could be seen although the 5th cervical vertebra was not seen about 10 % because it located in outside the exposure field.Using these horizontal and vertical indices, we studied the effect of swallowing posture change. The angle change before and after pulling down the jaw was measured mean 13 degrees. Comparing the habitual position and the chin tuck position, T2-P2 and T3-P3 distance ratio between the tongue surface and the surface of the pharynx from Ment on increased from 0.82 to 0.86 and 0.76 to 0.81.respectively. That means pulling down the chin makes the width of the pharynx narrow.In conclusion, this study suggests 1. when determining the cervical vertebral line to connect the lower ends of C2 and C4 may be better than C2 and C5. 2.nasal cavity may be used instead of palatal plane.