Nishio Masaki, Niimi Seiji
Department of Speech and Hearing Science, International University of Health and Welfare, Ohtawara, Tochigi, Japan.
Folia Phoniatr Logop. 2004 Sep-Oct;56(5):291-304. doi: 10.1159/000080066.
The intelligibility of monosyllabic speech, word speech, and conversational speech was evaluated in 113 dysarthric speakers, and the presence and severity of swallowing disorders were evaluated using videofluoroscopic and bedside examinations. The results revealed a high correlation between swallowing function and all levels of speech intelligibility. Furthermore, the prevalence of concomitant dysphagia in dysarthric patients was quite high regardless of the primary etiology and time elapsed since the onset. However, the relationship between the two functions is more complex than is initially apparent. The prevalence and severity of dysphagia vary markedly according to the type of dysarthria. Patients in the flaccid, spastic, and mixed categories encompass a broad range of severity levels with many individuals being severely impaired, while patients in the ataxic, hypokinetic, and unilateral upper motor neuron categories seldom have severe concomitant swallowing problems. Furthermore, the correlation coefficient between conversational intelligibility and swallowing function varies considerably according to the type of dysarthria. The correlation was not significant in the flaccid, hypokinetic, and UUMN dysarthria groups. Based on these findings, we discuss herein the clinical management of dysarthric patients with dysphagia.
对113名构音障碍患者的单音节言语、单词言语和对话言语的可懂度进行了评估，并使用视频荧光镜检查和床边检查对吞咽障碍的存在情况和严重程度进行了评估。结果显示吞咽功能与所有言语可懂度水平之间存在高度相关性。此外，无论原发性病因和发病后的时间长短，构音障碍患者中吞咽困难的患病率都相当高。然而，这两种功能之间的关系比最初看起来更为复杂。吞咽困难的患病率和严重程度因构音障碍的类型而异。弛缓型、痉挛型和混合型患者的严重程度范围广泛，许多人受到严重损害，而共济失调型、运动减少型和单侧上运动神经元型患者很少有严重的吞咽伴随问题。此外，对话可懂度与吞咽功能之间的相关系数因构音障碍的类型而有很大差异。在弛缓型、运动减少型和单侧上运动神经元型构音障碍组中，相关性不显著。基于这些发现，我们在此讨论伴有吞咽困难的构音障碍患者的临床管理。
