Tomik Jerzy, Tomik Barbara
Katedra i Klinika Otolaryngologii, Collegium Medicum, Uniwersytetu Jagiellońiskiego w Krakowie.
Przegl Lek. 2006;63(2):77-80.
Swallowing is a complex motor event that is difficult to investigate in man. A slowed ability to eat a meal, loss of salivary control with drooling, episodic coughing, and choking and nasal regurgitation occurred due to the dysphagia. Swallowing disorders can be divided into oropharyngeal dysphagia and oesophageal dysphagia. The most common cause of oropharyngeal dysphagia is cerebrovascular accidents; other causes may include oropharyngeal structural lesions, systematic and local muscular diseases, and diverse neurologic disorders. Oesophageal dysphagia may result from neuromuscular disorders, mobility abnormalities, and intrinsic or extrinsic obstructive lesions. Initial evaluation of patients with suspected oropharyngeal dysphagia includes patient history, laryngological and neurological examination, and careful videofluoroscopic study of pharyngeal dynamics. Initial evaluation of patients with suspected oesophageal dysphagia includes patient history and barium swallow with oesophagography. Classifying dysphagia as oropharyngeal, oesophageal and obstructive, or neuromuscular symptom complexes leads to a successful diagnosis in 80% of patients.
吞咽是一个复杂的运动过程,在人体中很难进行研究。吞咽困难导致进食能力减慢、唾液控制丧失伴流口水、发作性咳嗽、呛噎以及鼻反流。吞咽障碍可分为口咽性吞咽困难和食管性吞咽困难。口咽性吞咽困难最常见的原因是脑血管意外;其他原因可能包括口咽结构病变、系统性和局部肌肉疾病以及各种神经障碍。食管性吞咽困难可能由神经肌肉疾病、运动异常以及内在或外在阻塞性病变引起。疑似口咽性吞咽困难患者的初步评估包括患者病史、喉镜和神经学检查,以及仔细的咽部动力学视频荧光透视研究。疑似食管性吞咽困难患者的初步评估包括患者病史和食管造影钡餐检查。将吞咽困难分为口咽性、食管性和阻塞性或神经肌肉症状复合体,80%的患者可获得成功诊断。