Martin-Harris Bonnie, Brodsky Martin B, Michel Yvonne, Lee Fu-Shing, Walters Bobby
Department of Otolaryngology-Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, Suite 1141, Charleston, SC 29425, USA.
J Speech Lang Hear Res. 2007 Jun;50(3):585-94. doi: 10.1044/1092-4388(2007/041).
The purpose of this investigation was to determine bolus head timing and location relations with the onset of hyoid movement at the initiation of the pharyngeal swallow and at the onset of swallow-related apnea.
Bolus head timing and location and the timing of swallow-related apnea were recorded from frame-by-frame analyses of 5-ml single liquid swallows using dual-modality videofluoroscopy and nasal airflow recordings in 82 consecutive, healthy volunteers. The presence, depth, and response to airway entry were also recorded and related to the bolus head location and the onset of hyoid movement.
The majority of participants-80% on at least 1 trial-produced the onset of hyoid movement at pharyngeal swallow initiation after the bolus head passed the posterior angle of the mandible. There was a trend in older participants for later onset of hyoid movement and onset of apnea relative to bolus head arrival at the posterior angle of the mandible.
Although entry of the bolus head into the pharynx prior to hyoid movement may result in a threat to the laryngeal airway, these data demonstrate that a "delay" by itself cannot be assumed to indicate a disordered swallow without coexisting impairments of swallowing physiology.
本研究旨在确定在咽期吞咽起始时及吞咽相关呼吸暂停开始时，食团头部的时间和位置与舌骨运动起始之间的关系。
使用双模态荧光透视和鼻气流记录，对82名连续的健康志愿者进行逐帧分析，记录5毫升单一液体吞咽时食团头部的时间和位置以及吞咽相关呼吸暂停的时间。还记录了气道入口的存在、深度和反应，并将其与食团头部位置和舌骨运动起始相关联。
大多数参与者（至少在1次试验中有80%）在食团头部通过下颌骨后角后，在咽期吞咽起始时出现舌骨运动起始。老年参与者中，相对于食团头部到达下颌骨后角，舌骨运动起始和呼吸暂停起始有延迟的趋势。
尽管食团头部在舌骨运动之前进入咽部可能会对喉气道造成威胁，但这些数据表明，在没有吞咽生理功能同时受损的情况下，不能仅凭“延迟”就认定为吞咽障碍。
