Ohio University, Grover Center, Athens, 45701-2979, USA.
Dysphagia. 2010 Mar;25(1):20-5. doi: 10.1007/s00455-009-9224-1. Epub 2009 Aug 5.
Reduced maximal hyoid excursion has been suspected as one of the primary physiologic causes of aspiration after a stroke. Vertical and anterior displacement of hyoid excursion is critical to epiglottic closure for airway protection and the opening of the upper esophageal sphincter (UES). Without these carefully timed and well-executed components, the bolus cannot pass safely through the pharynx. The purpose of this study was to evaluate vertical and anterior displacement of the hyoid bone during oropharyngeal swallowing in two groups of subjects: (1) 16 stroke patients who aspirate before or during the swallow (aspirators), and (2) 33 stroke patients who do not aspirate (nonaspirators). Means and standard deviations for anterior and vertical displacement were analyzed for 5- and 10-ml thin-liquid boluses using the ImageJ program (136 swallows). A two-way analysis of variance (ANOVA) was run with group and volume as independent variables. There was no significant difference between the two groups for vertical or anterior displacement. Maximal anterior displacement of the hyoid bone was slightly longer in nonaspirators than in aspirators. Aspiration before and during the swallow may be related more to the triggering of pharyngeal swallow than to the maximal extent of hyoid excursion.
舌骨最大上移距离减小被怀疑是中风后发生吸入的主要生理性原因之一。舌骨垂直和向前移动对于会厌关闭以保护气道和开放食管上括约肌（UES）至关重要。如果没有这些精心计时和执行良好的组件，食团就不能安全地通过咽部。本研究的目的是评估两组受试者在口咽吞咽期间舌骨的垂直和向前移动：（1）16 名在吞咽前或吞咽期间发生吸入的中风患者（吸入者），以及（2）33 名未发生吸入的中风患者（非吸入者）。使用 ImageJ 程序（136 次吞咽）分析了 5ml 和 10ml 稀薄液团的前向和垂直位移的平均值和标准差。采用组和容量作为自变量进行双因素方差分析（ANOVA）。两组之间在垂直或前向位移方面没有显著差异。非吸入者的舌骨最大前向位移略长于吸入者。吞咽前和吞咽期间的吸入可能与咽吞咽的触发有关，而与舌骨最大上移距离无关。
