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[环咽肌条与吞咽困难]

[Cricopharyngeal bar and Dysphagia].

作者信息

Kühn D, Miller S, Ptok M

机构信息

Klinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover, Hannover, Germany. k

出版信息

Laryngorhinootologie. 2013 Apr;92(4):230-3. doi: 10.1055/s-0032-1330030. Epub 2012 Dec 18.

Abstract

BACKGROUND

The term Cricopharyngeal Bar (CPB) describes a posterior indentation at the pharyngoesophageal junction which becomes apparent during a Video Fluoroscopic Swallowing Exam (VFSE, modified barium swallow). The eff ect CPBs might have on swallowing is still under debate. This paper intends to review appearance, eff ects and the associated therapy of CPBs.

METHOD

For this systematic review a selective literature research in PubMed has been carried out.

RESULTS

CPBs are usually diagnosed during VFSE. As VFSEs are mostly carried out in dysphagic patients, CBPs were also associated with dysphagia. Even though, CPBs are often related to dysphagia, they do also appear in patients without dysphagia. Therefore, the appearance of a CBP does not automatically represent the cause of dysphagic symptoms. Its impact on swallowing might, however, depend on the dimension of the protrusion as well as the weakening and dysfunction of the inferior pharyngeal constrictor muscle.

DISCUSSION

CBPs often present as an incidental finding during a modified barium swallow. A relation to dysphagia can only be assumed for severe CPBs. Therapy options include cricopharyngeal myotomy or esophago-gastro endoscopy using either bougies or balloons.

摘要

背景

环咽肌压迹(CPB)一词描述了在视频荧光吞咽检查(VFSE,改良钡剂吞咽造影)过程中在咽食管交界处出现的后部压痕。CPB对吞咽可能产生的影响仍存在争议。本文旨在综述CPB的表现、影响及相关治疗方法。

方法

为进行该系统评价,在PubMed上进行了选择性文献检索。

结果

CPB通常在VFSE过程中被诊断出来。由于VFSE大多在吞咽困难的患者中进行,因此CPB也与吞咽困难有关。尽管如此,CPB也常出现在无吞咽困难的患者中。因此,CPB的出现并不一定代表吞咽困难症状的原因。然而,其对吞咽的影响可能取决于突出程度以及下咽缩肌的减弱和功能障碍。

讨论

CPB常在改良钡剂吞咽造影时偶然发现。只有严重的CPB才可能与吞咽困难有关。治疗选择包括环咽肌肌切开术或使用探条或球囊的食管-胃镜检查。

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