Miller S, Jungheim M, Kühn D, Ptok M
Klinik für Phoniatrie und Pädaudiologie, MHH OE 6510, Hannover.
HNO. 2013 Jul;61(7):623-6. doi: 10.1007/s00106-013-2693-4.
Traditional dysphagia therapy (TDT) aims to improve swallowing by means of compensatory strategies including postural changes or swallowing maneuvers. These techniques are mainly applied in order to modify swallowing by affecting bolus transport to facilitate safe swallowing. Videos demonstrating actual, laryngoscopically verified effects on the pharyngeal and laryngeal structures involved are rare in the current literature. This paper aims to assess various maneuvers used in TDT endoscopically.
A selective literature search for endoscopic imaging of swallowing maneuvers and postural changes applied in TDT was performed in PubMed.
Each of the techniques commonly used in TDT influenced the pharyngeal or laryngeal structures distinctly.
All of the techniques examined for this paper represent techniques commonly applied in traditional dysphagia therapy. The specific changes observed endoscopically of the anatomic structures involved are distinct, but sometimes seem only marginal in comparison to the initial configurations. It should hence not be surprising that these swallowing techniques occasionally only slightly improve swallowing. The videos included in this article demonstrate the actual impact of the swallowing techniques and may therefore be of use to physicians prescribing and implementing TDT.
传统吞咽困难疗法(TDT)旨在通过包括姿势改变或吞咽动作在内的代偿策略来改善吞咽。这些技术主要用于通过影响食团运输来改变吞咽,以促进安全吞咽。目前文献中很少有视频展示对所涉及的咽喉结构的实际、经喉镜证实的效果。本文旨在通过内镜评估TDT中使用的各种动作。
在PubMed上对TDT中应用的吞咽动作和姿势改变的内镜成像进行了选择性文献检索。
TDT中常用的每种技术对咽喉结构的影响都截然不同。
本文研究的所有技术均为传统吞咽困难疗法中常用的技术。在内镜下观察到的所涉及解剖结构的具体变化是明显的,但与初始形态相比,有时似乎仅为轻微变化。因此,这些吞咽技术偶尔仅能略微改善吞咽也就不足为奇了。本文中的视频展示了吞咽技术的实际影响,因此可能对开处方和实施TDT的医生有用。