Nascimento Weslania V, Cassiani Rachel A, Santos Carla M, Dantas Roberto O
Division of Gastroenterology of the Department of Medicine, Medical School of Ribeirão Preto, University of São Paulo, Ribeirão Preto SP, Brazil.
J Neurogastroenterol Motil. 2015 Jan 1;21(1):78-82. doi: 10.5056/jnm14055.
BACKGROUND/AIMS: Swallowing is a complex function with the control of the swallowing center being located in the brain stem. Our aim in this investigation was to evaluate, in healthy volunteers, the oral and pharyngeal transit of 2 bolus volumes and 2 consistencies, and the influence of these boluses on the proportion of pharyngeal clearance duration/hyoid movement duration.
Videofluoroscopic evaluation of swallows was performed in 30 healthy volunteers, aged 29-77 years (mean 58 years). The subjects swallowed in duplicate of 5 mL and 10 mL of thick liquid barium and honey thick barium. We measured the duration of oral transit, pharyngeal transit, pharyngeal clearance, upper esophageal sphincter opening, hyoid movement, oropharyngeal transit, and the relation pharyngeal clearance duration/hyoid movement duration.
A 10 mL bolus volume caused a longer UES opening duration than a 5 mL bolus volume, for both consistencies. The pharyngeal transit was longer for honey thick bolus consistency than for thick liquid, with both the volumes of 5 mL and 10 mL. For pharyngeal clearance, the difference was significant only with the 10 mL bolus volume. There was no difference associated with bolus volume or consistency in the relation between pharyngeal clearance duration and hyoid movement duration.
Increase in the swallowed bolus volume causes a longer UES opening duration and an increase in bolus consistency from thick liquid to honey thick causes a longer pharyngeal transit duration. The proportion between pharyngeal clearance and hyoid movement does not change with bolus volume or bolus consistency.
背景/目的：吞咽是一项复杂的功能，吞咽中枢的控制位于脑干。本研究的目的是评估健康志愿者中两种团块体积和两种黏稠度的口腔和咽部通过情况，以及这些团块对咽部清除持续时间/舌骨运动持续时间比例的影响。
对30名年龄在29 - 77岁（平均58岁）的健康志愿者进行吞咽的视频荧光透视评估。受试者分两次吞咽5毫升和10毫升的浓稠液体钡剂以及蜂蜜浓稠度的钡剂。我们测量了口腔通过时间、咽部通过时间、咽部清除时间、食管上括约肌开放时间、舌骨运动时间、口咽部通过时间，以及咽部清除持续时间/舌骨运动持续时间的关系。
对于两种黏稠度的情况，10毫升的团块体积导致食管上括约肌开放持续时间比5毫升的团块体积更长。5毫升和10毫升体积的蜂蜜浓稠度团块的咽部通过时间比浓稠液体的更长。对于咽部清除，仅在10毫升团块体积时差异显著。在咽部清除持续时间和舌骨运动持续时间的关系中，未发现与团块体积或黏稠度相关的差异。
吞咽团块体积的增加会导致食管上括约肌开放持续时间延长，团块黏稠度从浓稠液体增加到蜂蜜浓稠度会导致咽部通过持续时间延长。咽部清除和舌骨运动之间的比例不会随团块体积或团块黏稠度而改变。
