Jungheim M, Schubert C, Miller S, Ptok M
Klinik und Poliklinik für Phoniatrie und Pädaudiologie, Medizinische Hochschule Hannover, Hannover.
Laryngorhinootologie. 2015 Sep;94(9):601-8. doi: 10.1055/s-0034-1395532. Epub 2015 Mar 4.
High resolution manometry (HRM) can provide information about the muscular contraction of the pharynx and the upper esophageal sphincter (UES) and represents an important tool in the diagnostics of dysphagia. To compare the results of swallowing studies interindividually and to identify pathological swallows, normative data are necessary. Normative data for the use of an HRM-probe with a large diameter has already been published. As previously has been shown these probes can influence the normal contraction of the pharynx and the UES. In this study comprehensive normal values are presented for small HRM-probes in diameter (2 mm), that only minimally affect pharyngeal and UES contractions.
29 healthy volunteers underwent pharyngeal and upper esophageal HRM. All subjects performed 10 water swallows of 2 ml in an upright position. Pressure and time dependent parameters of the velopharyngeal region, the tongue base and the UES have been evaluated. Mean and median values and different percentile ranges were calculated.
The normative values for the key parameters were (mean±SD): maximum velopharyngeal pressure 269.9±113.1 mmHg, maximum tongue base pressure 278±93.6 mmHg, maximum UES pressure 205.8±64.0 mmHg, UES resting pressure 42.5±18.7 mmHg and relaxation time of the UES 681.6±86.8 ms. Further parameters have been measured.
Time dependent values are comparable to those already published. Especially in the UES lower pressures can be measured when a small HRM-probe is used. The normative data established in this study might help to distinguish pathological from physiological swallows using HRM.
高分辨率测压法(HRM)可提供有关咽部和食管上括约肌(UES)肌肉收缩的信息,是吞咽困难诊断中的一项重要工具。为了在个体间比较吞咽研究结果并识别病理性吞咽,规范数据是必要的。使用大直径HRM探头的规范数据已经公布。如先前所示,这些探头会影响咽部和UES的正常收缩。在本研究中,给出了直径为2毫米的小型HRM探头的综合正常值,该探头对咽部和UES收缩的影响极小。
29名健康志愿者接受了咽部和食管上段的HRM检查。所有受试者在直立位进行10次2毫升水的吞咽。评估了腭咽区域、舌根和UES的压力及时间相关参数。计算了均值、中位数和不同百分位数范围。
关键参数的规范值为(均值±标准差):腭咽最大压力269.9±113.1毫米汞柱,舌根最大压力278±93.6毫米汞柱,UES最大压力205.8±64.0毫米汞柱,UES静息压力42.5±18.7毫米汞柱,UES松弛时间681.6±86.8毫秒。还测量了其他参数。
时间相关值与已发表的结果相当。特别是使用小型HRM探头时,可测得UES较低的压力。本研究建立的规范数据可能有助于使用HRM区分病理性吞咽和生理性吞咽。