Allen Jacqui E
University of Auckland, Grafton, Auckland, New Zealand.
Curr Opin Otolaryngol Head Neck Surg. 2016 Dec;24(6):494-499. doi: 10.1097/MOO.0000000000000307.
The purpose of the review is to examine current research focused on upper oesophageal sphincter (UES) and cricopharyngeus muscle function, and how better understanding UES physiology will translate to improved management.
Although much is known about UES function, new information describing the dynamics of the UES and cricopharyngeus is being identified through manometry, combined fluoromanometry, and anatomic study. Response of the UES to injury, reflux, and surgical interventions is reported. Direct surgical treatment of cricopharyngeus noncompliance with or without diverticuli continues to show benefit and long-term results support a sustained improvement in three-quarters of patients.
UES and cricopharyngeus function is complex and dynamic. It is affected by internal signals such as posture and constitution of refluxate, aging, and interventions particularly radiation and surgery. Clear understanding of the triggers and responses of the UES will enable clinicians to choose the correct therapy for their dysphagic patients.
本综述旨在探讨目前聚焦于食管上括约肌（UES）和环咽肌功能的研究，以及更好地理解UES生理学如何转化为改善治疗。
尽管对UES功能已有很多了解，但通过测压、联合透视测压及解剖学研究，正在发现描述UES和环咽肌动态变化的新信息。报告了UES对损伤、反流及手术干预的反应。对伴有或不伴有憩室的环咽肌功能不全进行直接手术治疗持续显示出益处，长期结果支持四分之三的患者病情持续改善。
UES和环咽肌功能复杂且动态变化。它受诸如姿势、反流物成分、衰老等内部信号以及特别是放疗和手术等干预措施的影响。清楚了解UES的触发因素和反应将使临床医生能够为吞咽困难患者选择正确的治疗方法。
