Yagi Naomi, Nagami Shinsuke, Lin Meng-Kuan, Yabe Toru, Itoda Masataka, Imai Takahisa, Oku Yoshitaka
Department of Neurology, Graduate School of Medicine, Kyoto University, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
Clinical Research Center for Medical Equipment Development (CRCMeD), Kyoto University Hospital, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan.
Med Biol Eng Comput. 2017 Jun;55(6):1001-1017. doi: 10.1007/s11517-016-1561-2. Epub 2016 Sep 24.
The assessment of swallowing function is important for the prevention of aspiration pneumonia. We developed a new swallowing monitoring system that uses respiratory flow, swallowing sound, and laryngeal motion. We applied this device to 11 healthy volunteers and 10 patients with dysphagia. Videofluoroscopy (VF) was conducted simultaneously with swallowing monitoring using our device. We measured laryngeal rising time (LRT), the time required for the larynx to elevate to the highest position, and laryngeal activation duration (LAD), the duration between the onset of rapid laryngeal elevation and the time when the larynx returned to the lowest position. In addition, we evaluated the coordination between swallowing and breathing. We found that LAD was correlated with a VF-derived parameter, pharyngeal response duration (PRD) in healthy subjects (LAD: 959 ± 259 ms vs. PRD: 1062 ± 149 ms, r = 0.60); however, this correlation was not found in the dysphagia patients. LRT was significantly prolonged in patients (healthy subjects: 320 ± 175 ms vs.
465 ± 295 ms, P < 0.001, t test). Furthermore, frequency of swallowing immediately after inspiration was significantly increased in patients. Therefore, the new device may facilitate the assessment of some aspects of swallowing dysfunction.
吞咽功能评估对于预防吸入性肺炎很重要。我们开发了一种新的吞咽监测系统,该系统利用呼吸气流、吞咽声音和喉部运动。我们将此设备应用于11名健康志愿者和10名吞咽困难患者。在使用我们的设备进行吞咽监测的同时进行了电视荧光吞咽造影检查(VF)。我们测量了喉部上升时间(LRT),即喉部升至最高位置所需的时间,以及喉部激活持续时间(LAD),即快速喉部上升开始至喉部回到最低位置的持续时间。此外,我们评估了吞咽与呼吸之间的协调性。我们发现,在健康受试者中,LAD与VF衍生参数咽反应持续时间(PRD)相关(LAD:959±259毫秒 vs. PRD:1062±149毫秒,r = 0.60);然而,在吞咽困难患者中未发现这种相关性。患者的LRT显著延长(健康受试者:320±175毫秒 vs. 患者:465±295毫秒,P < 0.001,t检验)。此外,患者吸气后立即吞咽的频率显著增加。因此,这种新设备可能有助于评估吞咽功能障碍的某些方面。