Zancan Maralice, Luchesi Karen Fontes, Mituuti Claudia Tiemi, Furkim Ana Maria
Universidade Federal de Santa Catarina - UFSC, Florianópolis (SC), Brasil.
Codas. 2017 Mar 16;29(2):e20160067. doi: 10.1590/2317-1782/20172016067.
Literature review on the onset locations of the pharyngeal phase of swallowing in asymptomatic and symptomatic adults and elderly people.
Research was conducted in the PubMed, BIREME and SciELO databases through the descriptors fluoroscopy (fluoroscopia), deglutition (deglutição) and pharynx (faringe).
Studies published between 2005 and 2015, carried out with adults and elderly people who underwent swallowing videofluoroscopy (SVF), and citing the onset location of the pharyngeal phase of swallowing.
Descriptive analysis and meta-analysis were performed, evaluating the heterogeneity and the measures grouped with random effects through I2 statistics. For ratio calculation in the meta-analysis, the locations described in the articles were classified according to the Modified Barium Swallowing protocol - Measurement Tool for Swallowing Impairment (MBSImp).
Twelve articles were selected for descriptive analysis and seven for meta-analysis. Heterogeneity was found between studies, especially due to clinical and methodological differences. The random effect indicated predominance (58%) of the onset of the pharyngeal phase of swallowing at levels 0 and 1 of the MBSImP. In asymptomatic individuals, the onset of the pharyngeal phase was observed in the oral cavity, base of the tongue, dorsum of the tongue and vallecula. In symptomatic individuals, onset was mainly observed in the oropharynx, vallecula, hypopharynx and pyriform sinus.
We noted a greater frequency of the onset of the pharyngeal phase of swallowing in the vallecula. The onset of the pharyngeal phase in the hypopharynx and pyriform sinus was more often observed among elderly individuals or with comorbidities that could alter swallowing.
对无症状及有症状的成年人和老年人吞咽咽期的起始部位进行文献综述。
通过荧光透视检查（fluoroscopia）、吞咽（deglutição）和咽（faringe）等描述词，在PubMed、BIREME和SciELO数据库中进行研究。
2005年至2015年间发表的研究，研究对象为接受吞咽视频荧光透视检查（SVF）的成年人和老年人，并引用了吞咽咽期的起始部位。
进行描述性分析和荟萃分析，通过I2统计评估异质性以及采用随机效应分组的测量指标。在荟萃分析中进行比值计算时，根据改良钡餐吞咽协议 - 吞咽障碍测量工具（MBSImp）对文章中描述的部位进行分类。
选择了12篇文章进行描述性分析，7篇进行荟萃分析。研究之间存在异质性，尤其是由于临床和方法学差异。随机效应表明，在MBSImP的0级和1级水平，吞咽咽期起始占主导（58%）。在无症状个体中，吞咽咽期起始于口腔、舌根、舌背和会厌谷。在有症状个体中，起始主要见于口咽、会厌谷、下咽和梨状窦。
我们注意到吞咽咽期起始于会厌谷的频率更高。在下咽和梨状窦的吞咽咽期起始在老年人或伴有可能改变吞咽的合并症的个体中更常观察到。
