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使用320排区域探测器计算机断层扫描测量吞咽过程中的咽喉容积

Measurement of Pharyngo-laryngeal Volume During Swallowing Using 320-Row Area Detector Computed Tomography.

作者信息

Iida Takatoshi, Kagaya Hitoshi, Inamoto Yoko, Shibata Seiko, Saitoh Eiichi, Kanamori Daisuke, Hashimoto Shuji, Katada Kazuhiro, Tohara Haruka, Ueda Koichiro

机构信息

Division of Medically Compromised Geriatric Dentistry, Department of Critical Care Medicine and Dentistry, Graduate School of Dentistry, Kanagawa Dental University, 82, Inaoka-cho, Yokosuka, Kanagawa, 238-8580, Japan.

Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan.

出版信息

Dysphagia. 2017 Dec;32(6):749-758. doi: 10.1007/s00455-017-9818-y. Epub 2017 Jul 3.

Abstract

This study aimed to (1) evaluate changes in bolus and air volumes in the pharyngo-laryngeal cavity during swallowing and (2) determine how differences in these volumes during swallowing are influenced by bolus amount using 320-row area detector computed tomography (320-ADCT). Three-, 10-, and 20-ml honey-thick liquids (5% w/v) were presented to ten healthy subjects placed in a 45° reclining position. 3D images were created in 29 phases at an interval of 0.1 s for 3.15 s. Changes in bolus and air volumes in the pharyngo-laryngeal cavity were calculated. The two one-sided tests were used to determine equivalency of the pharyngo-laryngeal volume of each event (i.e., onset of hyoid elevation, soft palate closure, true vocal cord closure, closure of laryngeal vestibule, epiglottis inversion, pharyngo-esophageal sphincter opening) for each bolus volume. The pharyngo-laryngeal volume during swallowing was about 20 ml before swallowing. The volume temporarily increased with tongue loading, but decreased to about 0 ml with pharyngeal contraction. Subsequently, the volume returned to the original volume after airway opening. Most of the air was released from the pharyngo-laryngeal space before the bolus flowed into the esophagus during swallowing. As the bolus volume to be swallowed increased, the maximal pharyngo-laryngeal volume increased, but changes in air volume remained constant. 320-ADCT allowed for analysis of dynamic volume changes in the pharyngo-laryngeal cavity, which will increase our knowledge of kinematic and volumetric mechanisms during swallowing.

摘要

本研究旨在

(1)评估吞咽过程中咽喉腔内团块和空气量的变化;(2)使用320排区域探测器计算机断层扫描(320-ADCT)确定吞咽过程中这些量的差异如何受团块量的影响。将三种10毫升和20毫升的蜂蜜稠度液体(5% w/v)喂给10名处于45°斜躺姿势的健康受试者。在3.15秒内以0.1秒的间隔创建29个阶段的3D图像。计算咽喉腔内团块和空气量的变化。使用双侧检验确定每个团块量的每个事件(即舌骨抬高开始、软腭闭合、声带真部闭合、喉前庭闭合、会厌反转、咽食管括约肌开放)的咽喉体积的等效性。吞咽前咽喉体积约为20毫升。随着舌头加载,体积暂时增加,但随着咽部收缩降至约0毫升。随后,气道开放后体积恢复到原始体积。在吞咽过程中,大部分空气在团块流入食管之前从咽喉空间释放。随着吞咽团块量的增加,最大咽喉体积增加,但空气量的变化保持不变。320-ADCT允许分析咽喉腔的动态体积变化,这将增加我们对吞咽过程中运动学和体积机制的了解。

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