Knigge Molly A, Thibeault Susan L
Voice and Swallow Clinics, University of Wisconsin - Madison, Madison, Wisconsin.
Diane M. Bless Endowed Chair in Otolaryngology Head and Neck Surgery, Department of Surgery/Otolaryngology, University of Wisconsin - Madison, Madison, Wisconsin.
Head Neck. 2018 Jan;40(1):203-212. doi: 10.1002/hed.24977. Epub 2017 Oct 30.
No practice guidelines have been established for swallowing outcomes after cricopharyngeal myotomy (CPM). The purpose of this systematic review was to summarize evidence for swallowing outcomes in patients undergoing CPM to treat symptomatic cricopharyngeal dysfunction, in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) protocol.
Swallowing outcomes examined included penetration/aspiration ratings, manometric measures, patient-rated dysphagia scales, clinician-rated dysphagia scales, diet level, and weight.
Three databases were queried for studies published between January 1995 and July 2015, resulting in a total of 122 full-text eligible records. Studies were screened and reviewed, culminating in 10 studies meeting inclusion criteria. Critical appraisal of study design, swallowing outcomes measures, and statistical analysis were summarized.
This systematic review revealed insufficient evidence for guiding clinical practice. Future investigations should use validated patient-rated and clinician-rated instruments as well as detailed high-resolution manometry measures to optimally capture postoperative swallowing outcomes.
目前尚无关于环咽肌切开术(CPM)后吞咽结果的实践指南。本系统评价的目的是根据系统评价和Meta分析的首选报告项目(PRISMA)方案,总结接受CPM治疗症状性环咽肌功能障碍患者吞咽结果的证据。
所检查的吞咽结果包括渗透/误吸评级、测压指标、患者自评吞咽困难量表、临床医生评定的吞咽困难量表、饮食水平和体重。
查询了三个数据库中1995年1月至2015年7月发表的研究,共获得122条符合全文要求的记录。对研究进行筛选和评审,最终有10项研究符合纳入标准。总结了对研究设计、吞咽结果测量和统计分析的批判性评价。
本系统评价显示,指导临床实践的证据不足。未来的研究应使用经过验证的患者自评和临床医生评定工具,以及详细的高分辨率测压指标,以最佳地获取术后吞咽结果。