吞咽后嗓音改变：与电视荧光透视检查结果的相关性
Postswallow voice modification: compatibility with videofluoroscopy findings.
作者信息
Santos Karoline Weber Dos, Scheeren Betina, Maciel Antônio Carlos, Cassol Mauriceia
机构信息
Grupo Hospitalar Conceição - Porto Alegre (RS), Brasil.
Irmandade Santa Casa de Misericórdia de Porto Alegre - Porto Alegre (RS), Brasil.
出版信息
Codas. 2017 Dec 4;29(6):e20170004. doi: 10.1590/2317-1782/20172017004.
PURPOSE
Verify whether voice modification after swallowing is associated with videofluoroscopic examination data.
METHODS
27 patients with oropharyngeal dysphagia underwent recording of sustained phonation of vowel /a/ before and after swallowing during videofluoroscopy. The GRBAS scale and the wet voice parameter were used to evaluate the data. Videofluoroscopy results showed stasis of food in the valleculae and piriform recesses, laryngeal penetration, tracheal aspiration, and degree of dysphagia.
RESULTS
Decreased dysphonia grade and asthenia and increased strain were observed after swallowing, with no difference for the wet voice parameter. Sensitivity and specificity of ± 50% were observed for food stasis in the valleculae and piriform recesses. Sensitivity values of 80 and 66-75% were observed for detection of laryngeal penetration and tracheal aspiration and modification of vocal strain, respectively. Negative predictive values of 77-91% were found for the three assessment parameters with no correlation with the degree of oropharyngeal dysphagia.
CONCLUSION
Modification of the GRBAS scale parameters after swallowing showed good compatibility with videofluoroscopy findings.
目的
验证吞咽后嗓音改变是否与电视荧光吞咽造影检查数据相关。
方法
27例口咽吞咽困难患者在电视荧光吞咽造影检查期间，于吞咽前后进行元音/a/的持续发声记录。采用GRBAS量表和湿声参数对数据进行评估。电视荧光吞咽造影检查结果显示会厌谷和梨状窝食物残留、喉穿透、气管误吸及吞咽困难程度。
结果
吞咽后观察到发声障碍等级和无力程度降低，紧张度增加，湿声参数无差异。会厌谷和梨状窝食物残留的敏感度和特异度均为±50%。检测喉穿透、气管误吸及发声紧张度改变的敏感度值分别为80%和66%-75%。三个评估参数的阴性预测值为77%-91%，与口咽吞咽困难程度无关。
结论
吞咽后GRBAS量表参数的改变与电视荧光吞咽造影检查结果具有良好的一致性。
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