吞咽压力变异性与咽部区域、食团体积、年龄和性别的关系
Swallowing Pressure Variability as a Function of Pharyngeal Region, Bolus Volume, Age, and Sex.
作者信息
Jones Corinne A, Ciucci Michelle R, Abdelhalim Suzan M, McCulloch Timothy M
机构信息
Department of Neurology, The University of Texas at Austin, Austin, Texas, U.S.A.
Department of Surgery, Division of Otolaryngology - Head & Neck Surgery, University of Wisconsin-Madison, Madison, Wisconsin, U.S.A.
出版信息
Laryngoscope. 2021 Jan;131(1):E52-E58. doi: 10.1002/lary.28667. Epub 2020 Apr 18.
OBJECTIVES
Within-individual movement variability occurs in most motor domains. However, it is unknown how pharyngeal swallowing pressure varies in healthy individuals. We hypothesized that: 1) variability would differ among pharyngeal regions; 2) variability would decrease with increased bolus volume; 3) variability would increase with age; and 4) there would be no sex differences.
STUDY DESIGN
Case series.
METHODS
We used pharyngeal high-resolution manometry to measure swallowing pressure in the following regions: velopharynx, tongue base, hypopharynx, and upper esophageal sphincter. Data were collected from 97 healthy adults (41 male) aged 21 to 89 years during thin liquid swallows: 2 mL, 10 mL, and participant-selected comfortable volume. Pressure variability was measured using coefficient of variation. Repeated measures analysis of variance was used to assess impacts of region, bolus volume, age, and sex on pressure variability.
RESULTS
There was a significant region × volume interaction (P < .001) and significant main effect of age (P = .005). Pressures in the hypopharynx region were more variable than all other regions (P ≤ .028), and pressures in the tongue base region were less variable than all other regions (P ≤ .002) except at 2 mL volumes (P = .065). Swallowing pressure variability was significantly different in the velopharynx and upper esophageal sphincter regions, with comfortable volume and 2 mL swallows having greater variability than 10 mL swallows (P ≤ .026). Pressure variability significantly increased with increasing age (P = .002). There were no effects of sex on pressure variability (P ≥ .15).
CONCLUSION
Pharyngeal swallowing pressure variability differs according pharyngeal region, volume, and age but not sex. Abnormal swallowing pressure variability may reflect deviations in motor control in persons with swallowing impairment, and results from this study can be used as normative data for future investigations evaluating swallowing pressure generation.
LEVEL OF EVIDENCE
4 Laryngoscope, 131:E52-E58, 2021.
目的
个体内部运动变异性存在于大多数运动领域。然而，健康个体的咽部吞咽压力如何变化尚不清楚。我们假设：1）不同咽部区域的变异性会有所不同；2）变异性会随着食团体积的增加而降低；3）变异性会随着年龄的增长而增加；4）不存在性别差异。
研究设计
病例系列研究。
方法
我们使用咽部高分辨率测压法测量以下区域的吞咽压力：腭咽、舌根、下咽和食管上括约肌。在97名年龄在21至89岁的健康成年人（41名男性）吞咽稀液体（2毫升、10毫升以及参与者自行选择的舒适体积）时收集数据。使用变异系数测量压力变异性。采用重复测量方差分析来评估区域、食团体积、年龄和性别对压力变异性的影响。
结果
存在显著的区域×体积交互作用（P <.001）以及年龄的显著主效应（P =.005）。下咽区域的压力比所有其他区域更具变异性（P ≤.028），舌根区域的压力比所有其他区域（除了2毫升体积时，P =.065）更稳定（P ≤.002）。腭咽和食管上括约肌区域的吞咽压力变异性显著不同，舒适体积和2毫升吞咽时的变异性大于10毫升吞咽时（P ≤.026）。压力变异性随着年龄的增长而显著增加（P =.002）。性别对压力变异性没有影响（P ≥.15）。
结论
咽部吞咽压力变异性因咽部区域、体积和年龄而异，但与性别无关。异常的吞咽压力变异性可能反映吞咽功能受损者运动控制的偏差，本研究结果可作为未来评估吞咽压力产生的调查的规范数据。
证据水平
4 喉镜，131:E52 - E58，2021年。
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