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高分辨率测压法在全喉切除术中的适用性

The applicability of high resolution manometry in total laryngectomy.

作者信息

Santos Taís Lima, Herbella Fernando Augusto Mardiros, Azevedo Renata Rangel

机构信息

Escola Paulista de Medicina - Universidade Federal de São Paulo, São Paulo (SP), Brasil.

出版信息

Codas. 2020 Nov 20;32(6):e20190006. doi: 10.1590/2317-1782/20202019006. eCollection 2020.

Abstract

PURPOSE

This study aims to measure the pressure of the pharynx and the pharyngoesophageal segment (PES) at rest and during phonation in total laryngectomized patients, with different levels of voice production.

METHODS

four total laryngectomized individuals participated in the study, All patients underwent High Resolution Manometry (MAR) at rest and during phonation. After this process, a descriptive analysis of the results was performed.

RESULTS

we observed that during rest the patients had PES pressure below normal and this data may be related to changes in the muscular connections at the level of the upper esophageal sphincter (UES) especially the interruption of the cricopharyngeal plexus. During phonation, two patients presented higher UES pressure values during phonation, when compared to the values found at rest, suggesting that introduction of air into the esophagus is followed by pharyngoesophageal contraction and that during phonation the patients with good esophageal speech may develop more pressure in this region.

CONCLUSION

Studies with a greater number of participants may help define, for example, subjects who may benefit from procedures such as cricopharyngeal myotomy or other medical conduct in order to facilitate the acquisition of esophageal voice in these patients.

摘要

目的

本研究旨在测量全喉切除患者在静息状态和发声过程中,不同发声水平下咽部和咽食管段(PES)的压力。

方法

四名全喉切除患者参与了本研究,所有患者均在静息状态和发声过程中接受了高分辨率测压法(MAR)。在此过程之后,对结果进行了描述性分析。

结果

我们观察到,在静息状态下,患者的PES压力低于正常水平,这一数据可能与食管上括约肌(UES)水平的肌肉连接变化有关,尤其是环咽神经丛的中断。在发声过程中,与静息状态下的值相比,两名患者在发声时呈现出更高的UES压力值,这表明空气进入食管后会伴随咽食管收缩,并且在发声过程中,具有良好食管语音的患者在该区域可能会产生更大的压力。

结论

更多参与者的研究可能有助于确定,例如,哪些受试者可能从环咽肌切开术或其他医疗行为等手术中受益,以便促进这些患者获得食管语音。

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