Department of Rehabilitation Medicine, College of Medicine, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam, 31116, Republic of Korea.
Department of Nanobiomedical Science & BK21 PLUS NBM Research Center for Regenerative Medicine, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan, Chungnam, 31116, Republic of Korea.
Dysphagia. 2021 Dec;36(6):1054-1062. doi: 10.1007/s00455-020-10238-4. Epub 2021 Jan 5.
The effectiveness of the chin tuck maneuver is still controversial, despite being widely used in clinical practice. The chin tuck maneuver has been shown to be able to reduce or eliminate aspiration in a group of patients with a number of favorable conditions, but its effectiveness in preventing or managing penetration remains unclear. This study was designed to investigate whether the chin tuck maneuver is effective in reducing penetration. Images from a videofluoroscopic swallowing study (VFSS) taken from 76 patients with penetration were collected and reviewed retrospectively. The severity of penetration was assessed by the penetration ratio (ratio of the penetration depth to the length of the epiglottis) measured and calculated from the images in which the deepest penetration was observed. The penetration ratio was significantly decreased in the chin tuck posture compared with the ratio in the neutral position (p = 0.001). Significant reducing effect was observed in 26 (34.2%) out of 76 patients. When comparing other parameters of VFSS, residues in the vallecular and pyriformis sinuses were less severe in the effective group. Chin tuck significantly decreased residues in both effective and ineffective group. The results demonstrate that the chin tuck maneuver can reduce penetration, but its effectiveness is limited.
尽管颏部前推手法在临床实践中被广泛应用,但它的有效性仍存在争议。颏部前推手法已被证明能够减少或消除一组具有多种有利条件的患者的误吸,但它在预防或处理渗透方面的有效性尚不清楚。本研究旨在探讨颏部前推手法是否能有效减少渗透。我们收集了 76 例渗透患者的视频荧光透视吞咽研究(VFSS)图像,并进行了回顾性分析。通过测量和计算图像中观察到的最深渗透深度与杓状软骨长度的比值,评估渗透的严重程度。与中立位相比,颏部前推位的渗透比值显著降低(p=0.001)。76 例患者中有 26 例(34.2%)观察到显著降低。比较 VFSS 的其他参数, vallecular 和 pyriformis 窦中的残留物在有效组中较不严重。颏部前推手法在有效和无效组中均能减少残留物。结果表明,颏部前推手法可以减少渗透,但效果有限。