Kashima Kazutaka, Watanabe Kenichi, Sato Takeshi, Katori Yukio
Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
Dysphagia. 2023 Apr;38(2):510-516. doi: 10.1007/s00455-021-10274-8. Epub 2021 Mar 17.
The association between swallowing function and cough strength in patients with unilateral vocal fold paralysis (UVFP) is unknown. We evaluated the relationship between voluntary cough strength and dysphagia among patients with UVFP (UVFP group) by comparing their data with that of corresponding healthy participants (healthy control [HC] group) in a prospective observational study. From February 1st, 2018 to March 30th, 2019, we recruited patients with a voice disorder due to UVFP, who were referred to our university hospital. Patients with a history of laryngeal surgery, vagal nerve paralysis, or cardiac and respiratory failure were excluded. Descriptive and clinical data regarding swallowing, voice, and cough peak flow (CPF) were collected as a measure of cough strength. The UVFP group comprised six women and seven men (median age, 68.0 years), and the HC group comprised six women and eight men (median age 65.5 years). The groups differed significantly in the Eating Assessment Tool (EAT)-10 scores and CPF rates (P < 0.001). Among patients with UVFP, 84.6% had an abnormal EAT-10 score of ≥ 3. Additionally, 16.7% of the patients exhibited liquid aspiration with contrast medium on a videofluorographic swallowing study (VFSS). There was no correlation between the CPF values, EAT-10 scores, or the VFSS results. Therefore, patients with severe UVFP, whose condition had been fixed, had difficulties when swallowing (85% of cases), and some even presented with aspiration on VFSS (20% of cases), while receiving a regular diet.
单侧声带麻痹（UVFP）患者吞咽功能与咳嗽强度之间的关联尚不清楚。在一项前瞻性观察性研究中，我们通过将单侧声带麻痹患者（UVFP组）的数据与相应健康参与者（健康对照[HC]组）的数据进行比较，评估了UVFP患者的自主咳嗽强度与吞咽困难之间的关系。2018年2月1日至2019年3月30日，我们招募了因UVFP导致声音障碍并转诊至我校医院的患者。排除有喉部手术史、迷走神经麻痹或心脏及呼吸衰竭病史的患者。收集有关吞咽、声音和咳嗽峰值流量（CPF）的描述性和临床数据，作为咳嗽强度的衡量指标。UVFP组包括6名女性和7名男性（中位年龄68.0岁），HC组包括6名女性和8名男性（中位年龄65.5岁）。两组在进食评估工具（EAT）-10评分和CPF率方面存在显著差异（P<0.001）。在UVFP患者中，84.6%的患者EAT-10评分异常，≥3分。此外，16.7%的患者在视频荧光吞咽造影检查（VFSS）中出现造影剂液体误吸。CPF值、EAT-10评分或VFSS结果之间无相关性。因此，病情已稳定的重度UVFP患者在接受常规饮食时存在吞咽困难（85%的病例），有些患者甚至在VFSS中出现误吸（20%的病例）。
