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环状软骨上喉切除术:衰老对吞咽安全性的影响。

Supracricoid laryngectomy: the impact of senescence on swallowing safety.

机构信息

Instituto Nacional de Câncer José Alencar Gomes da Silva - INCA, Rio de Janeiro, RJ, Brazil.

Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil.

出版信息

Einstein (Sao Paulo). 2021 May 10;19:eAO5715. doi: 10.31744/einstein_journal/2021AO5715. eCollection 2021.

Abstract

OBJECTIVE

To investigate the association between aging and the functional aspects of swallowing (laryngeal penetration and laryngotracheal aspiration) in individuals who underwent supracricoid laryngectomy in the late period and without complaints.

METHODS

A total of 70 patients, 56 (80%) aged >60 years and 14 (20%) <60 years, under outpatient follow-up, after cancer treatment and with no complaints of swallowing, performed functional evaluation using the swallowing videofluoroscopy. Image classification was performed using the penetration-aspiration scale developed by Rosenbek. The χ2 test and logistic regression were applied to associate the age categories to the outcomes (penetration and aspiration).

RESULTS

Patients aged over 60 years had a higher prevalence of penetration (24.29%) and aspiration (48.57%) than patients aged under 60 years. In this sample, aspiration was associated with age. Patients aged over 60 years were more likely to present penetration (27% more) during swallowing than patients under 60 years. Patients aged over 60 years had an approximately four-fold greater probability of laryngotracheal aspiration than patients aged under 60 years.

CONCLUSION

In patients without complaints of swallowing in the late postoperative period of supracricoid laryngectomy, there is a greater probability of laryngotracheal aspiration in elderly aged over 60 years than in individuals under 60 years.

摘要

目的

研究晚期行环杓状软骨切除术且无吞咽抱怨的患者,其衰老与吞咽功能方面(喉渗透和喉气管吸入)的相关性。

方法

共纳入 70 名患者,56 名(80%)年龄>60 岁,14 名(20%)年龄<60 岁,均为癌症治疗后门诊随访且无吞咽抱怨的患者,采用吞咽频闪摄像技术进行功能评估。采用 Rosenbek 开发的渗透-吸入量表对图像进行分类。采用卡方检验和逻辑回归将年龄类别与结果(渗透和吸入)相关联。

结果

60 岁以上患者的渗透(24.29%)和吸入(48.57%)发生率高于 60 岁以下患者。在该样本中,吸入与年龄相关。与 60 岁以下患者相比,60 岁以上患者在吞咽时发生渗透的可能性更高(高 27%)。60 岁以上患者发生喉气管吸入的可能性是 60 岁以下患者的约 4 倍。

结论

在晚期行环杓状软骨切除术且无吞咽抱怨的患者中,60 岁以上老年患者发生喉气管吸入的可能性大于 60 岁以下患者。

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