Department of Oral and Maxillofacial Surgery, Charité - University Medical Center Berlin, Berlin, Germany.
Phoniatrics and Pedaudiology, Department of Otorhinolaryngology, University Medical Center Göttingen, Göttingen, Germany.
J Oral Rehabil. 2021 Sep;48(9):1044-1049. doi: 10.1111/joor.13220. Epub 2021 Jul 7.
Dysphagia as a sequel and possible early sign of amyotrophic lateral sclerosis (ALS) is caused by progressive impaired bulbar motor function.
To evaluate bulbar motor dysfunction in patients suffering from ALS compared to a healthy reference group.
A clinical study and prospective group comparison was designed. Patients and healthy volunteers were examined in the outpatient clinic of our university medical center. Ten patients with ALS and 20 healthy volunteers were included. All participants underwent a flexible endoscopic evaluation of swallowing (FEES) and a manometric measurement of the maximal sub-palatal atmospheric pressure generated by suction as well as of the prevalent pressure during swallowing. Additionally, the Sydney Swallow Questionnaire (SSQ) was completed by all participants to score the self-rated extent of dysphagia.
Comparing maximal suction pressures, the group of patients showed significantly lower values (p < .001). There was a significant correlation between reduced pressures and the degree of dysphagia (SSQ score) (r = -0.73).
As the oral cavity is an easily accessible compartment of the upper digestive tract, manometric measurements might serve as a simple instrument in order to detect or to monitor bulbar motor dysfunction. Oral manometry may facilitate early detection and monitoring of dysphagia in ALS. Larger studies are required to confirm our findings.
吞咽困难是肌萎缩侧索硬化症（ALS）的继发病症，也是早期的可能症状，由进行性延髓运动功能障碍引起。
评估 ALS 患者的延髓运动功能障碍，并与健康对照组进行比较。
采用临床研究和前瞻性组比较设计。在我们大学医学中心的门诊，对患者和健康志愿者进行了检查。共纳入 10 名 ALS 患者和 20 名健康志愿者。所有参与者均接受了灵活的内镜吞咽评估（FEES）和最大腭下大气压力的测压检查，该压力通过抽吸产生，并对吞咽时的常见压力进行了测压检查。此外，所有参与者均完成了悉尼吞咽问卷（SSQ），以评估自我报告的吞咽困难程度。
与最大抽吸压力相比，患者组的数值明显较低（p<0.001）。压力降低与吞咽困难程度（SSQ 评分）之间存在显著相关性（r=-0.73）。
由于口腔是上消化道易于接近的部位，测压检查可能作为一种简单的工具，用于检测或监测延髓运动功能障碍。口腔测压法可能有助于早期发现和监测 ALS 中的吞咽困难。需要更大规模的研究来证实我们的发现。
