Department of Rehabilitation, Seirei Mikatahata General Hospital, Hamamatsu, Japan.
Department of Dysphagia Rehabilitation, Division of Gerontology and Gerodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Geriatr Gerontol Int. 2021 Oct;21(10):907-912. doi: 10.1111/ggi.14256. Epub 2021 Aug 5.
Dentures play an important role in improving masticatory and oropharyngeal swallowing functions in some edentulous patients without dysphagia. However, few studies have been conducted on patients with dysphagia. This study investigated the effect of dentures on pharyngeal swallowing function in patients with dysphagia.
Older inpatients with dysphagia who used well-fitting dentures were included in the study. Videofluoroscopic swallowing study findings with and without dentures were compared. Pharyngeal residue and area as spatial, the distance between the maxilla and mandible, hyoid bone/laryngeal displacement, and upper esophageal sphincter opening as kinematics, oral/pharyngeal transit time as temporal measurements, and patient-reported symptoms were evaluated. The primary outcome was the pharyngeal residue measured using the normalized residue ratio scale. Comparisons were made using the paired t-test, Wilcoxon signed-rank test and Fisher's exact test.
The mean age of the 27 participants was 86.1 ± 6.8 years. The vallecular residue was more in those without dentures (with dentures: 0.01 [0-0.02], without dentures: 0.03 [0-0.08]; P = 0.003). The pyriform sinus residue showed no significant difference. Denture removal significantly increased the pharyngeal area. The distance between the maxilla and mandible decreased in the absence of dentures, and other kinematic measurements showed no significant differences. Oral/pharyngeal transit time was prolonged without dentures.
Morphological changes caused by the removal of dentures led to pharyngeal expansion, which may result in increased vallecular residue. A treatment plan that considers the effect of dentures on pharyngeal swallowing function may provide rehabilitation that is more effective. Geriatr Gerontol Int 2021; 21: 907-912.
义齿对于改善某些无吞咽困难的无牙患者的咀嚼和口咽吞咽功能起着重要作用。然而,关于吞咽困难患者的研究甚少。本研究旨在探讨义齿对吞咽困难患者咽吞咽功能的影响。
纳入使用合适义齿的吞咽困难老年住院患者,比较有无义齿时的视频透视吞咽研究结果。评估咽残留和面积(空间)、上下颌骨之间的距离、舌骨/喉位移、食管上括约肌开放(运动学)、口腔/咽部通过时间(时间)和患者报告的症状。主要结局指标是使用标准化残留比量表测量的咽残留。使用配对 t 检验、Wilcoxon 符号秩检验和 Fisher 确切检验进行比较。
27 名参与者的平均年龄为 86.1±6.8 岁。无义齿时会有更多的会厌谷残留(有义齿:0.01[0-0.02],无义齿:0.03[0-0.08];P=0.003)。梨状隐窝残留无显著差异。义齿去除后咽腔面积明显增大。无义齿时上下颌骨之间的距离减小,其他运动学测量无显著差异。无义齿时口腔/咽部通过时间延长。
义齿去除引起的形态学变化导致咽腔扩张,可能导致会厌谷残留增加。考虑义齿对咽吞咽功能的影响的治疗计划可能提供更有效的康复治疗。