Suppr超能文献

推进喉内收肌反射测试超越感觉阈检测。

Advancing Laryngeal Adductor Reflex Testing Beyond Sensory Threshold Detection.

机构信息

Department of Otolaryngology - Head and Neck Surgery, University of Missouri School of Medicine, One Hospital Dr. MA314, Columbia, MO, 65212, USA.

Electrical Engineering and Computer Science, University of Missouri, Columbia, MO, USA.

出版信息

Dysphagia. 2022 Oct;37(5):1151-1171. doi: 10.1007/s00455-021-10374-5. Epub 2021 Oct 22.

Abstract

Flexible endoscopic evaluation of swallowing with sensory testing (FEESST) is a promising clinical tool to assess airway integrity via the laryngeal adductor reflex (LAR). The current clinical protocol relies on sensory threshold detection, as relatively little is known about the motor response of this sensorimotor airway protective reflex. Here, we focused on characterizing normative LAR motion dynamics in 20 healthy young participants using our prototype high-pressure syringe-based air pulse device and analytic software (VFtrack™) that tracks vocal fold (VF) motion in endoscopic videos. Following device bench testing for air pulse stimulus characterization, we evoked and objectively quantified LAR motion dynamics in response to two suprathreshold air pulse stimuli (40 versus 60 mm Hg), delivered to the arytenoid mucosa through a bronchoscope working channel. The higher air pressures generated by our device permitted an approximate 1 cm endoscope working distance for continual visualization of the bilateral VFs throughout the LAR. Post hoc video analysis identified two main findings: (1) there are variant and invariant subcomponents of the LAR motor response, and (2) only a fraction of suprathreshold stimuli evoked complete glottic closure during the LAR. While the clinical relevance of these findings remains to be determined, we have nonetheless demonstrated untapped potential in the current FEESST protocol. Our ongoing efforts may reveal LAR biomarkers to quantify the severity of laryngeal pathology and change over time with natural disease progression, spontaneous recovery, or in response to intervention. The ultimate goal is to facilitate predictive modeling of patients at high risk for dysphagia-related aspiration pneumonia.

摘要

采用感觉测试的灵活内镜吞咽评估(FEESST)是一种有前途的临床工具,可通过喉内收反射(LAR)评估气道完整性。目前的临床方案依赖于感觉阈值检测,因为对这种感觉运动性气道保护反射的运动反应相对知之甚少。在这里,我们使用我们的原型高压注射器空气脉冲装置和分析软件(VFtrack™)专注于对 20 名健康年轻参与者的正常 LAR 运动动力学进行特征描述,该软件可在内镜视频中跟踪声带(VF)运动。在对空气脉冲刺激特征进行设备基准测试后,我们通过支气管镜工作通道向杓状软骨黏膜发出并客观地量化了对两个超阈值空气脉冲刺激(40 与 60mmHg)的 LAR 运动动力学。我们的设备产生的较高空气压力允许内窥镜工作距离约为 1cm,以便在 LAR 期间持续观察双侧 VF。事后视频分析确定了两个主要发现:(1)LAR 运动反应存在可变性和不变性亚成分;(2)只有一部分超阈值刺激在 LAR 期间引起完全声门关闭。虽然这些发现的临床意义仍有待确定,但我们已经在当前的 FEESST 方案中展示了未开发的潜力。我们正在进行的努力可能会揭示 LAR 生物标志物,以量化喉病理的严重程度,并随着自然疾病进展、自发恢复或对干预的反应而随时间变化。最终目标是促进对有吞咽相关吸入性肺炎风险的患者进行预测建模。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验