Department of Clinical Speech and Language Studies, Trinity College Dublin, Dublin, Ireland.
Dysphagia. 2022 Dec;37(6):1697-1714. doi: 10.1007/s00455-022-10418-4. Epub 2022 Mar 2.
There has been a recent shift towards proactive dysphagia intervention in motor neurone disease (MND) to maintain physiological reserve. Pharyngeal high-resolution manometry (PHRM) can quantify swallowing pathophysiology to inform and evaluate proactive dysphagia intervention. This study aims to explore the current use of PHRM as a dysphagia evaluation in adults with MND. A scoping review based on the Joanna Briggs Framework was completed. Four electronic databases (PubMed, EMBASE, CINAHL and Web of Science core) were searched (inception to March 2021) by two independent researchers. Data were analysed according to (i) PHRM protocol and analysis methods and the feasibility of same, (ii) swallow biomechanics data and (iii) dysphagia intervention effects as measured by PHRM. Six studies with 78 people with MND (PwMND) were included. There was considerable variation in PHRM protocol and analysis methods. Five studies reported a 100% completion rate and three studies reported no adverse events. Swallow biomechanics data were reported across all studies. The effects of sensory stimulation, increased bolus consistency, effortful swallow and cricopharyngeal myotomy were evaluated using PHRM with 20 PwMND across four studies with varying effects. Literature on the use of PHRM in PwMND is limited. Variability in PHRM methods restricts comparison of metrics. PHRM appears to be a feasible tool for PwMND. PHRM can provide novel swallow physiology data in PwMND and quantify discrete effects of compensatory and surgical dysphagia interventions not detectable by videofluoroscopy or FEES. Further research on the effects of proactive dysphagia intervention as measured by PHRM is required.
最近，人们开始积极干预肌萎缩侧索硬化症（MND）患者的吞咽问题，以维持其生理储备。高分辨率咽测压（PHRM）可定量分析吞咽生理病理，为主动干预吞咽障碍提供依据和评估。本研究旨在探讨 PHRM 作为 MND 成人吞咽障碍评估手段的应用现状。研究采用乔安娜·布里格斯循证卫生保健系统综述方法。两名独立研究员于 2021 年 3 月前分别在 PubMed、EMBASE、CINAHL 和 Web of Science 核心数据库中进行检索。研究结果根据（i）PHRM 方案及分析方法的可行性，（ii）吞咽生物力学数据，（iii）PHRM 测量的吞咽障碍干预效果进行分析。共纳入 6 项研究，涉及 78 例 MND 患者（PwMND）。PHRM 方案及分析方法差异较大。5 项研究报告的完成率为 100%，3 项研究报告无不良事件。所有研究均报告了吞咽生物力学数据。4 项研究中共有 20 例 PwMND 接受了感觉刺激、增加食团稠度、努力吞咽和环咽肌切开术等干预，并用 PHRM 评估其效果，结果各有不同。目前有关 PHRM 在 PwMND 中应用的文献有限，方法的多样性限制了指标的比较。PHRM 似乎是一种可行的 PwMND 评估工具。PHRM 可为 PwMND 提供新的吞咽生理学数据，并定量分析视频透视或纤维内镜吞咽功能检查无法检测到的代偿性和手术性吞咽障碍干预措施的离散效果。需要进一步研究 PHRM 测量的主动干预吞咽障碍的效果。
