McConnel F M, Mendelsohn M S, Logemann J A
Head Neck Surg. 1986 Sep-Oct;9(1):3-12. doi: 10.1002/hed.2890090103.
Investigation of postlaryngectomy dysphagia is usually limited to the standard barium swallow. Manofluorography (mano, manometry; fluoro, videofluoroscopy; graphy, picture) is a new technique that permits analysis of simultaneous manometry and videofluoroscopy of deglutition. Manofluorography provides more detailed analysis of the swallowing dynamics during the pharyngeal stage of deglutition than either barium studies or manometry used alone. This study uses manofluorography to examine swallowing in two patient groups, total laryngectomees and total laryngectomees with tongue impairment, to analyze the role of various anatomic components in the swallowing process. Pharyngeal transit times were prolonged in both patient groups studied, with the tongue impairment group exhibiting the longest times. The postlaryngectomy pharynx offered greater resistance to bolus flow. The laryngectomy patients compensated by using increased lingual propulsion, whereas the patients with tongue impairment and total laryngectomy could not. This emphasizes the importance of the tongue in bolus propulsion in the pharynx. Other postoperative changes in swallowing are discussed.
喉切除术后吞咽困难的研究通常局限于标准的钡餐吞咽检查。吞咽压力-荧光造影术（mano，测压法；fluoro，视频荧光透视法；graphy，成像法）是一项新技术，它能够同时对吞咽进行测压和视频荧光透视分析。与单独使用钡餐检查或测压法相比，吞咽压力-荧光造影术能更详细地分析吞咽咽部阶段的吞咽动力学。本研究采用吞咽压力-荧光造影术检查两组患者的吞咽情况，即全喉切除患者和伴有舌功能障碍的全喉切除患者，以分析吞咽过程中各种解剖结构的作用。在这两组研究对象中，咽部通过时间均延长，其中舌功能障碍组的时间最长。喉切除术后的咽部对食团流动的阻力更大。喉切除患者通过增加舌部推进力来代偿，而伴有舌功能障碍的喉切除患者则无法做到。这凸显了舌在咽部食团推进中的重要性。文中还讨论了吞咽的其他术后变化。
