McConnel F M, Mendelsohn M S, Logemann J A
Head Neck Surg. 1987 Jan-Feb;9(3):142-50. doi: 10.1002/hed.2890090303.
Manofluorography (mano: manometry, fluoro: videofluoroscopy, graphy: picture) provides a simultaneous display of manometry and fluoroscopy on one video screen. This study uses manofluorography to analyze the swallowing patterns of nine patients who had undergone supraglottic laryngectomy. The results show that during swallowing the pharyngeal mechanism for preventing aspiration depends upon three processes: (1) tight lingual-laryngeal contact, (2) coordination of the swallowing reflex, and (3) tongue base and pharyngeal constrictor clearing of the hypopharynx and laryngeal inlet. Anterior suspension of the larynx under the tongue base serves to improve lingual-laryngeal contact. This close contact during deglutition protects the airway from the bolus and also opens the postcricoid region, aiding bolus passage into the esophagus. Impairment of the swallowing reflex, which can cause severe aspiration before the swallowing reflex is triggered, can be rehabilitated by swallowing therapy. Minor aspiration is commonly caused by impaired clearing of the superior hypopharynx after supraglottic laryngectomy.
食管压力-荧光成像（食管压力测定、荧光：视频荧光透视、成像：图像）可在一个视频屏幕上同时显示食管压力测定和荧光透视结果。本研究采用食管压力-荧光成像分析9例接受声门上喉切除术患者的吞咽模式。结果显示，吞咽过程中防止误吸的咽部机制取决于三个过程：（1）舌-喉紧密接触；（2）吞咽反射的协调；（3）舌根和咽缩肌清除下咽和喉入口。舌根下方喉的前悬吊有助于改善舌-喉接触。吞咽时这种紧密接触可保护气道免受食团影响，还可打开环状软骨后区，有助于食团进入食管。吞咽反射受损可导致在吞咽反射触发前出现严重误吸，可通过吞咽治疗恢复。轻微误吸通常由声门上喉切除术后下咽上部清除功能受损引起。
