Angle Orthod. 2023 Sep 1;93(5):552-557. doi: 10.2319/101222-703.1.
To evaluate swallowing function in relation to oropharyngeal dysphagia (OD) in adolescents who had transverse maxillary deficiency with posterior crossbite and high-arched palate, before, and after rapid maxillary expansion (RME).
Twenty patients (mean age: 13.0 ± 3.1) with bilateral posterior crossbite and high-arched palate (RME group: RMEG) and 20 volunteers (mean age: 13.4 ± 2.6) with Class I crowding without posterior crossbite or high-arched palate (control group: CG) were recruited. OD signs and symptoms were evaluated using the Eating Assessment Tool-10 (EAT-10) questionnaire, patient complaints, and physical examination of swallowing function before (T1) and 7 months after (T2) RME. Additionally, fiberoptic endoscopic evaluation of swallowing (FEES) with water, yogurt, and cracker was performed. In CG, evaluation of swallowing was performed only once, corresponding to T1 of RMEG.
Prevalence of OD signs and symptoms based on patient complaints and physical examination of swallowing was low (5%-15%), and nonsignificant differences were observed between CG and RMEG at T1 for these parameters as well as for EAT-10 scores. Total post-swallow pharyngeal residue with yogurt was significantly different between CG and RMEG at T1, with a prevalence of 60% in RMEG (P < .05). There was no significant difference regarding residue with yogurt between T1 and T2 in RMEG (P > .05).
Patients with a maxillary transverse deficiency were affected by pharyngeal residue as indicated by FEES, but it did not appear to improve in short-term follow-up in patients treated with RME.
评估患有上颌横向发育不足伴后牙反颌和高拱形腭的青少年的吞咽功能与口咽性吞咽困难(OD)之间的关系,在快速上颌扩张(RME)前后。
招募了 20 名(平均年龄:13.0 ± 3.1)双侧后牙反颌和高拱形腭的患者(RME 组:RMEG)和 20 名(平均年龄:13.4 ± 2.6)无后牙反颌或高拱形腭的 Class I 拥挤患者(对照组:CG)。使用饮食评估工具-10(EAT-10)问卷、患者主诉和吞咽功能的体格检查评估 OD 体征和症状,在 RME 前(T1)和 7 个月后(T2)进行。此外,还进行了纤维内镜吞咽评估(FEES),使用水、酸奶和饼干。在 CG 中,吞咽评估仅进行一次,对应于 RMEG 的 T1。
基于患者主诉和吞咽功能体格检查的 OD 体征和症状的患病率较低(5%-15%),在这些参数和 EAT-10 评分方面,CG 和 RMEG 在 T1 时无显著差异。与 CG 相比,RMEG 在用酸奶进行总吞咽后咽部残留量在 T1 时差异有统计学意义,RMEG 组的患病率为 60%(P <.05)。RMEG 中 T1 和 T2 之间酸奶残留量无显著差异(P >.05)。
上颌横向发育不足的患者通过 FEES 表现为咽部残留,但在接受 RME 治疗的患者中,在短期随访中似乎没有改善。