School of Communication Sciences and Disorders, Faculty of Health, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College St., Halifax, NS, B3M 1N8, Canada.
Central Michigan University, College of Health Professions, 1280 East Campus Dr., Mt. Pleasant, MI, 48859, USA.
Eur Arch Otorhinolaryngol. 2023 Nov;280(11):4979-4985. doi: 10.1007/s00405-023-08114-6. Epub 2023 Jul 7.
The purpose of this study was to determine whether transnasal passage of a flexible endoscope results in changes in salivary flow rate (SFR), spontaneous swallow frequency (SSF), and masticatory efficiency (ME) in healthy adults.
Data were collected from 15 healthy adults, 20-63 years of age. SFR and SSF were measured at baseline, after endoscope insertion, and after endoscope removal. The Test of Masticating and Swallowing Solids was administered at baseline and while the endoscope was in the hypopharynx. A repeated measures ANOVA was used to determine the effect of endoscope insertion on SFR and SSF. A paired samples t-test was used to determine the effect of endoscope insertion on total mastication time and number of masticatory cycles required with a cracker bolus. Statistical significance was set at α = 0.05.
SFR was found to be significantly increased during endoscope placement in the hypopharynx (M = 0.471 g/min, SD = 0.175, p = 0.002) as well as following endoscope removal (M = 0.481 g/min, SD = 0.231, p = 0.004), as compared to baseline (M = 0.310 g/min, SD = 0.130). Total mastication time and number of masticatory cycles required with a cracker bolus were significantly decreased when the endoscope was present in the hypopharynx, as compared to baseline t(14) = 3.054, p = 0.009; t(14) = 3.250, p = 0.006, respectively.
Visualization of swallowing during FEES is an important method for objectively evaluating several anatomical and functional parameters of the pharynx and larynx. Insertion of the endoscope into the hypopharynx during FEES may stimulate salivary secretion and improve ME, which could influence interpretation of FEES and resulting clinical recommendations.
本研究旨在确定经鼻插入柔性内镜是否会改变健康成年人的唾液流量（SFR）、自发吞咽频率（SSF）和咀嚼效率（ME）。
共纳入 15 名 20-63 岁的健康成年人，在基线时、内镜插入后和内镜取出后测量 SFR 和 SSF。在基线时和内镜位于下咽时进行咀嚼和吞咽固体测试。采用重复测量方差分析来确定内镜插入对上 SFR 和 SSF 的影响。采用配对样本 t 检验来确定内镜插入对上咀嚼时间和咀嚼饼干所需的咀嚼周期数的影响。统计学意义设定为α=0.05。
在下咽放置内镜期间（M=0.471g/min，SD=0.175，p=0.002）以及取出内镜后（M=0.481g/min，SD=0.231，p=0.004），SFR 均显著增加，与基线时相比（M=0.310g/min，SD=0.130）。与基线相比，在下咽放置内镜时，咀嚼饼干所需的总咀嚼时间和咀嚼周期数显著减少（t(14)=3.054，p=0.009；t(14)=3.250，p=0.006）。
FEES 期间可视化吞咽是客观评估咽和喉的几个解剖和功能参数的重要方法。FEES 期间将内镜插入下咽可能会刺激唾液分泌并提高 ME，这可能会影响对 FEES 的解释和由此产生的临床建议。
