Department of Physical Medicine and Rehabilitation, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, 22 Gwanpyeong-ro 170 Beon-gil Dongan-gu, Anyang, Gyeonggi-do, 14068, Republic of Korea.
Dysphagia. 2024 Jun;39(3):468-475. doi: 10.1007/s00455-023-10631-9. Epub 2023 Oct 30.
Pharyngeal muscle changes occur in patients with Parkinson's disease and related disorders (PRD); however, the association between the structural alterations in the pharynx and the symptoms of dysphagia remains unclear. We assessed structural changes and contractile forces by measuring pharyngeal wall thickness and width. We aimed to define the pharyngeal measurements and determine their value as diagnostic tools for dysphagia. The pharyngeal wall thickness (PWT), pharyngeal width at rest (PWR), and shortest pharyngeal width at swallowing (PWS) were measured using lateral neck roentgenograms and videofluoroscopic swallowing study. We compared the PWR and PWT between the PRD and control groups using an independent t-test. The Kendall correlation test was performed on the radiological data of the pharynx (PWT, PWR and PWS), dysphagia scales (Penetration-Aspiration scale [PAS] and Dysphagia Outcome and Severity Scale [DOSS]), and Hoehn and Yahr scale (HY scale). The PWT was smaller and the PWR greater in the PRD than in the control group (p < 0.05). The dysphagia scales (PAS and DOSS) were correlated with the radiological data (PWT and PWS) and the HY scale (p < 0.05). The HY scale score also correlated with the PWT (p < 0.05). The optimal cutoff points of the PWT and PWR for predicting aspiration were 4.05 and 16.05 mm in the PRD group, respectively. Using the PWT, PWR and PWS, muscle atrophy and contractile strength of the pharynx can be estimated. The combination of the PWT and PWR can be a simple indicator for predicting swallowing disorders at the bedside.
咽肌无力改变发生于帕金森病和相关疾病（PRD）患者中；然而，咽结构改变与吞咽困难症状之间的关系仍不清楚。我们通过测量咽壁厚度和宽度来评估结构变化和收缩力。我们旨在定义咽测量值，并确定其作为吞咽困难诊断工具的价值。使用侧颈部射线照相和视频荧光透视吞咽研究测量咽壁厚度（PWT）、静止时的咽宽度（PWR）和吞咽时最短的咽宽度（PWS）。我们使用独立 t 检验比较了 PRD 组和对照组的 PWR 和 PWT。对咽的放射学数据（PWT、PWR 和 PWS）、吞咽困难量表（渗透-吸入量表 [PAS] 和吞咽困难结局和严重程度量表 [DOSS]）和 Hoehn 和 Yahr 量表（HY 量表）进行 Kendall 相关检验。PWT 在 PRD 组中小于对照组，而 PWR 则大于对照组（p < 0.05）。吞咽困难量表（PAS 和 DOSS）与放射学数据（PWT 和 PWS）和 HY 量表相关（p < 0.05）。HY 量表评分也与 PWT 相关（p < 0.05）。PRD 组中预测吸入的 PWT 和 PWR 的最佳截断点分别为 4.05 和 16.05 mm。使用 PWT、PWR 和 PWS，可以估计咽的肌肉萎缩和收缩力。PWT 和 PWR 的组合可以成为床边预测吞咽障碍的简单指标。
