Ekberg O
Acta Radiol Diagn (Stockh). 1986 Nov-Dec;27(6):691-6. doi: 10.1177/028418518602700612.
Closure of the laryngeal vestibule during swallowing is important for protection of the airways. The present investigation included 53 patients with dysphagia examined cineradiographically with the head held in resting posture, flexion and extension. The ability to protect the airways by the downward movement of the epiglottis and by obliteration of the laryngeal vestibule was studied in different postures of the head. Of 35 patients with normal laryngeal obliteration with the head in resting position 10 showed a defective closure at swallowing in extension. In 18 patients with defective closure of the laryngeal vestibule in resting position 9 were improved on flexion and two on extension of the head. In one patient with defective closure of the laryngeal vestibule in resting position swallowing in flexion showed an aggravated dysfunction. In four other patients the defective closure became more marked on extension. Four patients had less effective downward movement of the epiglottis with the head in extension. Of 10 patients with defective epiglottic movement with the head in resting position two were improved on tilting the head forwards. The results show that the position of the head influences the closure of the airways during swallowing. Patients with defective protection of the laryngeal vestibule should be instructed to swallow with the head tilted forwards.
吞咽过程中喉前庭的关闭对于气道保护至关重要。本研究纳入了53例吞咽困难患者，在头部处于静息姿势、前屈和后伸位时进行了动态X线造影检查。研究了在头部不同姿势下，会厌向下运动及喉前庭闭塞对气道的保护能力。在35例头部处于静息位时喉闭塞正常的患者中，10例在后伸位吞咽时出现关闭缺陷。在18例静息位喉前庭关闭缺陷的患者中，9例在头部前屈时改善，2例在头部后伸时改善。1例静息位喉前庭关闭缺陷的患者，前屈位吞咽时功能障碍加重。另外4例患者在后伸时关闭缺陷更明显。10例静息位会厌运动缺陷的患者中，2例头部前倾时改善。结果表明，头部位置会影响吞咽时气道的关闭。喉前庭保护功能缺陷的患者应接受指导，头部前倾时吞咽。
