Department of Otolaryngology and Head and Neck Surgery, The University of Tokyo, Tokyo, Japan.
Ear Nose Throat Head and Neck Surgery Institute, The Medical City, Pasig, Philippines.
Eur Arch Otorhinolaryngol. 2024 Jun;281(6):2807-2817. doi: 10.1007/s00405-024-08452-z. Epub 2024 Jan 24.
To discuss the different swallowing improvement surgeries that address one or more dysfunctional pharyngolaryngeal structures causing dysphagia. These surgeries reduce the risk of aspiration without sacrificing vocal function.
We searched the PubMed database and used Google Scholar search engine to find studies discussing the different swallowing improvement surgeries. A manual search of references in selected articles and reviews was done as well. No chronologic limitation was set for the studies; however, only articles written in English and Japanese were considered. Due to the nature of this article, no particular inclusion or exclusion criteria were set when searching for studies to be used as references; however, all relevant studies were reviewed and agreed upon by the authors for inclusion in this review article.
RESULTS/DISCUSSION: Surgeries to improve swallowing function can be categorized into those that reinforce nasopharyngeal closure or pharyngeal contraction, improve laryngeal elevation or pharyngoesophageal segment opening, and those that improve vocal fold closure to protect the airway during swallowing. They are an effective alternative treatment that may significantly improve these patients' quality of life. Swallowing rehabilitation with the altered pharyngolaryngeal structures is required post-operatively to significantly improve patients' dysphagia.
Surgeries to improve swallowing function address specific dysfunctional sites involved in the swallowing mechanism. Choosing the most appropriate surgery for each patient requires knowledge of the pathophysiology for their dysphagia and detailed pre-operative work-up.
讨论不同的吞咽改善手术，以解决一个或多个导致吞咽困难的咽-喉结构功能障碍。这些手术可以降低误吸风险，同时不牺牲发声功能。
我们在 PubMed 数据库中进行了检索，并使用 Google Scholar 搜索引擎查找了讨论不同吞咽改善手术的研究。还对选定文章和综述中的参考文献进行了手动搜索。本研究没有设定时间限制；但是，仅考虑了英文和日文的文章。由于本文的性质，在寻找用作参考文献的研究时没有设定特定的纳入或排除标准；但是，作者对所有相关研究进行了审查和同意，纳入了本综述。
结果/讨论：改善吞咽功能的手术可分为加强咽后闭合或咽收缩、改善喉抬高或咽食管段开口、改善声带闭合以在吞咽时保护气道的手术。这些手术是一种有效的替代治疗方法，可以显著提高这些患者的生活质量。术后需要进行吞咽康复训练，以显著改善患者的吞咽困难。
改善吞咽功能的手术针对吞咽机制中涉及的特定功能障碍部位。为每个患者选择最合适的手术需要了解其吞咽困难的病理生理学，并进行详细的术前评估。
