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环甲肌功能障碍:一种从诊断到治疗都定义不清的疾病。

Cricopharyngeus muscle dysfunction: a poorly defined disorder from diagnosis to treatment.

机构信息

Department of Otolaryngology-Head & Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, USA.

Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, USA.

出版信息

Eur Arch Otorhinolaryngol. 2024 Sep;281(9):4519-4527. doi: 10.1007/s00405-024-08644-7. Epub 2024 May 7.

Abstract

PURPOSE

Cricopharyngeus muscle dysfunction (CPMD) is a common clinical occurrence with very few clear diagnostic criteria and multiple pathways for treatment. Incidence of CPMD is not known, but some data suggest around 25% of people with dysphagia experience some degree of CPMD, which negatively impacts swallowing safety and efficiency. Workup and treatment of CPMD can require multidisciplinary collaboration across laryngologists, speech-language pathologists with training in dysphagia management, and gastroenterologists. The purpose of this paper is to review what is known about CPMD and identify areas of future research in CPMD diagnosis and treatment.

METHODS

An overview of CPMD, relative treatments and disorders, and a discussion of future areas of research needed to improve clinical care of CPMD.

RESULTS

Details regarding historical background, pathophysiology and treatment practiced for CPMD are included.

CONCLUSION

In summary, CPMD is a poorly defined disease due to a lack of understanding of its pathophysiology and the lack of consensus diagnostic criteria. Well-designed, prospective clinical trials are necessary to develop a better understanding of clinical incidence of CPMD, impact of the disorder on oropharyngeal swallowing, and how to approach treatment of the disorder surgically or in conjunction with therapy directed by a specialized speech-language pathologist.

摘要

目的

环咽肌功能障碍(CPMD)是一种常见的临床病症,其诊断标准不明确,治疗方法也多种多样。CPMD 的发病率尚不清楚,但有数据表明,约 25%的吞咽困难患者存在不同程度的 CPMD,这会对吞咽安全性和效率产生负面影响。CPMD 的检查和治疗可能需要多学科协作,包括喉科医生、接受过吞咽障碍管理培训的言语语言病理学家和胃肠病学家。本文旨在回顾 CPMD 的已知情况,并确定 CPMD 诊断和治疗的未来研究领域。

方法

对 CPMD、相关治疗和疾病进行概述,并讨论未来需要研究的领域,以改善 CPMD 的临床护理。

结果

本文介绍了 CPMD 的历史背景、发病机制和治疗方法的细节。

结论

总之,CPMD 是一种定义不明确的疾病,这是由于对其发病机制缺乏了解以及缺乏共识性的诊断标准。有必要设计良好的前瞻性临床试验,以更好地了解 CPMD 的临床发病率、该疾病对口咽吞咽的影响,以及如何通过手术或联合由专业言语语言病理学家指导的治疗来治疗该疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ea7/11392966/5942e47297e2/405_2024_8644_Fig1_HTML.jpg

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