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全喉切除男性患者的吞咽运动学

Swallowing Kinematics in Male Patients with Total Laryngectomy.

作者信息

Gölaç Hakan, Aydınlı Fatma E, Dumbak Aydan B, İncebay Önal, Enver Necati, Yapar Dilek, Düzlü Mehmet, Bulut Elif G, Süslü Nilda S, Yılmaz Metin

机构信息

Department of Speech and Language Therapy, Faculty of Health Sciences, Gazi University, Ankara, Türkiye.

Department of Speech and Language Therapy, Faculty of Health Sciences, Hacettepe University, Ankara, Türkiye.

出版信息

Laryngoscope. 2025 Feb;135(2):809-817. doi: 10.1002/lary.31825. Epub 2024 Oct 7.

Abstract

OBJECTIVE

The present study aimed to investigate the symptomatic swallowing complaints in individuals with total laryngectomy (TL) and reveal how swallowing kinematics differs between those with and without symptomatic dysphagia complaints.

METHODS

A total of 34 subjects with TL were included in the study. Swallowing kinematics of those with symptomatic swallowing complaints (Group 1) were compared to those without (Group 2). Kinematic parameters including pharyngeal transit duration (PTD), maximum pharyngeal constriction ratio (MPCR), upper esophageal sphincter opening ratio (UESOR), upper esophageal sphincter opening duration (UESOD), and bolus clearance ratio (BCR) were investigated from Videofluoroscopic Swallowing Study (VFSS) records via ImageJ software.

RESULTS

Symptomatic swallowing complaints were determined in 47.1% of the subjects (n = 16). Difficulty while swallowing solid foods and pills, diminished pleasure of eating, food getting stuck in the throat, and increased level of stress during swallowing were among the major swallowing complaints in the present cohort. PTD, MPCR, and BCR parameters were significantly higher in subjects with symptomatic swallowing complaints than those without.

CONCLUSION

These preliminary findings indicate that almost half of individuals with TL may have symptomatic swallowing complaints. The underlying pathophysiology of this phenomenon may be the devianced kinematic parameters including PTD, MPCR, and BCR in this population. Therefore, it is recommended to include the kinematic measurements in the dysphagia evaluation protocol in individuals with TL, most notably in those with symptomatic swallowing complaints.

LEVEL OF EVIDENCE

3 Laryngoscope, 135:809-817, 2025.

摘要

目的

本研究旨在调查全喉切除术(TL)患者的吞咽症状性主诉,并揭示有症状性吞咽困难主诉和无此主诉的患者之间吞咽运动学的差异。

方法

本研究共纳入34例全喉切除术患者。将有吞咽症状性主诉的患者(第1组)的吞咽运动学与无此主诉的患者(第2组)进行比较。通过ImageJ软件从视频荧光吞咽造影研究(VFSS)记录中调查包括咽部通过时间(PTD)、最大咽部收缩率(MPCR)、食管上括约肌开放率(UESOR)、食管上括约肌开放持续时间(UESOD)和食团清除率(BCR)在内的运动学参数。

结果

47.1%的患者(n = 16)存在吞咽症状性主诉。吞咽固体食物和药丸困难、进食愉悦感降低、食物卡在喉咙以及吞咽时压力增加是本队列中的主要吞咽主诉。有吞咽症状性主诉的患者的PTD、MPCR和BCR参数显著高于无此主诉的患者。

结论

这些初步研究结果表明,几乎一半的全喉切除术患者可能有吞咽症状性主诉。这一现象的潜在病理生理学可能是该人群中包括PTD、MPCR和BCR在内的运动学参数异常。因此,建议在全喉切除术患者的吞咽困难评估方案中纳入运动学测量,尤其是有吞咽症状性主诉的患者。

证据级别

3《喉镜》,135:809 - 817,2025年。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f31f/11725695/c07b2525862e/LARY-135-809-g002.jpg

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