Bayona Howell Henrian, Inamoto Yoko, Saitoh Eiichi, Aihara Keiko, Shibata Seiko, Otaka Yohei
Graduate School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan.
Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Aichi, Japan.
Dysphagia. 2025 Jul 16. doi: 10.1007/s00455-025-10855-x.
This study aimed to establish reference values for quantitative measurements of pharyngeal volume and residue during swallowing in healthy individuals and to examine how these measurements are influenced by age, sex, height, and bolus properties. We performed a retrospective analysis of 288 swallows from 135 healthy Japanese adults (median age, 43 years; height, 163 cm) who underwent Swallowing CT. Test boluses included thin or extremely thick liquids in either 3 mL, 10 mL, or 20 mL amounts. Pharyngeal cavity volume at bolus hold (PVHOLD), unobliterated air and bolus volume at maximum pharyngeal constriction (PVMAX), and pharyngeal volume constriction ratio (PVCR), and post-swallow pharyngeal residue were measured on dynamic 3D-CT images using a semi-automated software. We determined the 2.5th, 50th, 97.5th percentile values to obtain normative reference values for each parameter and made generalized linear regression models to determine how these volume measurements are associated with demographic factors and bolus properties. Normative values (median [97.5th percentile]) across all swallows were PVHOLD 20.9 cm [38.6 cm], PVMAX 0.3 cm [2.1 cm], PVCR 98.8% [2.5th percentile 89.1%], and residue 0 cm [0.4 cm]. Males exhibited larger values than females. PVHOLD significantly increased with height (β = 0.465, p < 0.001) and age (β = 0.068, p = 0.001), while PVMAX and PVCR increased with larger bolus volumes (β = 0.293, p = 0.005) and in thicker consistencies (β = 0.376, p = 0.017). Pharyngeal residue was present in 98/288 (34.0%) of swallows and was significantly associated with increasing bolus volume (adjusted odds ratio [aOR] = 1.865 [95% confidence interval: 1.275-2.727]), age (aOR = 1.025 [1.010-1.040]), thicker bolus (aOR = 1.806 [1.275-2.727]). Each 1 cm increase in PVMAX was associated with nearly double the odds of residue (aOR = 1.86 [1.202-2.862]). Similarly, each 1% decrease in PVCR corresponded to a 10.6% increase in the odds of residue (aOR = 1.106 [1.015-1.295]). These normative data provide a bases for comparing individuals with or without pharyngeal impairments.
本研究旨在建立健康个体吞咽过程中咽部容积和残留物定量测量的参考值，并研究这些测量值如何受到年龄、性别、身高和食团特性的影响。我们对135名健康日本成年人（中位年龄43岁；身高163厘米）进行的吞咽CT检查中的288次吞咽进行了回顾性分析。测试食团包括3毫升、10毫升或20毫升的稀液或极稠液体。使用半自动软件在动态3D-CT图像上测量食团停留时的咽腔容积（PVHOLD）、最大咽缩窄时未消失的空气和食团容积（PVMAX）、咽容积缩窄率（PVCR）以及吞咽后咽部残留物。我们确定了第2.5、50、97.5百分位数的值，以获得每个参数的标准参考值，并建立广义线性回归模型，以确定这些容积测量值与人口统计学因素和食团特性之间的关联。所有吞咽的标准值（中位数[第97.5百分位数]）为PVHOLD 20.9厘米[38.6厘米]、PVMAX 0.3厘米[2.1厘米]、PVCR 98.8%[第2.5百分位数89.1%]和残留物0厘米[0.4厘米]。男性的值高于女性。PVHOLD随身高（β = 0.465，p < 0.001）和年龄（β = 0.068，p = 0.001）显著增加，而PVMAX和PVCR随食团体积增大（β = 0.293，p = 0.005）和浓度增加（β = 0.376，p = 0.017）而增加。288次吞咽中有98次（34.0%）出现咽部残留物，且与食团体积增加（调整优势比[aOR]=1.865[95%置信区间：1.275 - 2.727]）、年龄（aOR = 1.025[1.010 - 1.040]）、较稠食团（aOR = 1.806[1.275 - 2.727]）显著相关。PVMAX每增加1厘米，残留物的几率几乎增加一倍（aOR = 1.86[1.202 - 2.862]）。同样，PVCR每降低1%，残留物的几率增加10.6%（aOR = 1.106[1.015 - 1.295]）。这些标准数据为比较有无咽部损伤的个体提供了依据。
