Kahrilas P J
Department of Medicine, Northwestern University Medical School, Chicago, IL 60611, USA.
Baillieres Clin Gastroenterol. 1994 Dec;8(4):651-64. doi: 10.1016/0950-3528(94)90017-5.
Oropharyngeal dysphagia is usually either a secondary manifestation of neuromuscular disease or a primary abnormality related to structural aberrations of the oropharynx. In either case, a focused history is essential in defining the malfunction and distinguishing oropharyngeal dysphagia from globus, xerostomia, or oesophageal dysphagia. The functional evaluation of the oropharyngeal swallow is best accomplished by a videofluoroscopic swallowing study which is used to assess efficacy of functional elements within the swallow: nasopharyngeal closure, UOS opening, airway protection, tongue loading, tongue pulsion and pharyngeal clearance. Both diagnosis and therapy of oropharyngeal dysphagia are based on this functional assessment.
口咽吞咽困难通常要么是神经肌肉疾病的继发表现，要么是与口咽结构异常相关的原发性异常。在任何一种情况下，详细的病史对于明确功能障碍以及区分口咽吞咽困难与咽部异物感、口干或食管吞咽困难都至关重要。口咽吞咽功能的评估最好通过视频荧光吞咽造影检查来完成，该检查用于评估吞咽过程中各功能要素的有效性：鼻咽闭合、上食管括约肌开放、气道保护、舌部负载、舌部推动和咽部清除。口咽吞咽困难的诊断和治疗均基于这种功能评估。
