Shaker R, Ren J, Zamir Z, Sarna A, Liu J, Sui Z
MCW Dysphagia Institute, Medical College of Wisconsin, Milwaukee.
Gastroenterology. 1994 Aug;107(2):396-402. doi: 10.1016/0016-5085(94)90164-3.
BACKGROUND/AIMS: Swallows triggered by direct stimulation of pharyngeal structures may help to prevent aspiration by emptying the pharynx. The aims of this study were to compare the biomechanical events of the pharyngeal and primary swallow, determine the threshold volume of liquid required to trigger the pharyngeal swallows, and determine the effect of aging, position, and temperature on this threshold volume.
Concurrent manometry, video fluoroscopy, and video endoscopy were used to study young and elderly healthy volunteers.
During pharyngeal swallows, in contrast to primary swallows, the free portion of the tongue did not make contact with the hard palate. In addition, pharyngeal swallows did not result in oral bolus clearance. All other biomechanical events, including deglutitive glottal function, were similar in both types of swallows. The threshold volume for pharyngeal swallows in young volunteers was significantly smaller than in the elderly (P < 0.01). Temperature and position did not have significant effects on threshold volume.
Swallowing is readily induced by water stimulation of the pharynx. Pharyngeal swallows do not induce lingual peristalsis or clearance of oral content. The threshold volume of the pharyngeal swallow is significantly higher in the elderly than in the young, but it is not affected by body position or bolus temperature.
背景/目的：直接刺激咽部结构引发的吞咽动作可能通过清空咽部来帮助预防误吸。本研究的目的是比较咽部吞咽和初次吞咽的生物力学事件，确定引发咽部吞咽所需的液体阈值量，并确定年龄、体位和温度对该阈值量的影响。
使用同步测压法、视频荧光透视法和视频内镜检查法对年轻和老年健康志愿者进行研究。
在咽部吞咽过程中，与初次吞咽不同，舌的游离部分未与硬腭接触。此外，咽部吞咽并未导致口腔内食团清除。在两种类型的吞咽中，所有其他生物力学事件，包括吞咽时的声门功能，均相似。年轻志愿者咽部吞咽的阈值量显著小于老年志愿者（P < 0.01）。温度和体位对阈值量无显著影响。
咽部受水刺激很容易诱发吞咽。咽部吞咽不会诱发舌蠕动或清除口腔内容物。咽部吞咽的阈值量在老年人中显著高于年轻人，但不受体位或食团温度的影响。
