Remacle M, Samain B, Hanson P, Melange M, Laloux P, Swine C
ORL, Cliniques Universitaires UCL de Mont-Godinne, Yvoir.
Acta Otorhinolaryngol Belg. 1994;48(1):45-53.
Pharyngo-oesophageal dyskinesias present a common symptomatology associated with those difficulties in swallowing for which the radio-manometric assessment is well known. Radiology, nevertheless, with an overall analysis of deglutition and its iatrogenic complications, as well as manometry of the superior oesophageal sphincter (OSS) with its diversity of results, according to the material, techniques, age, sex and stress involved, has convinced us of the necessity for a supplementary dynamic examination. Electromyography (EMG), simultaneously by the inferior constrictor (IC) and cricopharyngeal (CP) muscles, analyses with precision the electric activity of these two muscles, as well as the pharyngosphincteral synchronism. It is an easy examination, reproducible and without complications. In less than one year, nineteen patients suffering exclusively from a pharyngo-oesophageal dyskinesia benefited by this complete assessment. The secondary aetiologies are clearly predominant. Gastro-oesophageal reflux represents a quarter of those detected by an anamnesis alone. EMG detects 68% of functional anomaly of the OSS; manometry finds 47% and radiology 32%. Extramucosal myotomy of the OSS concerns incomplete or uncoordinated relaxation, preferentially by left cervical approach. The preliminary results, both clinical and manometric, are very satisfactory.
咽食管运动障碍呈现出一种与吞咽困难相关的常见症状，而放射测压评估对此类吞咽困难是众所周知的。然而，放射学通过对吞咽及其医源性并发症的全面分析，以及对食管上括约肌（OSS）的测压（其结果因所涉及的材料、技术、年龄、性别和压力而异），让我们确信有必要进行补充动态检查。肌电图（EMG）通过同时检测咽下缩肌（IC）和环咽肌（CP）的电活动，精确分析这两块肌肉的电活动以及咽括约肌同步性。这是一项简单的检查，可重复且无并发症。在不到一年的时间里，19例仅患有咽食管运动障碍的患者通过这种全面评估而受益。继发性病因明显占主导地位。胃食管反流仅通过问诊就占所检测病例的四分之一。肌电图检测出68%的食管上括约肌功能异常；测压发现47%，放射学发现32%。食管上括约肌的黏膜外肌切开术适用于不完全或不协调的松弛，优先采用左颈入路。初步的临床和测压结果都非常令人满意。
