Sundgren P, Maly P, Gullberg B
Department of Diagnostic Radiology, University of Lund, Malmö General Hospital, Sweden.
Br J Radiol. 1993 Sep;66(789):768-72. doi: 10.1259/0007-1285-66-789-768.
The relationship between bolus volume (2.5, 5, 10 and 20 ml) and larynx elevation during swallowing was assessed in 10 non-dysphagic and 10 dysphagic individuals without pharyngeal dysfunction. Laryngeal elevation in different types of pharyngeal dysfunction was assessed in 60 non-dysphagic and 75 dysphagic patients. All subjects were examined with liquid barium and cineradiography at 50 frames/s. The laryngeal elevation was measured at the moment when the bolus reached the level of the valleculae and at maximum elevation. Elevation of the larynx, both the initial and maximal, was not influenced by sex, age or presence of dysphagia. Elevation of the larynx at the moment when the bolus reached the valleculae, when expressed in per cent of maximum elevation, was lower with 10 and 20 ml bolus volumes compared with 2.5 ml bolus volume (p < 0.05) in the 10 dysphagic individuals. Pharyngeal dysfunction was associated with significantly lower initial elevation of the larynx, at the moment when the bolus reached the level of the valleculae, although the maximal laryngeal elevation was normal. Initial elevation was 30% lower (p = 0.03) in patients with aspiration of bolus material into the trachea, 22% lower (p = 0.007) in those with defective closure of the laryngeal vestibule without aspiration and 16% lower (p = 0.06) in those with incoordination of the cricopharyngeal muscle compared with patients without dysfunction.
在10名无吞咽困难和10名有吞咽困难但无咽部功能障碍的个体中，评估了吞咽时推注量（2.5、5、10和20毫升）与喉提升之间的关系。在60名无吞咽困难和75名有吞咽困难的患者中，评估了不同类型咽部功能障碍时的喉提升情况。所有受试者均采用液体钡剂和每秒50帧的电影放射摄影进行检查。在推注到达会厌谷水平时和最大提升时测量喉提升。喉的初始和最大提升不受性别、年龄或吞咽困难的影响。在10名有吞咽困难的个体中，当推注到达会厌谷时的喉提升，以最大提升的百分比表示，与2.5毫升推注量相比，10毫升和20毫升推注量时较低（p<0.05）。咽部功能障碍与推注到达会厌谷水平时喉的初始提升显著降低有关，尽管喉的最大提升正常。与无功能障碍的患者相比，有推注物质误吸入气管的患者初始提升低30%（p = 0.03），有喉前庭关闭不全但无误吸的患者低22%（p = 0.007），有环咽肌不协调的患者低16%（p = 0.06）。
