Kahrilas P J, Logemann J A
Department of Medicine, Northwestern University, Chicago, Illinois.
Dysphagia. 1993;8(3):259-65. doi: 10.1007/BF01354548.
Bolus volume is an important modifier of the biomechanical events of the oropharyngeal swallow. The biomechanical events comprising a swallow can be divided into events associated with the reconfiguration of the pharynx into a swallow pathway and events associated with bolus transport from the oropharynx into the esophagus. Volume modification is achieved differently for the events of reconfiguration and propulsion. In the case of reconfiguration, a longer time is allocated to the process, as exemplified by sustained laryngeal elevation and hyoid excursion during larger volume swallows. On the other hand, in the case of bolus expulsion, volume accommodation is accomplished within the same period of time by utilizing increased vigor of expulsion. The result of deglutitive volume accommodation is a remarkably different fluoroscopic appearance of a small vs. a large volume swallow. The larger volume swallow seemingly takes longer and results in much more vigorous bolus expulsion than a small volume. However, this is more related to the bolus than the swallow.
团块体积是口咽吞咽生物力学事件的一个重要调节因素。构成一次吞咽的生物力学事件可分为与咽重新配置成吞咽通道相关的事件以及与团块从口咽输送到食管相关的事件。对于重新配置和推进事件，体积调节的实现方式不同。在重新配置的情况下，该过程会分配更长的时间，例如在吞咽较大体积时喉持续抬高和舌骨偏移所体现的那样。另一方面，在团块排出的情况下，通过增加排出力度在相同时间内完成体积调节。吞咽时体积调节的结果是小体积吞咽和大体积吞咽在荧光透视下呈现出明显不同的表现。大体积吞咽似乎花费的时间更长，并且导致团块排出比小体积吞咽更有力。然而，这更多地与团块而非吞咽本身有关。
