Lindbichler F, Raith J, Uggowitzer M, Hausegger K
Department of Radiology, University Hospital Graz, Austria.
AJR Am J Roentgenol. 1998 Jan;170(1):129-32. doi: 10.2214/ajr.170.1.9423616.
This study was performed to evaluate the frequency of postdeglutitive aspiration in lateral hypopharyngeal pouches and to correlate postdeglutitive aspiration to pouch size and dynamics.
Two radiologists retrospectively analyzed 325 videofluorography examinations of patients swallowing. The 325 patients were 22-81 years old, 173 men and 152 women. Patients who had undergone surgery of the hypopharynx were excluded from the study. All pouches found on videofluorography were classified into grade I, II, or III. Because iodinated contrast agent had been used initially, patients who had no or minimal aspiration underwent a second imaging examination using high-density barium.
Of the 325 patients, 118 had lateral hypopharyngeal pouches: 77 bilateral and 41 unilateral. Postdeglutitive aspiration was diagnosed in 14 (56%) of the 25 grade III pouches and in two (3%) ot the 58 grade II pouches. Aspiration was not seen in any of the 112 grade I pouches.
The prevalence of postdeglutitive aspiration is high in patients who have grade III pouches. To date, no appropriate conservative treatment has been described; however, in severe cases surgery is warranted.
本研究旨在评估下咽外侧憩室吞咽后误吸的发生率，并将吞咽后误吸与憩室大小及动态变化相关联。
两名放射科医生回顾性分析了325例患者吞咽的视频荧光造影检查。325例患者年龄在22 - 81岁之间，男性173例，女性152例。接受过下咽手术的患者被排除在研究之外。所有在视频荧光造影中发现的憩室均被分为I级、II级或III级。由于最初使用了碘化造影剂，无或仅有微量误吸的患者使用高密度钡剂进行了第二次成像检查。
在325例患者中，118例有下咽外侧憩室：双侧77例，单侧41例。25个III级憩室中有14个（56%）诊断为吞咽后误吸，58个II级憩室中有2个（3%）诊断为吞咽后误吸。112个I级憩室中均未发现误吸。
III级憩室患者吞咽后误吸的发生率较高。迄今为止，尚未描述适当的保守治疗方法；然而，在严重情况下手术是必要的。
