Cook I J
University of New South Wales and Department of Gastroenterology, St. George Hospital, Sydney, Australia.
Dig Dis. 1998 May-Jun;16(3):125-33. doi: 10.1159/000016856.
Oral-pharyngeal dysphagia is a common problem with a high morbidity and mortality. In general, it is not managed as well as esophageal dysphagia by gastroenterologists. A number of techniques are now available for the assessment of oral-pharyngeal dysphagia. However, a careful clinical assessment followed by a video barium swallow is all that is required for the diagnosis and management in the majority of patients. Pharyngeal manometry is likely to play an increasingly important role in the assessment of difficult or atypical cases in whom it can provide functional information not achievable with videoradiography alone. Videolaryngoscopy is a quick and simple way of detecting structural lesions and of assessing deglutitive airway protection. Videolaryngoscopy is non-invasive and easily performed in an office setting. Ultrasonography is a convenient way of assessing lingual function, but provides no more information than the video barium swallow. Pharyngeal scintigraphy is likely to assume a greater clinical relevance as a means of quantifying swallow efficiency and response to therapy.
口咽吞咽困难是一个常见问题，发病率和死亡率都很高。一般来说，胃肠病学家对其处理不如食管吞咽困难那样有效。现在有多种技术可用于评估口咽吞咽困难。然而，对于大多数患者的诊断和管理而言，仔细的临床评估后进行视频吞钡检查就足够了。咽测压法在评估困难或非典型病例时可能会发挥越来越重要的作用，因为它可以提供仅靠视频放射成像无法获得的功能信息。电子喉镜检查是检测结构病变和评估吞咽时气道保护的快速简便方法。电子喉镜检查是非侵入性的，在门诊环境中易于进行。超声检查是评估舌功能的便捷方法，但提供的信息并不比视频吞钡检查更多。咽闪烁扫描作为一种量化吞咽效率和评估治疗反应的手段，可能会具有更大的临床意义。
