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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Patterns of swallowing failure following medialization in unilateral vocal fold immobility.
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Patterns of swallowing failure following medialization in unilateral vocal fold immobility.

机译：吞咽失败的模式，在单侧声带固定不动中发生。

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摘要

OBJECTIVE To quantify the incidence of penetration and aspiration following medialization for unilateral vocal cord immobility (UVCI) and determine patterns of failure.STUDY DESIGN Blinded analysis consecutive case series.METHODS Prospective blinded analysis of videofluoroscopic swallowing studies of patients who had received a medialization procedure was conducted, determining the incidence of penetration and aspiration by using the Penetration-Aspiration Scale. Pharyngeal transport measures were also assessed. Associations between clinical factors and penetration-aspiration were statistically determined.RESULTS Sixty-seven videofluoroscopic swallowing studies were reviewed in patients (mean age, 63.3 y) who had undergone vocal fold medialization (14 laryngoplasties and 53 vocal cord injections) for UVCI. Unilateral vocal cord immobility was left-sided in 56 patients (83.6%), and 50 patients (74.6%) had a postsurgical etiologic factor for their immobility. Thirty (44.8%) and 16 (23.9%) patients demonstrated penetration and aspiration, respectively. Penetration most often occurred during the swallow, but aspiration was equally likely to occur during or after the swallow. No differences in the incidence of penetration or aspiration were noted according to the side of vocal fold paralysis ( =.20, chi test) or etiologic factor ( =.69). Further analysis found that swallow factors significantly associated with penetration and aspiration were swallow delay ( =.001, Wilcoxon ranked pairs test) and reduced laryngeal elevation ( =.001), as well as bolus residues in the valleculae ( =.002), piriform sinus ( =.001), or posterior pharynx ( =.008).CONCLUSIONS Many patients demonstrate significant radiographic aspiration even after medialization procedures for UVCI. Although glottal incompetence is a known risk factor for aspiration, other factors including pharyngeal bolus transport are important in determining an effective swallow in UVCI.
机译：目的量化单侧声带固定（UVCI）介入治疗后穿透和误吸的发生率并确定失败的方式。研究设计盲法分析连续病例系列。方法对接受介入治疗的患者进行的荧光透视吞咽研究的前瞻性盲法分析是进行，使用渗透-吸入量表确定渗透和吸入的发生率。还评估了咽部运输措施。结果确定了67例视频透视吞咽研究，这些患者接受UVCI声带介导（14例喉成形术和53例声带注射术）的吞咽研究（平均年龄63.3岁）。单侧声带固定不动的患者为56例（83.6％），而50例（74.6％）的患者有术后病因。分别有30例（44.8％）和16例（23.9％）病人表现出穿透力和误吸。渗透最常发生在吞咽过程中，但在吞咽过程中或吞咽后也有可能发生误吸。根据声带麻痹的一侧（= .20，卡氏检验）或病因（= .69），未观察到穿透或误吸的发生率差异。进一步的分析发现，吞咽延迟与吞咽延迟（= .001，Wilcoxon分级配对检验）和降低的喉咙抬高（= .001）以及在瓣膜中的推注物残留（= .002），梨状肌等与吞入和吸入显着相关的吞咽因素有关。结论：鼻窦（= .001）或咽后部（= .008）。结论即使对UVCI进行了介入治疗，许多患者仍表现出显着的影像学检查。尽管声门功能不全是已知的吸入危险因素，但其他因素（包括咽部推丸运输）对于确定有效吞咽UVCI至关重要。

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