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首页> 外文期刊>American Journal of Physiology >Biomechanics of failed deglutitive upper esophageal sphincter relaxation in neurogenic dysphagia.
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Biomechanics of failed deglutitive upper esophageal sphincter relaxation in neurogenic dysphagia.

机译：在神经源性吞咽困难中脱胶性食管上括约肌松弛失败的生物力学。

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摘要

Our aims were to examine the etiology and biomechanical properties of the nonrelaxing upper esophageal sphincter (UES) and the relationship between UES opening and failed relaxation. We examined the relationships among swallowed bolus volume, intrabolus pressure, sagittal UES diameter, the pharyngeal swallow response, and geniohyoid shortening in 18 patients with failed UES relaxation, 23 healthy aged controls, and 15 with Zenker's diverticulum. Etiology of failed UES relaxation was 56% medullary disease, 33% Parkinson's or extrapyramidal disease; and 11% idiopathic. Extent of UES opening ranged from absent to normal and correlated with preservation of the pharyngeal swallow response (P = 0.012) and geniohyoid shortening (P = 0.046). Intrabolus pressure was significantly greater compared with aged controls (P < 0.001) or Zenker's diverticulum (P < 0.001). The bolus volume-dependent increase in intrabolus pressure evident in controls was not observed in failed UES relaxation. The nonrelaxing UES therefore displays a constant loss of sphincter compliance throughout the full, and potentially normal, range of expansion during opening. Adequacy of UES opening is influenced by the degree of preservation of the pharyngeal swallow response and hyolaryngeal traction. In contrast, the stenotic UES displays a static loss of compliance, only apparent once the limit of sphincter expansion is reached.
机译：我们的目的是检查无松弛的食管上括约肌（UES）的病因和生物力学特性，以及UES开放与松弛失败之间的关系。我们检查了18例UES放松失败的患者，23例健康的老年对照和15例Zenker憩室的吞咽推注量，推注内压力，矢状UES直径，咽部吞咽反应和舌骨舌骨缩短之间的关系。 UES放松失败的病因是56％的髓样疾病，33％的帕金森氏病或锥体外系疾病;和11％的特发性。 UES开放的程度从无到正常不等，并与咽咽反应的保留（P = 0.012）和舌骨舌骨缩短有关（P = 0.046）。与老年对照组（P <0.001）或Zenker憩室（P <0.001）相比，推注内的压力明显更高。在UES放松失败时未观察到对照中明显的推注体积内推注体积依赖性增加。因此，非松弛UES在打开过程中的整个扩展范围（可能是正常扩展）中显示出括约肌顺应性的恒定损失。 UES开放的充分性受咽吞咽反应和鼻咽牵引力的保留程度影响。相比之下，狭窄的UES会显示出静态的顺应性损失，只有在达到括约肌扩张的极限时才会显现出来。

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