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学科主题: 临床医学
题名:
Relative contribution of various airway protective mechanisms to prevention of aspiration during swallowing
作者: Medda, BK; Kern, M; Ren, JL; Xie, PY; Ulualp, SO; Lang, IM; Shaker, R
关键词: suprahyoid muscles ; vocal cord ; epiglottis ; larynx
刊名: AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY
发表日期: 2003-06-01
DOI: 10.1152/ajpgi.00395.2002
卷: 284, 期:6, 页:G933-G939
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Gastroenterology & Hepatology ; Physiology
研究领域[WOS]: Gastroenterology & Hepatology ; Physiology
关键词[WOS]: UPPER ESOPHAGEAL SPHINCTER ; PHARYNGEAL BOLUS TRANSIT ; ZENKERS DIVERTICULUM ; COORDINATION ; PARALYSIS ; SURGERY ; CLOSURE ; PHASES
英文摘要:

Deglutitive airway protective mechanisms include glottal closure, epiglottal descent, and anterosuperior displacement of the larynx. Aspiration of swallowed material may occur during the pre-, intra-, or postpharyngeal phase of swallowing. Our objectives were to determine the relative contribution of the airway protective mechanisms during each phase of swallow in 14 decerebrated cats before and after suprahyoid myotomy, epiglottectomy, and unilateral cordectomy. After myotomy, superior excursions of the hyoid, thyroid, and cricoid cartilages and anteroposterior diameter of maximum upper esophageal spincter (UES) opening were significantly diminished, but the incidence of pharyngeal residue significantly increased ( P < 0.05). No aspiration was observed in the predeglutitive period. After myotomy, the incidence of aspiration significantly increased in both intra- and postdeglutitive periods. Epiglottectomy did not alter aspiration incidence, but unilateral cordectomy resulted in a 100% incidence of intra- and postdeglutitive aspiration. In conclusion, glottal closure constitutes the primary mechanism for prevention of intra- and postdeglutitive aspiration, but laryngeal elevation may assist this function. Bolus pulsion without laryngeal distraction can open the UES, but at risk of aspiration due to decreased pharyngeal clearance. The epiglottis provides no apparent airway protection during any phase of swallowing.

语种: 英语
WOS记录号: WOS:000182699700009
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/54547
Appears in Collections:北京大学第一临床医学院_消化内科_期刊论文

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作者单位: 1.Med Coll Wisconsin, Dept Radiol, Milwaukee, WI 53226 USA
2.Med Coll Wisconsin, Dept Med, Milwaukee, WI 53226 USA
3.Med Coll Wisconsin, Froedtert Mem Lutheran Hosp, Div Gastroenterol & Hepatol, Dysphagia Inst, Milwaukee, WI 53226 USA
4.Med Coll Wisconsin, Dept Otolaryngol & Human Commun, Milwaukee, WI 53226 USA
5.Peking Univ, Dept Gastroenterol, Hosp 1, Beijing 100034, Peoples R China

Recommended Citation:
Medda, BK,Kern, M,Ren, JL,et al. Relative contribution of various airway protective mechanisms to prevention of aspiration during swallowing[J]. AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY,2003,284(6):G933-G939.
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