嚥下のメカニズムとその障害

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This paper is a discussion of the mechanisms of normal and disturbed swallowing based on studies undertaken by the author and on a review of the literature. The morphology of the peripheral receptor involved in deglutition was studied by electron microscope, and it was observed that the endings of the sensory nerves distributed in the laryngeal mucosa have no myelin sheath and are composed of nonmedullated nerve fibers. The afferent impulse in the deglutitive reflex is conveyed to multiple synapses via the solitary nucleus, and is then conveyed to the medullary reticular formation. The efferent impulse from the central nervous system activates the internal laryngeal muscles, the infra- and supra- hyoid muscles and the pharyngeal constrictor muscles according to predetermined programming. Case studies are presented of patients suffering from swallowing disturbances associated with the Wallenberg syndrome, the Ramsay-Hunt syndrome, neural sarcoidosis, the Meige syndrome, etc.
耳鼻咽喉科臨床学会の論文