固形造影剤を用いた嚥下動態の検討

概要

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The purpose of this paper is to discuss the differences of pharyngeal swallowing according to the type of bolus. Using hand-made solid boluses, the authors examined the swallowing function of 36 individuals, 17 patients with a sensation of lump in the throat (group 1) and 19 patients with difficulty swallowing a solid bolus (group 2) through the fluorography. Two transit times of the movements of the boluses (liquid and solid) were measured; phase 1 represented the time between the passing of the apex of the bolus from the faucial isthmus to the entrance of the esophageal, and phase 2 the time it took the bolus to pass through the esophageal orifice. For liquid boluses, no significant difference was detected between the 2 groups for either phase 1 or phase 2. On the other hand, the phase 1 transit time for a solid bolus was longer than that for a liquid bolus, especially in group 2. In addition, the solid bolus was arrested at the level of the vallecula and/or pyriform sinus in 15 patients (42%). Therefore, the use of the solid bolus made clear the existence of a swallowing disorder in the pharyngeal phase, especially the decrease of swallowing power of the oral and pharyngeal muscle and/or the lowered sensitivity of the swallowing reflex.
耳鼻咽喉科臨床学会の論文