A Procedure Combining Ultrasonography and Videoendoscopy for Evaluation of Swallowing Function

概要

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Videofluorography (VF) provides a dynamic view of deglutition; however, its clinical utility is compromised by the need to transport gravely ill patients to a radiology suite and by the potential hazard of radiation exposure. Videoendoscopy (VE), in contrast, can be performed at the bedside. VE has limited ability to assess swallowing function because its field is obscured by epiglottic excursion. These limitations led us to pursue a new method for periodic evaluation of swallowing function. To compare our technique combining ultrasonography (US) and VE with VF in a healthy control, these images were displayed simultaneously. Both VF and US identified the commencement of laryngeal elevation. The pharynx, thereafter, became invisible with VE (A). Next the bolus head reached the pyriform sinus (P). After that, laryngeal elevation was at maximum height for both VF and US (M). The timing of elevation as measured by VF and US (0.83±0.17sec and 0.85±0.19, respectively) were almost equivalent, and the averages of laryngeal elevation were 35.0±3.0mm and 33.5±2.9mm, respectively. The A-P interval was 0.18±0.07sec, which suggested that P can be visible in dysphagic patients with a delay of swallowing reflex. Our technique, like VF, can demonstrate the key attributes in the quantitative parameters of swallowing.
The Japan Laryngological Associationの論文