I型喉裂修复术后吞咽困难的长期随访
Long-Term Follow-Up of Dysphagia After Type I Laryngeal Cleft Repair.
文献信息
| PMID | 42782100 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Abhinav Mehta |
| 作者单位 | Department of Otolaryngology-Head and Neck Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA. |
| 期刊 | The Laryngoscope |
| SCI 分区 | Q2 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 评估I型喉裂（LC-1）手术治疗后吞咽困难的长期病程。
方法： 对I型喉裂手术治疗后持续存在吞咽功能障碍的连续患儿进行回顾性分析。随访时采用电视透视吞咽造影检查（VFSS）评估吞咽功能。VFSS结果采用渗透-误吸量表（PAS）和功能性经口摄食量表（FOIS）评分进行评估。比较随访期间PAS和FOIS评分。p＜0.05认为有统计学意义。
结果： 21例I型喉裂（n＝5）经内镜下修复（n＝16）或注射喉成形术（n＝5）治疗后持续存在吞咽困难的患者（男13例，女8例，年龄范围：5个月至16岁）随访1至6.2年。大多数患者为白人（71%）和非西班牙裔（67%）；90%存在合并症。10例患者观察到口腔期吞咽异常，8例吞咽触发异常，19例咽期异常，5例食管期异常。5例患儿（24%）吞咽所有阶段的损害均得到缓解。口腔期损害在7例患者中缓解（70%），咽期在7例中缓解（38%），食管期在5例中缓解（100%），吞咽触发在6例中缓解（75%）。PAS评分持续改善，中位评分从术后5降至末次随访时3（p＝0.03）。FOIS评分持续改善，中位评分从术后4升至末次随访时5（p＜0.001）。
结论： I型喉裂手术治疗后，吞咽多个阶段的损害持续改善。需要进一步研究以确定在更大规模I型喉裂患儿群体中预测长期吞咽功能改善的因素。
英文摘要
OBJECTIVE: To evaluate the long-term course of dysphagia after surgical treatment of Type I laryngeal cleft (LC-1).
METHODS: A retrospective review was conducted on consecutive children with persistent swallowing dysfunction after surgical treatment of LC-1. Swallowing function was assessed using a video fluoroscopic swallow study (VFSS) at follow-up. VFSS findings were assessed using the penetration aspiration scale (PAS) and functional oral intake scale (FOIS) scores. PAS and FOIS scores were compared within the follow-up period. p < 0.05 was considered significant.
RESULTS: Twenty-one patients with persistent dysphagia (13 male, 8 female, age range: 5 months to 16 years) after endoscopic repair (n = 16) or injection laryngoplasty (n = 5) for LC-1 (n = 5) were followed for 1-6.2 years. Most patients were White (71%) and non-Hispanic (67%); 90% had comorbid conditions. Swallowing abnormalities were observed in the oral phase in 10 patients, swallow triggering in 8, pharyngeal phase in 19, and esophageal phase in 5. In five children (24%), impairments in all phases of swallowing were resolved. Impairment of the oral phase resolved in seven patients (70%), pharyngeal phase in seven (38%), esophageal phase in five (100%), and swallow triggering in six (75%). PAS scores continued to improve, with median scores decreasing from 5 postoperatively to 3 at the last follow-up (p = 0.03). FOIS scores continued to improve, with median scores increasing from 4 postoperatively to 5 at the last follow-up (p < 0.001).
CONCLUSION: The impairment in multiple phases of swallowing continued to improve after surgical treatment of LC-1. Further research is necessary to determine the factors that predict improvement in long-term swallowing function in larger groups of children with LC-1.