瓦伦贝格综合征吞咽困难的外科改善手术：英文和日文文献的范围综述。
Swallowing Improvement Surgery for Dysphagia in Wallenberg Syndrome: A Scoping Review of the English and Japanese Literature.
文献信息
| PMID | 42795989 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Yi-An Lu |
| 作者单位 | Department of Otolaryngology and Head and Neck Surgery, The University of Tokyo, Tokyo 113-8655, Japan. |
| 期刊 | Journal of clinical medicine |
| SCI 分区 | Q1 |
| IF | 3.5 |
| 研究类型 | 综述 Meta · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
背景： 瓦伦贝格综合征（WS）相关的吞咽困难通常经吞咽康复改善；然而，持续性病例可能需要手术干预。已有多种吞咽改善手术的报道，但其策略和结局仍不明确。本范围综述总结了WS吞咽改善手术的证据。方法：按照PRISMA-ScR框架检索了PubMed、Scopus、Web of Science和Ichushi-Web。纳入报告WS吞咽改善手术的英文和日文研究。对患者特征、手术方式、结局和并发症进行描述性综合。结果：21项研究共53例患者符合纳入标准。大多数患者术前存在严重吞咽困难，需要肠内喂养。所有患者均行环咽肌切开术，至少66.0%接受了联合手术，最常见的是喉悬吊术。可获得的术后数据表明许多患者经口进食改善，但结局报告不完整。部分患者需要分期手术，因为单次手术未能充分解决其复杂的吞咽障碍。结论：报告的结局提示，吞咽改善手术可能有助于特定WS患者改善经口进食。联合手术的频繁使用凸显了个体化、基于病理生理的外科管理的重要性。然而，现有证据无法区分手术效果与自发恢复、康复或患者选择的影响。
英文摘要
Background: Dysphagia associated with Wallenberg syndrome (WS) often improves with swallowing rehabilitation; however, persistent cases may require surgical intervention. Various swallowing improvement procedures have been reported, but their strategies and outcomes remain unclear. This scoping review summarized the evidence on swallowing improvement surgery for WS. Methods: PubMed, Scopus, Web of Science, and Ichushi-Web were searched in accordance with the PRISMA-ScR framework. English- and Japanese-language studies reporting swallowing improvement surgery for WS were included. Patient characteristics, surgical procedures, outcomes, and complications were descriptively synthesized. Results: Twenty-one studies involving 53 patients met the inclusion criteria. Most patients had profound preoperative dysphagia requiring enteral feeding. Cricopharyngeal myotomy was performed in all patients, and at least 66.0% underwent combined procedures, most commonly with laryngeal suspension. Available postoperative data indicated improved oral intake in many patients, although outcome reporting was incomplete. Some patients required staged procedures because a single procedure did not adequately address their complex swallowing impairment. Conclusions: Reported outcomes suggest that swallowing improvement surgery may contribute to improved oral intake in selected patients with WS. The frequent use of combined procedures highlights the importance of individualized, pathophysiology-based surgical management. However, the evidence cannot distinguish surgical effects from spontaneous recovery, rehabilitation, or patient selection.