自然吞咽过程中舌骨及喉室移动度的研究

Movement of the hyoid bone and ventriculus laryngis in normal swallowing

目的：测量自然吞咽过程中舌骨及喉室的最大移动度。方法选取40例志愿者为研究对象，使用普通X线模拟机采集自然吞咽视频，通过视频分析软件对吞咽视频进行连续快速截图，测量自然吞咽过程中舌骨及喉的最大移动度。采用单因素方差分析差异。结果40例志愿者平均吞咽时间为（1．13±0．28） s。吞咽过程中舌骨及喉室的移动是先向上，然后向外最后回到静息位置。舌骨前后方向最大移动度为（0．90±0．30） cm，垂直方向最大移动度（0．93±0．36） cm；喉室前后方向最大移动度为（0．69±0．25） cm，垂直方向最大移动度（1．04±0．45） cm。进一步研究发现年龄因素对吞咽时间有影响（ P＝0．03），男女之间相近（ P＝0．13）。性别、年龄因素对舌骨和喉室移动度无影响（ P＝0．28～0．81、0．20～0．88）。结论自然吞咽会引起舌骨及喉室向前上方移动，这种移动在头颈部放疗计划制定过程中值得考虑。

Objective To measure the maximum movement of the hyoid bone and ventriculus laryngis during normal swallowing. Methods Forty volunteers were selected as subjects, and an X？ray simulator was used to collect the videos of normal swallowing. Video analysis software was used to capture continuous and quick screenshots of these videos, and the maximum movement of the hyoid bone and ventriculus laryngis was measured. The difference in movement was analyzed by one？way analysis of variance. Results The mean time for swallowing in 40 volunteers was 1.13＆#177;0.28 s. During the process of swallowing, the hyoid bone and ventriculus laryngis moved upward first, then outward, and finally returned to the resting position. The maximum movement of the hyoid bone forward and backward was 0.90＆#177;0.30 cm;the maximum vertical movement of the hyoid bone was 0.93＆#177;0.36 cm. The maximum movement of the ventriculus laryngis forward and backward was 0.69＆#177; 0. 25 cm;the maximum vertical movement of the ventriculus laryngis was 1.04＆#177;0.45 cm. Further studies showed the effect of age on the time for swallowing （P=0.03）, with similar results for the male and female （ P=0.13） . Sex and age had no effects on movement of the hyoid bone and ventriculus laryngis （P=0.28？0.81 and 0.20？0.88）. Conclusions During normal swallowing, the hyoid bone and the ventriculus laryngis move first upward and then forward. These movements should be considered during the development of radiotherapy plan for head and neck cancer.