誤嚥と筋電図所見

末梢臓器における誤嚥の Mechanism

抄録

Aspiration may be caused by a variety of inco-ordination of swallowing.
In this experimental design, a physiologic and biomechanical method for observation of the laryngopharyngeal motion was devised. That is, electromyographic observations of the laryngeal and pharyngeal constrictor muscles, measurement of glottic preseure and measurement of tensile force by laryngeal elevation were made in fully conscious and slightly anesthetized animals.
These electromyographic and biomechanical observations of normal deglutition in the dog were characterized by a co-ordinated pattern of sequent three motions; laryngeal elevation, laryngeal closure and transportation of the bolus.
Experimentally, aspiration was brought about by cutting superior laryngeal nerve, recurrent laryngeal nerve, vagal nerve and hypoglossal nerve.
In the series of bilaterally sacrificed internal branch of the superior laryngeal nerves, the electrical phasic activity of the intrinsic laryngeal muscles and laryngeal closure were delayed about 90msec. during swallowing in slightly anesthetized condition, and in the series of bilaterally sectioned recurrent laryngeal nerves, degree of the laryngeal closure was markedly disturbed (34%). And also, degree of the laryngeal elevation at swallowing was 48% in the series of bilaterally sectioned hypoglossal nerves.
From these experimental observations, mechanism of aspiration was described and discussed in clinical relation to aspiration.