著者

兵頭 政光 相原 隆一 河北 誠二 湯本 英二

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.7, no.1, pp.64-70, 1995-06-01 (Released:2012-09-24)

参考文献数

14

被引用文献数

2 5

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The hypopharyngeal constrictor muscle consists of the thyropharyngeal (TP) and cricopharyngeal (CP) muscles. These two muscles cooperatively and, in a sense, competitively work at the pharyngeal swallowing stage. Contraction of the TP muscle drives bolus into the esophagus, while the CP muscle ralaxes and allows the bolus to pass through the upper esophageal sphincter which is made by a contraction of the CP muscle.We investigated histochemical properties of these two muscles. Acetylcholine esterase stain showed that the neuromuscular junctions of the CP muscle were scattered in the horizontal direction compaired to those of the TP muscle. Glycogen depletion test showed that the glycogen-negative muscle fibers were distributed uniformly througout the TP muscle, while those of the CP muscle decreased in number from the stimulated side toward the unstimulated side. These results suggested that the CP muscle fibers terminate in the belly of the muscle, and that length of the CP muscle fiber is not uniform. Actomyosin ATPase stain revealed that type 2B fiber was predominant in the TP muscle, while type 1 fiber was predominant in the CP muscle. The mean diameter of the TP muscle fibers was larger than that of the CP muscle.In conclusion, the histochemical properties of the TP and CP muscle showed a great contrast to each other. But these different properties gradually change around the border of the two muscles.

著者

兵頭 政光 森 敏裕 河北 誠二 湯本 英二

出版者

日本喉頭科学会

雑誌

喉頭 (ISSN:09156127)

巻号頁・発行日

vol.12, no.1, pp.31-35, 2000-06-01 (Released:2012-09-24)

参考文献数

14

被引用文献数

1

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Oropharyngeal swallowing disorder results from the disruption of the integrated mechanism of deglutition. This disruption occurs when the lower cranial nerves have been paralyzed due to a cerebrovascular accident or by a skull base lesion. In this article, we postoperatively evaluated the outcomes of 26 patients who had undergone surgical intervention for severe dysphagia caused by lower cranial nerve deficits. The ages of the patients ranged from 22 to 79 years, with an average of 58 years. Etiology of dysphagia consisted of cerebrovascular accidents in 14 cases, skull base lesions in 7, parapharyngeal space lesions in 2, and others in 3. Twenty-one patients had been entirely dependent on tube feeding or intravenous hyperalimentation preoperatively. The series of surgical procedures included cricopharyngeal myotomy (CPM) in 10 cases, CPM with laryngeal suspension (LS) in 6, CPM with vocal fold medialization (VFM) in 3, CPM with both LS and VFM in 6, and VFM in 1. Twenty-three patients (88%) had success in postoperative swallowing function improvement, and oral food intake was restored. Although structured swallowing rehabilitation is mandatory for patients with pharyngeal swallowing disorders, surgical strategies should be considered as a choice of treatment for patients with prolonged pharyngeal swallowing dysfunction.