Temporal sequence of swallow events during the oropharyngeal swallow.

PURPOSE To (a) identify and characterize the temporal relation of selected structural movements during the oropharyngeal swallow across participants, (b) determine whether patterns of movement could be identified, and (c) determine whether the temporal relations were affected by aging and bolus characteristics. METHOD Retrospective analysis of videofluoroscopic swallows of 100 normal participants (age range=22-92 years) was conducted. Two swallows each of 3-ml and 10-ml liquids and a 1-3-ml paste bolus were analyzed. The onset of a number of structural movements and bolus arrival points were compared against a single reference event: onset of upper esophageal sphincter (UES) opening. RESULTS Normal participants demonstrated predominant sequences in pharyngeal movement patterns with some variability. The use of voluntary swallow maneuvers by these normal participants accounted for some degree of this variability. Volume, consistency, and age all affected the temporal relation between onset of specific motor events relative to the onset of UES opening. Increasing bolus volume was associated with a shorter temporal difference between UES opening and onset of other pharyngeal movements. In contrast, a thicker bolus was associated with longer temporal differences. Younger participants generally demonstrated shorter temporal differences between events than did older participants. CONCLUSION Temporal relations between structural movements are not fixed but can be systematically affected by bolus characteristics and age.

[1]  R. Leonard,et al.  Airway Protection: Evaluation with Videofluoroscopy , 2003, Dysphagia.

[2]  P J Kahrilas,et al.  Closure mechanisms of laryngeal vestibule during swallow. , 1992, The American journal of physiology.

[3]  S. Langmore,et al.  Timing of Glottic Closure during Swallowing: A Combined Electromyographic and Endoscopic Analysis , 2005, The Annals of otology, rhinology, and laryngology.

[4]  P J Kahrilas,et al.  Influence of bolus volume on swallow-induced hyoid movement in normal subjects. , 1988, AJR. American journal of roentgenology.

[5]  E. Dejaeger,et al.  Swallowing and the duration of the hyoid movement in normal adults of different ages , 1996, Aging.

[6]  D. Hanson,et al.  Timing of glottic closure during normal swallow , 1995, Head & neck.

[7]  I. Cook,et al.  Influence of aging on oral-pharyngeal bolus transit and clearance during swallowing: scintigraphic study. , 1994, The American journal of physiology.

[8]  J. Brasseur,et al.  Opening mechanisms of the human upper esophageal sphincter. , 1989, The American journal of physiology.

[9]  P J Kahrilas,et al.  Upper esophageal sphincter opening and modulation during swallowing. , 1989, Gastroenterology.

[10]  D. Cerenko,et al.  Timing of major events of pharyngeal swallowing. , 1988, Archives of otolaryngology--head & neck surgery.

[11]  I. Aydogdu,et al.  Effects of bolus volume on oropharyngeal swallowing: an electrophysiologic study in man. , 1997, The American journal of gastroenterology.

[12]  K. Kendall.  Oropharyngeal Swallowing Variability , 2002, The Laryngoscope.

[13]  R. Shaker,et al.  Normal laryngeal valving patterns during three breath-hold maneuvers: A pilot investigation , 2005, Dysphagia.

[14]  C. Larson,et al.  Viscosity effects on EMG activity in normal swallow , 2004, Dysphagia.

[15]  R. Leonard,et al.  Sequence Variability During Hypopharyngeal Bolus Transit , 2003, Dysphagia.

[16]  P J Kahrilas,et al.  Volitional augmentation of upper esophageal sphincter opening during swallowing. , 1991, The American journal of physiology.

[17]  P J Kahrilas,et al.  Effects of bolus volume, viscosity, and repeated swallows in nonstroke subjects and stroke patients. , 1993, Archives of physical medicine and rehabilitation.

[18]  J. Logemann,et al.  Evaluation and treatment of swallowing disorders , 1984 .

[19]  A. Rademaker,et al.  Oropharyngeal swallow efficiency as a representative measure of swallowing function. , 1994, Journal of speech and hearing research.

[20]  W. dodds,et al.  Tipper and dipper types of oral swallows. , 1989, AJR. American journal of roentgenology.

[21]  P J Kahrilas,et al.  Upper esophageal sphincter function during deglutition. , 1988, Gastroenterology.

[22]  S. Niimi,et al.  Role of Laryngeal Movement and Effect of Aging on Swallowing Pressure in the Pharynx and Upper Esophageal Sphincter , 2000, The Laryngoscope.

[23]  A. Rademaker,et al.  Temporal and biomechanical characteristics of oropharyngeal swallow in younger and older men. , 2000, Journal of speech, language, and hearing research : JSLHR.

[24]  W J Hogan,et al.  Coordination of deglutitive glottic closure with oropharyngeal swallowing. , 1990, Gastroenterology.

[25]  T. Gay,et al.  Oral and laryngeal muscle coordination during swallowing , 1994, The Laryngoscope.

[26]  T. Gay,et al.  Coordination of oral cavity and laryngeal movements during swallowing. , 1994, Journal of applied physiology.

[27]  J. Dent,et al.  Influence of normal aging on oral-pharyngeal and upper esophageal sphincter function during swallowing. , 1995, The American journal of physiology.

[28]  W. dodds,et al.  Effect of bolus volume and consistency on swallow-induced submental and infrahyoid electromyographic activity. , 1990, Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas.

[29]  R. Shaker,et al.  Effect of age and bolus variables on the coordination of the glottis and upper esophageal sphincter during swallowing. , 1993, The American journal of gastroenterology.

[30]  Bruce J. Baum,et al.  Durational aspects of the oral-pharyngeal phase of swallow in normal adults , 2006, Dysphagia.

[31]  G. Lof,et al.  Oropharyngeal swallowing in normal adults of different ages. , 1992, Gastroenterology.

[32]  V. Raut,et al.  Effect of bolus consistency on swallowing – does altering consistency help? , 2001, European Archives of Oto-Rhino-Laryngology.

[33]  R. Shaker,et al.  Timing of videofluoroscopic, manometric events, and bolus transit during the oral and pharyngeal phases of swallowing , 2006, Dysphagia.

[34]  J. F. Tracy,et al.  Preliminary observations on the effects of age on oropharyngeal deglutition , 1989, Dysphagia.

[35]  T J Hixon,et al.  Age and laryngeal airway resistance during vowel production in women. , 1992, Journal of speech and hearing research.

[36]  A. Rademaker,et al.  Oropharyngeal swallow in younger and older women: videofluoroscopic analysis. , 2002, Journal of speech, language, and hearing research : JSLHR.

[37]  R. Leonard,et al.  Timing of Events in Normal Swallowing: A Videofluoroscopic Study , 2000, Dysphagia.

[38]  P. Kahrilas,et al.  Oropharyngeal accommodation to swallow volume. , 1996, Gastroenterology.

[39]  J. Logemann.  Criteria for studies of treatment for oral-pharyngeal dysphagia , 1987, Dysphagia.

[40]  R. Shaker,et al.  Coordination of deglutitive vocal cord closure and oral-pharyngeal swallowing events in the elderly. , 1996, European journal of gastroenterology & hepatology.

[41]  J. Brasseur,et al.  Effect of swallowed bolus variables on oral and pharyngeal phases of swallowing. , 1990, The American journal of physiology.

[42]  C. Sapienza,et al.  Glottal airflow characteristics of women's voice production along an aging continuum. , 1996, Journal of speech and hearing research.

[43]  B. Johnston,et al.  Does age or sex affect pharyngeal swallowing? , 1998, Clinical otolaryngology and allied sciences.

[44]  A. Dachman,et al.  Timing in the normal pharyngeal swallow. Prospective selection and evaluation of 16 normal asymptomatic patients. , 1984, Investigative radiology.

[45]  A. Rademaker,et al.  Age and volume effects on liquid swallowing function in normal women. , 1998, Journal of speech, language, and hearing research : JSLHR.