European Archives of Oto-Rhino-Laryngology

, Volume 271, Issue 7, pp 1987–1997

Displacement of oropharyngeal structures during suction-swallowing cycles

  • W. Engelke
  • J. Glombek
  • M. Psychogios
  • S. Schneider
  • D. Ellenberger
  • P. Santander
Laryngology

DOI: 10.1007/s00405-014-2919-4

Cite this article as:
Engelke, W., Glombek, J., Psychogios, M. et al. Eur Arch Otorhinolaryngol (2014) 271: 1987. doi:10.1007/s00405-014-2919-4

Abstract

Suction ability plays an important role in supporting oral nutrition and needs special care following neurological disorders and tumor-associated defects. However, the details of suction are still poorly understood. The present study evaluates displacement of orofacial structures during suction and deglutition based on manometric controlled MRI. Nine healthy subjects were scanned wearing an intraoral mouthpiece for water intake by suction and subsequent swallowing. Suction-swallowing cycles were identified by intraoral negative pressure. Midsagittal MRI slices (3 T; temporal resolution 0.53 s) were analyzed at rest, suction and pharyngeal swallowing. The mandibular displacement was measured as the distance between the anterior nasal spine and the inferior point of the mandible. Following areas were defined: subpalatal compartment (SCA), retrolingual (RLA), epipharyngeal (EPA) and mouth floor area (MFA). During rest, an average distance of 7 cm was observed between the mandibular measurement points. The measured SCA was 3.67 cm2, the RLA 6.98 cm2, the EPA 9.00 cm2 and the MFA 15.21 cm2 (average values). At the end of suction, the mandibular distance reduces (to 6.88 cm), the SCA increases significantly (to 5.96 cm2; p = 0.0002), the RLA decreases (to 6.45 cm2), the EPA increases (to 10.59 cm2) and the MFA decreases (to 15.02 cm2). During deglutition, the mandible lifted significantly (to 6.81 cm; p = 0.0276), the SCA reduced to zero, the RLA was not measurable, the EPA reduces significantly (to 3.01 cm2; p < 0.0001) and the MFA increases (to 16.36 cm2). According to these observations, a combined displacement of the tongue in an anteroposterior direction with active tongue dorsum—velum contact appears to be the predominant activity during suction and responsible for the expansion of the subpalatal area.

Keywords

Suction Swallowing Dynamic MRI Dysphagia 

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • W. Engelke
    • 1
  • J. Glombek
    • 1
  • M. Psychogios
    • 2
  • S. Schneider
    • 3
  • D. Ellenberger
    • 3
  • P. Santander
    • 1
  1. 1.Department of Oral and Maxillofacial Surgery, Center for Dentistry, Oral Medicine and Craniomaxillofacial SurgeryUniversity of GöttingenGöttingenGermany
  2. 2.Department of Diagnostic and Interventional Neuroradiology, Center for RadiologyUniversity of GöttingenGöttingenGermany
  3. 3.Department of Medical Statistics, Center for Informatics, Statistics and EpidemiologyUniversity of GöttingenGöttingenGermany