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The Effect of Bolus Viscosity on Laryngeal Closure in Swallowing: Kinematic Analysis Using 320-Row Area Detector CT

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Abstract

The present study examined the effect of bolus viscosity on the onset of laryngeal closure (relative to hyoid elevation), the duration of laryngeal closure, and other key events of swallowing in ten healthy volunteers. All volunteers underwent 320-row area detector computed tomography swallow studies while swallowing 10 ml of honey-thick barium (5 % v/w) and thin barium (5 % v/w) in a 45° reclining position. Three-dimensional images of both consistencies were created in 29 phases at an interval of 0.10 s (100 ms) over a 2.90-s duration. The timing of the motions of the hyoid bone, soft palate, and epiglottis; the opening and closing of the laryngeal vestibule, true vocal cords (TVC), and pharyngoesophageal segment; and the bolus movement were measured and compared between the two consistencies. The result showed differing patterns of bolus movement for thin and thick liquids. With thin liquids, the bolus reached the hypopharynx earlier and stayed in the hypopharynx longer than with thick liquids. Among events of laryngeal closure, only the timing of TVC closure differed significantly between the two consistencies. With thin liquids, TVC closure started earlier and lasted longer than with thick liquids. This TVC movement could reflect a response to the faster flow of thin liquids. The results suggest that bolus viscosity alters the temporal characteristics of swallowing, especially closure of the TVC.

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Acknowledgments

The authors thank Mr. Ida, Ms. Kataoka, and Mr. Kobayashi, radiological technologists at Fujita Health University Hospital, for their invaluable assistance with the CT study. They also appreciate the valuable advice provided by Dr. Arthur J. Miller at the Department of Orofacial Sciences, School of Dentistry, University of California at San Francisco.

Conflict of interest

The authors have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan

    Yoko Inamoto, Sumiko Okada & Kikuo Ota

  2. Department of Rehabilitation, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan

    Eiichi Saitoh, Hitoshi Kagaya, Seiko Shibata & Mikoto Baba

  3. Department of Radiology, School of Medicine, Fujita Health University, Toyoake, Aichi, Japan

    Naoko Fujii & Kazuhiro Katada

  4. Department of Rehabilitation Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand

    Pattra Wattanapan

  5. Department of Physical Medicine and Rehabilitation, Department of Otolaryngology-Head and Neck Surgery, and Center for Functional Anatomy and Evolution, Johns Hopkins University, Baltimore, MD, USA

    Jeffrey B. Palmer

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  1. Yoko Inamoto
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  2. Eiichi Saitoh
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  3. Sumiko Okada
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  4. Hitoshi Kagaya
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  5. Seiko Shibata
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  6. Kikuo Ota
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  7. Mikoto Baba
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  8. Naoko Fujii
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  9. Kazuhiro Katada
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  10. Pattra Wattanapan
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  11. Jeffrey B. Palmer
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Corresponding author

Correspondence to Yoko Inamoto.

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Inamoto, Y., Saitoh, E., Okada, S. et al. The Effect of Bolus Viscosity on Laryngeal Closure in Swallowing: Kinematic Analysis Using 320-Row Area Detector CT. Dysphagia 28, 33–42 (2013). https://doi.org/10.1007/s00455-012-9410-4

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  • DOI: https://doi.org/10.1007/s00455-012-9410-4

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