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Dysphagia

, Volume 4, Issue 1, pp 8–15 | Cite as

Timing of videofluoroscopic, manometric events, and bolus transit during the oral and pharyngeal phases of swallowing

  • Ian J. Cook
  • Wylie J. Dodds
  • Roberto O. Dantas
  • Mark K. Kern
  • Benson T. Massey
  • Reza Shaker
  • Walter J. Hogan
Article

Abstract

The aims of this study were to evaluate and quantify the timing of events associated with the oral and pharyngeal phases of liquid swallows. For this purpose, we recorded 0–20 ml barium swallows in three groups of volunteers using videoradiographic, electromyographic, and manometric methods. The study findings indicated that a leading complex of tongue tip and tongue base movement as well as onset of superior hyoid movement and mylohyoid myoelectric activity occurred in a tight temporal relationship at the inception of swallowing. Two distinct general types of normal swallows were observed. The common “incisor-type” swallow began with the bolus positioned on the tongue with the tongue tip pressed against the upper incisors and maxillary alveolar ridge. At the onset of the “dipper-type” swallow the bolus was located beneath the anterior tongue and the tongue tip scooped the bolus to a supralingual location. Beginning with tongue-tip peristaltic movement at the upper incisors, the two swallow types were identical. Swallow events that occurred after lingual peristaltic movement at the maxillary incisors showed a volume-dependent forward migration in time that led to earlier movement of the hyoid and larynx as well as earlier opening of the upper esophageal sphincter in order to receive the large boluses that arrived sooner in the pharynx during the swallow sequence than did smaller boluses. The study findings indicated that timing of swallow events should be considered in reference to both swallow type and bolus volume. The findings also indicated an important distinction between peristaltic transit and bolus clearance.

Key words

Swallowing, oral phase Swallowing, pharyngeal phase Bolus transit Hyoid movement 

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References

  1. 1.
    Dodds WJ, Kahrilas PJ, Dent J, Hogan WJ: Considerations about pharyngeal manometry.Dysphagia 1:209–214, 1987CrossRefGoogle Scholar
  2. 2.
    Shawker TH, Sonies B, Stone M, Baum BJ: Real-time ultrasound visualization of tongue movement during swallowing.J Clin Ultrasound 11:485–490, 1983PubMedGoogle Scholar
  3. 3.
    Hamlet S, Jones L, Mathog R, Bolton M, Patterson R: Bolus propulsive activity of the tongue in dysphagic cancer patients.Dysphagia 3:18–23, 1988CrossRefPubMedGoogle Scholar
  4. 4.
    Dodds WJ, Hogan WJ, Lydon SB, Stewart ET, Stef JJ, Arndorfer RC: Quantitation of pharyngeal motor function in normal human subjects.J Appl Physiol 39:692–696, 1975PubMedGoogle Scholar
  5. 5.
    Dodds WJ, Man KM, Cook IJ, Kahrilas PJ, Stewart ET, Kern MK: Influence of bolus volume on swallow-induced hyoid movement in normal subjects.AJR 150:1307–1309, 1988PubMedGoogle Scholar
  6. 6.
    Kahrilas PJ, Dodds WJ, Dent J, Logemann JA, Shaker R: Upper esophageal sphincter function during deglution.Gastroenterology 92:52–62, 1988Google Scholar
  7. 7.
    Sokol EM, Heitmann P, Wolf BS, Cohen BR: Simultaneous cineradiographic and monometric study of the pharynx, hypopharynx and cervical esophagus.Gastroenterology 51:960–974, 1966PubMedGoogle Scholar
  8. 8.
    Miller AJ: Deglutition.Physiol Rev 62:129–184, 1982PubMedGoogle Scholar
  9. 9.
    Dodds WJ, Hogan WJ, Reid DP, Stewart ET, Arndorfer RC: A comparison between primary esophageal peristalsis following wet and dry swallows.J Appl Physiol 35:851–857, 1973PubMedGoogle Scholar
  10. 10.
    Curtis DJ, Cruess DF, Dachman AH, Maso E: Timing in the normal pharyngeal swallow.Invest Radiol 19:523–529, 1984PubMedGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1989

Authors and Affiliations

  • Ian J. Cook
    • 1
  • Wylie J. Dodds
    • 1
  • Roberto O. Dantas
    • 1
  • Mark K. Kern
    • 1
  • Benson T. Massey
    • 1
  • Reza Shaker
    • 1
  • Walter J. Hogan
    • 1
  1. 1.Departments of Radiology and MedicineMedical College of WisconsinMilwaukeeUSA

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