Comparison Between Automatic and Volitional Swallow in Healthy Individuals Using Tongue Array and Cervical Auscultation Modules

  • Krishnamurthy RahulEmail author
  • Narayanan Swapna
  • Ramachandran Resmitha
  • Krishnakumar Jyotsna
Original Article


In healthy normal individuals, the act of swallowing can be performed volitionally or can occur spontaneously. Several attempts have been made to look into the possible differences that might exist between automatic swallow (AS) and volitional swallow (VS). The present study is an attempt to physiologically differentiate AS from that of VS, using combined modules of tongue array and cervical auscultation of Digital Swallowing Workstation. 15 males and 15 female participants in the age range of 18–25 participated in the present study. They performed an AS task and a VS task. These were analyzed for parameters of maximum amplitude, duration and pressure. The result of the study revealed higher values for all the parameters of VS, but a statistically significant difference only for the duration parameter of cervical auscultation. This finding leads to the impression that the duration of vocal fold closure plays a major role in airway protection. Similar interesting findings on effect of gender and nature and organization of AS and VS have been discussed.


Swallowing Swallowing disorders Dysphagia Swallow physiology 


Compliance with Ethical Standards

Conflict of interest

All the authors of the present study declare that, we have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

An informed consent was obtained from all the participants of the study.


  1. 1.
    Logemann JA (1984) Aspiration in head and neck surgical patients. Ann Otol Rhinol Laryngol 94(4 Pt 1):373–376Google Scholar
  2. 2.
    Cassiani RA, Santos CM, Parreira LC, Dantas RO (2011) The relationship between the oral and pharyngeal phases of swallowing. Clinics 66(8):1385–1388CrossRefGoogle Scholar
  3. 3.
    Miller AJ (1982) Deglutition. Physiol Rev 62(1):129–184CrossRefGoogle Scholar
  4. 4.
    Rademaker AW, Pauloski BR, Logemann JA, Shanahan TK (1994) Oropharyngeal swallow efficiency as a representative measure of swallowing function. J Speech Lang Hear Res 37(2):314–325CrossRefGoogle Scholar
  5. 5.
    Ertekin C, Kiylioglu N, Tarlaci S, Turman AB, Secil Y, Aydogdu I (2001) Voluntary and reflex influences on the initiation of swallowing reflex in man. Dysphagia 16(1):40–47CrossRefGoogle Scholar
  6. 6.
    Nomura K, Utsumake A, Tomita K, Watanabe M, Ooka T, Hironaka S, Mukai Y (2011) Influence of command on tongue elevation during swallowing: examination of tongue pressure and ultrasound imaging. J Disabil Oral Health 12(4):149–158Google Scholar
  7. 7.
    Thexton AJ, Crompton AW, German RZ (2007) Electromyographic activity during the reflex pharyngeal swallow in the pig: Doty and Bosma (1956) revisited. J Appl Physiol 102(2):587–600CrossRefGoogle Scholar
  8. 8.
    Thexton AJ, Crompton AW, Owerkowicz T, German RZ (2009) Impact of rhythmic oral activity on the timing of muscle activation in the swallow of the decerebrate pig. J Neurophysiol 101(3):1386–1393CrossRefGoogle Scholar
  9. 9.
    Ertekin C (2011) Voluntary versus spontaneous swallowing in man. Dysphagia 26(2):183–192CrossRefGoogle Scholar
  10. 10.
    Martin RE, Goodyear BG, Gati JS, Menon RS (2001) Cerebral cortical representation of automatic and volitional swallowing in humans. J Neurophysiol 85(2):938–950CrossRefGoogle Scholar
  11. 11.
    Dziewas R, Sörös P, Ishii R, Chau W, Henningsen H, Ringelstein EB, Knecht S, Pantev C (2003) Neuroimaging evidence for cortical involvement in the preparation and in the act of swallowing. Neuroimage 20(1):135–144CrossRefGoogle Scholar
  12. 12.
    Lowell SY, Reynolds RC, Chen G, Horwitz B, Ludlow CL (2012) Functional connectivity and laterality of the motor and sensory components in the volitional swallowing network. Exp Brain Res 219(1):85–96CrossRefGoogle Scholar
  13. 13.
    Nonaka T, Yoshida M, Yamaguchi T, Uchida A, Ohba H, Oka S (2009) Contingent negative variations associated with command swallowing in humans. Clin Neurophysiol 120(10):1845–1851CrossRefGoogle Scholar
  14. 14.
    Humbert IA, German RZ (2013) New directions for understanding neural control in swallowing: the potential and promise of motor learning. Dysphagia 28(1):1–10CrossRefGoogle Scholar
  15. 15.
    Shaker R, Easterling C, Kern M, Nitschke T, Massey B, Daniels S et al (2002) Rehabilitation of swallowing by exercise in tube-fed patients with pharyngeal dysphagia secondary to abnormal UES opening. Gastroenterology 122(5):1314–1321CrossRefGoogle Scholar
  16. 16.
    Nagy A, Leigh C, Hori SF, Molfenter SM, Shariff T, Steele CM (2013) Timing differences between cued and noncued swallows in healthy young adults. Dysphagia 28(3):428–434CrossRefGoogle Scholar
  17. 17.
    Al-Toubi AK, Doeltgen SH, Daniels SK, Corey DM, Huckabee ML (2015) Pharyngeal pressure differences between four types of swallowing in healthy participants. Physiol Behav 140:132–138CrossRefGoogle Scholar
  18. 18.
    Nishino T, Takiwaze K, Yokokawa N, Hiraga K (1987) Depression of the swallowing reflex during sedation and/or relative analgesia produced by inhalation of 50% nitrous oxide in oxygen. Anesthesiology 67:995–998CrossRefGoogle Scholar
  19. 19.
    Singhi P, Kumar M, Malhi P, Kumar R (2007) Utility of the WHO ten questions screen for disability detection in a rural community—the North Indian experience. J Trop Pediatr 53(6):383–387CrossRefGoogle Scholar
  20. 20.
    Mackowiak RC, Brenman HS, Friedman MH (1967) Acoustic profile of deglutition. Proc Soc Exp Biol Med 125:149–152CrossRefGoogle Scholar
  21. 21.
    Hamlet S, Nelson R, Patterson R (1990) Interpreting the sounds of swallowing: fluid flow through the cricopharyngeous. Ann Otol Rhinol Laryngol 99:749–752CrossRefGoogle Scholar
  22. 22.
    Hiss SG, Treole K, Stuart A (2001) Effects of age, gender, bolus volume, and trial on swallowing apnea duration and swallow/respiratory phase relationships of normal adults. Dysphagia 16(2):128–135CrossRefGoogle Scholar
  23. 23.
    Kim Y, McCullough GH, Asp CW (2005) Temporal measurements of pharyngeal swallowing in normal populations. Dysphagia 20(4):290–296CrossRefGoogle Scholar
  24. 24.
    Martin-Harris B, Brodsky MB, Michel Y, Ford CL, Walters B, Heffner J (2005) Breathing and swallowing dynamics across the adult lifespan. Arch Otolaryngol Head Neck Surg 131(9):762–770CrossRefGoogle Scholar
  25. 25.
    Balasubramanium RK, Bhat JS (2012) Respiratory swallow coordination in healthy individuals. Int J Adv Speech Hear Res 1(1):1–9Google Scholar
  26. 26.
    Nikhil J, Naidu RK, Krishnan G, Manjula R (2014) Oral and pharyngeal transit time as a factor of age, gender, and consistency of liquid bolus. J Laryngol Voice 4(2):45CrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2019

Authors and Affiliations

  1. 1.Department of Audiology and Speech Language Pathology, Kasturba Medical College, MangaloreManipal Academy of Higher EducationManipalIndia
  2. 2.Department of Speech Language PathologyAll India Institute of Speech and HearingMysoreIndia

Personalised recommendations