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Effect of the Effortful Swallow on Pharyngeal Cavity Volume: Kinematic Analysis in Three Dimensions Using 320-Row Area Detector Computed Tomography

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A Correction to this article was published on 12 February 2023

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Abstract

This study evaluated the effects of the effortful swallow (ES) on pharyngeal cavity volume using three-dimensional kinematic analyses. Nine healthy volunteers (30.7 ± 7.8 years old) underwent a CT scan while swallowing 10 ml of honey thick liquid using no maneuvers (control) and during an ES. Upper and lower volumes (bordered by valleculae) of the pharyngeal air column and the bolus were measured at every frame and were compared between ES and control swallows. Duration of pharyngeal obliteration and the timing of swallowing events were also measured. Maximum volume and volume at the onset of hyoid anterosuperior movement using ES were significantly smaller than those in control swallows (p = 0.012, p = 0.015) in the upper pharynx but not significantly different in lower pharynx. Minimum pharyngeal volume was sustained for a longer time when ES was used compared to control swallows in both upper and lower pharynx (upper p = 0.016, lower p = 0.027). Onset of velopharyngeal closure was earlier when comparing ES and control swallows (p = 0.04). Termination of all events was significantly delayed when the ES was used (p < 0.05). Changes in the upper pharyngeal volume and in the onset of velopharyngeal closure suggest earlier pharyngeal constriction when using the ES. Longer pharyngeal obliteration and prolonged termination of velopharyngeal closure and epiglottis inversion suggest the prolonged pharyngeal constriction during the ES. These findings suggest the ES can be useful for improving the efficiency of swallowing.

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References

  1. Hind JA, Nicosia MA, Roecker EB, Carnes ML, Robbins J. Comparison of effortful and noneffortful swallows in healthy middle-aged and older adults. Arch Phys Med Rehabil. 2001;82(12):1661–5.

    Article  CAS  PubMed  Google Scholar 

  2. Huckabee ML, Butler SG, Barclay M, Jit S. Submental surface electromyographic measurement and pharyngeal pressures during normal and effortful swallowing. Arch Phys Med Rehabil. 2005;86(11):2144–9.

    Article  PubMed  Google Scholar 

  3. Fukuoka T, Ono T, Hori K, Tamine K, Nozaki S, Shimada K, et al. Effect of the effortful swallow and the Mendelsohn maneuver on tongue pressure production against the hard palate. Dysphagia. 2013;28(4):539–47.

    Article  PubMed  Google Scholar 

  4. Yeates EM, Steele CM, Pelletier CA. Tongue pressure and submental surface electromyography measures during noneffortful and effortful saliva swallows in healthy women. Am J Speech-Lang Pathol. 2010;19(3):274–81.

    Article  PubMed  Google Scholar 

  5. Huckabee ML, Steele CM. An analysis of lingual contribution to submental surface electromyographic measures and pharyngeal pressure during effortful swallow. Arch Phys Med Rehabil. 2006;87(8):1067–72.

    Article  PubMed  Google Scholar 

  6. Steele CM, Huckabee ML. The influence of orolingual pressure on the timing of pharyngeal pressure events. Dysphagia. 2007;22(1):30–6.

    Article  PubMed  Google Scholar 

  7. Bulow M, Olsson R, Ekberg O. Videomanometric analysis of supraglottic swallow, effortful swallow, and chin tuck in healthy volunteers. Dysphagia. 1999;14(2):67–72.

    Article  CAS  PubMed  Google Scholar 

  8. Bulow M, Olsson R, Ekberg O. Videomanometric analysis of supraglottic swallow, effortful swallow, and chin tuck in patients with pharyngeal dysfunction. Dysphagia. 2001;16(3):190–5.

    Article  CAS  PubMed  Google Scholar 

  9. Bulow M, Olsson R, Ekberg O. Supraglottic swallow, effortful swallow, and chin tuck did not alter hypopharyngeal intrabolus pressure in patients with pharyngeal dysfunction. Dysphagia. 2002;17(3):197–201.

    Article  PubMed  Google Scholar 

  10. Hiss SG, Huckabee ML. Timing of pharyngeal and upper esophageal sphincter pressures as a function of normal and effortful swallowing in young healthy adults. Dysphagia. 2005;20(2):149–56.

    Article  PubMed  Google Scholar 

  11. Takasaki K, Umeki H, Enatsu K, Tanaka F, Sakihama N, Kumagami H, et al. Investigation of pharyngeal swallowing function using high-resolution manometry. Laryngoscope. 2008;118(10):1729–32.

    Article  PubMed  Google Scholar 

  12. Hoffman MR, Mielens JD, Ciucci MR, Jones CA, Jiang JJ, McCulloch TM. High-resolution manometry of pharyngeal swallow pressure events associated with effortful swallow and the Mendelsohn maneuver. Dysphagia. 2012;27:418.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Fritz M, Cerrati E, Fang Y, Verma A, Achlatis S, Lazarus C, et al. Magnetic resonance imaging of the effortful swallow. Ann Otol Rhinol Laryngol. 2014;123(11):786–90.

    Article  PubMed  Google Scholar 

  14. Inamoto Y, Gonzalez-Fernandez M, Saitoh E. 3D-CT evaluation of swallowing: metrics of the swallowing response using swallowing CT. Dysphagia. 2021;37:237.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Agrawal D, Kern M, Edeani F, Balasubramanian G, Hyngstrom A, Sanvanson P, et al. Swallow strength training exercise for elderly: a health maintenance need. Neurogastroenterol Motil. 2018;30(10): e13382.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Inamoto Y, Saitoh E, Okada S, Kagaya H, Shibata S, Ota K, et al. The effect of bolus viscosity on laryngeal closure in swallowing: kinematic analysis using 320-row area detector CT. Dysphagia. 2013;28(1):33–42.

    Article  PubMed  Google Scholar 

  17. Olsson R, Kjellin O, Ekberg O. Videomanometric aspects of pharyngeal constrictor activity. Dysphagia. 1996;11(2):83–6.

    Article  CAS  PubMed  Google Scholar 

  18. Shaker R, Ren J, Podvrsan B, Dodds WJ, Hogan WJ, Kern M, et al. Effect of aging and bolus variables on pharyngeal and upper esophageal sphincter motor function. Am J Physiol. 1993;264(3 Pt 1):G427–32.

    CAS  PubMed  Google Scholar 

  19. Kahrilas PJ, Logemann JA, Lin S, Ergun GA. Pharyngeal clearance during swallowing: a combined manometric and videofluoroscopic study. Gastroenterology. 1992;103(1):128–36.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The authors sincerely appreciate the members of the department of Radiology, Fujita Health University for their assistance and suggestions.

Funding

This research was supported by JSPS KAKENHI (19K11310).

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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 & Keiko Aihara

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

    Yoko Inamoto, Eiichi Saitoh, Yuriko Ito, Hitoshi Kagaya, Seiko Shibata & Masahiko Mukaino

  3. Faculty of Radiological Technologies, School of Heath Sciences, Fujita Health University, Toyoake, Japan

    Masanao Kobayashi

  4. Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA

    Yoko Inamoto & Marlis F. Gonzalez

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  1. Yoko Inamoto
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  2. Eiichi Saitoh
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  9. Marlis F. Gonzalez
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Correspondence to Yoko Inamoto.

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The original version of the article was revised due to citation of table 2 and 3 were incorrect. It has been corrected.

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Inamoto, Y., Saitoh, E., Aihara, K. et al. Effect of the Effortful Swallow on Pharyngeal Cavity Volume: Kinematic Analysis in Three Dimensions Using 320-Row Area Detector Computed Tomography. Dysphagia 38, 1138–1145 (2023). https://doi.org/10.1007/s00455-022-10539-w

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  • DOI: https://doi.org/10.1007/s00455-022-10539-w

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