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Influence of cold stimulation on the normal pharyngeal swallow response

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Abstract

We examined the potential influence of cold stimulation of the anterior tonsillar pillars, before and after topical anesthesia, on the temporal linkage between the oral and pharyngeal components of the swallow. We hypothesized that if elicitation of the pharyngeal swallow were dependent upon stimulation of faucial mucosal receptors this response would be facilitated by cold tactile stimulation and inhibited by topical anesthesia. In 14 healthy volunteers undergoing simultaneous videoradiography and manometry we measured and compared regional transit and clearance times, and the timing of hyoid motion, upper esophageal sphincter relaxation, and opening within the swallow sequence. There was a significant, volume-dependent forward shift in timings of hyoid motion, upper esophageal sphincter (UES) relaxation profile, and opening which were influenced neither by cold stimulation nor topical anesthesia. Regional transit and clearance times and UES coordination were not influenced by cold stimulation. Pharyngeal clearance time was prolonged by tonsillar pillar anesthesia due to earlier arrival of the bolus head at this region (p=0.002). We conclude that the normal pharyngeal swallow response is neither facilitated nor inhibited by prior cold tactile stimulation or topical anesthesia to the tonsillar pillars, respectively. These observations do not support the hypothesis that elicitation of the pharyngeal swallow response is dependent upon stimulation of mucosal receptors in the tonsillar arches.

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References

  1. Miller A: Deglutition. Physiol Rev 62:129–184, 1982

    PubMed  Google Scholar 

  2. Pommerenke W: A study of sensory areas eliciting the swallow reflex. Am J Physiol 84:36–41, 1928

    Google Scholar 

  3. Miller F, Sherrington C: Some observations on the bucco-pharyngeal stage of reflex deglutition in the cat. Q J Exp Physiol 9:147–186, 1916

    Google Scholar 

  4. Sinclair W: Role of the pharyngeal plexus in initiation of swallowing. Am J Physiol 221(5):1260–1263, 1970

    Google Scholar 

  5. Miller A: Significance of sensory inflow to the swallowing reflex. Brain Res 43:147–159, 1972

    PubMed  Google Scholar 

  6. Mansson I, Sandberg N: Salivary stimulus and swallowing reflex in man. Acta Otolaryngol 79:445–450, 1975

    PubMed  Google Scholar 

  7. Cook IJ, Dodds WJ, Dantas RO, Kern MK, Massey BT, Shaker R, Hogan WJ: Timing of videofluoroscopic, manometric events, and bolus transit during the oral and pharyngeal phases of swallowing. Dysphagia 4:8–15, 1989

    PubMed  Google Scholar 

  8. Dantas R, Kern M, Massey B, Dodds W, Kahrilas P, Brasseur J, Cook I, Lang I: Effect of swallowed bolus variables on oral and pharyngeal phases of swallowing. Am J Physiol 258(Gastrointest Liver Physiol 21):G675-G681, 1990

    Google Scholar 

  9. Jacob P, Kahrilas P, Logemann J, Shah V, Ha T: Upper esophageal sphincter opening and modulation during swallowing. Gastroenterology 97:1469–1478, 1989

    PubMed  Google Scholar 

  10. Veis S, Logemann J: Swallowing disorders in persons with cerebrovascular accident. Arch Phys Med Rehabil 66:372–375, 1985

    PubMed  Google Scholar 

  11. Lazzara G, Lazarus C, Logemann J: Impact of thermal stimulation on the triggering of the swallow reflex. Dysphagia 1:73–77, 1986

    Google Scholar 

  12. Cook IJ, Dodds WJ, Dantas RO, Massey B, Kern MK, Lang IM, Brasseur JG, Hogan WJ: Opening mechanisms of the human upper esophageal sphincter. Am J Physiol 257:G748-G759, 1989

    PubMed  Google Scholar 

  13. Cook IJ, Gabb M, Panagopoulos V, Jamieson GG, Dodds WJ, Dent J, Shearman DJ: Pharyngeal (Zenker's) diverticulum is a disorder of upper esophageal sphincter opening. Gastroenterology 103:1229–1235, 1992

    PubMed  Google Scholar 

  14. Logemann JA: Evaluation and Treatment of Swallowing Disorders. San Diego: College Hill Press, 1983

    Google Scholar 

  15. Kahrilas PJ, Dodds WJ, Dent J, Logemann JA, Shaker R: Upper esophageal sphincter function during deglutition. Gastroenterology 95:52–62, 1988

    PubMed  Google Scholar 

  16. Bruning JL, Kintz BL: Computational Handbook of Statistics, 2nd ed. Illinois: Scott, Foresman and Co, 1977

    Google Scholar 

  17. Bucholz D, Bosma J, Donner M: Adaptation, compensation and decompensation of the pharyngeal swallow. Gastrointest Radiol 10:235–239, 1985

    PubMed  Google Scholar 

  18. Linden P, Tippett D, Johnston J, Siebens A, French J: Bolus position at swallow onset in normal adults: preliminary observations. Dysphagia 4:146–150, 1989

    PubMed  Google Scholar 

  19. Palmer J, Rudin N, Lara G, Crompton A: Coordination of mastication and swallowing. Dysphagia 7(4):187–200, 1992

    PubMed  Google Scholar 

  20. Pansson I, Sandberg N: Oro-pharyngeal sensitivity and elicitation of swallowing in man. Acta Otolaryngol (Stockh) 79:140–145, 1975

    Google Scholar 

  21. Sinclair W: Initiation of reflex swallowing from the naso- and oropharynx. Am J Physiol 218(4):956–959, 1971

    Google Scholar 

  22. Storey A: Laryngeal initiation of swallowing. Exp Neurol 20:359–365, 1968

    Article  PubMed  Google Scholar 

  23. Doty R: Influence of stimulus pattern on reflex deglutition. Am J Physiol 66:142–151, 1951

    Google Scholar 

  24. Valdez D, Salapatek A, Niznik G, Linden R, Diamant N: Swallowing and upper esophageal sphincter contraction with transcranial magnetic-induced electrical stimulation. Am J Physiol 264(27):G213-G219, 1993

    PubMed  Google Scholar 

  25. Doty RW: Neural organization of deglutition. In: Code CF, (ed.): Handbook of Physiology, Alimentary Canal, Sect 6, Vol 4. Washington DC: American Physiology Society, 1968, pp 1861–1902

    Google Scholar 

  26. Jean A, Car A: Inputs to the swallowing medullary neurones from the peripheral afferent fibers and the swallowing cortical area. Brain Res 178:567–572, 1979

    PubMed  Google Scholar 

  27. Miller A, Bowman J: Precentral cortical modulation of mastication and swallowing. J Dent Res 56:1154–1159, 1977

    PubMed  Google Scholar 

  28. Miller A: Characteristics of the swallowing reflex induced by peripheral nerve and brain stem stimulation. Exp Neurol 34:210–222, 1972

    PubMed  Google Scholar 

  29. Car A, Jean A, Roman C: A pontine primary relay for ascending projections of the superior laryngeal nerve. Exp Brain Res 22:197–210, 1975

    PubMed  Google Scholar 

  30. Sumi T: Role of reticular formation in the neural organization of deglutition. Jpn J Physiol 22:295–314, 1972

    PubMed  Google Scholar 

  31. Jean A: Control of the central swallowing program by inputs from the peripheral receptors. A review. J Auton Nerv Syst 10:225–233, 1984

    Article  PubMed  Google Scholar 

  32. Ali G, Laundl T, Shaw D, de Carle D, Cook I: Are mucosal receptors important in the control of pharyngeal and UES function during swallowing? Gastroenterology 140:A469, 1993

    Google Scholar 

  33. Rosenbek J, Robbins J, Fishback B, Levine R: Effects of thermal application on dysphagia after stroke. J Speech Hear Res 34:1257–1268, 1991

    PubMed  Google Scholar 

  34. Knauer C, Castell J, Dalton C, Nowak L, Castell D: Pharyngeal/upper esophageal sphincter pressure dynamics in humans: effects of pharmacologic agents and thermal stimulation. Dig Dis Sci 35:774–780, 1990

    PubMed  Google Scholar 

  35. Yamamoto T, Yuyama N, Kawarmura Y: Cortical neurons responding to tactile, thermal and taste stimulations of the rat tongue. Brain Res 221:202–206, 1981

    PubMed  Google Scholar 

  36. Calhoun K, Gibson B, Hartley L, Minton J, Hokanson J: Age-related changes in oral sensation. Laryngoscope 102:109–116, 1992

    PubMed  Google Scholar 

  37. Sweazy R, Bradley R: Responses of neurons in lamb nucleus tractus solitarius to stimulation of the caudal oral cavity and epiglottis with different stimulus modalities. Brain Res 5480:133–150, 1989

    Google Scholar 

  38. Heimlich H: Rehabilitation after stroke. Ann Otol Rhinol Laryngol 92:357–359, 1983

    PubMed  Google Scholar 

  39. Miglieta O: Evaluation of cold in spasticity. Am J Phys Med 41:148–151, 1962

    PubMed  Google Scholar 

  40. Olsen J, Stravano V: A review of cryotherapy. Phys Ther 51(8):840–853, 1972

    Google Scholar 

  41. Bawa P, Mekjavic I, Calanicie B: Effect of core cooling on short and long latency response. Brain Res 264:320–322, 1983

    PubMed  Google Scholar 

  42. Christensen L, Mohamed S: Effects of topical cooling on isometric contraction of the human masseter muscle. Arch Oral Biol 29(8):635–639, 1984

    PubMed  Google Scholar 

  43. Barnes W: Effects of heat and cold application on isometric muscular strength. Percept Mot Skills 56:886, 1983

    PubMed  Google Scholar 

  44. Kuehn D, Templeton P, Maynard J: Muscle spindles in the velopharyngeal musculature of humans. J Speech Hear Res 33:488–493, 1990

    PubMed  Google Scholar 

  45. Liss J: Muscle spindles in the human levator veli palatini and palatoglossus muscle. J Speech Hear Res 33:736–746, 1990

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Gastroenterology, The St George Hospital, University of New South Wales, Sydney, New South Wales, Australia

    Galib N. Ali DSM, FRACP, Tina M. Laundl BS, Karen L. Wallace BS, David J. deCarle MB, BS, FRACP & Ian J. S. Cook MD, FRACP

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  1. Galib N. Ali DSM, FRACP
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  2. Tina M. Laundl BS
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  3. Karen L. Wallace BS
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  4. David J. deCarle MB, BS, FRACP
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  5. Ian J. S. Cook MD, FRACP
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Ali, G.N., Laundl, T.M., Wallace, K.L. et al. Influence of cold stimulation on the normal pharyngeal swallow response. Dysphagia 11, 2–8 (1996). https://doi.org/10.1007/BF00385791

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