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At least 19 recordsLinked to original sources
PubMed1999

[Pathological deglutition pattern after tumor surgery of the oro- and hypopharynx. Analysis by differentiated deglutition].

Dysphagia is a common complaint following surgical intervention in the oral cavity and hypopharynx, often leading to prolonged postoperative recovery. Videofluoroscopy allows detailed visualization of deglutition, demonstrating the morphology as well as the functional aspects. Therefore, videofluoroscopy provides the basis for further therapeutic management. We discuss the pathology of deglutition in 19 patients recovering from tumor surgery of the oro- and hypopharynx. In most cases the results demonstrated severe impairment of both the oral and pharyngeal phase of deglutition. Our data emphasize the importance of the oral phase of deglutition for preparation and initiation of the following phases.

Deglutition Disorders↗
PubMed1990

[Study of deglutition using various sound signals].

In man quantitative information on deglutition may be obtained with the aid of various sounds recorded by way of microphone and magnetic tapes. The different tapes, microphonic, dynamic and piezoelectric, can be compared through the use of a Doppler signal in high middle position, thus showing the backward movements of the mylohyoïdeus. The sound of the deglutition consists of 1 to 3 peaks of great amplitude: 350 +/- 180 microV or 14 +/- 3.3 mV according to the type of microphone used (the piezo gives the greatest amplitude, specially in low frequency range); duration for the main phoneburst: 48 +/- 24 ms with a prolongation with the smaller noises: so total duration amounts to 400 ms. Each sound impulsion repeated in 10 Hz range includes frequency up to 6 KHz. The direct recording on a polygraph falls into 10-60 range; upper frequencies may be eliminated by filtering. In front, the inspiratory relative time increases of 57 +/- 12% without deglutition whereas it reaches 62 +/- 16% with deglutition. In clinical situation, a magnetic tape recorder can be used. The main components in normal situation of deglutition of saliva, water or yogurt show a frequent variability. Nevertheless, a certain number of recurring impulsions can be defined according to the type of deglutition, thus further defining several basic types of deglutition. Amplitude and duration deglutition type 1 (= one impulsion) was observed in young subjects for saliva and yogurt; deglutition type 2-3 (greater than or equal to 200 ms) more frequently for water and also in oldest subjects, whatever the mode of deglutition. In some pathological situations, a significant increase of amplitude and duration was observed. Technical conditions are discussed for application in clinical situations and their control in laboratory.

Adolescent↗
PubMed2001

Resting esophageal sphincter pressures and deglutition frequency in awake subjects after oropharyngeal topical anesthesia and laryngeal mask device insertion.

UNLABELLED: We investigated the effects of oropharyngeal topical anesthesia and placement of the standard (LMA) and the ProSeal (PLMA) laryngeal mask airway on resting gastroesophageal barrier pressure (GEBP), upper esophageal sphincter pressure (UESP), and deglutition frequency in awake subjects. Each subject was studied on 2 consecutive days: 1 day with the LMA and the other with the PLMA, in random order. GEBP and UESP were measured between deglutitions by using a pull-through technique in five sequential conditions: 1) after acclimatization to the manometer, 2) after topical anesthesia, 3) after the LMA or PLMA was self-inserted and the cuff inflated with either 10 or 30 mL of air in random order, 4) after the cuff volume was adjusted to the other randomized volume, and 5) after LMA or PLMA removal. Deglutition frequency was determined between pressure measurements by using a neck microphone. UESP was always larger than GEBP (P < 0.001 for all). Topical anesthesia had no influence on GEBP, UESP, or deglutition frequency. LMA and PLMA placement did not influence GEBP or UESP, but deglutition frequency was higher (P < 0.02 for all). GEBP and UESP did not vary between devices for any condition. Cuff volume did not influence GEBP or UESP. Deglutition frequency was more frequent for the LMA than the PLMA at a 30-mL cuff volume (P = 0.008). We conclude that resting GEBP and UESP are unaffected by oropharyngeal topical anesthesia and the LMA or PLMA in awake subjects, but that deglutition frequency is increased by the LMA or PLMA. This may have implications for the incidence of regurgitation in these situations. IMPLICATIONS: Resting gastroesophageal barrier pressure and upper esophageal sphincter pressure are unaffected by oropharyngeal topical anesthesia and laryngeal mask devices in awake subjects, but deglutition frequency is increased by laryngeal mask devices. This may have implications for the incidence of regurgitation in these situations.

Administration, Topical↗
PubMed1995

Deglutitive aspiration in patients with tracheostomy: effect of tracheostomy on the duration of vocal cord closure.

BACKGROUND/AIMS: Deglutitive aspiration in patients with tracheostomy has been attributed to impaired laryngeal movement, loss of protective laryngeal reflexes, and uncoordinated laryngeal closure. The aim of this study was to determine the effect of tracheostomy on the duration of deglutitive vocal cord closure. METHODS: Using concurrent videoendoscopy, respirography, and submental electromyography, deglutitive vocal cord closure and its temporal relationship with deglutitive apnea was compared between patients with tracheostomy and normal volunteers. RESULTS: Between-group comparison showed that the duration of vocal cord adduction/abduction in patients with tracheostomy was significantly shorter than that of normal volunteers (P < 0.05). Contrary to normal volunteers, in patients with tracheostomy, 5-mL water swallows significantly increased the duration of vocal cord adduction/abduction compared with that of dry swallows (P < 0.05). In addition, in patients with tracheostomy, deglutitive apnea and submental electromyography were not coordinated with vocal cord kinetics. CONCLUSIONS: Although the vocal cords close completely during swallowing in patients with tracheostomy, their duration of closure is significantly shorter compared with normal volunteers. Coordination of deglutitive vocal cord kinetics, apnea, and submental electromyography is altered in patients with tracheostomy. Contrary to normal controls, duration of deglutitive vocal cord closure in patients with tracheostomy is modified by the presence of liquid bolus.

Adult↗
PubMed1990

[Rehabilitation of deglutition in patients with pharyngeal carcinoma].

Surgical treatment of pharyngeal carcinoma implies different reconstructive procedures. Despite primary healing, in some cases cicatricial shrinkage occurs, resulting in dysphagia. Of 113 patients with carcinoma of the oro- and hypopharynx in the last 4 years, 35 patients were studied in a specific follow-up examination. Deglutition was evaluated via subjective responses to a questionnaire. Reproducible information was gained by videofluoroscopy and manometry of the pharyngo-esophageal segment. To assess deglutition, an arbitrary number scale was established with 7 for excellent and 1 for poor deglutition. After local tumour excision, partial and total pharyngectomy, pharyngolaryngectomy and additional myocutaneous grafting, the deglutition index ranged from 5.8 to 4.5 showing more striking differences in the time required for eating. Manometric analysis showed pressure peaks 10 times lower (3.5 hPa) than in normal subjects with prolongation of each swallow. Videofluoroscopy reveals even slight motility disturbances after ablative pharyngeal surgery. Typical findings are presented. The swallowing function after pharyngeal tumour operations requires the reconstruction of both the horizontal (oral) and vertical (pharyngeal) phase of deglutition. Since the base of the tongue seems to be the major driving force in bolus movement, it is not the extension of resection but the availability of remaining contractile tissue in the neopharynx, especially in the base of the tongue region, that determines the postoperative rehabilitation of deglutition.

Cineradiography↗
PubMed2001

Deglutitive movement of the tongue under local anesthesia.

The purpose of the present study was to investigate whether or not sensory input from the tongue affects deglutitive tongue movement. Subjects were seven healthy volunteers with anesthetic applied to the surface of the tongue (surface group) and seven healthy volunteers with the lingual nerve blocked by anesthetic (blocked group). We established six stages in deglutition and analyzed deglutitive tongue movement and the time between the respective stages by cineradiography before and after anesthesia. After anesthesia in both surface and blocked groups, deglutitive tongue movement slowed and bolus movement was delayed. The deglutitive tongue tip retreated in the blocked group. These results suggest that delay of tongue movement by anesthesia causes weak bolus propulsion and that deglutitive tongue tip position is affected by sensory deprivation of the tongue or the region innervated by the inferior alveolar nerve.

Adult↗
PubMed1988

Laryngeal reflex mechanism during deglutition--observation of subglottal pressure and afferent discharge.

In this investigation, particular attention was paid to elucidate the laryngeal reflex mechanism of protective closure and the sensory function of the larynx during deglutition. For this purpose, three different experimental procedures were adopted: (1) subglottal pressure of felines was measured during deglutition using a pressure transducer; (2) subglottal pressure of human beings was measured during deglutition using a pressure transducer; and (3) afferent discharges from superior and recurrent laryngeal nerves of felines were recorded. The following conclusions appear justified. (1) Feline and human subglottal pressure during deglutition showed the following pattern. The pressure rises with onset of deglutition, temporarily drops during laryngeal elevation, rises again during the downward movement of the larynx, and drops again at the end of the glutition. This pattern was not affected by the resection of the unilateral recurrent laryngeal nerve. (2) The superior laryngeal nerve is involved in the sensory function of the pharynx, larynx, and trachea. At least two types of afferent discharges from superficial and internal sensory nerves are suspected. Afferent discharges from the recurrent laryngeal nerves in the larynx and trachea are not as distinct as those of the superior laryngeal nerve, and this seems to correspond with various changes in the thorax. During deglutition, afferent discharges were recorded from superior to recurrent laryngeal nerves.

Animals↗
PubMed1993

Shape, volume, and content of the deglutitive pharyngeal chamber imaged by ultrafast computerized tomography.

BACKGROUND: Conventional radiographic techniques image only the silhouettes of the deglutitive pharyngeal chamber. This study aimed to accurately image the horizontal plane shape and content of the pharynx during swallowing. METHODS: Dynamic computerized tomography images of the pharynx were obtained at the rate of 17 per second during swallowing. Multiple adjacent levels were imaged in eight subjects and a single level was scanned in four subjects during swallows of varied volume. Images were analyzed for area, volume, and the bolus fraction of the deglutitive pharyngeal chamber. RESULTS: The deglutitive chamber enlarged to approximately 24 mL (during tongue loading) compared with a preswallow pharyngeal volume averaging 15 mL. Throughout the 10 mL swallows, the bolus occupied less than 30% of the lumen regardless of axial level. The bolus fraction of the deglutitive chamber increased with swallow volume, as did the dimensions of the upper esophageal sphincter and the bolus velocity through the upper esophageal sphincter. CONCLUSIONS: The deglutitive pharyngeal chamber was typically approximately 15 mL > the bolus volume, implying that an obligatory 15 mL of air was swallowed under these test conditions. Most swallowed air originated as air trapped within the pharynx and larynx as the oropharynx was sealed from above and below.

Adult↗