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Acta Otorhinolaryngologica Italica :... Oct 2019
Review
Topics: Child; Deglutition; Deglutition Disorders; Diagnosis, Differential; Fluoroscopy; Humans; Technology, Radiologic; Video Recording
PubMed: 30933173
DOI: 10.14639/0392-100X-1942 -
Brain and Nerve = Shinkei Kenkyu No... Feb 2015Swallowing is regarded as the first step in nutrition; it transports food boluses and liquid from the mouth to the stomach and is a defensive response to prevent... (Review)
Review
Swallowing is regarded as the first step in nutrition; it transports food boluses and liquid from the mouth to the stomach and is a defensive response to prevent aspiration. Swallowing movements are produced by a central pattern generator (CPG) located in the lower brainstem. The swallowing CPG includes two main groups of neurons: one is located within the nucleus tractus solitarii and contains the generator neurons involved in triggering, shaping, and timing the sequential or rhythmic swallowing pattern and the other is located in the ventrolateral medulla and contains switching neurons that distribute the swallowing drive to various pools of related motoneurons. Swallowing movements can be triggered by either central inputs or peripheral inputs from pharyngeal and laryngeal regions, but the precise neural mechanisms of the swallowing CPG remain to be fully elucidated. This review discusses the fundamental knowledge of ingestion behaviors, with a focus on swallowing.
Topics: Animals; Brain Stem; Deglutition; Eating; Humans; Muscle, Skeletal; Nerve Net; Neurons
PubMed: 25681361
DOI: 10.11477/mf.1416200108 -
The Journal of Laryngology and Otology Jul 2014
Topics: Deglutition; Hearing Loss, Sensorineural; Humans; Laryngectomy; Migraine Disorders; Vertigo
PubMed: 24968812
DOI: 10.1017/S0022215114000607 -
Dysphagia Apr 2023Electrokinesiographic study of swallowing (EKSS) can be useful for the assessment of patients with suspected or overt neurogenic dysphagia. EKSS consists of multichannel... (Review)
Review
Electrokinesiographic study of swallowing (EKSS) can be useful for the assessment of patients with suspected or overt neurogenic dysphagia. EKSS consists of multichannel recording of the electromyographic (EMG) activity of the suprahyoid/submental muscle complex (SHEMG), the EMG activity of the cricopharyngeal muscle (CPEMG), and the laryngopharyngeal mechanogram (LPM). The LPM is an expression of the mechanical changes that the laryngopharyngeal structures undergo during the pharyngeal phase of swallowing. This method allows detailed evaluation of the magnitude, duration and temporal relations of the different events that characterize oropharyngeal swallowing, and thus in-depth exploration both of physiological deglutition mechanisms and of pathophysiological features of swallowing in neurogenic dysphagia. Furthermore, EKSS can guide dysphagia treatment strategies, allowing identification of optimal solutions for single patients. For instance, CPEMG recording can identify incomplete or absent relaxation of the upper esophageal sphincter during the pharyngeal phase of swallowing, thus suggesting a therapeutic approach based on botulinum toxin injection into the cricopharyngeal muscle. More recently, the 'shape' of SHEMG and the reproducibility of both SHEMG and LPM over repeated swallowing acts have been implemented as novel electrokinesiographic parameters. These measures could be valuable for straightforward non-invasive investigation of dysphagia severity and response to dysphagia treatment in clinical practice.
Topics: Humans; Deglutition Disorders; Deglutition; Reproducibility of Results; Oropharynx; Pharynx; Electromyography
PubMed: 34313849
DOI: 10.1007/s00455-021-10336-x -
Dysphagia Apr 2022Videofluoroscopy and videoendoscopy dramatically changed the evaluation and management of swallowing disorders. Later advancements in techniques for the instrumental... (Review)
Review
Videofluoroscopy and videoendoscopy dramatically changed the evaluation and management of swallowing disorders. Later advancements in techniques for the instrumental evaluation of swallowing were limited by technique and positioning. The advent of 320-row area detector CT solved previous challenges and allowed for the study of swallowing physiology and dysphagia in greater detail. In this summary, we describe the history and evolution of CT technology and describe research and clinical applications for the evaluation of swallowing physiology and pathophysiology.
Topics: Benchmarking; Deglutition; Deglutition Disorders; Humans; Pharynx; Tomography, X-Ray Computed
PubMed: 33818630
DOI: 10.1007/s00455-021-10288-2 -
European Journal of Neurology Jan 2021
Topics: Deglutition; Humans
PubMed: 32986259
DOI: 10.1111/ene.14558 -
JPMA. the Journal of the Pakistan... Jun 2023Dysphagia defined as difficulty in swallowing, can result from multiple causes including, Stroke, head injury, Alzheimer, Dementia, Muscular dystrophy, Cerebral Palsy... (Review)
Review
Dysphagia defined as difficulty in swallowing, can result from multiple causes including, Stroke, head injury, Alzheimer, Dementia, Muscular dystrophy, Cerebral Palsy etc. It is associated with neuro-muscular impairments in different age groups. VitalStim® therapy is a relatively new approach to treat dysphagia. It provides neuromuscular electrical stimulation (NMES) of the involved muscles to improve the function of swallowing. This review summarizes the usefulness of VitalStim® in dysphagia, and barriers in its use in Pakistan.
Topics: Humans; Deglutition Disorders; Treatment Outcome; Electric Stimulation Therapy; Deglutition; Stroke
PubMed: 37427651
DOI: 10.47391/JPMA.23-46 -
Dysphagia Feb 2023This literature review explores a wide range of themes addressing the links between swallowing and consciousness. Signs of consciousness are historically based on the... (Review)
Review
This literature review explores a wide range of themes addressing the links between swallowing and consciousness. Signs of consciousness are historically based on the principle of differentiating reflexive from volitional behaviors. We show that the sequencing of the components of swallowing falls on a continuum of voluntary to reflex behaviors and we describe several types of volitional and non-volitional swallowing tasks. The frequency, speed of initiation of the swallowing reflex, efficacy of the pharyngeal phase of swallowing and coordination between respiration and swallowing are influenced by the level of consciousness during non-pathological modifications of consciousness such as sleep and general anesthesia. In patients with severe brain injury, the level of consciousness is associated with several components related to swallowing, such as the possibility of extubation, risk of pneumonia, type of feeding or components directly related to swallowing such as oral or pharyngeal abnormalities. Based on our theoretical and empirical analysis, the efficacy of the oral phase and the ability to receive exclusive oral feeding seem to be the most robust signs of consciousness related to swallowing in patients with disorders of consciousness. Components of the pharyngeal phase (in terms of abilities of saliva management) and evoked cough may be influenced by consciousness, but further studies are necessary to determine if they constitute signs of consciousness as such or only cortically mediated behaviors. This review also highlights the critical lack of tools and techniques to assess and treat dysphagia in patients with disorders of consciousness.
Topics: Humans; Deglutition; Consciousness; Consciousness Disorders; Deglutition Disorders; Reflex
PubMed: 35773497
DOI: 10.1007/s00455-022-10452-2 -
HNO Mar 2017It is estimated that 5 million people in Germany currently suffer from swallowing disorders. Due to increasing life expectancy and the good outcome of very premature... (Review)
Review
It is estimated that 5 million people in Germany currently suffer from swallowing disorders. Due to increasing life expectancy and the good outcome of very premature infants, this number is expected to increase. Swallowing normally occurs in four phases, and for each phase there are diagnostic tools to assess whether the problem is anatomic-organic or functional. A detailed case history is followed by clinical examination of the cranial nerves, the orofacial region, the swallowing reflex, and pharyngeal and esophageal transit. Attention is also paid to age-related changes in the swallowing process, nasal regurgitation, retention at the base of the tongue or in the hypopharynx, and signs of aspiration.
Topics: Deglutition; Deglutition Disorders; Diagnostic Techniques, Digestive System; Evidence-Based Medicine; Humans; Models, Biological; Pharynx
PubMed: 28233016
DOI: 10.1007/s00106-017-0333-0 -
CoDAS Mar 2017Literature review on the onset locations of the pharyngeal phase of swallowing in asymptomatic and symptomatic adults and elderly people. (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Literature review on the onset locations of the pharyngeal phase of swallowing in asymptomatic and symptomatic adults and elderly people.
RESEARCH STRATEGIES
Research was conducted in the PubMed, BIREME and SciELO databases through the descriptors fluoroscopy (fluoroscopia), deglutition (deglutição) and pharynx (faringe).
SELECTION CRITERIA
Studies published between 2005 and 2015, carried out with adults and elderly people who underwent swallowing videofluoroscopy (SVF), and citing the onset location of the pharyngeal phase of swallowing.
DATA ANALYSIS
Descriptive analysis and meta-analysis were performed, evaluating the heterogeneity and the measures grouped with random effects through I2 statistics. For ratio calculation in the meta-analysis, the locations described in the articles were classified according to the Modified Barium Swallowing protocol - Measurement Tool for Swallowing Impairment (MBSImp).
RESULTS
Twelve articles were selected for descriptive analysis and seven for meta-analysis. Heterogeneity was found between studies, especially due to clinical and methodological differences. The random effect indicated predominance (58%) of the onset of the pharyngeal phase of swallowing at levels 0 and 1 of the MBSImP. In asymptomatic individuals, the onset of the pharyngeal phase was observed in the oral cavity, base of the tongue, dorsum of the tongue and vallecula. In symptomatic individuals, onset was mainly observed in the oropharynx, vallecula, hypopharynx and pyriform sinus.
CONCLUSION
We noted a greater frequency of the onset of the pharyngeal phase of swallowing in the vallecula. The onset of the pharyngeal phase in the hypopharynx and pyriform sinus was more often observed among elderly individuals or with comorbidities that could alter swallowing.
Topics: Adult; Aged; Deglutition; Deglutition Disorders; Female; Fluoroscopy; Humans; Male; Oropharynx; Pharynx
PubMed: 28327783
DOI: 10.1590/2317-1782/20172016067