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Physiology (Bethesda, Md.) Jan 2023Despite centuries of investigation, questions and controversies remain regarding the fundamental genesis and motor pattern of swallow. Two significant topics include... (Review)
Review
Despite centuries of investigation, questions and controversies remain regarding the fundamental genesis and motor pattern of swallow. Two significant topics include inspiratory muscle activity during swallow (Schluckatmung, i.e., "swallow-breath") and anatomical boundaries of the swallow pattern generator. We discuss the long history of reports regarding the presence or absence of Schluckatmung and the possible advantages of and neural basis for such activity, leading to current theories and novel experimental directions.
Topics: Humans; Deglutition; Respiratory System
PubMed: 35998250
DOI: 10.1152/physiol.00005.2021 -
Acta Oto-rhino-laryngologica Belgica 1993Swallowing physiology and sucking reflex together with their significance are reviewed. The intra-oral events in children and adults are described. (Review)
Review
Swallowing physiology and sucking reflex together with their significance are reviewed. The intra-oral events in children and adults are described.
Topics: Adolescent; Adult; Child; Child, Preschool; Deglutition; Humans; Infant; Sucking Behavior
PubMed: 8317207
DOI: No ID Found -
L' Orthodontie Francaise 1982
Topics: Adult; Child; Deglutition; Deglutition Disorders; Fetus; Humans; Infant, Newborn; Masticatory Muscles
PubMed: 6965063
DOI: No ID Found -
Cross-System Integration of Respiration and Deglutition: Function, Treatment, and Future Directions.Dysphagia Aug 2023Swallowing occurs preferentially in the expiratory phase of the quiet breathing cycle and at mid-to-low tidal volume. This coordinative pattern imparts important... (Review)
Review
Swallowing occurs preferentially in the expiratory phase of the quiet breathing cycle and at mid-to-low tidal volume. This coordinative pattern imparts important biomechanical advantages to swallowing and airway protection and facilitate laryngeal elevation, laryngeal vestibular and vocal fold closure, and cricopharyngeal sphincter opening. This preferred coordinative relationship between breathing and swallowing is impaired in a variety of patient populations, including head and neck cancer survivors with dysphagia. We developed a training protocol to re-establish more optimal phasing of swallowing with breathing in these patients with striking outcomes, including reduced swallowing physiological impairments and improved airway protection. This motivated us to continue to refine and expand this training protocol and develop new assistive technologies for swallowing monitoring outside of the lab. In this review, we highlight the origins of our optimal respiratory-swallowing coordination hypothesis, describe the biomechanical advantages it provides, carefully describe our training protocol and findings, and chart a course for the next phase of this work. Our overall goal is to harness technology combined with carefully constructed learning paradigms to improve the lives of patients with impaired respiratory-swallowing coordination consequent to a variety of pathologies including head and neck cancer and degenerative neurological conditions such as Parkinson's disease.
Topics: Humans; Deglutition; Respiration; Deglutition Disorders; Larynx; Head and Neck Neoplasms
PubMed: 36378345
DOI: 10.1007/s00455-022-10538-x -
Acta Otorrinolaringologica Espanola 2014With intensive care patients, decannulation and deglutition disorders are frequent reasons for otorhinolaryngological assessment. The objective of a tracheostomy is to... (Review)
Review
With intensive care patients, decannulation and deglutition disorders are frequent reasons for otorhinolaryngological assessment. The objective of a tracheostomy is to maintain a patent airway. It does not necessarily prevent episodes of aspiration and may even favour them. When the cause that led to the tracheostomy resolves, a decannulation may be proposed. Deglutition is a complex act involving the coordinated interaction of several structures of the aerodigestive tract. Fibre-optic endoscopy and videofluoroscopy are 2 useful, complementary tools for the evaluation of patients with swallowing disorders. In managing these patients, a thorough knowledge of laryngeal and swallowing physiology, as well as of the different therapeutic alternatives, is required. Although it is not uncommon for swallowing disorders to coexist in tracheostomy patients, decannulation evaluation is not synonymous with deglutition assessment. A patient could be a candidate for decannulation and have a swallowing disorder, or a tracheostomy patient could swallow adequately. Knowing and understanding these concepts will lead to more efficient management and help to clarify communication between the intensive care physician and the otorhinolaryngologist. Ideally, a multidisciplinary team should be formed to evaluate and manage these patients.
Topics: Catheters; Critical Care; Decision Trees; Deglutition; Deglutition Disorders; Device Removal; Humans; Tracheostomy
PubMed: 23510902
DOI: 10.1016/j.otorri.2013.01.004 -
The American Journal of Medicine Dec 2001Information from neuronal pathway tracing and pharmacologic microstimulation studies, in conjunction with electrophysiological data, has begun to coalesce into a... (Review)
Review
Information from neuronal pathway tracing and pharmacologic microstimulation studies, in conjunction with electrophysiological data, has begun to coalesce into a coherent, if still incomplete, picture of the brain stem circuitry responsible for generating the motor patterns underlying deglutition and esophageal peristalsis in the rat. The intermediate, interstitial, and ventral subnuclei of the solitarius complex appear to play a pivotal part, as evidenced by their viscerosensory inputs and extensive projections to the parvicellular intermediate reticular formation of the medulla, to the brain stem deglutitive motor neuron pools, and to general visceral efferent preganglionic neurons controlling the upper alimentary tract striated and smooth musculature, respectively. The dense projections of the solitarial central subnucleus form a separate subcircuit controlling esophageal, and also some aspects of gastric, motility. Although not extensive, direct connections between the latter subnucleus and interneurons coordinating the buccopharyngeal stage of swallowing appear to exist. In both subcircuits, fast information transfer uses excitatory amino acidergic transmission by means of several glutamate-receptor subtypes. Release from tonic GABAergic inhibition exerted by local solitarial interneurons may provide a mechanism for triggering deglutitive premotoneuronal activity. Local or reticular cholinergic neurons are implicated in pharyngoesophageal coupling and the generation of propulsive esophagomotor output. The solitary interneurons under investigation engage in complex local dendritic and axonal projections within the solitarius complex. Further analysis of these local circuits and their transmitters should yield essential clues regarding the mechanisms underlying deglutitive motor pattern generation.
Topics: Autonomic Nervous System; Deglutition; Esophagus; Female; Humans; Male; Neural Pathways; Neurotransmitter Agents; Rhombencephalon; Sensitivity and Specificity
PubMed: 11749931
DOI: 10.1016/s0002-9343(01)00824-5 -
Dysphagia 1991Pharmacologic investigations into the transmission processes underlying fictive swallowing in the rat have disclosed the potential diversity of chemical signals used in... (Review)
Review
Pharmacologic investigations into the transmission processes underlying fictive swallowing in the rat have disclosed the potential diversity of chemical signals used in central deglutitive pathways. Monoaminergic mechanisms appear to serve as links between subcortical structures and the medullary pattern generator of swallowing (PGS), and may play a critical role in maintaining internal facilitatory drive, required by the PGS for optimal responsivity to peripheral sensory input. Cholinergic bulbar interneurons form an integral component of the PGS subnetwork controlling esophageal peristalsis. Local GABA neurons exert a tonic inhibition of the buccopharyngeal stage, may regulate buccopharyngeal-esophageal coupling, and may contribute to peristaltic rhythmic generation at both the premotoneuronal and motoneuronal level. Receptor subtypes for excitatory amino acids (glutamate, aspartate) are differentially associated with deglutitive premotoneurons for both the buccopharyngeal and esophageal stage, as well as with ambiguus motoneurons. Preliminary evidence suggests the existence of excitatory peptidergic mechanisms involving thyrotropin-releasing hormone, vasopressin, oxytocin, and somatostatin, a probable candidate for excitatory transmitter in the solitarioambigual internuncial projection to motoneurons innervating esophageal striated musculature. Further validation of this experimental model may ultimately help to establish a framework for the clinical recognition, management, and exploitation of drug actions on central deglutitive neuroeffectors.
Topics: Animals; Deglutition; Facial Muscles; Neural Pathways; Neuropharmacology; Neurotransmitter Agents; Rats
PubMed: 1680608
DOI: 10.1007/BF02493518 -
Laryngo- Rhino- Otologie Mar 2018
Topics: Deglutition; Deglutition Disorders; Endoscopy, Gastrointestinal; Fiber Optic Technology; Humans; Video Recording
PubMed: 29495039
DOI: 10.1055/s-0043-125008 -
Laryngo- Rhino- Otologie Feb 2018
Topics: Deglutition; Deglutition Disorders; Endoscopy, Digestive System; Fiber Optic Technology; Humans; Otolaryngology
PubMed: 29401545
DOI: 10.1055/s-0043-125007 -
Annual Review of Food Science and... Mar 2022Food oral processing (FOP) is a fast-emerging research area in the food science discipline. Since its first introduction about a decade ago, a large amount of literature... (Review)
Review
Food oral processing (FOP) is a fast-emerging research area in the food science discipline. Since its first introduction about a decade ago, a large amount of literature has been published in this area, forming new frontiers and leading to new research opportunities. This review aims to summarize FOP research progress from current perspectives. Food texture, food flavor (aroma and taste), bolus swallowing, and eating behavior are covered in this review. The discussion of each topic is organized into three parts: a short background introduction, reflections on current research findings and achievements, and future directions and implications on food design. Physical, physiological, and psychological principles are the main concerns of discussion for each topic. The last part of the review shares views on the research challenges and outlooks of future FOP research. It is hoped that the review not only helps readers comprehend what has been achieved in the past decade but also, more importantly, identify where the knowledge gaps are and in which direction the FOP research will go.
Topics: Deglutition; Food; Food Handling; Odorants; Taste
PubMed: 35333588
DOI: 10.1146/annurev-food-052720-103054