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European Archives of... 1997Morphologic correlates of physiologic closure mechanisms of the laryngeal vestibule were investigated in plastinated serial sections of 25 normal adult larynges. The... (Review)
Review
Morphologic correlates of physiologic closure mechanisms of the laryngeal vestibule were investigated in plastinated serial sections of 25 normal adult larynges. The anterior part of the laryngeal vestibule was seen to be bounded by the epiglottis and the thyroepiglottic ligament medially, and by lateral extensions of the periepiglottic adipose tissue laterally. The posterior part of the laryngeal vestibule was bordered by the aryepiglottic folds. Morphologically, the periepiglottic space and the aryepiglottic folds were completely separated by several transversely oriented collagenous fiber layers attached to the thyroid perichondrium laterally. This may suggest a corresponding functional separation, as described previously in the literature. Closure of the anterior part of the laryngeal vestibule during swallowing is probably related to the lowering of the epiglottis, with both depending on pressure exerted onto the periepiglottic adipose tissue. Closure of the posterior part of the laryngeal vestibule is most likely related to closure of the rima glottidis, with both depending on adduction of the arytenoid cartilage.
Topics: Adult; Aged; Aged, 80 and over; Deglutition; Female; Humans; Larynx; Male; Middle Aged
PubMed: 9438107
DOI: 10.1007/BF02439969 -
The Laryngoscope Apr 2012In this article we describe a methodology for obtaining high-quality dynamic magnetic resonance imaging (MRI) sequences of the swallow sequence in healthy volunteers.... (Comparative Study)
Comparative Study
OBJECTIVES/HYPOTHESIS
In this article we describe a methodology for obtaining high-quality dynamic magnetic resonance imaging (MRI) sequences of the swallow sequence in healthy volunteers. The study includes comparison to previous work done in our lab using a 1.5 Tesla (T) magnet.
STUDY DESIGN
Case series.
METHODS
Three healthy volunteers underwent turbo-fast low angle shot MRI at 3T while swallowing liquid boluses delivered via intravenous tubing to the oral cavity. Imaging was performed in the sagittal and axial planes.
RESULTS
Imaging provided by this sequence provided high temporal resolution, with the ability to depict deglutition in the axial and sagittal planes. Comparison with imaging at 1.5 T demonstrated benefits in temporal resolution and signal-to-noise. Anatomic information provided differed from comparative videofluoroscopy.
CONCLUSIONS
MRI of swallowing using the described technique is reliable and provides a unique evaluation of the swallowing sequence.
Topics: Adult; Deglutition; Female; Humans; Magnetic Resonance Imaging; Male; Pharynx; Reference Values; Reproducibility of Results
PubMed: 22253090
DOI: 10.1002/lary.22496 -
Acta Oto-laryngologica 1954
Topics: Deglutition; Humans
PubMed: 14349662
DOI: 10.3109/00016485409127655 -
Current Oncology Reports Mar 2004Difficulty in swallowing is a common complaint among patients with head and neck cancer. Preexistent dysphagia is often compounded by any of the side effects and... (Review)
Review
Difficulty in swallowing is a common complaint among patients with head and neck cancer. Preexistent dysphagia is often compounded by any of the side effects and sequelae of the current treatment modalities for malignancies of the head and neck. Surgery, radiotherapy, and chemoradiotherapy produce sensory and motor denervation and fibrosis of the upper aerodigestive tract musculature and mucosa. Clinicians must learn to anticipate and identify the various deficits of swallowing function in these patients. Flexible fiberoptic evaluation of swallowing and the modified barium swallow are critical tests for delineating the pathophysiology of these patients and establishing a protocol for their rehabilitation. Rehabilitation for patients with swallowing disorders decreases the morbidity of aspiration and allows for better nutrition, better hydration, and overall improvement in quality of life.
Topics: Deglutition; Deglutition Disorders; Head and Neck Neoplasms; Humans
PubMed: 14751094
DOI: 10.1007/s11912-004-0028-z -
Dysphagia Dec 2019The characteristics of the flows of boluses with different consistencies, i.e. different rheological properties, through the pharynx have not been fully elucidated. The... (Review)
Review
The characteristics of the flows of boluses with different consistencies, i.e. different rheological properties, through the pharynx have not been fully elucidated. The results obtained using a novel in vitro device, the Gothenburg Throat, which allows simultaneous bolus flow visualisation and manometry assessments in the pharynx geometry, are presented, to explain the dependence of bolus flow on bolus consistency. Four different bolus consistencies of a commercial food thickener, 0.5, 1, 1.5 and 2 Pa s (at a shear rate of 50 s)-corresponding to a range from low honey-thick to pudding-thick consistencies on the National Dysphagia Diet (NDD) scale-were examined in the in vitro pharynx. The bolus velocities recorded in the simulator pharynx were in the range of 0.046-0.48 m/s, which is within the range reported in clinical studies. The corresponding wall shear rates associated with these velocities ranged from 13 s (pudding consistency) to 209 s (honey-thick consistency). The results of the in vitro manometry tests using different consistencies and bolus volumes were rather similar to those obtained in clinical studies. The in vitro device used in this study appears to be a valuable tool for pre-clinical analyses of thickened fluids. Furthermore, the results show that it is desirable to consider a broad range of shear rates when assessing the suitability of a certain consistency for swallowing.
Topics: Deglutition; Food; Humans; In Vitro Techniques; Manometry; Viscosity
PubMed: 30840137
DOI: 10.1007/s00455-019-09995-8 -
Boletin Medico Del Hospital Infantil de... 2018Over the last 20 years, 640 premature newborns with alterations in suction-deglution have been taken care of in the neonatal intensive care unit at the Hospital Infantil... (Review)
Review
Over the last 20 years, 640 premature newborns with alterations in suction-deglution have been taken care of in the neonatal intensive care unit at the Hospital Infantil de México Federico Gómez, using techniques for patients with immaturity, and neurological, gastrointestinal, cardiologic and respiratory pathologies. This descriptive study includes the treatment employed mainly in premature newborns during this period. Suction, swallowing and breathing coordination are some of the most complex abilities that premature newborns face, due to their anatomofunctional immaturity and improper sensoriomotor integration for the high energy requirements they must meet. Sucking and swallowing are voluntary and involuntary processes that guarantee the safe passage of food from mouth to stomach, and require the coordination of the cranial nerves, the brain stem and cerebral cortex and muscles of the mouth, pharynx and esophagus. The rehabilitation treatment consists in the positioning of the newborn and caretaker, adaptation of teat, regulation of muscle tone and progressive intake of milk. The feeding processing was reduced to 1.5 weeks in newborns submitted to treatment, whereas in those who did not receive the treatment, the proccess took up to 3 weeks.
Topics: Deglutition; Deglutition Disorders; Humans; Infant, Newborn; Infant, Premature; Intensive Care Units, Neonatal; Mexico; Sucking Behavior
PubMed: 29652876
DOI: 10.24875/BMHIM.M18000001 -
Dysphagia 1994Aging affects some members of the swallowing orchestra and spares the others. It seems that changes in the pharynx of the elderly are more of a positive nature than a... (Comparative Study)
Comparative Study Review
Aging affects some members of the swallowing orchestra and spares the others. It seems that changes in the pharynx of the elderly are more of a positive nature than a negative one and reflect an adaptation to age-induced structural changes of the upper esophageal sphincter. In the esophagus, the positive change in deglutitive peristaltic amplitude and duration seem to revert to a negative one over the age of 90 years. In the upper esophageal sphincter, it appears that aging reduces the resting pressure, but spares its response to various stimuli. Considering the increasing elderly population and their medical needs, further normalcy data about various manometric aspects of deglutition is needed for physiologic studies as well as diagnostic and therapeutic purposes.
Topics: Adult; Aged; Aging; Deglutition; Deglutition Disorders; Esophagogastric Junction; Esophagus; Humans; Hypopharynx; Manometry; Middle Aged; Oropharynx; Pharynx; Time Factors
PubMed: 7805420
DOI: 10.1007/BF00301914 -
Progress in Brain Research 2014Swallowing and breathing utilize common muscles and an anatomical passage: the pharynx. The risk of aspiration of ingested material is minimized not only by the... (Review)
Review
Swallowing and breathing utilize common muscles and an anatomical passage: the pharynx. The risk of aspiration of ingested material is minimized not only by the laryngeal adduction of the vocal folds and laryngeal elevation but also by the precise coordination of swallows with breathing. Namely, swallows: (1) are preferentially initiated in the postinspiratory/expiratory phase, (2) are accompanied by a brief apnea, and (3) are often followed by an expiration and delay of the next breath. This review summarizes the expiratory evidence on the brainstem regions comprising the central pattern generator (CPG) that produces the pharyngeal stage of swallow, how the motor acts of swallowing and breathing are coordinated, and lastly, brainstem regions where the swallowing and respiratory CPGs may interact in order to ensure "safe" swallows.
Topics: Animals; Brain Stem; Central Pattern Generators; Deglutition; Humans; Respiration
PubMed: 25194202
DOI: 10.1016/B978-0-444-63488-7.00013-6 -
Physical Medicine and Rehabilitation... Nov 2008This article describes the evidence for the physiologic foundation and interpretation of the videofluorographic swallowing study (VFSS). The purpose and clinical...
This article describes the evidence for the physiologic foundation and interpretation of the videofluorographic swallowing study (VFSS). The purpose and clinical efficacy of VFSS are explained. Standardization of the VFSS procedure, protocol, interpretation, and reporting is highlighted as a critical step in future clinical practice and research. Individualized evidenced-based rehabilitation strategies are presented as key components that are systematically applied during the VFSS procedure and integrated into the swallowing management plan. A new tool that has been developed and tested for the quantification of swallowing impairment is introduced.
Topics: Deglutition; Deglutition Disorders; Fluoroscopy; Humans
PubMed: 18940640
DOI: 10.1016/j.pmr.2008.06.004 -
Seminars in Neurology Dec 1996
Review
Topics: Aging; Deglutition; Humans; Nervous System Physiological Phenomena; Oropharynx; Reference Values
PubMed: 9112310
DOI: 10.1055/s-2008-1040989