Analysis of pressure generation and bolus transit during pharyngeal swallowing

Abstract

Current pharyngeal deglutition theory has stressed the role of the pharyngeal constrictors as producing a peristaltic wave responsible for bolus propulsion through the pharynx. This thesis presents data obtained using manofluorography which supports the significance of tongue and laryngeal motion in swallowing. The usage of the term peristalsis to describe the constrictor contraction is challenged. The results of this quantitative study of swallowing in normal subjects, laryngectomized patients, and patients with restricted tongue motion show that tongue driving pressure and the negative pressure developed in the pharyngeal esophageal segment appear more important than the peristaltic-like pressure of the constrictors. Bolus transit is really dependent upon these two pressures. This model for analysis has clinical significance because it permits quantification of the pharyngeal swallowing mechanism.

Dysphagia: Evaluation and Treatment

“…As the tail of the bolus reaches the base of tongue level, the base of tongue and pharyn geal walls move toward each other, taking over pressure generation from the oral tongue, which has been responsible for propelling the bolus to this point [19,23,24], The tongue base and pharyngeal walls make complete contact with each other, applying pressure to the bolus below. The pharyngeal wall contrac tion laterally and posteriorly continues, fol lowing the bolus tail and clearing the pharynx of any residual food.…”

Effects of Voluntary Maneuvers on Tongue Base Function for Swallowing

“…The tongue base is believed to generate pressures to propel the bolus through the upper pharynx during swallowing [1]. Further, the rapid posterior motion of the tongue base toward the inferiorly bulging posterior pharyngeal wall during swallowing contributes to bolus clearance past the tongue base [2,3].…”

Application of wireless inertial measurement units and EMG sensors for studying deglutition — Preliminary results

“…Imtiaz esophageal phase. Of these, the oral and the pharyngeal phases are the most difficult to measure [1]. The exact mechanics of the swallowing process still remain unknown.…”

“…A number of studies have been done over the years by using different types and combinations of sensors. These include using videofluoroscopy [3][4], piezoelectric sensors [5][6], electromyography [4][6] [7], Electroencephalography [7], electrolaryngography [8], microphones [9] and pressure sensors [1][2] [4] etc. In addition, we note that Inertial Measurement Units (IMUs) have not been used in swallowing studies except for tracking limb movements [9].…”