Maturation of the Coordination Between Respiration and Deglutition with and Without Recurrent Laryngeal Nerve Lesion in an Animal Model

Abstract

The timing of the occurrence of a swallow in a respiratory cycle is critical for safe swallowing, and changes with infant development. Infants with damage to the recurrent laryngeal nerve, which receives sensory information from the larynx and supplies the intrinsic muscles of the larynx, experience a significant incidence of dysphagia. Using our validated infant pig model, we determined the interaction between this nerve damage and the coordination between respiration and swallowing during postnatal development. We recorded 23 infant pigs at two ages (neonatal and older, pre-weaning) feeding on milk with barium using simultaneous high-speed videofluoroscopy and measurements of thoracic movement. With a complete linear model, we tested for changes with maturation, and whether these changes are the same in control and lesioned individuals. We found (1) the timing of swallowing and respiration coordination changes with maturation; (2) no overall effect of RLN lesion on the timing of coordination, but (3) a greater magnitude of maturational change occurs with RLN injury. We also determined that animals with no surgical intervention did not differ from animals that had surgery for marker placement and a sham procedure for nerve lesion. The coordination between respiration and swallowing changes in normal, intact individuals to provide increased airway protection prior to weaning. Further, in animals with an RLN lesion, the maturation process has a larger effect. Finally, these results suggest a high level of brainstem sensorimotor interactions with respect to these two functions.

Pharyngeal contractile and regulatory characteristics are distinct during nutritive oral stimulus in preterm‐born infants: Implications for clinical and research applications

“…In our study, we noted gestational and postnatal maturational differences in preterm and full‐term‐born infants (Figure ). Our findings are in agreement with studies by Ballester et al, in that, among maturational piglet model for swallowing physiology, it was found that timing of swallowing and respiratory coordination changes with maturation . These effects were modified in piglets with peripheral neuropathology mediated by IX and X cranial nerves.…”

“…Our findings are in agreement with studies by Ballester et al, in that, among maturational piglet model for swallowing physiology, it was found that timing of swallowing and respiratory coordination changes with maturation. 23 These effects were modified in piglets with peripheral neuropathology mediated by IX and X cranial nerves. Prior to our evaluation, preterm infants had more oral feeding experiences ex-utero at identical PMA.…”

Specific Vagus Nerve Lesion Have Distinctive Physiologic Mechanisms of Dysphagia

“…The SLN lesioned pigs were older by several days then the RLN lesioned pigs. Pigs reach weaning age in about 25 days, and show maturation of certain feeding behaviors in that time (36,37). In particular, the (younger) RLN pigs were considerably variable in all studies (14,19,23).…”

Changes in the coordination between respiration and swallowing from suckling through weaning

“…All swallows were identified by one person after a training period in which inter-rater reliability reached 95%. Following Ballester et al [8], we extracted a 200 ms window of synchronized respiratory data, centred around the swallow, which was set to time 0. We measured delay between the time of the swallow and the onset of inspiration in the plethysmograph trace (figure 1b,c).…”