Physiology of Swallowing: Protection of the Airway

Martin, Brigitte; Robbins, Jane

doi:10.1055/s-2007-1009857

Cited by 11 publications

(5 citation statements)

References 53 publications

(125 reference statements)

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“…The onset of laryngealclosureandsuperoinferiorhyoidmovementareearly physiologic events during the pharyngeal swallow. 42,[47][48][49]55,65 It follows that these 2 events were highly correlated and composed the first functional unit. The onset of PES opening, maximal closure of the laryngeal vestibule, and maximal hyoid displacement compose the height of pharyngeal swallowingactivity,andformedthesecondfunctionalunit.These 3 events have a key role in airway protection and bolus propulsion through the pharynx and into the cervical esophagus.…”

Section: Commentmentioning

confidence: 99%

“…The onset of PES opening, maximal closure of the laryngeal vestibule, and maximal hyoid displacement compose the height of pharyngeal swallowingactivity,andformedthesecondfunctionalunit.These 3 events have a key role in airway protection and bolus propulsion through the pharynx and into the cervical esophagus. [47][48][49][50][51][52][53][54][55][56][57][58][59]65 Closure of the PES and reestablishment of an open airway (ie, laryngeal opening) were closely linked, and formed the third functional unit. The resumption of respiration (ie, APOff) and the return of the hyoid to its resting position were closely related in time.…”

Section: Commentmentioning

confidence: 99%

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Breathing and Swallowing Dynamics Across the Adult Lifespan

Martin‐Harris¹,

Brodsky²,

Michel³

et al. 2005

Arch Otolaryngol Head Neck Surg

250

251

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Background: Aberrations in the physiologic components of normal oropharyngeal swallowing have been linked to aspiration events and to predisposition to aspiration pneumonia, a common, deadly disease in elderly persons. Studies have demonstrated a temporal, physiologic link between breathing and the principal physiologic swallowing components involved in airway protection during swallowing. We developed a normative model of integrated breathing and swallowing patterns using concomitant videofluoroscopic images and nasal respiratory airflow recordings.Objectives: To establish normative temporal and respiratory-phase pattern relationships between breathing and swallowing in adult human beings across the aging continuum; to relate any alterations in these patterns to swallowing abnormality, an aspiration event during swallowing, and predisposition to aspiration pneumonia; and to develop clinically practical evaluation methods for identifying breathing and swallowing discoordination.Setting: Fluoroscopy suite in an acute care hospital.Participants: Eighty-two healthy adult volunteers gave informed consent. All eligible healthy volunteers were welcome and were screened for age, race, and sex for equal distribution of each.Intervention: Respiratory-phase patterns and the onset and duration of 11 predetermined swallowing events and associatedrespiratoryactivitieswerestudied.Allparticipants' single-liquidbariumswallowexaminationswerestudiedwith simultaneous videofluoroscopy and respiratory recordings.Main Outcome Measures: Onset of each of the 11 predetermined breathing and swallowing events was digitally recorded and analyzed. The phases of breathing before and after swallowing were identified. The presence, depth, and response to airway penetration were recorded and related to respiratory pattern.Results: Four respiratory-phase patterns were identified that changed with advanced age. The correlation analyses of the temporal breathing and swallowing events revealed a normal pattern of 4 clearly distinguishable functional units. Differences in apnea duration and apnea offset occurred with advanced age. Conclusion:This research provides evidence for clearly distinguishable patterns and functional groupings of breathing and swallowing events, a necessary first step toward determining whether abnormal breathing and swallowing patterns in patients with dysphagia are associated with health outcome.

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Section: Commentmentioning

confidence: 99%

Section: Commentmentioning

confidence: 99%

Breathing and Swallowing Dynamics Across the Adult Lifespan

Martin‐Harris¹,

Brodsky²,

Michel³

et al. 2005

Arch Otolaryngol Head Neck Surg

250

251

View full text Add to dashboard Cite

show abstract

“…Airway closure occurs during deglutition, as the pharynx is a shared pathway for breathing and transit of food from the oral cavity into the esophagus. Airway closure occurs secondary to true vocal fold closure, ventricular vocal fold medial movement, arytenoid to base of epiglottis approximation, epiglottic inversion, and aryepiglottic fold stiffening 1 . Subsequently, complete airway closure, which occurs in normal swallowing, requires a cessation in respiration, i.e., swallowing apnea (SA).…”

mentioning

confidence: 99%

Effects of Viscosity, Taste, and Bolus Volume on Swallowing Apnea Duration of Normal Adults

Butler

Postma

Fischer

2004

Otolaryngol.--head neck surg.

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“…The studies on coordination of swallowing and breathing referred to above (4)(5)(6) show that there is an apneic period during the swallowing act. This respiratory pause starts from the middle or late part of the oral phase of the swallow (4), which means that there is no respiratory gas flow through the nasal passages with resulting pressure changes, but atmospheric pressure at the time of tubal opening.…”

Section: Discussionmentioning

confidence: 99%

Nasal Gas Composition in Humans and its Implication on Middle Ear Pressure

Hergils

Magnuson²

1998

Acta Oto-Laryngologica

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The amount and composition of gas that enters the middle ear by the Eustachian tube is of interest in the study of middle ear pressure regulation. We have studied the gas composition in the nasal cavity through the respiratory cycle in humans by mass spectrometry. The findings were correlated to earlier findings regarding synchronization of swallowing and breathing. The composition of the gas that may pass the Eustachian tube at openings during swallowing seems to be very close to expiratory values: nitrogen 79.19%, oxygen 14.69%, argon 1.00% and carbon dioxide 5.10%.

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Physiology of Swallowing: Protection of the Airway

Cited by 11 publications

References 53 publications

Breathing and Swallowing Dynamics Across the Adult Lifespan

Breathing and Swallowing Dynamics Across the Adult Lifespan

Effects of Viscosity, Taste, and Bolus Volume on Swallowing Apnea Duration of Normal Adults

Nasal Gas Composition in Humans and its Implication on Middle Ear Pressure

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