Document Detail


Coordination of deglutitive glottic closure with oropharyngeal swallowing.
MedLine Citation:
PMID:  2338189     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The goals of this study were to quantify the temporal relationship between swallow-induced glottic closure and (a) signals of swallow initiation, such as hyoid bone movement, tongue base movement, and mylohyoid electrical activity; (b) pharyngeal peristalsis; (c) laryngeal elevation; (d) vestibular closure; and (e) oropharyngeal barium bolus transit. Eight normal subjects (age 20-30 yr) were studied by concurrent transnasal video laryngoscopy, pharyngeal intraluminal manometry, and submental surface electromyography. The manometric, electromyographic, and both video recordings were synchronized with one another using a specially designed event marker. Dry, 5-ml water, and 5-ml barium swallows were recorded. Frame-by-frame analysis of the video endoscopic recordings showed that deglutitive laryngeal kinetics consisted of vocal cord adduction associated with transverse approximation of the arytenoids followed by vertical approximation of arytenoids to the base of the epiglottis followed by laryngeal ascent and epiglottic descent. Onset of swallow-induced vocal cord adduction preceded the onset of hyoid bone movement, base of the tongue movement, and submental surface myoelectric activity by 0.33 +/- 0.04 (SE) s, 0.31 +/- 0.04 s, and 0.38 +/- 0.04 s, respectively. Onset of vocal cord adduction also preceded the initiation of peristalsis in the nasopharynx and its propagation to oropharynx and upper esophageal sphincter by 0.64 +/- 0.05 s, 0.82 +/- 0.05 s, and 1.08 +/- 0.04 s, respectively. The time between the onset of vocal cord adduction and their return to full opening was 2.2 +/- 0.09 s. It was concluded that (a) among events evaluated, vocal cord adduction is the initial event during the swallowing sequence; (b) laryngeal kinetics during deglutition have distinctive features, and their close coordination with other swallowing events suggests that they are an essential feature of the swallowing program; and (c) abnormal laryngeal kinetics or lack of coordination between the glottic closure mechanism and oropharyngeal bolus transport may have an important role in swallow-induced aspiration.
Authors:
R Shaker; W J Dodds; R O Dantas; W J Hogan; R C Arndorfer
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Gastroenterology     Volume:  98     ISSN:  0016-5085     ISO Abbreviation:  Gastroenterology     Publication Date:  1990 Jun 
Date Detail:
Created Date:  1990-06-18     Completed Date:  1990-06-18     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1478-84     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Medical College of Wisconsin, Milwaukee.
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MeSH Terms
Descriptor/Qualifier:
Adult
Deglutition / physiology*
Electromyography
Endoscopy
Esophagogastric Junction / physiology
Fluoroscopy
Glottis / physiology*
Humans
Hyoid Bone / physiology
Laryngoscopy
Larynx / physiology
Manometry
Movement
Muscle Contraction / physiology
Neck Muscles / physiology
Oropharynx / physiology*
Time Factors
Tongue / physiology
Transducers, Pressure
Videotape Recording
Grant Support
ID/Acronym/Agency:
DK25731/DK/NIDDK NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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