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PubMed2005

The effect of bilateral glossopharyngeal nerve anaesthesia on swallowing in horses.

REASONS FOR PERFORMING STUDY: Dysfunction of the glossopharyngeal nerve has been implicated as a cause of dysphagia in horses. However, recent studies have indicated that this is not the case. OBJECTIVES: To determine whether bilateral glossopharyngeal nerve anaesthesia would cause dysphagia in horses or result in measurable alterations in the timing, function, or sequence of swallowing. METHODS: Swallowing was evaluated in 6 normal horses with and without bilateral glossopharyngeal nerve anaesthesia. Swallowing dynamics were assessed subjectively and objectively based on time from prehension of food until swallowing, number of tongue movements until initiation of swallowing, depth of bolus at the base of the tongue prior to initiation of swallow and evidence of tracheal aspiration using fluoroscopy and endoscopy. RESULTS: There was no evidence of aspiration or dysphagia in horses before or after bilateral glossopharyngeal nerve block. No observed or measured differences in swallowing sequence or function could be detected in blocked compared to unblocked horses. However, there was a trend in blocked horses for the number of tongue pushes and the time to swallowing to be increased. CONCLUSIONS: Glossopharyngeal nerve function may not be essential for normal swallowing function in otherwise healthy horses. POTENTIAL RELEVANCE: Clinically, normal swallowing is not an appropriate test of glossopharyngeal nerve function and dysphagic horses should not be assumed to have glossopharyngeal nerve dysfunction.

Animals↗

PubMed1995

[Temporal and spatial pattern analysis of pharyngeal swallowing in patients with abnormal sensation in the throat].

There are many patients who complain of abnormal sensations, such as an obstructive sensation, foreign body sensation, difficulty in swallowing, etc., in the throat, which do not have an obvious cause. The causes of such unpleasant symptoms have not been adequately investigated. As one of the potential factors in volved in abnormal sensations in the throat, we considered the existence of subclinical dysphagia. We then performed videofluoroscopic analysis in patients with an abnormal sensation in the throat to examine whether or not there were functional disorders in swallowing. Videofluoroscopy was performed in 42 subjects, 30 patients with abnormal sensation in the throat and 12 volunteers without swallowing problems. We devised a temporal and spatial analysis system of swallowing using personal computer technology. Videofluoroscopic swallowing sequences during spoon feeding (3-5ml) and drinking from a cup (15-20ml) of liquid barium, were analyzed. The results suggest that two temporal measurements of swallow from videofluoroscopic studies are appropriate for parameter of subclinical dysphagia: the time it takes the bolus to move through pharynx from the point at which the bolus head passes the tongue base until the bolus head extends caudally beyond the piriform sinus while feeding from a spoon (S2), and the time it takes the bolus to move through the upper esophagus from the point at which the bolus head passes the bottom of the piriform sinus until the bolus tail passes the same point while drinking from a cup (C1). Then, we selected C1 and S2 for variables and detect the patients who have subclinical dysphagia with cluster analysis. Forty-two subjects were divided into two groups: those composed of 14 patients (cluster 1), and those composed of 16 patients and 12 controls (cluster 2). We thought 14 patients in cluster 1 would have subclinical dysphagia for the cause of abnormal sensation in the throat. Temporal and spatial analysis revealed three forms of pharyngeal swallow in cluster 1. In 6 patients, the bolus stall in the valleculae prior to the onset of the pharyngeal swallow. In other 6 patients, the bolus stall in the piriform sinus before swallowing reflex. In the other 2 patients, the bolus moved smoothly but slowly without delay in pharynx. Our results indicate that a delayed swallowing reflex is the main functional finding in videofluoroscopy in patients with subclinical dysphagia contributing to an abnormal sensatin in the throat.

Adult↗

PubMedDate not supplied

Cineradiography in closed and open pharyngeal swallow.

The pattern of swallowing by which the oral bolus reaches an air-containing oropharynx is called an 'open swallow' whereas the sequence in which the oropharynx is collapsed on the arrival of the bolus is called a 'closed swallow'. The significance of this distinction was further analyzed by a correlation with other laryngeal and pharyngeal functions during swallowing in a cineradiologic study in 75 dysphagic patients and 50 asymptomatic volunteers. The relative incidence of open and closed type swallows was similar in the two groups. The maximum elevation of the pharynx and larynx was the same in open and closed swallow, although in individuals with an open swallow the elevation occurred later than in individuals with a closed swallow. Epiglottic movement disturbances, defective closure of the laryngeal vestibule, pharyngeal constrictor muscle paresis, cricopharyngeal incoordination, cervical esophageal webs and Zenker diverticula were significantly more common in individuals with an open pharyngeal swallow than in those with closed swallowing.

Adult↗

PubMed1997

Effects of bolus volume on oropharyngeal swallowing: an electrophysiologic study in man.

OBJECTIVE: Different variables of oropharyngeal swallowing change in response to bolus volume and consistency as determined by manometric/videofluoroscopic studies. But the subject is debatable especially from the physiologic point of view. No electrophysiologic studies are available on human subjects. METHODS: The effects of bolus volume and viscosity on different variables of oropharyngeal swallowing were investigated using electrophysiologic methods. Mechanical upward and downward laryngeal movements and submental electromyographic (SM-EMG) activity of the laryngeal elevator muscles were recorded during dry and 3-, 10-, and 20-ml water swallowing in 14 normal subjects. Cricopharyngeus (CP) muscle was investigated during 3- and 10-ml water swallowing in 10 normal subjects. Semisolid and liquid swallowing were compared in eight normal subjects. RESULTS: The total duration of SM-EMG, time necessary for larynx elevation, CP-EMG pause related with upper esophageal sphincter opening and swallowing variability (jitter) all increased significantly with increasing bolus volume. Laryngeal superior relocation time and CP-EMG pause were shorter for semisolid swallowing compared with swallowing the same amount of liquid. CONCLUSION: The duration of SM-EMG activity, laryngeal upward-downward movements, and CP-EMG pause are affected by sensory inputs such as volume and viscosity of the bolus swallowed. The results indicate that sensory input modifies the central swallowing pattern although basic events remain the same in normal human subjects.

Adolescent↗

PubMed2025

Respiratory-swallow coordination training using bimodal signal biofeedback for patients with post-stroke dysphagia: a randomized controlled trial.

OBJECTIVE: The purpose was to investigate the effects of respiratory-swallow coordination training with bimodal signal biofeedback on swallowing function in patients with post-stroke dysphagia. METHODS: Post-stroke dysphagia Patients were randomly assigned to either the control group or the experimental group. The control group received conventional rehabilitation, while the experimental group underwent additional respiratory-swallow coordination training based on biofeedback. The training protocol consisted of three phases, conducted at an intensity of 30 min/day, 6 days/week, for two consecutive weeks. Outcome measures included the Functional Oral Intake Scale (FOIS) score, the Rosenbek Penetration-Aspiration Scale (PAS) score, respiratory-swallow coordination, and videofluoroscopic swallowing study temporal and kinematic parameter. Assessments were conducted at baseline, post-treatment, and at a one-month follow-up. RESULTS: Thirty patients were enrolled. Both groups showed significant improvement in FOIS scores from baseline to both two-week post-treatment and one-month follow-up (p < 0.001). Compared to the controls, the experimental group demonstrated significantly greater FOIS scoreimprovement at both post-treatment and follow-up (p < 0.001). The proportion of patients with a ≥ 2-point increase in FOIS scores was significantly higher in the experimental group than in the control group at both post-treatment (p < 0.01) and one-month follow-up (p < 0.01). After two weeks of treatment, the percentage of PAS scores ≥6 was significantly lower in the experimental group than in the control group (p < 0.001). Additionally, the percentage of optimal respiratory-swallow pattern was significantly higher in the experimental group than in the control group (p < 0.001). CONCLUSION: Bimodal signal biofeedback-based respiratory-swallow coordination training can effectively improve respiratory-swallow coordination and swallowing function in patients with post-stroke dysphagia.

Humans↗

PubMed2006

Biomarkers of exposure and effects of environmental contaminants on swallows nesting along the Rio Grande, Texas, USA.

We collected adult cave swallows (Petrochelidon fulva) and cliff swallows (P. pyrrhonota) during the breeding seasons in 1999 and 2000 from eight locations along the Rio Grande from Brownsville to El Paso (unless otherwise specified, all locations are Texas, USA) and an out-of-basin reference location. Body mass, spleen mass, hepatosomatic index (HSI), gonadosomatic index (GSI), thyroxine (T4) in plasma, DNA damage measured as the half-peak coefficient of variation of DNA content (HPCV) in blood cells, as well as acetylcholinesterase and butyrylcholinesterase in brain were compared with concentrations of organochlorines, metals, and metalloids in carcasses to determine potential effects of contaminants on swallows during the breeding season. Concentrations of 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (p,p'-DDE) were significantly greater in swallows from El Paso than in those from most locations, except for Pharr and Llano Grande. All swallows from these three locations had p,p'-DDE concentrations of 3 microg/g wet weight or greater. Swallows from El Paso either had or shared the highest concentrations of p,p'-DDE, polychlorinated biphenyls, and 13 inorganic elements. Swallows from El Paso exhibited greater spleen mass and HPCV values as well as lower T4 values compared with those from other locations. Thyroxine was a potential biomarker of contaminant exposure in swallows of the Rio Grande, because it was negatively correlated with p,p'-DDE and Se. Spleen mass was positively correlated with selenium and HSI and negatively correlated with body mass, GSI, Mn, and Ni. Overall, the present study suggests that insectivorous birds living in areas of high agricultural and industrial activity along the Rio Grande bioaccumulate environmental contaminants. These contaminants, particularly p,p'-DDE, may be among multiple factors that impact endocrine and hematopoietic function in Rio Grande swallows.

Animals↗

PubMedDate not supplied

Development of concentration thresholds for fetal swallowing and arginine vasopressin stimulation in the preterm ovine fetus.

We previously demonstrated that fetal swallowing was stimulated by intracarotid saline injections in the near term (130 +/- 1 days gestation) ovine fetus. In order to examine the ontogeny of the regulation of thirst-mediated swallowing behavior and arginine vasopressin (AVP) secretion, the present study examined fetal swallowing and AVP secretory responses to hypertonic NaCl and sucrose in preterm (115 days gestation) ovine fetuses. Five fetuses were chronically prepared with thyrohyoid, nuchal and thoracic esophagus, and diaphragm electromyogram (EMG) electrodes, an esophageal flow probe, and vascular catheters. Fetuses received intracarotid injections (0.15 ml/kg) of increasing concentrations of NaCl (0.15-2.55 M), administered at 2-min intervals. The threshold saline concentration for swallowing was defined as the minimum NaCl dose eliciting swallow responses (within 20 s) following 4 of 5 injections at each dose. In 2 fetuses, the threshold dose was 0.75 M (confirmed by 4 of 5 injections resulting in swallows at the next higher dose). In the other 3 animals, no swallowing threshold was observed (i.e., no dose through 2.55 M elicited swallows to 4 of 5 injections). There were no significant increases in AVP secretion. On a subsequent day, equimolar sucrose injections did not affect fetal swallowing activity or AVP secretion. Together with previous reports, these studies indicate that plasma osmolality dipsogenic mechanisms become functional in some ovine fetuses by 115 days gestation, while all fetuses exhibit intact osmotic dipsogenic responses at 130 days gestation. These results further suggest an acute process of development of dipsogenic responsiveness, rather than by gradually increasing sensitivity to osmotic stimuli.

Animals↗

PubMed1990

Swallowing responses induced by microinjection of glutamate and glutamate agonists into the nucleus tractus solitarius of ketamine-anesthetized rats.

Swallowing is a patterned motor activity generated by neurons located within the nucleus tractus solitarius (NTS). An excitatory amino acid (EAA) neurotransmitter, such as glutamate (GLU), is suspected of being involved in the initiation of swallowing by NTS neuronal components. However, swallowing can still be elicited in animals anesthetized with ketamine, an antagonist of the N-methyl-D-aspartate (NMDA) subclass of EAA receptors. The present experiments were therefore designed to investigate the influence of EAA administration within the NTS on the swallowing motor activity of rats anesthetized with ketamine. Pressure microinjections of GLU in doses ranging from 25 to 500 pmol elicited swallowing. This effect was dose-dependent and was not reproduced when control injections of the vehicle solution were performed. Microinjections of the GLU agonists, quisqualate (QUIS) and NMDA, in doses ranging between 2.5 and 50 pmol, also induced swallowing motor activities. QUIS, like GLU, elicited a short series of swallows at a brief latency while NMDA generated long-lasting rhythmic swallowing with a longer latency. Swallowing induced by GLU microinjections (100 pmol) was suppressed almost completely by local pretreatment with either the broad spectrum EAA receptor antagonist, gamma-D-glutamylglycine (250 pmol), or the more selective non-NMDA antagonist, 6-cyano-7-nitroquinoxaline-2,3-dione (50-100 pmol), but not by pretreatment with the selective NMDA antagonist, DL-2-amino-5-phosponovalerate (250 pmol). On the other hand, pretreatment with DL-2-amino-5-phosphonovalerate (50 pmol) suppressed the deglutitions induced by NMDA microinjections (10 pmol) but not those elicited by QUIS microinjections (10 pmol).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1994

Methodology for detecting swallowing sounds.

The use of cervical auscultation in the evaluation of the pharyngeal swallow may become a part of the clinical evaluation of dysphagic patients. Though its use is based on subjective evaluation, an acoustic analysis of swallowing sounds might establish more objective criteria in the detection of swallowing disorders. The present study sought to investigate three aspects of the methodology for detecting swallowing sounds: (1) the type of acoustic detector unit suited to an acoustic analysis of the pharyngeal swallow, (2) the type of adhesive suited for the attachment of the detector, and (3) the optimal site for sound detection of the pharyngeal swallow. An accelerometer with double-sided paper tape was selected as the appropriate detector unit because of its wide range of frequency response and small attenuation level. Using this detector unit, swallowing sounds and noise associated with simulated laryngeal elevation and the carotid pulse were acquired at 24 sites on the neck in 14 normal subjects; these signals were acoustically analyzed. The determination of the optimal site for detecting swallowing sounds was based on the signal-to-noise ratio. The site over the lateral border of the trachea immediately inferior to the cricoid cartilage is the optimal site for detection of swallowing sounds because this site showed the greatest signal-to-noise ratio with the smallest variance. The site over the center of the cricoid cartilage and the midpoint between the site over the center of the cricoid cartilage and the site immediately superior to the jugular notch were also considered to be the most appropriate sites.

Acceleration↗

PubMed1996

Quantitative aspects of swallowing in an elderly nondysphagic population.

The prevalence of swallowing impairment increases with age and is a major health care problem in the elderly. It has been assumed that age-related changes in nerves and muscles hamper muscle strength and coordination of swallowing. However, it is unclear what impairment is related to primary aging and what is the consequence of diseases prevalent in the elderly (secondary aging). In order to quantify swallowing in nondysphagic elderly we used the noninvasive ROSS (Repetitive Oral Suction Swallow) test. A total of 53 individuals aged 76 +/- 5 years (mean +/- SD) were examined. We found that the nondysphagic elderly demonstrated significant differences compared with young individuals in 10 of 17 measured variables, i.e., decreased peak suction pressure, increased frequency of multiple swallows after one ingestion, increased frequency of polyphasic laryngeal movements, increased frequency of inspiration after swallowing, and increased frequency of coughing during or after swallowing. Therefore, primary aging mainly seems to influence coordination of swallowing, but oral and pharyngeal swallow per se seem to be unaffected.

Adult↗

PubMed1996

Normal adult swallowing of liquid and viscous material: scintigraphic data on bolus transit and oropharyngeal residues.

Scintigraphic data are provided for 20 normal control subjects, 39-65 years of age. Each subject swallowed 10 cc of water and 10 cc of a more viscous material (1,100 centipoise) consisting of apple juice thickened with Thick-It, a commercial food thickener. The test substances were combined with 2.5 mCi Tc-99m sulfur colloid. Scintigraphic data were acquired in dynamic mode for 10 sec at 25 frames/sec as the subject swallowed. Time-activity (TA) data were used to compute transit times, percentage residues in the mouth and pharynx, percent ingested, and a derived swallow efficiency score. The liquid was ingested in a single swallow by all subjects, and 9 cc was actually transferred to the esophagus. In contrast, for the viscous material, 11/20 subjects performed a second clearing swallow within the 10-sec interval. On the first swallow with the viscous substance, an average of 7 cc was transferred to the esophagus. Scintigraphy offers an excellent technique for determining natural and preferred volumes for swallowing a variety of bolus consistencies, since it can quantify the volume of each swallow or partial swallow. In this group of subjects the oral discharge time was shorter with the viscous material than with the water, but the pharyngeal transit times were not significantly different for the two bolus consistencies. Numerical efficiency scores were lower for the viscous material, indicating that such a measure is bolus dependent.

Adult↗

PubMed1994

Factors that affect swallowing-related apnea times in humans.

The dynamics of deglutition were studied in relation to potential changes due to aging. Swallowing-related apnea time (SAT) was measured during "dry" and "wet" swallowing in 84 adults without dysphagia to examine if age-related variation of SAT corresponded to changes in deglutition dynamics due to aging and to determine possible significance. Swallowing movements were recorded using a transducer for measuring swallowing pressures. Respiratory flow rates during deglutition were measured with a heat-wave flowmeter as part of phonatory function testing system. Respiratory movements were recorded with a respiration pick-up band set at the diaphragm. Findings demonstrated that SAT did not change with aging but was prolonged in subjects over age 50 years. When topical anesthesia was omitted during study, SAT tended to be shorter during wet swallowing than during dry swallowing in all age groups. Statistically significant differences were observed between wet and dry swallowing SAT in subjects under the age of 39 years. When a topical anesthetic was applied to pharyngeal mucous membranes, SAT was prolonged. Finally, SAT results during wet swallowing determined in a anesthetized dog before and after topical anesthesia of the pharyngeal mucous membranes showed significant prolongation after topical anesthesia. These findings suggest that the sensation of the pharyngeal mucous membrane may be important in producing swallowing-related apnea and controlling its duration.

Adult↗

PubMed2004

Influence of orofacial dysfunctions on spatial and temporal dimensions of swallowing movements.

BACKGROUND AND AIM: Tongue dysfunctions are of etiologic significance for the development of malocclusions and speech disorders. Electromagnetic articulography is a means of recording orofacial movements. The aim of this study was therefore to analyze differences in the spatial and temporal sequence of swallowing movements under the influence of lip and tongue dysfunctions in order to develop new means of objectifying the diagnosis of such a dysfunction. PATIENTS AND METHOD: Thirty-one subjects were monitored during reflex swallowing and while swallowing 20 ml of water. All probands also underwent evaluation by a speech pathologist as well as palatography. The entire cohort was then divided into a viscerally and a somatically swallowing group, and the movement sequences were analyzed with reference to spatial and temporal parameters. RESULTS: The temporal parameters revealed fewer significant differences than the spatial parameters. Most differences were recorded for the section between palate separation point and end of swallowing. Specific spatial or temporal variables revealing a maximum number of differences between the two groups were found for each tongue region. Swallowing water revealed notably more significant intergroup differences. The most suitable variables during the swallowing of water were the maximum distance of tongue-palate contact and the distance or time interval between palate separation point and end of swallowing. CONCLUSION: The analysis of swallowing movements by electromagnetic articulography offers opportunities to evaluate tongue dysfunctions. The most suitable combination of variables was found for each of the regions investigated. Spatial analysis of the movement pattern seems to be the most reliable method.

Adolescent↗

PubMed2006

Postoperative swallowing function after posterior fossa tumor resection in pediatric patients.

OBJECTIVE: After tumor resection involving the posterior fossa, postoperative swallowing dysfunction may be anticipated. This retrospective study was designed to document swallowing abnormalities in children after posterior fossa brain tumor surgery and to recommend management approaches for children at risk for aspiration. METHODS: Twenty-four children referred postoperatively for a video fluoroscopic swallow study (VFSS) out of 127 children undergoing posterior fossa surgery for brain tumor resection from 1998 to 2001 were evaluated for oral, pharyngeal, and cervical esophageal transits. CONCLUSION: Less than half of the 24 children swallowed functionally within the first week after surgery. VFSS was an appropriate tool for diagnosing swallowing dysfunction, which is impossible to determine at bedside. Children with brain stem involvement and more difficult recovery had significantly worse swallowing function and greater aspiration. We recommend that children with compromised swallowing function should not feed orally until a radiographic swallowing assessment demonstrates functional and safe swallowing with or without therapeutic intervention.

Adolescent↗

PubMed2004

Identification of hypomorphic and null alleles of swallow via molecular and phenotypic analyses.

The swallow gene of Drosophila is required for the localization of two messenger RNAs, bicoid and hu-li tai shao, to the anterior pole of oocytes during the later stages of oogenesis. In addition, swallow appears to play a role in early embryogenesis, as swallow mutant embryos have defects in early nuclear cleavage and migration. In an effort to identify regions of the Swallow protein that are essential for function, we have initiated a molecular characterization of seven existing alleles of swallow. All seven alleles have been sequenced, and comparison to wild-type swallow indicates that the seven alleles include single amino acid substitutions that identify critical residues, as well as lesions that result in truncated proteins. Western blots using affinity-purified antibodies agree well with the DNA sequence data, and identify a probable null protein. In order to determine the extent to which each allele affects swallow function, females homozygous or hemizygous for each allele were tested for the range and abundance of (1) RNA localization defects, and (2) embryonic cuticular defects. Swallow alleles can be grouped into two categories: those that retain partial function, and those indistinguishable from the putative null allele. Some swallow mutant alleles partially rescue the dominant female sterility of mutations in the atypical 67C alpha-tubulin gene, supporting other studies that suggest a link between RNA localization and the microtubule cytoskeleton.

Alleles↗

PubMed2004

Cortical regulation during the early stage of initiation of voluntary swallowing in humans.

The aim of the present study was to reveal the spatiotemporal relations among cortical regions involved in the initiation of voluntary swallowing in humans using magnetoencephalography (MEG). As a control task, finger extension movement, which is purely voluntary, was also investigated using the same techniques. The swallowing-related activity was distributed widely for 2000 ms before the electromyogram onset of the right suprahyoid muscle; however, the finger-related activity occurred in the late stage of the recording. The cingulate cortex, the insula, and the inferior frontal gyrus were the main loci active prior to swallowing. These cortical loci coincide with those suggested by previous human brain mapping studies that investigated the brain mechanism which controls swallowing. Activation in the cingulate cortex was registered in the early stage of swallowing and could be related to the cognitive process regarding the food being safe to swallow. The activation in the insula lasted for a long time before the initiation of swallowing. This suggests that the long-lasting activation in the insula prior to swallowing is essential for the initiation of swallowing.

Adult↗

PubMed1989

Stimuli for fetal swallowing: systemic factors.

Although the fetal gastrointestinal tract is believed to be a major site of amniotic fluid absorption, there is little information with regard to the acute regulation of fetal swallowing. A model for the study of ovine fetal swallowing was developed to incorporate electromyograms, an esophageal flow probe, and a computer data acquisition and analysis program. The fetal swallowing responses to two primary thirst stimuli, plasma hyperosmolality and angiotensin II, were studied. On alternate days, chronically prepared fetal lambs (131 +/- 2 days) received an intravenous infusion of angiotensin II (100 ng/kg per minute) or bolus injections (3 ml) of 0.15 and 3.97 mol/L saline solution. In response to the angiotensin II infusion, fetal systolic (49.3 to 64.7 mm Hg; p less than 0.05) and diastolic (31.1 to 40.5 mm Hg; p less than 0.05) blood pressures significantly increased. However, fetal swallowing did not change from basal rates of 0.85 swallows per minute and a net esophageal flow of 0.98 ml/min. In response to the injection of 3.97 mol/L saline solution, fetal plasma osmolality increased (292 to 306 mOsm; p less than 0.05) and subsequently decreased to 300 mOsm at 15 minutes after the injection. Within 1 minute after injection of the hypertonic saline solution, fetal swallowing activity (6.0 swallows per minute; p less than 0.05) and net esophageal flow (2.4 ml/min; p less than 0.05) significantly increased. Swallowing returned to basal values within 5 minutes after the injection. The data indicate that ovine fetal responses to osmolar thirst challenges are intact at 130 days' gestation. Fetal swallowing and thus amniotic fluid volume may be affected by fetal responses to in utero stimuli.

Angiotensin II↗

PubMed1993

Effects of bolus volume, viscosity, and repeated swallows in nonstroke subjects and stroke patients.

This study examined the effects of bolus volume and viscosity and the variability of repeated swallows in ten stroke patients and ten age-matched nonstroke subjects. The ten stroke patients demonstrated single unilateral cortical (three subjects), subcortical (six subjects), or brainstem (one subject) infarcts on computed tomography or magnetic resonance imaging scans at three weeks post-ictus. All subjects underwent videofluoroscopic swallow studies in which seven temporal pharyngeal swallow measures were examined. Despite the dissimilarity in lesion locations, the swallow physiology in the stroke patients was relatively homogeneous, ie, no swallowing disorders severe enough to prevent oral intake. As bolus volume increased, pharyngeal delay time diminished in stroke patients, but not in nonstroke subjects. Increasing bolus volume affected three other pharyngeal swallow measures similarly in nonstroke and stroke subjects: laryngeal closure durations and cricopharyngeal (CP) opening durations increased and duration of tongue base contact to posterior pharyngeal wall decreased. On viscosity comparisons (liquid vs paste), both subject groups displayed longer duration of base of tongue contact to posterior pharyngeal wall. On paste swallows, nonstroke subjects had longer CP opening and lower swallow efficiency, whereas stroke patients did not. This study found no statistically significant learning/repetition effect for repeated swallows in either subject group, or both groups combined.

Adolescent↗