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At least 73 records · Page 4Linked to original sources
PubMed2003

A cineradiographic study of deglutitive tongue movement in patients with anterior open bite.

The purpose of this study was to use cineradiographic images to investigate tongue movement during deglutition in anterior open bite patients with tongue thrust. Each subject had semi-spherical lead markers attached to the tip and dorsal surface of the tongue and was asked to swallow 5 ml of diluted liquid barium. Tongue movement during deglutition was recorded in the mid-sagittal plane with an X-ray VTR system. The deglutition process was divided into 6 stages to analyze the movements of the tip and dorsal surface of the tongue in each stage. In open bite patients, both the tip and dorsum of the tongue were positioned anteriorly and inferiorly at rest and during the buildup of negative intraoral pressure. The dorsum of the tongue tended to move and be positioned anteriorly as the tongue tip protruded and pushed the maxillary and mandibular anterior teeth. The tongue tip traveled a significantly smaller distance from the stage of tongue rest position to that of most retruded tongue tip position and a significantly larger distance from the stage of most retruded tongue tip position to that of tongue tip fixation in open bite patients than in controls.

Adolescent↗
PubMed2002

Videofluoroscopy of deglutition in children after repair of esophageal atresia.

PURPOSE: To evaluate the functional disorders of the oral and pharyngeal phases of deglutition after repair of esophageal atresia in children. MATERIAL AND METHODS: 19 children (10 girls, 9 boys, mean age 22 months) underwent videofluoroscopy of deglutition after repair of esophageal atresia. The videofluoroscopic studies were assessed according to functional and morphological changes in the oral, pharyngeal and esophageal phases. The persistence of radiologic findings on videofluoroscopy was determined. RESULTS: The oral phase was normal in all patients. The main functional disorder of the pharyngeal phase was aspiration in 7 (37%) children. A completely normal deglutition in the pharyngeal and esophageal phases was not seen in any patient. CONCLUSION: Videofluoroscopy after repair of esophageal atresia is helpful in differentiation of functional and morphological disorders that can lead to prandial aspiration and have an influence on the decision about continued therapy.

Deglutition Disorders↗
PubMed2003

[Tracheoesophageal shunt for voice reconstruction after total laryngectomy to prevent from deglutition disorders].

OBJECTIVE: To observe the effect of tracheoesophageal shunt on voice reconstruction after total laryngectomy. METHODS: Seventy-nine patients with laryngeal cancer of T3 and T4 stages were conducted an operation of tracheoesophageal shunt after total laryngectomy. The vertical voiced slit with a length of 0.8-0.12 cm was made between the posterior wall of trachea and the frontal wall of esophagus, while the cricoid cartilage flap with the length of 2.0 cm and width of 1.2 cm was reserved to form cartilage mucosa flap as an edge to prevent deglutition disorders. Finally, membranous part of trachea was sutured together with the neck skin as an inclination edge. RESULTS: In this series, 71 of 79 patients kept good voice function, and 65 of 71 patients avoided deglutition disorders, but other patients failed to do so. The 3-year survival rate was 66.7% (14/21, for stage T3) and 64.9% (24/37, for stage T4), respectively. The 5-year survival rate was 6/10 (for stage T3) and 50.0% (10/20, for stage T4), respectively. CONCLUSION: The operation of tracheoesophageal shunt is advantageous to prevent deglutition disorders as well as to restore the voice function of larynx.

Adult↗
PubMed2005

[Observation on therapeutic effect of activating brain function to cause resuscitation needling method on deglutition disorders after stroke].

OBJECTIVE: To observe clinical therapeutic effect of acupuncture on poststroke deglutition disorders. METHODS: Sixty-eight inpatients of moderate and severe deglutition disorders were treated by the activating brain function to cause resuscitation needling method. RESULTS: Twenty-six cases were cured, 24 were remarkedly effective, 16 were effective, with a total effective rate of 97.06%. CONCLUSION: This needling method has a markedly therapeutic effect on poststroke moderate and severe deglutition disorders.

Acupuncture Points↗
PubMed1990

[Radiocinematographic assessment of deglutition after surgical treatment for oral and maxillary neoplasms].

The authors report the results of radiocinematographic examinations of 98 patients operated on for oral and maxillary neoplasms with analysis of the disturbances of various phases of deglutition in relation to the site and extent of the operation. Leakage into lower respiratory tract is discussed. Extensive operations in the mouth and on the lower and upper jaws were found to cause disturbances of both deglutition phases, and retention of contrast in postoperative tissue defects limitation of the movements of various anatomical structures were the most frequent disturbances of deglutition.

Cineradiography↗
PubMed1990

[Correlation between the radiologic study of deglutition and the clinical picture in systemic sclerosis (scleroderma)].

Fifty-one patients with systemic sclerosis (scleroderma) were studied by means of videofluoroscopy in order to evaluate the abnormalities in the oropharyngeal and esophageal phases of deglutition and to correlate the radiological patterns with the clinical features of the disease. Thirteen patients (25.5%) exhibited swallowing disorders such as oral leakage, retention, penetration, mild or moderate aspiration and abnormal upper esophageal sphincter behavior. These dysfunctions were more evident in patients with esophageal motility abnormalities. A normal radiological pattern in the esophagus was not associated with swallowing alterations. Remarkably, patients with oral-pharyngeal disorders had a higher incidence of lung diseases. Forty-five patients (88%) exhibited disorders of the esophageal phase of deglutition, such as mild or severe motility abnormalities or hiatal hernia, gastro-esophageal reflux, reflux esophagitis, and stricture. Radiological findings in the esophagus can be abnormal in the early stages of the disease. On the other hand, the radiological pattern of esophageal motility can be occasionally negative in advanced or extensive disease. This indicates a discrepancy between clinical symptoms and radiological picture of the esophagus. The radiological examination of the oral-pharyngeal and esophageal phases of deglutition is important in patients with scleroderma in order to evaluate visceral involvement, motility disorders, and risk of aspiration. Such radiological information can be useful in preventing esophagitis and pulmonary complications.

Adult↗
PubMed1995

[Radiologic differential diagnosis of neurologically-induced deglutition disorders].

This paper explains the differential diagnosis of neurological dysphagia. Special groups of diseases are described that can only be assessed by dynamic recording modalities like videofluoroscopy and high-speed cineradiography. The need for dynamic recording results from the physiological data of deglutition. The act of deglutition lasts only 0.7 s, but requires the well-coordinated action of 5 cranial nerves and 26 muscle groups. For a systematic analysis of the underlying neurological disease a precise description of possible pathological single observations from the oral cavity to the cardia is offered to the radiologist. Important hints concerning possible "pitfalls" due to non-neurologically caused pharyngoesophageal motility disturbances are given. Although dynamic recording does not always allow the precise diagnosis of the underlying neurological disease, it enables us to classify the motor disturbances and leads to distinct "groups of disease." Thus, dynamic recording of deglutition is of crucial importance for further conservative or functional surgical treatment of the dysphagic patient.

Cineradiography↗
PubMed1996

Coordination of deglutitive vocal cord closure and oral-pharyngeal swallowing events in the elderly.

OBJECTIVE: The temporal relationship between deglutitive glottic closure, oropharyngeal bolus transit and other biomechanical swallowing events was studied in 10 healthy elderly subjects by concurrent transnasal videolaryngoscopy, videofluoroscopy, intraluminal pharyngeal manometry and submental electromyography. The results were compared with those of a similar study in a group of young healthy volunteers published previously. RESULTS: Overall, the coordination of various deglutitive biomechanical events in the elderly group was found to be similar to that in the young. However, subtle differences were documented. Contrary to historical young controls, where the onset of the bolus movement from the mouth toward the pharynx invariably occurred after the vocal cords reached their maximum adduction, in the elderly this relationship was variable. In all swallows of two subjects it occurred 0.41 +/- 0.2 s after, and in another two it occurred 0.08 +/- 0.06 s before the maximal vocal cord adduction. Six subjects showed interchanging patterns. Except for the above-mentioned changes, the onset of vocal cord adduction in the elderly also preceded all other studied events, similar to previously published data in the young. In the elderly, the total duration between onset of vocal cord adduction and their complete reopening (2.47 +/- 0.1 s) was similar to that in the young. CONCLUSION: Although subtle alterations occur in the coordination of deglutitive vocal cord closure and oropharyngeal bolus transit in some elderly people, the overall coordination between airway protection and the transit aspect of the oral-pharyngeal phase of swallowing is preserved in the elderly.

Aged↗
PubMed1998

[The course of the oropharyngeal stage of deglutition in physiological condition. Computer topokinetic analysis of videofluoroscopic images].

The performed analysis covers the physiology of the pharyngeal phase of deglutition in 11 patients aged 45-65 years. The studies were carried out with the aid of roentgenocinematographic examinations (RTGC) and after preparing an adequate computer program, a computer topokinetic analysis was accomplished (CTA). The measurement of parameters established in CTA make it possible to obtain the image of the pathway passed by the anatomical structures, the dynamics, the shape and the relative distances of two anatomical structures, with the duration of the deglutition act being taken into consideration. The use of RTGC images in CTA allows for better understanding of the mechanism acting in the pharyngeal phase of deglutition act in physiological conditions.

Aged↗
PubMed1998

[Disorders of the pharyngeal stage of deglutition after classical and extended supraglottic laryngectomies. Computerized tomographic analysis of x-ray images].

In 20 patients with laryngeal cancers, of both sexes and aged from 17 to 76 years, a partly classical or extended supraglottic laryngectomy was performed. The accomplished roentgenocinematographic analysis dealt with the disorders of the pharyngeal phase of deglutition act (RTGC). Next, by selecting characteristic schemas of frames for individual phases of deglutition, a computerized topokinetic analysis was carried out (CTA). The deglutition disorders were estimated in relation to the spared anatomical structures, formation of glosso-laryngeal recesses after this type of operations as well as leakage of contrast medium into the trachea.

Adolescent↗
PubMed1994

Effect of aging on the deglutitive oral, pharyngeal, and esophageal motor function.

Aging affects some members of the swallowing orchestra and spares the others. It seems that changes in the pharynx of the elderly are more of a positive nature than a negative one and reflect an adaptation to age-induced structural changes of the upper esophageal sphincter. In the esophagus, the positive change in deglutitive peristaltic amplitude and duration seem to revert to a negative one over the age of 90 years. In the upper esophageal sphincter, it appears that aging reduces the resting pressure, but spares its response to various stimuli. Considering the increasing elderly population and their medical needs, further normalcy data about various manometric aspects of deglutition is needed for physiologic studies as well as diagnostic and therapeutic purposes.

Adult↗
PubMed1997

Impaired deglutitive airway protection: a videofluoroscopic analysis of severity and mechanism.

BACKGROUND & AIMS: Laryngeal vestibule penetration is a prerequisite for deglutitive aspiration. This study aimed to analyze the mechanism and model the risk of laryngeal penetration before or during the pharyngeal swallow. METHODS: Videofluoroscopic swallowing studies of 29 patients with neurogenic dysphagia with penetration before or during the pharyngeal swallow were compared with 12 controls. A stepwise regression analysis was used to define the coordinative defects leading to bolus penetration into the laryngeal vestibule. The mechanism was biomechanically analyzed. RESULTS: The stepwise regression modeled a laryngeal penetration index from the coordination between laryngeal vestibule closure and bolus release at the glossopalatal junction and the timing of upper esophageal sphincter opening relative to glossopalatal junction opening. The model accounted for 86% of the observed variance in severity of laryngeal penetration among the dysphagics. The observed incoordination resulted from both delayed initiation and slowed enactment of deglutitive laryngeal elevation. CONCLUSIONS: A dysphagic individual's risk of incurring laryngeal penetration before or during 1-, 3-, or 5-mL swallows is proportional to two temporal measures of coordination made from 1-mL swallows. The severity of the relevant defects (delayed and slowed laryngeal elevation) is proportional to the severity of swallow dysfunction.

Adolescent↗
PubMedDate not supplied

Factors in successful deglutition following supraglottic laryngeal surgery.

Aspiration is the major problem in deglutition associated with conservation laryngeal surgery. Closure of the glottic sphincter, depression of the epiglottis over the laryngeal inlet, elevation of the thyrohyoid complex under cover of the base of the tongue and appropriate relaxation of the cricopharyngeal muscle to permit unobstructed passage of food into the esophagus are important mechanisms that prevent food from entering the trachea. Partial laryngeal surgery can interfere with one or a combination of these mechanisms. Analysis of the records of all evaluable patients who underwent horizontal supraglottic resections from January 1976 to June 1981 was undertaken. The incidence of deglutition problems is reported. In addition, the effects of resection or preservation of the hyoid, arytenoid, base of tongue and branches of the vagus and the effect of cricopharyngeal myotomy upon ultimate swallowing function are analyzed.

Adult↗
PubMed2003

[Clinical and videofluoroscopic evaluation of deglutition in children with tetraparetic spastic cerebral palsy].

Cerebral palsy is a condition that may be associated with swallowing disorders, that is, oropharingeal dysphagia. The aim of this study was to characterize and compare the swallowing processes of 32 children with this condition, by clinical and videofluoroscopic evaluation, with special focus on tracheal aspiration detectability. Results show an important compromise of oral phase. The most important findings during the pharyngeal phase were velopharingeal incompetence and residuals on the pharyngeal recesses. Aspiration was more common with liquids, before and after deglutition. On clinical and videofluoroscopic evaluation, cervical hyperextension was the commonest postural abnormality. Videofluoroscopy confirmed the occurrence of aspiration on most of the cases that presented suggestive signs of aspiration during clinical evaluation. We conclude that clinical and videofluoroscopic evaluations are complementary on deglutition evaluation and together may point to the most specific rehabilitation procedure.

Cerebral Palsy↗
PubMed1992

[A cinefluorographic study of hyoid bone movement during deglutition].

A quantitative study was performed to analyze movement of the hyoid bone on swallowing in 71 patients with pharyngo-laryngeal neurosis (44 males, 27 females), who had no abnormal findings either morphologically or functionally. The lateral X-ray cine (30 frames/sec) was taken while the patients swallowed the contrast medium in the upright position, and precise movement of the hyoid bone was examined using a motion analyzer. The movement was divided into 5 phases; initial slow elevation from the resting position (1st elevation phase), then a quick upwards shift to the highest position (2nd elevation phase), where the hyoid bone remained temporarily (static phase), followed by rapid and slow descending shifts towards the resting position (1st and 2nd descending phase, respectively). The resting position of the hyoid bone is significantly lower in males than in females and it seemed to get lower with age in both sex. When compared to the younger group (age 10-30), the older group (age 60-70) had significantly more distance and longer duration of deglutition in the 1st elevation phase, whereas the 2nd elevation phase did not differ among the age group. The results of this study indicate that prolongation of the time and distance of the 1st elevation phase are more significant in the older group, which may well explain the cause of delayed of deglutition.

Adolescent↗
PubMed1988

[Dynamic radiologic study with video recording of the oral and pharyngeal stages of normal deglutition].

The upsurge of interest in dynamic radiology of the oral pharyngeal phases of deglutition can be explained by: (a) the increased survival-rate in neuromuscular diseases; (b) the improved results in head and neck surgery and radiotherapy; (c) the awareness of the existence of a "silent" form of dysphagia. This paper is aimed at divulgating the radiological dynamic investigation of deglutition by videorecording, and at assessing the findings of a study on 119 consecutive non-dysphagic patients (55 males and 64 females; mean age 54 years) as a control group for future studies on dysphagic patients. Seventy-nine out of 119 subjects (66.4%) were found to be normal. Various abnormalities were observed in the remaining 40 (33.6%), such as barium penetration in the subepiglottic or supraglottic space (20 cases), dysmotility of the epiglottis (14 cases), transient and mild cricopharyngeal muscle dysfunction (17 cases), diverticula (6 cases). Further studies are needed to evaluate the true significance and implication of these findings in asymptomatic patients. Finally, a more widespread use of this method is hoped for, in order to establish its diagnostic and clinical efficacy.

Administration, Oral↗
PubMed1998

Severe craniofacial malformations and deglutition dysfunction in a brother and sister: new syndrome?

We report seemingly unique craniofacial malformations and deglutition dysfunction in a sib pair. The boy had right maxillomandibular alveolar synechae, ankylosis of right temporomandibular joint, hypoplasia of the zygomatico-maxillary region, nasal deviation to the left, choanal stenosis, and exophthalmos due to shallow orbita. His ears were apparently low-set with prominent lobules. He had severe gastroesophageal reflux and increasing respiratory problems and died at age 11 months. Psychomotor development was normal. His 10-year-old sister had similar craniofacial malformations and a cleft soft palate. She also had a severe deglutition dysfunction and developed a thoracolumbar kyphoscoliosis. Psychomotor development was normal. The parents were healthy and non-consanguineous. The malformations in the sibs do not fit any reported craniofacial malformation syndrome and may represent a previously unrecognized monogenic disorder. This may be an autosomal recessive or dominant trait with gonadal mosaicism in one of the parents.

Abnormalities, Multiple↗
PubMed2001

Evaluation of the anatomical and functional properties of deglutition with various kinetic high-speed MRI sequences.

We evaluated various fast MR sequences for obtaining anatomical and dynamic functional information during deglutition. Seven healthy volunteers underwent MRI of the oropharynx during swallowing of an oral positive-contrast agent. Single-slice imaging was performed in the median sagittal plane while subjects were in a supine position. Twenty serial images were obtained using EPI, FLASH, and turbo-FLASH sequences. The dynamic (movement-related) information and the anatomical resolution of the soft tissues were evaluated during deglutition. The FLASH sequence provided high-quality images at rest. During swallowing, however, the images were significantly degraded by movement artifacts and had inferior temporal resolution. The EPI evidenced better temporal resolution, but was degraded by strong distortions and movement artifacts. The turbo-FLASH sequence provided the best temporal resolution and sufficient spatial resolution during motion. This sequence proved optimal for the investigation of swallowing function, and is expected to be of value for the documentation of functional disturbances in patients with oropharyngeal pathology.

Deglutition↗