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PubMed2001

Analysis of pharyngeal swallowing in healthy subjects.

The Biomechanics of pharyngeal swallowing was investigated by videofluorography in 10 healthy subjects (9 men and 1 woman) during swallowing of 3 ml of fluid contrast medium and a small spoonful of jelly contrast medium. The items measured were the sequential movement of the hyoid bone: hyoid bone angle; epiglottis angle: antero-posterior diameters of the thyroid cartilage, larynx, hypopharynx, and pharyngoesophageal junction: and transport time of the swallowed bolus. It was concluded that the movement of the hyoid bone and thyroid cartilage and the angle of the epiglottis were important for evaluation of pharyngeal swallowing, and that the antero-posterior and vertical movement of the hyoid bone showed a significant relationship to transport time of the swallowed bolus as far as the esophagus, which was within 400 msec on average.

Adult↗
PubMed2001

[Objective evaluation of the influence of the tongue base reconstruction on the swallowing disorders].

Laryngographic, manometric and videorentgenocinematographic examinations of swallowing were conducted on 54 patients after partial laryngectomy and on 35 subjects being a control group. Resection of a part of the base of the tongue is the factor that causes intensified difficulty during swallowing and increase in the frequency of the occurrence of aspiration. The results of manometric and videorentgenocinematographic examinations indicate that the shape and mobility of the tongue has the greatest influence on the efficient swallowing in patients who have undergone partial laryngectomy due to cancer initially located in the supraglottic area. The importance of remaining the possibly non-deformed structure and mobility of the tongue during partial laryngectomy involves the issue of reconstruction of defects occurred during the surgery. Both manometric and videorentgenocinematographic examinations confirm the effectiveness of the method involving reconstruction of defects in a part of the base of the tongue with a graft of angio-pedunculated submandibular gland. The study of effectiveness of glottis or neoglottis performed with the use of laryngograph showed no relation between glottis/neoglottis occlusion effectiveness index and intensified swallowing disorders. This shows the lack of compensating option in swallowing disorders with the help of a mechanism based on an efficient glottis or neoglottis occlusion alone.

Aged↗
PubMed2001

[Objective evaluation of the influence of the hyoid bone resection on the disorders in the act of swallowing].

Laryngographic, manometric and videorentgenocinematographic examinations of swallowing were conducted on 49 patients after partial laryngectomy and on 35 subjects being a control group. The results of examinations indicate that the mobility of remaining after the surgery parts of the larynx have the great influence on the efficient swallowing. The larynx mobility is closely related to the remaining of the hyoid bone. Resection of the hyoid bone or its part is the factor that causes intensified difficulty during swallowing and increase in the frequency of the occurrence of aspiration. The study of effectiveness of glottis or neoglottis performed with the use of laryngograph showed no relation between glottis/neoglottis occlusion effectiveness index and intensified swallowing disorders. This shows the lack of compensating option in swallowing disorders with the help of an mechanism based on an efficient glottis or neoglottis occlusion alone.

Aged↗
PubMed2001

Prevalence of adapted swallowing in a population of school children.

Adapted swallowing (AS) and its effects on dentofacial balance are frequently observed in children with orofacial myofunctional alterations. The preliminary objective of this research was to identify the frequency of cases of adapted swallowing in a population of school children, and targeting early treatment to prevent morphofunctional alteration of the face and its consequences on dentofacial harmony. One hundred school children between seven and nine years old attending the Children and Adolescents' Supporting Program (PRODECAD) of the State University of Campinas (UNICAMP) Brazil were selected at random and examined. Orofacial myofunctional assessments were carried out through standardized protocol. Results indicated the prevalence of adapted swallowing associated with resting posture alterations of dentofacial structures and mastication with dentofacial disharmony was 57%. Adapted swallowing without alteration of dentofacial form was observed in 19% of cases, and 24% of cases had a swallowing pattern within normal limits. The high prevalence of alterations suggests the need for early professional intervention.

Brazil↗
PubMed2002

Polychlorinated-naphthalenes, -biphenyls, -dibenzo-p-dioxins, -dibenzofurans and p,p'-DDE in bluefin tuna, swordfish, cormorants and barn swallows from Italy.

Concentrations of p,p'-DDE, polychlorinated biphenyl congeners (PCBs), polychlorinated-dibenzo-p-dioxins (PCDDs), -dibenzofurans (PCDFs) and -naphthalenes (PCNs) were measured in bluefin tuna, swordfish, common cormorants, and barn swallows collected from Italy. Average concentrations of PCBs in livers of tuna, swordfish, cormorant, and swallows were 930, 745, 1420 and 1230 ng PCBs g-1, w.w. respectively. p,p'-DDE was found in tuna, swordfish, cormorant, and swallow livers at mean concentrations of 82, 135, 166 and 95 ng DDE g-1, w.w. respectively. PCNs were found in all the samples analyzed, although at concentrations less than those reported for biota from the Baltic Sea. PCBs, particularly, non-ortho coplanar PCBs accounted for 80-90% of the total TEQs in tuna and swordfish. Relative contribution of PCDDs/DFs to TEQs was greater in cormorants and swallows compared to that in fishes. PCDD/DF congeners accounted for up to 80 and 45% of the total TEQs in cormorants and swallows, respectively.

Animals↗
PubMed2002

Speech and swallowing function after reconstruction with a radial forearm free flap or a pectoralis major flap for tongue cancer.

BACKGROUND AND PURPOSE: The tongue plays a more significant role in English than in Mandarin, both in apical-palatal consonant production and tense-lax distinction. Theoretically, the same surgical intervention may produce a less significant impact on postoperative Mandarin production. The impact of tongue reconstruction on Mandarin articulation has not been reported. This study compared the tongue function outcome obtained using two methods of tongue reconstruction, radial forearm free flap transfer and pectoralis major flap transfer. METHODS: Twenty-five patients with carcinoma of the tongue underwent tumor resection. The surgical defects were reconstructed using a pectoralis major flap in six patients and a radial forearm flap in 19 patients. Swallowing and speech function were evaluated 6 months to 5 years after the reconstruction. Speech intelligibility and a Mandarin articulation test were used to evaluate the articulation proficiency before and after surgery. Clinical evaluation of deglutition included a questionnaire on dietary habits and a swallowing rating of 1 to 7. RESULTS: Clinical evaluation showed that patients with free flap reconstruction had more intelligible speech (p = 0.014) even after total glossectomy. Assessment of data obtained by clinical questionnaire showed no significant difference between the two groups in swallowing function. Motility due to flap pliability increased speech intelligibility but had little effect on swallowing function. CONCLUSION: Our results suggest that radial forearm flap transfer is better than pectoralis major flap transfer in preserving speech function and that there is no significant difference between the two methods of reconstruction in their impact on swallowing function.

Deglutition↗
PubMed2002

Gastrointestinal imaging update: swallowing disorders and sphincter of Oddi dysfunction.

This update focuses on swallowing disorders and sphincter of Oddi dysfunction. Anatomy and physiology of swallowing are described, as are the signs, symptoms, and etiology of swallowing disorders. The imaging of these patients, particularly with videofluoroscopic swallowing study and fiberoptic endoscopic examination of swallowing, is then discussed. Sphincter of Oddi dysfunction as a cause of postcholecystectomy syndrome as well as its classification is described. This is followed by an explanation of the roles of fatty meal sonography and hepatobiliary scintigraphy in patients with sphincter of Oddi dysfunction, particularly type II and type III.

Barium Sulfate↗
PubMed2004

Videofluoroscopy and videoendoscopy in evaluation of swallowing function in 31 patients submitted to surgery for advanced buccopharyngeal carcinoma.

Swallowing function has been evaluated by means of videofluoroscopy and videoendoscopy in 31 patients submitted to surgery for local extended bucco-pharyngeal carcinoma. Aim was to better predict functional deficits and subsequent recovery perspectives of patients as far as concerns swallowing. In 30 patients, surgery was combined with radiotherapy, pre-operative in 6 cases and post-operative in 24. Site and extension of resection were defined using Urken's classification of hard and soft tissue deficits. In 3 cases, resection included half of tongue base and was followed by direct closure of the surgical defect. In 4 cases, the entire hemitongue (hemibody and hemibase) was resected and repair was performed with a free flap. In 5 cases, the whole tongue base was resected (posterior glossectomy). In 2 of these, direct closure of the gap was performed while the other 3 received a free flap. Another 3 cases required resection of the entire mobile tongue with corresponding buccal floor. All were repaired with free flaps. In 6 cases, resection comprised half the tongue base and adjacent tonsillar fossa and was performed using a transmandibular approach (demolitive in 3 cases, reconstructive in 3). Of these patients, 3 received direct closure and 3 reconstruction with a free flap. In 4 patients, resection included the tonsillar fossa and soft palate while in 5 other patients the whole soft palate was resected in addition to the tonsillar fossa. All these 9 patients received repair with free flaps. The remaining patient underwent resection of the entire oro-hypopharyngeal posterior wall, reconstructed with a free flap. During video-endoscopy examination, both liquid and soft meal ("pudding") were given to patients. Diagnostic parameters studied were: grade of pharyngo-laryngeal sensitivity, latency in onset of pharyngeal swallowing reflux, drop of the bolus in pre-swallowing phase, grade of the pharyngeal residual, inhalation and pooling of saliva. Data collected may be usefully employed not only in predicting the type and grade of swallowing deficit related to the extension of resection and repair technique used, but could also be helpful in the choice of the most appropriate behavioural procedure of rehabilitation for the patient.

Carcinoma, Squamous Cell↗
PubMed2005

Use of computer and respiratory inductance plethysmography for the automated detection of swallowing in the elderly.

Deglutition disorders can occur at any age but are especially prevalent in the elderly. The resulting morbidity and mortality are being recognized as major geriatric health issues, Because of difficulties in studying swallowing in the frail elderly, a new, non-invasive, user-friendly, bedside technique has been developed. Ideally suited to such patients, this tool, an intermediary between purely instrumental and clinical methods, combines respiratory inductance plethysmography (RIP) and the computer to detect swallowing automatically, Based on an automated analysis of the airflow estimated by the RIP-derived signal, this new tool was evaluated according to its capacity to detect clinical swallowing from among the 1643 automatically detected respiratory events, This evaluation used contingency tables and Receiver Operator Characteristic (ROC) curves, Results were all significant (chi2(1,n=1643)>100, p<0.01). Considering its high accuracy in detecting swallowing (area under the ROC curve greater than 0.9), this system would be proposed to study deglutition and then deglutition disorders in the frail elderly, to set up medical supervision and to evaluate the efficiency of a swallowing disorder remedial therapeutic.

Aged↗
PubMed2006

[Clinical value of barium swallow in observing esophageal tumor regression during radiotherapy].

BACKGROUND & OBJECTIVE: Barium swallow is widely used to observe the treatment response of esophageal squamous cell carcinoma (ESCC) and as a routine examination for long-term follow-up in China because of its convenience and inexpensiveness. This study was to observe esophageal tumor regression by barium swallow during radiotherapy, analyze the correlations of tumor regression speed to short-term response and long-term survival, and evaluate the clinical value of barium swallow during radiotherapy for ESCC. METHODS: Clinical data from 94 patients with ESCC, treated with radiotherapy (39 patients) or chemoradiotherapy (55 patients) from Jan. 2001 to Jun. 2003 at Cancer Center of Sun Yat-sen University, were retrospectively reviewed. Of the 94 patients, 18 (19.1%) were at stage II, 36 (36.3%) at stage III, and 42 (44.6%) at stage IV. Barium swallow was performed at the radiation dose of 40 Gy and the radiation end, and the X-ray appearance was classified according to Zhengzhou Meeting criteria. The patients were divided into 3 groups according to their tumor regression speed: Group A had rapid regression, with the X-ray appearance classified as grade I or II at 40 Gy, Group B had slow regression, with the X-ray appearance classified as grade III or IV at 40 Gy, but as grade I or II at the radiation end, Group C had obvious residual tumors, with the X-ray appearance kept being classified as grade III or IV till radiation end. The correlations of tumor regression speed to short-term response and long-term survival were analyzed. RESULTS: The complete response (CR) rates were 100.0% in Group A, 65.2% in Group B, and 28.3% in Group C (P<0.001), the 3-year survival rates were 44.0%, 24.2%, and 17.3%, respectively (P<0.001). Multivariate Cox regression analysis showed that short-term response and M stage were independent prognostic factors. The 3-year survival rates of CR patients were 44.0% in Group A, 32.6% in Group B, and 42.2% in Group C (P=0.814). The locoregional failure rates were 50% in Group A, 88% in Group B, and 81% in Group C, and the occurrence rates of severe radiation-related complications were 19%, 0%, and 6%, respectively. CONCLUSIONS: Barium swallow during radiotherapy for ESCC could be used to judge tumor regression speed, which is closely related to short-term response. Short-term response is an important prognostic factor of ESCC.

Adult↗
PubMed2006

Evaluation of Swallowing Patterns of the Tongue Using Real-time B-mode Sonography.

The aim of the present study was to evaluate the swallowing patterns of the tongue using B-mode sonography. A total of 65 patients aged between eight and 35 years were enrolled in the study including 25 controls. The swallowing patterns of the 40 patients were divided into groups of ten normal, 12 inconsistent, and 18 abnormal. Eight patients with a swallowing abnormality had Angle Class I occlusions, two had Class II, and the remaining ten patients had Class III. The majority of abnormal or inconsistent swallowing patterns were found in cases of mandibular prognathism. Quantitative data was not analyzed in this study. The results of this study show that B-mode sonography, being a non-invasive procedure permitting direct visualization of the movements of the tongue in both coronal and sagittal planes, can be used with certainty for diagnosing swallowing abnormalities.

Adolescent↗
PubMedDate not supplied

[Influence of the viscosity of the swallowed food bolus on the motility of the pharynx].

In 9 young men, healthy volunteers, we studied the effect of dry swallows, liquid and paste swallows on the pharyngeal motility. The viscosities of liquids and past were 200 centipoise (cP), 300 cP and 60000 cP, respectively. The bolus volume was 10 ml. For pharyngeal manometry we used two strain-gauge manometric probes taped together, so that a total of six transducers were staggered at 1.5 cm intervals. After its passage through the nose, the assembly was positioned so that all its transducers faced posteriorly, and manometric activity was recorded from oropharynx, hypopharynx and upper esophageal sphincter (UES). We also recorded infra-hyoid electromiographic activity. The amplitude and duration of the oropharyngeal and hypopharyngeal peristaltic pressure complex were not changed by the different boluses. The velocity of peristaltism propagation between oropharynx and UES was slower for paste than for liquids or dry swallows. The increased of viscosity was associated with longer duration of UES relaxation, and greater intrabolus pressure in hypopharynx and UES. The infra-hyoid electromiographic activity was longer for paste than for liquids or dry swallows. These findings suggest that pharyngeal motility is affected by the characteristics of the swallowed bolus.

Adolescent↗
PubMed1990

[Parametric esophageal scintigrams of transit studies using the multiple swallow technique: a comparison of a new method with a standard esophageal transit test].

Established single-swallow techniques for the assessment of oesophageal motility disorders encompass a high potential of falsely positive/negative findings caused by the considerable variability between single swallows. In this study, therefore, a new form of parametric oesophageal scintigraphy (POeS) is introduced which allows simultaneous assessment of 15-20 consecutive swallows. To assess the value of this combined qualitative/semiquantitative method 166 patients with various oesophageal motility disorders were tested in an intraindividual comparison with a standard oesophageal transit test (OeTT). In contrast to OeTT, POeS yields specific image patterns which permit a differentiation between various forms of peristaltic disorder. By the use of POeS the bolus behaviour during its oesophageal passage is well characterized, the main location of the functional disorder can be identified and a correct classification of the severity can be achieved as well. In contrast to OeTT, diagnosis in POeS is based on a series of consecutive swallows. Misinterpretation due to possible variations between single swallows is often observed in OeTT, providing up to 30% false-positive and 52% false-negative findings which are almost eliminated using POeS.

Deglutition↗
PubMed1990

Radionuclide uptake and growth of barn swallows nesting by radioactive leaching ponds.

Populations of barn swallows (Hirundo rustica) nested seasonally near the Test Reactor Area (TRA) radioactive leaching ponds on the Idaho National Engineering Laboratory (INEL). These birds utilized leaching pond arthropods as a food source and contaminated mud for nest construction and thus accumulated radioactive materials. Over 20 fission and activation products were detected in immature and adult TRA birds. The radionuclide exhibiting the highest mean concentration in adult birds was 51Cr, with 16.1 Bq g-1 (435 pCi g-1). Mean concentrations of detectable radionuclides were used to calculate internal dose rates. Approximately 72% of the total dose rate of 219 microGy d-1 (22 mrad d-1) for adult birds was due to 24Na. Swallow thyroids contained a mean 131I concentration of 3330 Bq g-1. An average dose rate to the thyroid was calculated to be 4300 microGy d-1 or 450 mGy (45 rad) for the entire breeding season. Data from LiF-700 thermoluminescent dosimeters in swallow nests indicated that average dose rates were 840 microGy d-1 for eggs and 2200 Gy d-1 for nestlings, for a total of 54 mGy (5.4 rad) during the nesting period. The breeding biology and growth rate were investigated for TRA swallows and comparison group located 15 km and 100 km away. Total mortality rates for the comparison group vs. 1976 and 1977 TRA populations were not found to be significantly (p greater than 0.9) different. Nonlinear regression was used to fit individual growth curves and estimate parameters using a logistic model. First clutch TRA swallows were found to have a significantly (p less than 0.05) lower mean growth rate compared to either the first clutch comparison group or the second clutch of TRA birds. Mean asymptotic weights achieved by immature TRA birds were also found to be significantly (p less than 0.05) lower than those achieved by comparison group birds. Both growth rate and asymptotic weights for TRA birds were within the normal range reported in the literature. The cause for the statistical difference in growth rate between the comparison group and TRA first clutch populations could not be determined.

Animals↗
PubMed1988

Serological examinations for antibodies against West Nile virus, Semlikivirus and chikungunyavirus in laboratory mice, parasitized by nidicole fauna from swallow's nests.

Experimental mice in swallow's (NMRI) nests highly infested with swallow bugs (Hirundo rustica) revealed antibodies against West Nile virus, Semliki virus and Chikungunya virus. Additional nidicole ectoparasites were not controlled and could also play a role in the occurrence of infection in experimental mice. Swallows and sparrows (Passer domesticus) additional nest inhabitants appear to be the ultimate link in this infection pathway as swallow bugs seldom migrate into dwellings to infest humans. RMSF-group antibodies and antibodies against ornithosis are rather seldom found. The import of West Nile virus, Chikungunya virus and Semliki virus to Austria through bug-parasitized swallows or other nidicole mites and insects can be assumed based on the presented results.

Animals↗
PubMed1987

[Mechanisms of adaptation of breathing and swallowing coordination following partial laryngectomy].

Integrated study of respiration and deglutition includes 48 healthy examinees and 30 patients after partial laryngectomy. Every act of swallowing is accompanied by a respiratory pause (swallow apnoea) which in healthy subjects lasts for approximately 0.7438 sec. In the patients after partial laryngectomy swallow apnoeas are significantly prolonged and last for approximately 1.2482 sec. Swallow apnoea is usually followed by expiration. This is observed in the majority of subjects, its function being the protection of the lower respiratory pathways. Besides the interaction between breathing and swallowing, synergism is also present, functioning as adaptive mechanism of the upper respiratory and gastrointestinal system.

Adolescent↗
PubMed1987

[Coordinating breathing and swallowing following laryngectomy].

Integrated study of respiration and deglutition includes 48 healthy examinees and 22 patients after laryngectomy. Laryngectomy changes the relationship between breathing and swallowing. In healthy subjects 70.68 per cent of swallows occurs during the expiratory phase and more than 80 per cent are followed by expiration. In the patients after laryngectomy 58.01 per cent of swallows coincide with the end of the expiration end the beginning of the inspiration and near 80 per cent of swallows are followed by inspiration. Laryngectomy eliminates necessity for specific coordination of breathing and swallowing and makes possible manifestation of the central neural control.

Adolescent↗
PubMed1995

[Classification and interpretation of the oral swallowing phase using B+M mode ultrasound].

A cushion device and B+M mode ultrasonography technique were used in 30 healthy volunteers to study tongue movement during swallowing. M-mode images show an amplitude-time diagram, in which the entire tongue movement during swallowing can be easily scrutinized. The different tongue movements during swallowing result in several turning points on the graph of the M-mode sonogram, which divide the oral swallowing phase into five subphases (I, IIa, IIb, IIIa, IIIb). Based on this new classification of swallowing, the tongue movements of the participants were interpreted and classified.

Adolescent↗