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At least 1,063 records · Page 59Linked to original sources
PubMed1999

Behaviors of bulbar respiratory interneurons during fictive swallowing and vomiting.

Behaviors of the same individual medullary respiratory interneurons were examined during both swallowing and vomiting. In 8 decerebrated and paralyzed cats, 18 neurons having either augmenting expiratory (E-AUG), decrementing expiratory (E-DEC), decrementing inspiratory (I-DEC), or constant inspiratory (I-CON) firing patterns were recorded near the most rostral part of the nucleus ambiguus. All neurons exhibited elementary reflexes to single-shock stimulation of the superior laryngeal nerve. During fictive swallowing elicited by superior laryngeal nerve stimulation, all neurons were basically inactive. During fictive vomiting induced by vagal stimulation and/or emetic drugs, all E-AUG and E-DEC neurons tested either were silent or fired weakly between successive retches, whereas I-DEC and I-CON neurons tested exhibited burst activity during the retching and early-expulsion phases. These results indicate that these bulbar respiratory neurons, which may be involved in respiratory rhythmogenesis, are multifunctional neurons that could also be involved in vomiting but not likely in swallowing.

Animals↗
PubMed1991

Swallowing function following hypopharyngeal reconstruction with the pectoralis major musculocutaneous flap.

Swallowing function was studied in three patients following the pectoralis major musculocutaneous reconstruction of the hypopharynx and cervical esophagus after extensive resection for hypopharyngeal cancer. Fluoroscopy and endoscopy revealed the formation of a sphincter-like ring at the proximal end of the remaining intact esophagus. This ring may act to prevent reflux from the lower esophagus, although its sphincteric power is weak. Manometric testing showed that no swallowing pressure was produced in the reconstructed gullet; therefore, bolus propulsion at the pharyngeal stage occurs mainly by gravity. Follow-up studies on swallowing indicate a minimum length of the suture line of 11 cm in order to prevent esophageal stenosis due to anastomotic stricture at the distal mucocutaneous junction.

Aged↗
PubMed1992

[Facial, lingual and pharyngeal electromyography in children: a method to study sucking and swallowing disorders and their pathophysiology].

The authors describe an electromyogaphic protocol developed with the aim of evaluating the sucking-swallowing function and of studying the pathophysiology of its disturbances in the newborn and in infants. This protocol consists of associating several techniques. Some of them are traditional: EMG of the facial muscles and nerves and blink reflex, while others are original: EMG of the tongue and hypoglossal nerve, EMG of the velum palatinum, and a dynamic study using a baby bottle, of the sucking and swallowing reflex for a liquid meal. For each technique, practical procedures are described together with normal results observed between birth and 3 years of age. The authors report on abnormalities observed in pathological conditions and discuss their significance in major nosological contexts. They emphasize the value of this EMG protocol in assessing the sucking-swallowing reflex, in revealing anatomo-functional disturbances in the brainstem and in tackling the pathophysiological aspects of aspiration pneumopathies, feeding difficulties and bucco-facial malformations.

Child, Preschool↗
PubMed2002

Swallow syncope associated with paroxysmal atrial fibrillation.

Swallow or deglutition syncope is a very unusual potentially lethal but treatable disorder. We report the case of a 26-year-old woman, who presented with a history of recurrent, multiple fainting episodes precipitated by swallowing. Twenty-four-hour manometry and pH recording together with continuous 24-h ECG monitoring revealed multiple episodes of symptomatic and asymptomatic paroxysmal atrial fibrillation, and significant gastro-oesophageal reflux associated with swallowing. Oesophageal function tests and continuous electrocardiographic evaluation is important in the diagnosis of this rare condition.

Adult↗
PubMed2004

Clinical and immunopathologic effects of swallowed fluticasone for eosinophilic esophagitis.

BACKGROUND & AIMS: Eosinophilic esophagitis (EE) is a recently recognized clinical disorder that is understood poorly. We aimed to determine the efficacy of swallowed fluticasone propionate on the immunopathologic features associated with EE. METHODS: A retrospective analysis was performed on 20 pediatric patients with EE. Inclusion criteria specified a peak eosinophil density of > or =24 cells per 400x field in the esophagus and treatment with swallowed fluticasone between 2 endoscopic assessments. Histologic specimens were examined for eosinophil and CD8(+) lymphocyte infiltration, papillary lengthening, and proliferation of the basal layer as determined by monoclonal anti-Ki-67 (MIB-1) antibody staining. RESULTS: The mean time interval between endoscopic assessments was 4.8 months. The patients were divided equally between allergic and nonallergic groups based on the results of skin-prick testing. All of the nonallergic patients responded to fluticasone propionate. The endoscopic appearance of the mucosa improved and microscopic evaluation showed markedly reduced eosinophil infiltration, reduced basal layer hyperplasia documented by a reduced number of MIB-1(+) cells, and a reduced number of CD8(+) lymphocytes. However, allergic patients were relatively refractory to therapy; 20% had a partial response, whereas 20% had no detectable improvement. Esophageal eosinophil levels before and after therapy in all patients strongly correlated with the level of epithelial cell proliferation as measured by MIB-1 staining. CONCLUSIONS: Collectively, these results suggest that patients treated with swallowed fluticasone have improved endoscopic, histologic, and immunologic parameters associated with EE. However, patients with identifiable allergies who fail dietary elimination may have a blunted response to treatment.

Administration, Oral↗
PubMed2004

Drooling, saliva production, and swallowing in cerebral palsy.

Fourteen participants (six females, eight males) ranging in age from 7 years 11 months to 18 years 2 months (mean 11y 7mo) with a confirmed diagnosis of spastic cerebral palsy (CP) were included in the study. Participants included those who drooled (CP+, n=14); age- and sex-matched children with spastic CP who were dry to mild and never to infrequent droolers (CP-, n=14) as well as typically developing peers (CTRL, n=14) served as controls. Frequency of swallowing was measured by using simultaneous cervical ausculation and videotaping of the head and neck. Saliva production was measured with the Saxon test, a simple gauze-chewing procedure. In addition, Pediatric Evaluation of Disability Inventory (PEDI), Test of Nonverbal Intelligence-3 (TONI-3), dysarthria severity scale, and Gross Motor Function Classification System (GMFCS) scores were obtained for each participant. Both groups of participants with CP tended to swallow less frequently than typically developing participants and tended to produce less saliva than typically developing controls; however, these differences were not statistically significant. No correlation was found between amount of saliva produced and amount drooled (r=0.245). An analysis of variance (ANOVA) conducted on the PEDI functional skills mean scores indicated significant differences between the three groups (F(2,39)=23.522,p<0.0001). Likewise, an ANOVA conducted on the TONI-3 scores revealed statistically significant differences between the three groups (F(2,39)=31.761, p<0.0001). A Spearman's rho correlation indicated that GMFCS scores were not significantly correlated with drooling severity (Spearman's rho correlation=0.3951,p=0.037). Drooling severity was found to be positively correlated with dysarthria severity (Spearman's rho correlation=0.82,p<0.0001). These findings suggest that drooling in patients with CP is related to swallowing difficulties rather than hypersalivation.

Adolescent↗
PubMed1999

Pharyngeal pouch endoscopic stapling--are post-operative barium swallow radiographs of any value?

Posterior pharyngeal pouch endoscopic stapling has gained increasing popularity among otolaryngologists especially in elderly patients. Post-operative barium swallow appearances can create confusion with the appearance of persistent pouches. We describe our experience in 10 patients, three of whom had external excision with cricopharyngeal myotomy and the remaining seven had endoscopic stapling approach. All three patients who had external excision showed no residual pouch whereas all seven patients who had endoscopic techniques performed showed some residual pouch. We were unsuccessful in our attempt to correlate post-operative symptoms with radiological appearance. Attempts by other radiologists at identifying pre- and post-operative barium swallow radiographs in patients who had endoscopic stapling of pharyngeal pouch were unsuccessful. We conclude that post-operative barium swallow radiography plays no role in determining the success of endoscopic stapling of pharyngeal pouch.

Aged↗
PubMed2003

Ketamine reduces swallowing-evoked pain after paediatric tonsillectomy.

BACKGROUND: Ketamine efficacy as an analgesic adjuvant has been studied in several clinical settings with conflicting results. The aim of this study was to investigate the effect of ketamine on spontaneous and swallowing-evoked pain after tonsillectomy. METHODS: Fifty children were randomized to receive premedication with either ketamine 0.1 mg kg(-1) i.m. or placebo given 20 min before induction of a standard general anaesthesia. All children received rectal diclofenac 2 mg kg(-1) and fentanyl 1 micro g kg(-1) i.v. before surgery. RESULTS: The ketamine group showed significantly lower pain scores both at rest and on swallowing, with less total paracetamol consumption (P < 0.05) during the 24 h after surgery. Significantly more patients required postoperative morphine titration in the control group (P < 0.05). The time to the first oral intake, and duration of i.v. hydration, were significantly shorter and the quality of oral intake was significantly better in the ketamine group (P < 0.05). There were no differences in the incidence of vomiting or dreaming between the groups. CONCLUSION: Premedication with a small dose of ketamine reduces swallowing-evoked pain after tonsillectomy in children who received an analgesic regimen combining an opioid and a NSAID.

Analgesics, Opioid↗
PubMed1992

Perception of cliff swallow calls by birds (Hirundo pyrrhonota and Sturnus vulgaris) and humans (Homo sapiens).

We tested for species differences in the perception of the cliff swallow chick begging call. One cliff swallow (Hirundo pyrrhonota), 3 European starling (Sturnus vulgaris), and 3 human (Homo sapiens) subjects were trained on go-no-go or repeating background tasks to discriminate between all possible stimulus pairs, measured by percentage of correct response and latency. We used multidimensional scaling to convert the similarity measures into a 2-dimensional map for each subject. Most of the maps were significantly correlated in Dimension 1 but not in Dimension 2. A cluster analysis separated bird and human maps. To identify the most important acoustic cues for each subject, we regressed the coordinates of each dimension on acoustic variables measured from the stimuli. For all subjects, center frequency was Dimension 1. Different acoustic cues were associated with Dimension 2, with agreement only on bandwidth, by the cliff swallow and 1 starling.

Animal Communication↗
PubMed1996

The cortical topography of human swallowing musculature in health and disease.

Because no detailed information exists regarding the topographic representation of swallowing musculature on the human cerebral cortex in health or disease, we used transcranial magnetic stimulation to study the cortical topography of human oral, pharyngeal and esophageal musculature in 20 healthy individuals and the topography of pharyngeal musculature in two stroke patients, one with and one without dysphagia. Our results demonstrate that swallowing musculature is discretely and somatotopically represented on the motor and premotor cortex of both hemispheres but displays interhemispheric asymmetry, independent of handedness. Following stroke, dysphagia appeared to be associated with smaller pharyngeal representation on the intact hemisphere, which increases in size with recovery of swallowing.

Adolescent↗
PubMed2005

Does barium influence tongue behaviors during swallowing?

The validity of videofluoroscopic swallowing assessments rests on the understanding that thin, nectar-, honey-, and spoon-thick radiopaque liquids resemble nonopaque liquids, both in their consistency and in the variations in swallowing that they elicit. Tongue movements during sequential swallows of opaque and nonopaque liquids were studied in 8 healthy participants in 2 age groups (<30 years, >50 years) using electromagnetic midsagittal articulography. Differences included smaller sip size, longer oropharyngeal transit times, and greater variability in tongue movement patterns with opaque liquids compared to nonopaque liquids, but effect sizes for these differences were small. Transit times were significantly longer for older participants than younger participants. We recommend matching radiopaque bolus size in videofluoroscopy to the patient's habitually preferred sip mass for comparator nonopaque liquids.

Adult↗
PubMed1993

Speech and swallowing function after anterior tongue and floor of mouth resection with distal flap reconstruction.

The purpose of this study was to assess the postoperative functioning of oral cancer patients with resections of the anterior tongue and floor of mouth, reconstructed with distal flap closure. Speech and swallowing performance was assessed for 11 men and 5 women preoperatively and at 1 and 3 months postoperatively following a standardized protocol. Speech tasks included an audio recording of a brief conversation and of a standard articulation test; swallowing function was examined using videofluoroscopy. Data were also collected on the number and duration of speech/swallowing treatment sessions, as well as the amount and duration of radiation therapy. Statistical analyses revealed that patients demonstrated a significant and severe impairment in speech and swallow functioning after surgery, with no recovery of function by 3 months post-healing. The degree of impairment in these patients may be related to the adynamic character of the distal flap used for reconstruction. Lack of improvement at the 3-month evaluation may be related to either the timing of postoperative radiation therapy or the low rate (44%) and amount of speech/swallowing treatment provided to these patients.

Adult↗
PubMed1998

Does age or sex affect pharyngeal swallowing?

The influence of age and gender on the pharyngeal pressure wave during swallowing was investigated in 73 healthy volunteers using a four-sensor manometry probe. The distal sensor was placed within the upper oesophageal sphincter (UOS) and three proximal sensors were located in the pharynx 2, 4 and 6 cm above the UOS. Twenty-nine variables describing the amplitude and timing of the swallow waveforms for a 5 ml water bolus were recorded from the pharynx and the UOS. Analysis of the results indicated that aging was associated with slowing of the swallow response in the pharynx, impaired opening of the UOS and a marked reduction in resting UOS tone.

Adult↗
PubMed2003

Handy measurement for tongue motion and coordination with laryngeal elevation at swallowing.

At the oral stage of swallowing, the tongue plays a major role and proper tongue performance is necessary to form the bolus and transfer it to the pharynx. For the present study we built a prototype device for safe and handy objective estimation of tongue motion and coordination with laryngeal elevation at swallowing. The device records tongue pressure by means of two strain gauge pressure transducers aligned 20 mm apart on a brass strap placed along the palatal midline. Laryngeal vibration is recorded with piezo-electric acceleration transducers. Time differences between pressure onset at the anterior and posterior transducers and the first spike from laryngeal vibration are measured. Ten healthy subjects were asked five times to swallow 5 mL of water. Pressure onset at the anterior transducer preceded posterior pressure by 294 +/- 164 ms. Given the distance between the transducers, the tongue contracted (squeezed) at a speed of 93 +/- 60 mm s(-1). Laryngeal vibration occurred 671 +/- 175 ms after the onset of anterior pressure. There was considerable variation in these parameters between subjects. Though the data is limited, the device successfully and easily revealed certain aspects of tongue motion and coordination with laryngeal elevation.

Adult↗
PubMed2000

Offspring sex ratios in tree swallows: females in better condition produce more sons.

Organisms are expected to adjust the sex ratio of their offspring in relation to the relative fitness benefits of sons and daughters. We used a molecular sexing technique that amplifies an intron of the CHD1 gene in birds to examine the sex ratio at egg-laying in socially monogamous tree swallows (Tachycineta bicolor). We examined all individuals in 40 broods (210 young), including all unhatched eggs and nestlings. Thus, the sex ratio we measured was the same as the sex ratio at laying. Overall, the mean sex ratio per brood (+/- SD) was biased significantly towards males (57 +/- 2% male). Within broods, male-biased sex ratios were associated with females in better body condition, and these females were more likely to produce sons in better condition. Tree swallows have one of the highest known levels of extra-pair paternity in birds (38-76% extra-pair young), and, as a consequence, variance in male reproductive success is greater than that of females. Thus, in tree swallows, investment in sons has the potential for higher fitness returns than investment in daughters, assuming that sons in better condition have greater reproductive success.

Animals↗
PubMed1999

Alteration of swallowing and oesophageal peristalsis by different initiators of deglutition.

It has long been believed that once initiated, the involuntary phase of deglutition follows a stereotypical pattern, that is modified only by ongoing sensory input from the transported bolus. To test the hypothesis that the mode of sensory activation of deglutition can modify the motor response irrespective of bolus characteristics, the mylohyoid, lower oesophageal sphincter (LES) and oesophageal body response to swallows induced in anaesthetized opossums by pharyngeal stroking or superior laryngeal nerve (SLN) stimulation (unilateral and bilateral) were compared. In comparison with unilateral SLN stimulation, swallows triggered by pharyngeal stroking resulted in a greater mylohyoid spike burst and LES relaxation. There was no significant difference in the oesophageal and LES motor response to pharyngeal stroking vs bilateral SLN stimulation, although the mylohyoid response was of greater magnitude with pharyngeal stroking. These studies demonstrate that the motor component of deglutition can be altered by different sensory initiators of swallowing, and provides a possible link between oropharyngeal and oesophageal motor disorders.

Animals↗
PubMed2003

Modulation of oesophago-UOS contractile reflex: effect of proximal and distal esophageal distention and swallowing.

Upper oesophageal sphincter (UOS) tone is influenced by intraoesophageal pressure events. Our aim was to test the hypothesis that UOS tone is responsive to simultaneous inhibitory and stimulatory signals originating from the oesophagus and compare effect of proximal and distal oesophageal air distention on oesophageal balloon-stimulated UOS contraction. We studied 16 healthy volunteers, ages 19-80 years in two stages. We induced UOS contraction by distending various size balloons intraoesophageally and studied response of contracted UOS to oesophageal air distentions and swallowing. Intraoesophageal injections of 60-ml room air resulted in UOS pressure augmentation (31%), relaxation (64%) and no effect in the remaining 5% of instances. The majority of air injections into the oesophageal segment proximal to the distended balloon were followed by relaxation of the contracted UOS, whereas, the majority of oesophageal air distentions distal to the balloon resulted in augmentation of UOS contraction (P < 0.01). Swallowing resulted in complete relaxation of the UOS. In conclusion, UOS contractile response to oesophageal balloon distention is overridden by further augmentation or relaxation as a result of oesophageal air distention and swallowing. Contractile and inhibitory responses of the contracted UOS to generalized oesophageal distention is region-specific.

Adult↗