Abstract
Swallowing disturbances are common after neurological disease and oropharyngeal tumor resection. In this case the oral stage is often affected. So far the clinical evaluation of the oral phase is limited. Recently the role of pressure changes during oropharyngeal swallowing has been pointed out, but until now there are not enough data. Thereby 52 healthy adults aged between 20 and 45 years were examined using an oral shield (Silencos®, Bredent, Senden, Germany) connected to a digital manometer (GDUSB 1000®, Greisinger electronics, Regenstauf, Germany) able to record pressures in a range of 2,000 to −1,000 mbar at a frequency of 1 kHz. Three swallowing conditions were measured: an active bolus intake (ABI) of water, a passive bolus application of a water-bolus (PWA) and a passive application of a gel-bolus (PGA). We found negative pressures with a median value of −278.9 mbar during ABI, of −24.2 mbar during PWA and of −29.4 mbar during PGA. Significant differences in pressure amplitudes and the pressure pattern were observed depending on the kind of bolus application and its consistency. The used test presents a simple and easy to handle method to assess the oral phase of swallowing.
Highlights
Swallowing, a vital function that secures nutrition and hydration, relies on a complex neuromuscular control and achieves an efficient bolus transport with a protected airway [1]
We found negative pressures with a median value of -278.9 mbar during active bolus intake (ABI), of -24.2 mbar during passive bolus application of a water-bolus (PWA) and of -29.4 mbar during Passive gel-bolus application (PGA)
During the passive bolus application a volume of 2 ml was chosen with the aim to allowing a subtle swallowing
Summary
Swallowing, a vital function that secures nutrition and hydration, relies on a complex neuromuscular control and achieves an efficient bolus transport with a protected airway [1]. In healthy subjects this mechanism remains mostly unnoticed during passive swallowing of saliva or during eating and drinking [2, 3]. With regard to the biofunctional model proposed by Engelke [6] the several participating structures during swallowing can be explained as an interaction of biofunctional compartments and biofunctional valves According to this model, the interocclusal compartment can be described as the space surrounding the dental arches and is limited anteriorly by the lips. In the past negative pressure amplitudes have already been described in the esophagus and their implication in swallowing has been discussed [7]
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