STUDIES ON THE 2ND STAGE OF DEGLUTITION BY CINERADIOGRAPHIC METHOD

Abstract

Cineradiographic method has made possible detailed visual analysis of the 2nd stage of deglutition and its pathologic physiology. In this study were done the cineradiographic examinations at 54 subjects; 10 were considered to be normal, 44 were pathologic.According to measurement of tongue base mortion and pharyngeal peristal wave at every frame of the cineradiograph was formed the cineradiographic pattern of deglutition which consist of upper, middle and lower pharyngeal peristaltic wave pattern (U.P.W.P., M.P.W. and L.P.W.P.) and tongue base mortion pattern (T.B.M.P.).In normal cases, U.P.W.P. was consisted of a large positive wave, M.P.W.P.; a small negative and medium positive wave, L.P.W.P; a large negative wave, T.B.M.P.; the 1st small negative and positive, the 2nd large negative and positive waves. From these elements, author concluded that the positive waves of U.P.W.P. and M.P. W.P., the negative wave of L.P.W.P., and the 1st positive and the 2nd negative wave of T.B.M.P. were considered basic factor at swllowing.In pathologic cases; a dominant pharyngeal peristaltic wave was found in patients who were suffered tongue base resection, the 12th cranial nerve paralysis, cleft palate or upper esophageal stricture. In laryngectomized patients was observed a large pharyngeal peristaltic wave or abnormal pharyngeal constrictive wave. A most dominant tongue base mortion was observed in laryngectomized patients with partial hypopharyngeal constrictor and cervical esophagus resection, and the 9th and 10th cranial nerve paralysis. In the patients who were suffered the 9th, 10th and 12th cranial nerve paralysis, were observed that pharyngeal peristaltic wave and tongue base mortion were weak and showed incomplete deglutition.Based on the above results, author concluded that the distortion in pathologic deglutition was considered to be adaptation by the residual function with its hyperactivity and fenctional modification and deglutition was classified 4 types; normal tongue base mortion, pharyngeal peristaltic and paralytic types.