Temporal characteristics of hyolaryngeal structural movements in normal swallowing. (16th March 2015)

• Record Type: Journal Article
• Authors: Nam, Hyung Seok; Oh, Byung‐Mo; Han, Tai Ryoon
• Is Part Of: Laryngoscope. Volume 125:Number 9(2015:Sep.)
• Page Start: 2129
• Page End: 2133
• Publication Date: 2015-03-16
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.25229
• Languages: English
• ISSNs: 0023-852X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="lary25229-sec-0001" sec-type="section"> <title>Objectives/Hypothesis</title> <p>To evaluate the relationship between movements of hyolaryngeal structures and fluid bolus transition in normal swallowing using automatized kinematic analysis of the videofluoroscopic swallowing study (VFSS).</p> </sec> <sec id="lary25229-sec-0002" sec-type="section"> <title>Study Design</title> <p>A prospective, descriptive study.</p> </sec> <sec id="lary25229-sec-0003" sec-type="section"> <title>Methods</title> <p>Seventy‐five healthy volunteers underwent VFSS with 2 mL of diluted barium. The timing and sequence of structural movements were measured for laryngeal elevation (LE), hyoid excursion (HE), epiglottic rotation (ER), and fluid bolus transition.</p> </sec> <sec id="lary25229-sec-0004" sec-type="section"> <title>Results</title> <p>The rapid movement of LE (reference time point) was initiated simultaneously with the fluid bolus head passing the mandibular angle (−0.05 s, <italic>P</italic> = .07), followed by rapid onset of HE with significant temporal difference (<italic>P</italic> < .001). After the hyoid onset, onset of ER (0.17 s, <italic>P</italic> < .001), entrance of the bolus through upper esophageal sphincter (0.33 s, <italic>P</italic> < .001), maximal point of LE (0.52 s, <italic>P</italic> < .001), HE (0.53 s, <italic>P</italic> = .344), and maximal point of ER (0.64 s, <italic>P</italic> < .001) followed sequentially. For subgroup analysis, we classified 50 subjects without premature bolus loss (PBL) or pharyngeal triggering delay (PTD) into the "early group, " and 24 subjects with PBL or PTD for <1 s into the "late group." In both groups, the sequence of the structural movements did not change. The early group showed significant correlation between the fluid transition and structural movements; both LE and HE were initiated when the bolus passed the mandibular angle, and the ER was initiated when the bolus reached the vallecula.</p> </sec> <sec id="lary25229-sec-0005" sec-type="section"> <title>Conclusions</title> <p>We demonstrated a characteristic pattern of hyolaryngeal structural movements in normal swallowing. The results may serve as a basis for classifying and analyzing aspiration patterns in patients with dysphagia.</p> </sec> <sec id="lary25229-sec-0006" sec-type="section"> <title>Level of Evidence</title> <p>NA <italic>Laryngoscope</italic>, 125:2129–2133, 2015</p> </sec> </abstract>