scholarly journals Utilizing inspiratory airflows during standard polysomnography to assess pharyngeal function in children during sleep

2015 ◽  
Vol 51 (4) ◽  
pp. 431-438 ◽  
Author(s):  
Brian M. McGinley ◽  
Jason P. Kirkness ◽  
Hartmut Schneider ◽  
Abhishek Lenka ◽  
Philip L. Smith ◽  
...  
Keyword(s):  
Dysphagia ◽  
1988 ◽  
Vol 3 (1) ◽  
pp. 46-48 ◽  
Author(s):  
Olle Ekberg ◽  
Göran Nylander ◽  
Frans-Thomas Fork ◽  
Staffan Sjöberg ◽  
Marianne Birch-Iensen ◽  
...  

1987 ◽  
Vol 28 (1) ◽  
pp. 35-39 ◽  
Author(s):  
O. Ekberg ◽  
I. Redlund-Johnell ◽  
K. G. Sjöblom

Pharyngeal function was studied in 31 patients with rheumatoid arthritis. Eighteen of these patients had dysphagia. Cervical spine abnormalities were present in 14. Destruction of the capitulum and/or ramus of the mandible was registered in 9. Pharyngeal dysfunction was revealed in 20. Patients with a vertical dislocation of the C1–C2 in relation to the occipital bone and patients with destruction of the capitulum and/or ramus of the mandible had an increased frequency of pharyngeal dysfunction. Pharyngeal dysfunction is thought to be due to mechanical factors and caused by derangements of muscular attachments and turning points.


1997 ◽  
Vol 87 (5) ◽  
pp. 1035-1043 ◽  
Author(s):  
Lars I. Eriksson ◽  
Eva Sundman ◽  
Rolf Olsson ◽  
Lena Nilsson ◽  
Hanne Witt ◽  
...  

Background Functional characteristics of the pharynx and upper esophagus, including aspiration episodes, were investigated in 14 awake volunteers during various levels of partial neuromuscular block. Pharyngeal function was evaluated using videoradiography and computerized pharyngeal manometry during contrast bolus swallowing. Methods Measurements of pharyngeal constrictor muscle function (contraction amplitude, duration, and slope), upper esophageal sphincter muscle resting tone, muscle coordination, bolus transit time, and aspiration under fluoroscopic control (laryngeal or tracheal penetration) were made before (control measurements) and during a vecuronium-induced partial neuromuscular paralysis, at fixed intervals of mechanical adductor pollicis muscle train-of-four (TOF) fade; that is, at TOF ratios of 0.60, 0.70, 0.80, and after recovery to a TOF ratio > 0.90. Results Six volunteers aspirated (laryngeal penetration) at a TOF ratio < 0.90. None of them aspirated at a TOF ratio > 0.90 or during control recording. Pharyngeal constrictor muscle function was not affected at any level of paralysis. The upper esophageal sphincter resting tone was significantly reduced at TOF ratios of 0.60, 0.70, and 0.80 (P < 0.05). This was associated with reduced muscle coordination and shortened bolus transit time at a TOF ratio of 0.60. Conclusions Vecuronium-induced partial paralysis cause pharyngeal dysfunction and increased risk for aspiration at mechanical adductor pollicis TOF ratios < 0.90. Pharyngeal function is not normalized until an adductor pollicis TOF ratio of > 0.90 is reached. The upper esophageal sphincter muscle is more sensitive to vecuronium than is the pharyngeal constrictor muscle.


Radiology ◽  
1969 ◽  
Vol 92 (4) ◽  
pp. 758-762 ◽  
Author(s):  
Michael T. Gyepes ◽  
Donald T. Desilets

2014 ◽  
Vol 120 (2) ◽  
pp. 312-325 ◽  
Author(s):  
Anna I. Hårdemark Cedborg ◽  
Eva Sundman ◽  
Katarina Bodén ◽  
Hanne Witt Hedström ◽  
Richard Kuylenstierna ◽  
...  

Abstract Background: Intact pharyngeal function and coordination of breathing and swallowing are essential for airway protection and to avoid respiratory complications. Postoperative pulmonary complications caused by residual effects of neuromuscular-blocking agents occur more frequently in the elderly. Moreover, elderly have altered pharyngeal function which is associated with increased risk of aspiration. The purpose of this study was to evaluate effects of partial neuromuscular block on pharyngeal function, coordination of breathing and swallowing, and airway protection in individuals older than 65 yr. Methods: Pharyngeal function and coordination of breathing and swallowing were assessed by manometry and videoradiography in 17 volunteers, mean age 73.5 yr. After control recordings, rocuronium was administered to obtain steady-state train-of-four ratios of 0.70 and 0.80 followed by spontaneous recovery to greater than 0.90. Results: Pharyngeal dysfunction increased significantly at train-of-four ratios 0.70 and 0.80 to 67 and 71%, respectively, compared with 37% at control recordings, and swallowing showed a more severe degree of dysfunction during partial neuromuscular block. After recovery to train-of-four ratio of greater than 0.90, pharyngeal dysfunction was not significantly different from the control state. Resting pressure in the upper esophageal sphincter was lower at all levels of partial neuromuscular block compared with control recordings. The authors were unable to demonstrate impaired coordination of breathing and swallowing. Conclusion: Partial neuromuscular block in healthy elderly individuals causes an increased incidence of pharyngeal dysfunction from 37 to 71%, with impaired ability to protect the airway; however, the authors were unable to detect an effect of partial neuromuscular block on coordination of breathing and swallowing.


1998 ◽  
Vol 107 (4) ◽  
pp. 344-348 ◽  
Author(s):  
Yukio Ohmae ◽  
Masami Ogura ◽  
Satoshi Kitahara ◽  
Takehiro Karaho ◽  
Tetsuzo Inouye

This study quantified the effects of head rotation on pharyngeal swallowing in healthy subjects. Videofluoroscopic and oropharyngeal manometric examinations of pharyngeal swallowing were performed on seven volunteers with the head in neutral and rotated positions. Videofluoroscopic study revealed that head rotation swallow causes the bolus to lateralize away from the direction of head rotation. Pharyngeal manometric study indicated that the pharyngeal peak pressures toward the side of head rotation were significantly increased, whereas the pharyngeal pressures opposite the side of head rotation were not affected. Head rotation swallow produced a significant fall in upper esophageal sphincter (UES) resting pressure and a delay in UES closing. We concluded that the head rotation swallow in normal subjects not only alters the bolus pathway, but also has a useful effect on both pharyngeal clearance and UES dynamics.


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