Manofluorographic Analysis of Bolus Volume Effect in Normal Swallowing

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  • 一回嚥下量の変化が嚥下運動に及ぼす影響―Ｍａｎｏｆｌｕｏｒｏｇｒａｐｈｙによる解析―
  • 1カイ エンゲリョウ ノ ヘンカ ガ エンゲ ウンドウ ニ オヨボス エイキョウ Manofluorography ニ ヨル カイセキ

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Abstract

The purpose of this study is to define the influence of bolus volume by examining of the temporal correlation between presenting times of videofluorographic events and swallowing pressure wave components. Simultaneous videofluorography and manometry were performed on 10 healthy adults in swallowing 0-ml (saliva swallow), 5-ml and 10-ml aliquots of liquid barium with a pressure transducer. Its three strain gauge sensors were positioned in the tongue base, hypopharynx, and pharyngoesophageal sphincter (PES). The following events were measured to analyze the presenting time differences from videofluorographic events to related swallowing pressure wave components : A) presenting times of the videofluorographic events : (1)onset of complete tongue base (TB) contact to postpharyngeal wall (PPW), (2) onset of TB detachment from PPW, (3) onset of complete laryngeal closure, (4) onset of laryngeal opening, (5) onset of hyoid superior motion, (6) onset of hyoid anterior motion, (7) hyoid arrival in maximum position, (8) onset of hyoid descent, (9) complete PES closure; and B) swallowing pressure wave components : tongue base T wave onset, T wave peak, T wave end, hypopharyngeal e wave onset, e wave peak, hypopharyngeal c wave peak, c wave end, PES E wave onset, E wave peak, PES wave descent to atmospheric pressure (Pa), PES wave rise to Pa, PES C wave peak. Results : The presenting time differences from ‘T wave end’to ‘onset of TB detachment from PPW’,‘E wave onset’to ‘onset of hyoid superior motion’, and‘E wave peak’to ‘onset of hyoid anterior motion’were extremely short for each bolus volume. The presenting time difference from‘onset of PES opening’to ‘PES wave descend to Pa’ was also extremely short and a minus quantity for 0-ml and 5-ml, but a plus quantity for 10-ml. The presenting time difference from‘PES wave rise to Pa’to ‘complete PES closure’ was shortest in swallowing the 0-ml bolus volume, intermediate for 5-ml, and longest for 10-ml. Conclusion : These findings suggest that the presenting times of both‘T wave end’ and‘onset of TB detachment from PPW’ indicate the appearance time of the identical event in deglutition, and in the same way show ‘E wave onset’ and ‘onset of hyoid superior motion’, and ‘E wave peak’ and ‘onset of hyoid anterior motion’. The temporal correlation between fluorographic PES opening and PES pressure relaxation was thus affected by differences in bolus volume.

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