[Dysphagia] audible swallow

[RBeecher at chw.org (Beecher, Robert)]

The sound produced during an audible swallow is typically due to air being forced through the UES. In order to produce the sound the posterior tongue is used to seal off the pharynx and then with a downward plunger-type motion and pharyngeal constrictor compression pressurizes the contents of the pharynx - food + air until it is forced through the UES. The pressure forces the UES partially open as the sound is produced. I usually find the audible swallow in children with GER and motor impairment that affects typical hyolaryngeal movement. Clinically, you are likely to observe that the child or adult dips the chin slightly and then hyperextends the head and neck slightly as the swallow is initiated.  The pattern is observed fairly consistently.

I agree that the audible swallow is a "strong" swallow as the contraction of the musculature appears to be a good deal stronger than during a typical swallow. In most cases that I have seen, the audible (strong) swallow appears to be a purposeful compensation in the presence of difficulty with UES relaxation. In those cases I would not label it as disordered. Most of the motor impaired children that I have seen who produced an audible swallow did so on an inconsistent basis. In these cases, the audible swallow could be considered disordered. However, motor impaired children and adults may also be coping with difficulty with UES relaxation as well as motor impairment.

Bob

Robert Beecher, M.S., CCC-SLP
Senior Speech/Language Pathologist
Masters Family Speech and Hearing Center
Children's Hospital of Wisconsin
Milwaukee, WI


 -----Original Message-----
From: 	dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com]  On Behalf Of Shawn Loper
Sent:	Tuesday, August 30, 2005 11:09 PM
To:	M. Tervo; dysphagia@b9.com
Subject:	Re: [Dysphagia] audible swallow

I had been told at one time that an audible swallow is evidence of a 
"strong" swallow & was desirable.  This was during observing e-stim tx.  On 
the other hand, I have also heard that an audible swallow was a disordered 
swallow, indicating trouble with coordination.  I would also like further 
information!

----- Original Message ----- 
From: "M. Tervo" <tervomm@yahoo.com>
To: <dysphagia@b9.com>
Sent: Tuesday, August 30, 2005 8:19 PM
Subject: [Dysphagia] audible swallow


>I heard at a conference that a audible swallow is a disordered swallow.  I 
>have been unable to locate any info that explains the details of this...can 
>anyone please explain this further?
>
>
>
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