[Dysphagia] Pharyngeal reflex triggering

[eripley at yahoo.com (Irene Campbell-Taylor)]

Re: [Dysphagia] Pharyngeal reflex Triggering
To: Luckyluck <astapane@spark.net.gr>

The answer to your question depends on whether or not you want to know about initiation of the swallow during VFSS - an unnatural situation - or what happens in real life. The two have little in common. Please see:

Dua KS; Ren J; Bardan E; Xie P; Shaker R. Coordination of deglutitive glottal function and pharyngeal bolus transit during normal eating.Gastroenterology, 112:73-83  1997 

Deglutitive glottal function during the preparatory phase of swallowing 

and its coordination with bolus transit during normal eating are important for airway protection. 

The aim of this study was to examine this coordination during consumption of a normal meal. 

Fifteen healthy volunteers were studied using a videoendoscopic and videofluoroscopic 

technique.  A total of 207 liquid and 470 solid bolus swallows were analyzed. 

In 60% of liquid and 76% of solid food swallows, the bolus was seen in the pharynx 

before a swallow was initiated. Entry of boluses into the pharynx was associated with 

brief partial adduction of the vocal cords. Solid food entered and traversed the
pharynx at the midline, whereas liquid bolus was split around the larynx and rejoined in the hypopharynx.Swallowing was initiated significantly earlier when bolus made contact with the upper third of the epiglottis compared with vallecula or pyriform sinuses. In more than half of the instances, during normal eating, food enters the pharynx during the preparatory phase before a swallow is initiated, the path of pharyngeal transit of solid bolus is different from that of liquid bolus, and the epiglottal edge appears to be the most sensitive trigger zone for swallowing.


Dr I Campbell-Taylor
Clinical Neuroscientist
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