Pharyngeal Effects of Bolus Volume, Viscosity, and Temperature in Patients With Dysphagia Resulting From Neurologic Impairment and in Normal Subjects

Author:

Bisch Elizabeth M.1,Logemann Jeri A.1,Rademaker Alfred W.2,Kahrilas Peter J.3,Lazarus Cathy L.4

Affiliation:

1. Communication Sciences and Disorders, Northwestern University Evanston, IL Lakeside and Veterans Administration Hospital Chicago, IL

2. Lurie Cancer Center Biometry Section, Northwestern University, Chicago, IL

3. Department of Medicine, Northwestern University, Chicago, IL

4. Communication Sciences and Disorders, Northwestern University, Evanston, IL

Abstract

The oropharyngeal swallow of 10 patients with mild dysphagia at 3 weeks after a cerebrovascular accident (stroke), 10 normal subjects, and 8 neurologically impaired patients with moderate to severe dysphagia was studied videofluorographically to examine the effects of 2 bolus temperatures (room temperature and 33°F), 2 volumes, and 2 viscosities on the durations of pharyngeal stage swallow events and the frequency and nature of oropharyngeal swallowing problems and bolus transit. Normal subjects exhibited significantly longer pharyngeal response times and longer laryngeal elevation only for 1 ml cold liquid. The stroke patients and the 8 significantly dysphagic neurologically impaired patients exhibited very few significant effects of temperature on swallowing disorders or swallow measures. Increases in bolus volume and viscosity decreased pharyngeal delay times in both neurologically impaired patient groups. Stroke patients exhibited significantly longer pharyngeal delay times but shorter pharyngeal response times, laryngeal closure, cricopharyngeal opening, and laryngeal elevation than normal subjects on some bolus volumes and viscosities. Results are discussed in terms of the potentially therapeutic effects of bolus volume and viscosity.

Publisher

American Speech Language Hearing Association

Subject

Speech and Hearing,Linguistics and Language,Language and Linguistics

Reference13 articles.

1. Effect of swallowed bolus variables on oral and pharyngeal phases of swallowing;Dantas R. O.;American Journal of Physiology,1990

2. Pharyngeal upper esophageal sphincter pressure dynamics in humans: Effects of pharmacologic agents and thermal stimulation;Knauer C. M.;Digestive Diseases and Sciences,1990

3. Upper esophageal sphincter opening and modulation during swallowing

4. Deglutitive tongue action: Volume accommodation and bolus propulsion

5. Swallowing disorders in closed head trauma patients;Lazarus C.;Archives of Physical Medicine and Rehabilitation,1987

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