Effect of a Tongue-Holding Maneuver on Posterior Pharyngeal Wall Movement During Deglutition

Abstract

Effects of a tongue-holding maneuver on anterior bulging of the posterior pharyngeal wall (PPW) during swallowing were investigated in 10 young adult normal subjects. Videofluorographic images of 3-ml liquid barium swallows were digitized to quantify the extent of anterior bulge of the PPW with and without the maneuver at the mid and the inferior levels of the second cervical vertebra. A significant increase in PPW bulging was seen with the maneuver at both pharyngeal levels. These findings indicate potential for developing new treatment techniques to facilitate compensatory anterior movement of the PPW, which has not been a target for direct treatment in the past. At present, the tongue-holding maneuver can be employed clinically as an easy method for testing the compliance of the PPW videofluorographically. However, the use of the maneuver per se, which inhibits posterior retraction of the base of tongue (BOT), resulted in increasing the pharyngeal (specifically vallecular) residue after the swallow. The results also indicate the importance of tongue movement in triggering the pharyngeal swallow.