Effect of aging, position, and temperature on the threshold volume triggering pharyngeal swallows

Shaker, Reza; Ren, Junlong; Zamir, Zafar; Sarna, Achal; Liu, Jianmin; Sui, Zhumei

doi:10.1016/0016-5085(94)90164-3

Cited by 172 publications

(106 citation statements)

References 13 publications

Supporting

Mentioning

102

Contrasting

Unclassified

Order By: Relevance

“…PGCR, PUCR and RPS were elicited in 25 healthy volunteers (mean age 24 yr, range 17-31; 8 males) using the previously described technique of concurrent unsedated transnasal laryngo-pharyngoscopy, UES manometry (Dentsleeve), and submental electromyogram (EMG) (11,2,4,3,14,2,4) (Fig. 1).…”

Section: Slow Pharyngeal Water Perfusionmentioning

confidence: 99%

“…Aerodigestive reflexes triggered by pharyngeal stimulation such as that which may occur by entry of refluxate into the pharynx or during antegrade transit of substances have been proposed to protect the airways against aspiration. For example, at a threshold volume, fluid in the pharynx can trigger an irrepressible swallow: reflexive pharyngeal swallow (RPS) (9,11,2,6,8,4) that not only leads to glottal closure but also clears the pharynx of any residual fluid. At a lower threshold volume, fluid in the pharynx can protect the airways by eliciting glottal closure without a swallow: pharyngoglottal closure reflex (PGCR) (3,14).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Pharyngeal airway protective reflexes are triggered before the maximum volume of fluid that the hypopharynx can safely hold is exceeded

Dua

Surapaneni

Kuribayashi

et al. 2011

American Journal of Physiology-Gastrointestinal and Liver Physi

Self Cite

View full text Add to dashboard Cite

Dua K, Surapaneni SN, Kuribayashi S, Hafeezullah M, Shaker R. Pharyngeal airway protective reflexes are triggered before the maximum volume of fluid that the hypopharynx can safely hold is exceeded. Am J Physiol Gastrointest Liver Physiol 301: G197-G202, 2011. First published May 12, 2011 doi:10.1152/ajpgi.00046.2011Aerodigestive reflexes triggered by pharyngeal stimulation can protect the airways by clearing fluid from the pharynx. The objective of this study was to determine the relationship between the maximum capacity of fluid that can safely dwell in the hypopharynx [hypopharyngeal safe volume (HPSV)] before spilling into the larynx and the threshold volumes required to trigger pharyngoglottal closure reflex (PGCR), pharyngo-upper esophageal sphincter contractile reflex (PUCR), and reflexive pharyngeal swallow (RPS). Twenty-five healthy volunteers (mean age 24 yr, 8 males) were studied in the semi-inclined supine position. PGCR, PUCR, and RPS were elicited using techniques of concurrent upper esophageal sphincter manometry and pharyngolaryngoscopy. The hypopharynx was then anesthetized to abolish RPS. HPSV was determined by infusing water in the pharynx, and perfusion was stopped when the infusate reached the superior margin of the interarytenoid fold. The threshold volumes for triggering PGCR, PUCR, and RPS by slow and rapid injections before pharyngeal anesthesia were 0.18 Ϯ 0.02 and 0.09 Ϯ 0.02 ml; 0.20 Ϯ 0.020 and 0.13 Ϯ 0.04 ml; and 0.61 Ϯ 0.04 and 0.4 Ϯ 0.06 ml, respectively. All of the above volumes were significantly smaller than the HPSV (0.70 Ϯ 0.06 ml, P Ͻ 0.01) except for the threshold volume to elicit RPS during slow perfusion, which was not significantly different (P ϭ 0.23). We conclude that pharyngeal aerodigestive reflexes are triggered by both slow and rapid pharyngeal perfusion of water at significantly smaller volumes than the maximum capacity of the hypopharynx to safely hold contents without spilling into the airway. These reflexes thereby aid in prevention of aspiration. aerodigestive reflexes; airway protection; pharyngo-glottal closure reflex; pharyngo-upper esophageal sphincter contractile reflex; reflexive pharyngeal swallow; hypopharyngeal safe volume

show abstract

Section: Slow Pharyngeal Water Perfusionmentioning

confidence: 99%

mentioning

confidence: 99%

Pharyngeal airway protective reflexes are triggered before the maximum volume of fluid that the hypopharynx can safely hold is exceeded

Dua

Surapaneni

Kuribayashi

et al. 2011

American Journal of Physiology-Gastrointestinal and Liver Physi

Self Cite

View full text Add to dashboard Cite

show abstract

“…Our study showed that all of our chronic cough patients with GER-p had not pulmonary aspiration may suggest that the upper esophageal sphincter or laryngeal protective reflexes prevented pulmonary aspiration (40)(41)(42). It also possible that the reflux may make it only as far as the larynx and that the cough in patients with GER can be protective mechanism preventing pulmonary aspiration.…”

Section: Discussionmentioning

confidence: 66%

Is gastroesophageal reflux contribute to the development chronic cough by triggering pulmonary fibrosis

Aksu

Songür²,

Songür³

et al. 2015

Turk J Gastroenterol

View full text Add to dashboard Cite

Background/Aims: Previous studies have shown that the prevalence of abnormal acid reflux in fibrotic lung disease patients is high, and in particular, patients with secondary pulmonary fibrosis show higher esophageal acid exposure than normal controls. There are also some findings that, in patients with pathological reflux, pulmonary fibrosis may develop. The aim of this study is to investigate if pulmonary fibrosis is involved in the pathogenesis of chronic cough due to Gastroesophageal Reflux. Materials and Methods: A prospective study was performed in twenty-one patients with chronic cough due to gastroesophageal reflux who was diagnosed as reflux esophagitis by upper gastrointestinal endoscopy, histology, and in ten healthy controls without GER or any lung disease. All participitants underwent laryngoscopic examination and gastroesophageal scintigraphy with late lung imaging. Bronchoalveolar lavage fluid total and differential cell counts, T and B cell subsets, and the concentrations of IL-1β and TNF-α were measured. Results: Reflux extending into the proximal esophagus was noted in 52.5%, and posterior laryngitis was present in 90.5% of the patients. No evidence of pulmonary aspiration was noted in the patients with reflux on scintigraphic examination. No significant difference was found between the GER and control groups in terms of cellular content, IL-1β and TNF-α levels or mean T cell subsets and B cell counts in bronchoalveolar lavage fluid. Forced expiratory volume in one second, forced vital capacity FEV 1 /FVC, total lung capacity, and carbon monoxide diffusion capacity values were within normal limits in the gastroesophageal reflux group. Conclusion: Our findings do not support the hypothesis that gastroesophageal reflux leads to chronic cough by triggering alveolar epithelial injury and subsequent pulmonary fibrosis.

show abstract

“…Previous studies indicated that pharyngeal motility changed according to the nature of the swallowed food (21)(22)(23) and that a more viscous consistency would be related to more neuromuscular control, in comparison to less viscous consistency, because it provides more proprioceptive stimuli that could affect the onset of the pharyngeal phase in more anterior structures, such as the base of the tongue (24,25) . This theory could not be observed in this study, because larger capsules were triggered in the pharyngeal phase at a more posterior location than the smaller ones, even though they offered more proprioceptive stimuli.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the location of capsules swallowed with food during the pharyngeal phase triggering in asymptomatic adults

Uchimura

Barcelos

Paiva

et al. 2014

CoDAS

View full text Add to dashboard Cite

Descritores RESUMOObjetivo: Avaliar a localização de cápsulas gelatinosas duras no disparo da fase faríngea em adultos assintomáticos. Métodos: Realizou-se videofluoroscopia da deglutição em 60 indivíduos (14 homens e 46 mulheres), entre 27 e 55 anos, que foram avaliados com cápsulas gelatinosas duras #00 e #3 preenchidas com sulfato de bário, ingeridas com alimentos líquidos e pudim em livre oferta. Considerou-se o primeiro movimento de elevação laríngea como indicador do disparo da fase faríngea da deglutição. Na análise estatística, utilizou-se o teste de McNemar. Resultados: Cápsulas #3 apresentaram maior porcentagem de localização no dorso da língua em comparação à cápsula #00, e cápsulas #00 apresentaram maior porcentagem de localização na base da língua e valécula em comparação à #3. Foram encontradas diferenças entre as diferentes cápsulas na deglutição com líquido (p=0,016) e pudim (p=0,037). Conclusão: O tamanho da cápsula influenciou na localização do disparo da fase faríngea. Cápsulas menores iniciaram a fase faríngea na região mais anterior (dorso da língua) em comparação às cápsulas maiores.

show abstract

Effect of aging, position, and temperature on the threshold volume triggering pharyngeal swallows

Cited by 172 publications

References 13 publications

Pharyngeal airway protective reflexes are triggered before the maximum volume of fluid that the hypopharynx can safely hold is exceeded

Pharyngeal airway protective reflexes are triggered before the maximum volume of fluid that the hypopharynx can safely hold is exceeded

Is gastroesophageal reflux contribute to the development chronic cough by triggering pulmonary fibrosis

Evaluation of the location of capsules swallowed with food during the pharyngeal phase triggering in asymptomatic adults

Contact Info

Product

Resources

About