Effects of bolus consistency and reclining position on kinematic swallowing events in analysis using 320-row area detector computed tomography

Abstract

This study used 320-row area detector computed tomography (320-ADCT) to determine whether kinematic swallowing events and bolus movement through the oropharynx are affected by bolus consistency and angle of recline. Fourteen healthy adults (4 men, 10 women; age, 22-90 years) underwent 320-ADCT assessment during three 10-mL barium swallow tests, with honey-thick liquid at 60° recline (60°thick), thin liquid at 60° recline (60°thin), and thin liquid at 45° recline (45°thin). The times of swallowing events were measured and compared among the different tests. Bolus propulsion, onset time of true vocal cord (TVC) closure, and upper esophageal sphincter opening were significantly earlier for 60°thin than for 60°thick. Onset time did not significantly differ between 60°thin and 45°thin; however, greater variability was noted for onset of TVC closure with 45°thin, as the TVC started to close before onset of swallowing in 30% of participants. Modulation of TVC closure depends on bolus transport in different reclining positions. The 45° reclining position elicited preswallow TVC closure in some participants, which suggests that excessive recline can increase perceived risk of airway invasion during swallowing.

3D-CT Evaluation of Swallowing: Metrics of the Swallowing Response Using Swallowing CT

“…Conversely, laryngeal vestibule closure and epiglottis inversion did not vary between consistencies suggesting that true vocal cords closure occurs independent from the other two events. True vocal cords modulation was further analyzed in a study of posture and consistency [ 38 ]. The study compared the timing of events when swallowing under three different conditions: thin liquid reclining 45°, thin liquid reclining 60°, and honey-thick liquid reclining 60°.…”

Echtzeit-Magnetresonanztomografie (real-time, RT-MRT) zur Evaluation von Schluckstörungen bei Patienten mit neurologischen Erkrankungen

“…Die Inzidenz der DM 1 liegt in Deutschland bei 1:10.000 bis 1:20.000 und ist somit eine der am häufigsten vorkommenden Muskeldystrophien (Schoser und Grimm 2009). Gegenstand der aktuellen Forschung sind derzeit neben der in dieser Arbeit beschriebenen Magnetresonanztomografie auch der Einsatz von Elektromyografie (Ertekin 2001;Hara et al 2018), Computertomographie (Tsuzuki et al 2020) sowie die Sonografie zur Beurteilung von Schluckstörungen (Kuhl et al 2003).…”