Delayed Initiation of the Pharyngeal Swallow: Normal Variability in Adult Swallows Purpose The purpose of this investigation was to determine bolus head timing and location relations with the onset of hyoid movement at the initiation of the pharyngeal swallow and at the onset of swallow-related apnea. Method Bolus head timing and location and the timing of swallow-related apnea were ... Research Article
Research Article  |   June 01, 2007
Delayed Initiation of the Pharyngeal Swallow: Normal Variability in Adult Swallows
 
Author Affiliations & Notes
  • Bonnie Martin-Harris
    Medical University of South Carolina
  • Martin B. Brodsky
    Medical University of South Carolina and University of Pittsburgh
  • Yvonne Michel
    Medical University of South Carolina
  • Fu-Shing Lee
    Medical University of South Carolina
  • Bobby Walters
    Medical University of South Carolina
  • Contact author: Bonnie Martin-Harris, Department of Otolaryngology—Head and Neck Surgery, Medical University of South Carolina, 135 Rutledge Avenue, Suite 1141, Charleston, SC 29425. E-mail: harrisbm@musc.edu.
Article Information
Swallowing, Dysphagia & Feeding Disorders / Speech / Research Articles
Research Article   |   June 01, 2007
Delayed Initiation of the Pharyngeal Swallow: Normal Variability in Adult Swallows
Journal of Speech, Language, and Hearing Research, June 2007, Vol. 50, 585-594. doi:10.1044/1092-4388(2007/041)
History: Received December 6, 2005 , Revised July 12, 2006 , Accepted September 5, 2006
 
Journal of Speech, Language, and Hearing Research, June 2007, Vol. 50, 585-594. doi:10.1044/1092-4388(2007/041)
History: Received December 6, 2005; Revised July 12, 2006; Accepted September 5, 2006
Web of Science® Times Cited: 32

Purpose The purpose of this investigation was to determine bolus head timing and location relations with the onset of hyoid movement at the initiation of the pharyngeal swallow and at the onset of swallow-related apnea.

Method Bolus head timing and location and the timing of swallow-related apnea were recorded from frame-by-frame analyses of 5-ml single liquid swallows using dual-modality videofluoroscopy and nasal airflow recordings in 82 consecutive, healthy volunteers. The presence, depth, and response to airway entry were also recorded and related to the bolus head location and the onset of hyoid movement.

Results The majority of participants—80% on at least 1 trial—produced the onset of hyoid movement at pharyngeal swallow initiation after the bolus head passed the posterior angle of the mandible. There was a trend in older participants for later onset of hyoid movement and onset of apnea relative to bolus head arrival at the posterior angle of the mandible.

Conclusion Although entry of the bolus head into the pharynx prior to hyoid movement may result in a threat to the laryngeal airway, these data demonstrate that a “delay” by itself cannot be assumed to indicate a disordered swallow without coexisting impairments of swallowing physiology.

Acknowledgments
This study was funded by Grant R03 DC04864 from the National Institute on Deafness and Other Communication Disorders. We thank all of the participants who graciously offered their time.
Order a Subscription
Pay Per View
Entire Journal of Speech, Language, and Hearing Research content & archive
24-hour access
This Article
24-hour access