Motions of the posterior pharyngeal wall in human swallowing: a quantitative videofluorographic study.
OBJECTIVE
To quantify segmental motions of the posterior pharyngeal wall during swallowing.


METHODS
Prospective study.


METHODS
Hospital radiology suite.


METHODS
Six healthy adult volunteers.


METHODS
Videofluorography of the pharynx in posteroanterior and lateral projections during water swallows by 6 able-bodied adults. Radiopaque suction markers, inserted through the nose, were attached by suction to the midline of the posterior pharyngeal wall of the upper and lower oropharynx, pharyngoesophageal segment (PES), or cervical esophagus.


METHODS
Displacement of the larynx, hyoid bone, and markers.


RESULTS
Marker pathways were ovoid in the oropharynx but linear in the PES and esophagus. Marker displacement was greatest in the vertical dimension, intermediate in posteroanterior dimension, and smallest in mediolateral dimension. Vertical displacement was greater for the PES marker than for larynx, hyoid bone, or oropharynx markers (p < .001), so that the pharynx shortened significantly during each swallow. Marker displacement was unaffected by bolus volume.


CONCLUSIONS
The pharyngeal wall shortened during swallowing. The mechanism for PES elevation may differ from that of laryngeal elevation. Shortening of the pharynx may be produced by contraction of the pharyngeal suspensory muscles and traction on the larynx by suprahyoid muscles.
Palmer
J B
JB
Department of Physical Medicine and Rehabilitation, Johns Hopkins University and Good Samaritan Hospital, Baltimore, MD, USA. jpalmer@jhmi.edu
Tanaka
E
E
Ensrud
E
E
D000328:Adult; D003679:Deglutition / Q000502:physiology*; D004947:Esophagus / Q000000981:diagnostic imaging / Q000502:physiology; D005260:Female; D005471:Fluoroscopy / Q000379:methods; D006801:Humans; D006928:Hyoid Bone / Q000000981:diagnostic imaging / Q000502:physiology; D007830:Larynx / Q000000981:diagnostic imaging / Q000502:physiology*; D008297:Male; D009068:Movement / Q000502:physiology*; D010609:Pharyngeal Muscles / Q000000981:diagnostic imaging / Q000502:physiology*; D010614:Pharynx / Q000000981:diagnostic imaging / Q000502:physiology*; D011446:Prospective Studies; D012016:Reference Values; D014741:Video Recording