[The influence of oral and pharyngeal phases on the swallowing dynamic].
BACKGROUND
The pharyngeal phase of swallowing has received more attention than oral phase although they are presumably interdependent.


OBJECTIVE
1. to evaluate, through the videofluoroscopic method, the oral phase of swallowing in order to observe the characteristics organization of the liquid bolus in healthy volunteers and the variations of this organization in exams of patient with dysphagia; 2. to establish the functional interrelation between both organization and ejection stages; 3. to verify the presence (or absence) of interference of the oral phase over the pharyngeal phase.


METHODS
Videofluoroscopic assessment has been performed in patients with stroke (15), patients with Parkinson disease (15) and in health volunteers (14). All of the studied individuals were submitted to the swallowing videofluoroscopic evaluation following protocol described by Junqueira and Costa. We privileged the incidence in right profile with middle of liquid contrast (solution of barium sulfate).


RESULTS
According to the intra-oral organization of the contrasted bolus, we could classify the oral organization as: 1. closed, 2. open, that can be subdivided in open "anterior restricted" and "open expanded", 3. prolonged, and 4. unstable. The ejection can be defined as: 1. appropriate, 2. lentify, and 3. in two times. The correlation among the oral dynamics acted by the organization and pharyngeal phases can be noticed as: 1. appropriate, 2. adapted, and 3. altered. The organization and ejection types as well as the observed correlations are shown with statistics significance.


CONCLUSIONS
The closed organization type was the one characterized as normal. The "open expanded", "prolonged" and "unstable" organization type can be associated with alteration in the swallowing process. The "lentify" and "two times" ejection types also point to swallowing physiology alteration. There are functional correlation between organization and oral ejection. The oral organization has influence, not only in the quality of the oral ejection, but also, in the effective dynamics of the pharyngeal phase.
Yamada
Elaine Keiko
EK
Departamento de Radiologia, Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ.
Siqueira
Karina Oliveira de
KO
Xerez
Denise
D
Koch
Hilton Augusto
HA
Costa
Milton Melciades B
MM
D000328:Adult; D000368:Aged; D002493:Central Nervous System Diseases / Q000503:physiopathology*; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000502:physiology; D010300:Parkinson Disease / Q000503:physiopathology; D010614:Pharynx / Q000502:physiology; D020521:Stroke / Q000503:physiopathology