title: Role of peripheral reflexes in the initiation of the esophageal phase of swallowing.
abstract: The aim of this study was to determine the role of peripheral reflexes in initiation of the esophageal phase of swallowing. In 10 decerebrate cats, we recorded electromyographic responses from the pharynx, larynx, and esophagus and manometric data from the esophagus. Water (1-5 ml) was injected into the nasopharynx to stimulate swallowing, and the timing of the pharyngeal and esophageal phases of swallowing was quantified. The effects of transection or stimulation of nerves innervating the esophagus on swallowing and esophageal motility were tested. We found that the percent occurrence of the esophageal phase was significantly related to the bolus size. While the time delays between the pharyngeal and esophageal phases of swallowing were not related to the bolus size, they were significantly more variable than the time delays between activation of muscles within the pharyngeal phase. Transection of the sensory innervation of the proximal cervical esophagus blocked or significantly inhibited activation of the esophageal phase in the proximal cervical esophagus. Peripheral electrical stimulation of the pharyngoesophageal nerve activated the proximal cervical esophagus, peripheral electrical stimulation of the vagus nerve activated the distal cervical esophagus, and peripheral electrical stimulation the superior laryngeal nerve (SLN) had no effect on the esophagus. Centripetal electrical stimulation of the SLN activated the cervical component of the esophageal phase of swallowing before initiation of the pharyngeal phase. Therefore, we concluded that initiation of the esophageal phase of swallowing depends on feedback from peripheral reflexes acting through the SLN, rather than a central program.
authors.affiliation: Dysphagia Research Institute, Division of Gastroenterology and Hepatology and Department of Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin.
authors.forename: Ivan M
authors.initials: IM
authors.lastname: Lang
authors.forename: Bidyut K
authors.initials: BK
authors.lastname: Medda
authors.forename: Arash
authors.initials: A
authors.lastname: Babaei
authors.forename: Reza
authors.initials: R
authors.lastname: Shaker
mesh_terms: D000818:Animals; D002415:Cats; D003679:Deglutition / Q000502:physiology*; D004576:Electromyography / Q000379:methods; D004947:Esophagus / Q000294:innervation / Q000502:physiology; D007823:Laryngeal Nerves / Q000502:physiology; D007830:Larynx / Q000502:physiology*; D008365:Manometry / Q000379:methods; D009046:Motor Neurons / Q000502:physiology; D010614:Pharynx / Q000294:innervation / Q000502:physiology; D010812:Physical Stimulation / Q000379:methods; D011930:Reaction Time; D012018:Reflex / Q000502:physiology*; D014630:Vagus Nerve / Q000502:physiology
keywords: esophageal phase of swallowing; recurrent laryngeal nerve; superior laryngeal nerve