title: Magnetic resonance imaging of the effortful swallow.
abstract: OBJECTIVE
  The effortful swallow was designed to improve posterior mobility of the tongue base and increase intraoral pressures. We characterized the effects of this maneuver via dynamic magnetic resonance imaging (dMRI) in healthy patients.
  
  
  METHODS
  A 3-T scanner was used to obtain dMRI images of patients swallowing pudding using normal as well as effortful swallows. Ninety sequential images were acquired at the level of the oropharynx in the axial plane for each swallow; 3 series were obtained for each swallow type for each patient. Images were acquired every 113 ms during swallowing. The images were analyzed with respect to oropharyngeal closure duration, anteroposterior and transverse distance between the oropharyngeal walls, and oropharyngeal area before and after closure.
  
  
  RESULTS
  Preswallow reduced pharyngeal area was observed (P = .02; mean = 212.61 mm² for effortful, mean = 261.92 mm² for normal) as well as prolonged pharyngeal closure during the swallow (P < .0001; mean = 742.18 ms for effortful, mean = 437.31 ms for normal). No other differences were noted between swallow types. Interrater and intrarater reliability of all measurements was excellent.
  
  
  CONCLUSIONS
  This preliminary investigation is the first to evaluate the effects of effortful swallows via dMRI. In our cohort, consistent physiologic changes were elicited, consistent with clinical dogma regarding this maneuver.
authors.affiliation: NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Fritz
authors.affiliation: NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Cerrati
authors.affiliation: Division of Biostatistics, Department of Population Health, New York University School of Medicine, New York, New York, USA.
authors.forename: Yixin
authors.initials: Y
authors.lastname: Fang
authors.affiliation: NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, USA.
authors.forename: Avanti
authors.initials: A
authors.lastname: Verma
authors.affiliation: NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, USA.
authors.forename: Stratos
authors.initials: S
authors.lastname: Achlatis
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Albert Einstein College of Medicine, New York, New York, USA.
authors.forename: Cathy
authors.initials: C
authors.lastname: Lazarus
authors.affiliation: NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, USA ryan.branski@nyumc.org.
authors.forename: Ryan C
authors.initials: RC
authors.lastname: Branski
authors.affiliation: NYU Voice Center, Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York, USA.
authors.forename: Milan
authors.initials: M
authors.lastname: Amin
mesh_terms: D003679:Deglutition / Q000502:physiology*; D005260:Female; D064368:Healthy Volunteers; D006801:Humans; D008279:Magnetic Resonance Imaging; D010609:Pharyngeal Muscles / Q000502:physiology; D010614:Pharynx / Q000502:physiology*
keywords: deglutition; effortful swallow; imaging; magnetic resonance imaging