Onset locations of the pharyngeal phase of swallowing: meta-analysis.
OBJECTIVE
Literature review on the onset locations of the pharyngeal phase of swallowing in asymptomatic and symptomatic adults and elderly people.


METHODS
Research was conducted in the PubMed, BIREME and SciELO databases through the descriptors fluoroscopy (fluoroscopia), deglutition (deglutição) and pharynx (faringe).


METHODS
Studies published between 2005 and 2015, carried out with adults and elderly people who underwent swallowing videofluoroscopy (SVF), and citing the onset location of the pharyngeal phase of swallowing.


METHODS
Descriptive analysis and meta-analysis were performed, evaluating the heterogeneity and the measures grouped with random effects through I2 statistics. For ratio calculation in the meta-analysis, the locations described in the articles were classified according to the Modified Barium Swallowing protocol - Measurement Tool for Swallowing Impairment (MBSImp).


RESULTS
Twelve articles were selected for descriptive analysis and seven for meta-analysis. Heterogeneity was found between studies, especially due to clinical and methodological differences. The random effect indicated predominance (58%) of the onset of the pharyngeal phase of swallowing at levels 0 and 1 of the MBSImP. In asymptomatic individuals, the onset of the pharyngeal phase was observed in the oral cavity, base of the tongue, dorsum of the tongue and vallecula. In symptomatic individuals, onset was mainly observed in the oropharynx, vallecula, hypopharynx and pyriform sinus.


CONCLUSIONS
We noted a greater frequency of the onset of the pharyngeal phase of swallowing in the vallecula. The onset of the pharyngeal phase in the hypopharynx and pyriform sinus was more often observed among elderly individuals or with comorbidities that could alter swallowing.
Universidade Federal de Santa Catarina - UFSC, Florianópolis (SC), Brasil.
Maralice
M
Zancan
Universidade Federal de Santa Catarina - UFSC, Florianópolis (SC), Brasil.
Karen Fontes
KF
Luchesi
Universidade Federal de Santa Catarina - UFSC, Florianópolis (SC), Brasil.
Claudia Tiemi
CT
Mituuti
Universidade Federal de Santa Catarina - UFSC, Florianópolis (SC), Brasil.
Ana Maria
AM
Furkim
D000328:Adult; D000368:Aged; D003679:Deglutition / Q000502:physiology*; D003680:Deglutition Disorders / Q000503:physiopathology*; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D009960:Oropharynx / Q000502:physiology; D010614:Pharynx / Q000502:physiology*