Dysphagia
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Review Comparative Study
Esophago/pharyngo/laryngeal interrelationships: airway protection mechanisms.
This presentation is part of a parallel seminar entitled "Esophago/Pharyngo/Laryngeal Interrelationships." It reports on some of the work done to elucidate the intricate mechanisms involved in transporting food/liquid through the pharynx while simultaneously protecting the airway from aspiration. Significant species differences occur during swallowing, which influence the interpretation of experimental results. Briefly discussed in this panel presentation are the distinction between the glottic closure reflex and laryngospasm; some variations that occur in normal and disordered adult swallowing; the sequence of events during swallowing; differences in the reciprocal relationship between breathing and swallowing in adults as contrasted with infants; and laryngeal reflexes engendered by esophageal stimulation.
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Comparative Study
Simultaneous videoradiography and pharyngeal solid state manometry (videomanometry) in 25 nondysphagic volunteers.
Recent technological advances in manometry, including solid state transducers and computerized analysis, allows for reliable interpretation of intraluminal pharyngeal pressures. Simultaneous videoradiography (barium swallow) provides fluoroscopic control of the manometric sensors (videomanometry), thereby eliminating the uncertainty of sensor dislocation during laryngeal elevation. This is the first study describing normal manometric parameters in videomanometry during barium swallow. ⋯ A specific finding was discovered when the epiglottis tilts down hitting the manometric sensor. This epiglottic tilt was identified in 7 subjects (28%) and caused pressures of around 600 mmHg. A standardized manometric technique is important in videomanometry, and normal values as described in this study are essential in clinical use.