Takashi Hiraoka1, Jeffrey B Palmer2, Martin B Brodsky3, Mitsumasa Yoda4, Haruhi Inokuchi5, Akio Tsubahara6. 1. Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA; Department of Rehabilitation Medicine, Kawasaki Medical School, Kurashiki, Okayama, Japan. Electronic address: hiraoka@med.kawasaki-m.ac.jp. 2. Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA; Department of Otolaryngology-Head and Neck and Center for Functional Anatomy and Evolution, Johns Hopkins University, Baltimore, MD, USA. Electronic address: jpalmer@jhmi.edu. 3. Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA. Electronic address: brodsky@jhmi.edu. 4. Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA. Electronic address: m-yoda@med.showa-u.ac.jp. 5. Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD, USA. Electronic address: hinokuchi@m.u-tokyo.ac.jp. 6. Department of Rehabilitation Medicine, Kawasaki Medical School, Kurashiki, Okayama, Japan. Electronic address: tsuba@med.kawasaki-m.ac.jp.
Abstract
OBJECTIVE: When eating solids, stage II transport (St2Tr) propels triturated food into the pharynx for bolus formation and storage before swallowing. Although the existence of St2Tr is acknowledged, the reason for its existence remains unclear. Understanding it may facilitate development of food appropriate for individuals with dysphagia. The purpose of this study was to explore how measures of duration of eating and swallowing affect the number of St2Tr cycles. DESIGN: Videofluorography was performed on 13 healthy subjects eating 6-g squares of banana, tofu, and cookies. Measurements included the number of St2Tr cycles, duration of processing (from food entering the mouth to onset of swallowing), pre-upper esophageal sphincter (UES) transit duration (from onset of swallowing to onset of UES transit), UES transit duration (leading edge to trailing edge passing the UES), and total sequence duration (from onset of swallowing to terminal swallow). Principal component (PC) analysis was used to identify factors affecting the number of St2Tr cycles. Analysis of covariance was performed using the 1st PC as an independent variable for predicting the number of St2Tr cycles. RESULTS: All four duration measures were significantly positively correlated with the number of St2Tr cycles. Analysis revealed two orthogonal PCs with variable loading. The 1st PC was a function of the timing variables. The 2nd PC was a function of the number of swallows. CONCLUSIONS: The number of St2Tr cycles was associated with measures of food transit duration and was greater with harder foods before processing and more viscous foods just before swallowing.
OBJECTIVE: When eating solids, stage II transport (St2Tr) propels triturated food into the pharynx for bolus formation and storage before swallowing. Although the existence of St2Tr is acknowledged, the reason for its existence remains unclear. Understanding it may facilitate development of food appropriate for individuals with dysphagia. The purpose of this study was to explore how measures of duration of eating and swallowing affect the number of St2Tr cycles. DESIGN: Videofluorography was performed on 13 healthy subjects eating 6-g squares of banana, tofu, and cookies. Measurements included the number of St2Tr cycles, duration of processing (from food entering the mouth to onset of swallowing), pre-upper esophageal sphincter (UES) transit duration (from onset of swallowing to onset of UES transit), UES transit duration (leading edge to trailing edge passing the UES), and total sequence duration (from onset of swallowing to terminal swallow). Principal component (PC) analysis was used to identify factors affecting the number of St2Tr cycles. Analysis of covariance was performed using the 1st PC as an independent variable for predicting the number of St2Tr cycles. RESULTS: All four duration measures were significantly positively correlated with the number of St2Tr cycles. Analysis revealed two orthogonal PCs with variable loading. The 1st PC was a function of the timing variables. The 2nd PC was a function of the number of swallows. CONCLUSIONS: The number of St2Tr cycles was associated with measures of food transit duration and was greater with harder foods before processing and more viscous foods just before swallowing.
Authors: Kyung K Peck; Ryan C Branski; Cathy Lazarus; Victoria Cody; Devon Kraus; Samantha Haupage; Cindy Ganz; Andrei I Holodny; Dennis H Kraus Journal: Laryngoscope Date: 2010-11 Impact factor: 3.325