1991 Fiscal Year Final Research Report Summary
Study of Pathogenesis in Dysphagia
| Project/Area Number |
02670767
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Otorhinolaryngology
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| Research Institution | Ehime University |
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Principal Investigator |
OKAMURA Hiroshi Ehime University, School of Medicine, Assistant Professor, 医学部, 助教授 (30026950)
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| Co-Investigator(Kenkyū-buntansha) |
HYODO Masamitu Ehime University, Hospital, Assistant, 医学部附属病院, 助手 (00181123)
MORI Toshihiro Ehime University, School of Medicine, Assistant, 医学部, 助手 (50200374)
NAKAMURA Koshiro Ehime University, School of Medicine, Assistant, 医学部, 助手 (10164295)
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| Project Period (FY) |
1990 – 1991
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| Keywords | deglutition / dysphagia / fluorography / swallowing pressure / esophageal orifice / cricopharyngeal muscle / geriatrics / swallowing reflex |
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| Research Abstract |
In this research project, normal and pathological swallowing function was evaluated through multidimensional analyses of deglutition.
Investigation of Swallowing Mechanisms by Pharyngo-esophageal Fluorography
The following findings were often observed in geriatric group ; laryngeal penetration and disorder of movement of epiglottis in using liquid contrast medium and retention of bolus in the valleculla and pharyngeal splitting deglutition in using solid contrast medium. The same findings were also observed in the group with a sensation of difficulty in swallowing. These results suggest that propelling power of bolus and swallowing reflectory mechanism may be distorted in geriatric group and at the initial stage of dysphagia.
Investigation of Swallowing Mechanisms by Measurements of Swallowing Pressure and Electromyographic Recordings
The cricopharyngeal muscle mainly regulated the resting tone of the esophageal orifice and was innervated by the pharyngo-esophageal nerve unilaterally. The
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normal critical ranges of the swallowing pressure at the velopharyngeal, hypopharyngeal and cervico-esophageal regions were determined through observation of 30 normal adults. From these ranges, the classification of swallowing pressure curve which consists of 5 types was defined. The normal conduction curve of swallowing pressure was an S-like figure and this curve could visualize normal or abnormal pattern of conduction of swallowing pressure. The relaxation of the esophageal orifice started at the pharyngeal end. Therefore, to investigate the relaxation of the esophageal orifice in swallowing, it was recommended that the intraluminal pressure should be measured at the pharyngeal end. The critical ranges of the time and duration of the relaxation was also determined.
Multi-dimensional Analyses of Pathogenesis of Dysphogia
Multi-dimensional analyses of pathogenesis of dysphagia was investigated in 130 patients with dysphagia. The application of solid bolus for fluorography is a useful method for detecting the loss of swallowing reflex and the decrease of propelling power of bolus. The program of swallowing in the central nervous system can be clarified by the conduction curve of swallowing pressure, and the propelling power of bolus by the classification of swallowing pressure curve. Moreover, the relaxing mechanisms of the esophageal orifice are diagnosed by the measurement of the intraluminal pressure at the pharyngeal end. Less
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