Abstract
Videofluoroscopic pharyngeal timings of individuals with dysphagia were compared with timings from individuals without dysphagia to determine if any abnormal pharyngeal movements were associated with dysphagia.
Sixteen lateral pharyngeal outpouchings were seen in 50 dysphagic volunteers, whereas 71 were noted in 138 asymptomatic individuals. The outpouchings appeared just after oral delivery of the bolus into the pharynx after onset of the swallow at approximately 500 ms, as compared to the initial appearance during the mid-pharyngeal swallow at 750 ms in asymptomatic individuals (P<0.01). The outpouchings disappeared during mid-pharyngeal swallow in symptomatic volunteers, at approximately 800 ms compared to disappearance during pharyngeal relaxation in asymptomatic volunteers at approximately 1100 ms (P<0.01). No other timing event was delayed nor event duration prolonged when the two groups were compared.
This observation of earlier appearance followed by earlier disappearance of lateral pharyngeal outpouchings in dysphagic individuals may be caused by inner longitudinal pharyngeal muscles that are inhibited and then contract earlier than those seen in asymptomatic individuals. Outpouchings appearing later at the onset of pharyngeal contraction were not associated with dysphagia.
Similar content being viewed by others
References
Curtis DJ: Laryngeal dynamics.CRC Crit Rev Diagn Imaging 18:29–80, 1982
Bachman AL, Seaman WV, Macken KL: Lateral pharyngeal diverticula.Radiology 91:774–782, 1968
Norris CW: Pharyngoceles of the hypopharynx.Laryngoscope 89:1788–1807, 1979
Curtis DJ: Anatomy, physiology, radiology of the pharynx. In Castell DO, Johnson L (eds):Esophageal Function in Health and Disease. New York, Elsevier Biomedical, 1983, pp 347–359
Curtis DJ, Cruess DF, Dachmann A: Timing in the normal pharyngeal swallow: A blind selection of sixteen normal asymptomatic patients.Invest Radiol 19:523–529, 1984
Winters C Jr, Spurling TJ, Chobanian SJ, Curtis DJ, et al. Barrett's esophagus: A prevalent occult complication of gastroesophageal reflux disease.Gastroenterology 92:118–124, 1987
Curtis DJ, Brahman SL, Holborow GS, Worman DD: Pharyngeal muscular explanations for observed swallowing distortions of the normal laryngopharnyx. (in press)
Doty RW, Bosma JF: An electromyographic analysis of reflex deglution.J Neurophysiol 19:44–60, 1956
Winans CS: The pharyngeoesphageal closure mechanism. A manometric study.Gastroenterology 63:768–777, 1972
Cohen BR, Wolf BS: Cineradiographic and intraluminal pressure correlations in the pharynx and esophagus inHandbook of Physiology, Section 6: Alimentary Canal, Volume 4: Motility. Washington, DC: American Physiologic Society, 1968, pp 1841–1860
Blair RL, Berry H, Briant TDR: Laryngeal electromyography: Techniques and application.Otolaryngol Clin N Am 11:325–345, 1978
Takenouchi S, Koyama T, Kawasaki M, Ogura JH: Movements of the vocal cords.Acta Otolaryngol 65:33–50, 1968
Yoshida Y: Electromyographic and x-ray study on normal deglutition.Clinical Otolaryngol (Jap) 25:825–872, 1980
Tanaka E, Palmer J, Siebens A: Bipolar suction electrodes for pharyngeal electromyography.Dysphagia 1:39–40, 1986
Author information
Authors and Affiliations
Additional information
The opinions expressed herein are those of the authors and are not to be construed as reflecting the views of the Department of the Army, Department of the Navy, Uniformed Services University of the Health Sciences, or the Department of Defense.
Supported in part by USUHS Grant #CO8900 and Naval Clinical Investigation Protocol No. 84-06-2038.
Rights and permissions
About this article
Cite this article
Curtis, D.J., Cruess, D.F., Crain, M. et al. Lateral pharyngeal outpouchings: A comparison of dysphagic and asymptomatic patients. Dysphagia 2, 156–161 (1988). https://doi.org/10.1007/BF02424934
Issue Date:
DOI: https://doi.org/10.1007/BF02424934