Bolus aggregation in the oropharynx does not depend on gravity
Open accessAbstract
OBJECTIVE: To determine whether bolus aggregation in the oropharynx (before swallowing) depends on gravity. DESIGN: Before-during trial, with subjects serving as their own controls. SETTING: Hospital radiology suite. PARTICIPANTS: Five asymptomatic adult volunteers. INTERVENTIONS: Videofluorography was performed while subjects ate soft and hard foods containing barium, first seated upright and then kneeling face down (quadruped position). MAIN OUTCOME MEASURES: Duration of food processing in the oral cavity, bolus aggregation in the valleculae, and pharyngeal swallow. RESULTS: Transport of chewed solid food from the oral cavity to the oropharynx (stage II transport) typically started several seconds before onset of swallow, regardless of head position or initial food consistency. Bolus aggregation in the valleculae (between the epiglottis and the tongue) began an average of 1.7 +/- 2.5sec before the onset of the pharyngeal swallow (p < .001). Stage II transport was driven by tongue-palate contact. CONCLUSIONS: Transport of chewed solid food from the oral cavity to the pharynx is driven actively by tongue-palate contact and does not depend on gravity. A bolus may accumulate in the valleculae for several seconds before the swallow.
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The tongue plays a critical role in bolus propulsion, and tongue strengthening exercises can improve swallowing function.
“The tongue plays a critical role in bolus propulsion22 and tongue strengthening exercises can be of benefit in improving swallowing function;23”
From Classification of high-resolution manometry data according to videofluoroscopic parameters using pattern recognition (2013) · cites this paper as [22]
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Hoffman, M. R., Jones, C. A., Geng, Z., Abelhalim, S. M., Walczak, C. C., Mitchell, A. R., Jiang, J. J., & McCulloch, T. M. (2013) · Otolaryngology–Head and Neck Surgery · doi:10.1177/0194599813489506 · Cited by 45 · see citing works
- Authors
- Palmer, J. B.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Palmer, Jeffrey B.
- ORCID
- Palmer, Jeffrey B.
- Venue
- Archives of Physical Medicine and Rehabilitation
- Publisher
- Elsevier BV
- Published
- 1998-06
- Volume
- 79
- Issue
- 6
- Pages
- 691-696
- ISSN
- 0003-9993 (ISSN-L)
- OpenAlex
- W2037240769
- Cited by
- 108
- References
- 16
- Citations by year
- 2026: 2 · 2025: 2 · 2023: 3 · 2022: 6 · 2021: 3 · 2020: 5 · 2019: 8 · 2018: 4 · 2017: 10 · 2016: 1 · 2015: 6 · 2014: 5 · 2013: 8 · 2012: 4
- FWCI
- 8.50
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Archives of Physical Medicine and Rehabilitation (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r29dc001575-02)
- National Institute on Deafness and Other Communication Disorders (R29-DC01575, R01DC002123)
- Topics
- Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
- Health Sciences › Medicine › Physiology › Voice and Speech Disorders
- Health Sciences › Medicine › Otorhinolaryngology › Head and Neck Cancer Studies
- Keywords
- oropharynx, gravity, swallowing, pharyngeal swallow, tongue-palate contact, head position, food consistency, videofluorography
- MeSH terms
- Adult, Deglutition, Female, Fluoroscopy, Gravitation, Humans, Male, Models, Biological, Oropharynx, Posture, Time Factors, Videotape Recording
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