Skip to main content

Advertisement

Log in

Swallowing performance in patients with vocal fold motion impairment

  • Published:
Dysphagia Aims and scope Submit manuscript

Abstract

Twenty-seven patients with vocal fold motion impairment underwent detailed pharyngoesophagel manometry with a strain gauge assembly linked to a computer recorder. Nine were known to have lesions of the central vagal trunk or nucleus, 9 had recurrent laryngeal nerve (RLN) palsy, and the remainder were idiopathic. The site of the lesion was a more important determinant of subjective swallowing performance than the position of the involved cord at laryngoscopy. Patients with cental lesions had lower tonic and contraction upper esophageal sphincter (UES) pressures than 25 age-matched controls, suggesting that high cervical branches of the lower cranial nerves are important in UES excitatory innervation. RLN palsy patients showed significantly increased pharyngeal contraction amplitude and reduced pharyngoesophageal wave durations. The results suggest that the dysphagia associated with vocal fold motion impairment is not simply due to the disruption of laryngeal deglutitive kinetics, but to independent effects on pharyngeal function.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Lund WS, Ardran GM: The motor nerve supply of the cricopharyngeal sphincter. Ann Otol Rhinol Laryngol 53:353–367, 1964

    Google Scholar 

  2. Mebis J, Ramaekers D, Geboes K, Desmet V, Vantrappen G: The human pharyngo-esophageal sphincter has a characteristic neural and vascular supply. (Abstract) Gastroenterology 100:S468, 1991

  3. Rontal E, Rontal M, Morse G, Brown EM: Vocal cord injection in the treatment of acute and chronic aspiration. Laryngoscope 86:625–634, 1976

    Google Scholar 

  4. Woo JKS, Hassett CA van, Chan HS: Teflon injection for unilateral vocal cord paralysis and its effect on lung function. Clin Otolaryngol 17:497–500, 1992

    Google Scholar 

  5. Ardran GM, Kemp FH: The protection of the laryngeal airway during swallowing. Br J Radiol 25:406–416, 1952

    Google Scholar 

  6. Reynolds RPE, Effer GL, Bendeck MP: The upper esophageal sphincter in the cat: the role of central innervation assessed by transient vagal blockade. Can J Physiol Pharmacol 65:96–99, 1987

    Google Scholar 

  7. Shin T, Umezaki T, Maeyama T, Morikawa I: Glottic closure during swallowing in the recurrent laryngeal nerve-paralysed cat. Otolaryngol Head Neck Surg 100:187–194, 1989

    Google Scholar 

  8. Hwang K: Mechanism of the functional recovery of the cervical portion of the esophagus after bilateral resection of the pharyngoesophageal nerve in the dog. Am J Physiol 174:231–234, 1953

    Google Scholar 

  9. Henderson RD, Boszko A, vanNostrand AWP: Pharyngoesophageal dysphagia and recurrent laryngeal nerve palsy. J Thorac Cardiovasc Surg 68:507–512, 1974

    Google Scholar 

  10. Wilson JA, Pryde A, Macintyre CCA, Heading RC: Normal pharyngoesophageal motility: a study of 50 healthy subjects. Dig Dis Sci 34:1590–1599, 1989

    Google Scholar 

  11. Ward PH, Berci G: Observations on so-called idiopathic vocal cord paralysis. Ann Otol Rhinol Laryngol 91:558–563, 1982

    Google Scholar 

  12. Sasaki CT, Horiuchi M, Ikari T, Kirchner JA: Vocal cord positioning by selective denervation: old territory revisited. Ann Otol 89:541–546, 1980

    Google Scholar 

  13. Miller AJ: Neurophysiological basis of swallowing. Dysphagia 1:91–100, 1986

    Google Scholar 

  14. Shaker R, Dodds WJ, Dantas RO, Hogan WJ, Arndorfer RC: Coordination of deglutitive glottic closure with oropharyngeal swallowing. Gastroenterology 98:1478–1484, 1990

    Google Scholar 

  15. Miller AJ: Characteristics of the swallowing reflex induced by peripheral nerve and brainstem stimulation. Exp Neurol 34:210–222, 1972

    Google Scholar 

  16. Jacob P, Kahrilas PJ, Herzon G, McLaughlin B: Determinants of upper esophageal sphincter pressure in dogs. Am J Physiol 259:G245-G251, 1990

    Google Scholar 

  17. Aharinejad S, Firbas W: Die Innervation des menschlichen Osophagus. Acta Anat (Basel) 136:715–720, 1989

    Google Scholar 

  18. Hudson LC, Cummings JF: The origins of innervation of the esophagus of the dog. Brain Res 326:125–136, 1985

    Google Scholar 

  19. Khurana RK, Petras JM: Sensory innervation of the canine esophagus, stomach and duodenum. Am J Anat 192:293–306, 1991

    Google Scholar 

  20. Cunningham ET, Sawchenko PE: Central neural control of esophageal motility: a review. Dysphagia 5:35–51, 1990

    Google Scholar 

  21. Altschuler SM, Bao XM, Miselis RR: Dendritic architecture of nucleus ambiguus motoneurons projecting to the upper alimentary tract in the rat. J Comp Neurol 309:402–414, 1991

    Google Scholar 

  22. Yang M, Zirkle MS, Zhao XS, Miselis RR, Altschuler SM: Brainstem localisation and connectivity of premotor neurons conrolling the esophageal phase of swallowing as determined by the transneuronal passage of pseudorabies virus (PRV) (Abstract). Gastroenterology 102:A536, 1992

  23. Reynolds RP, Effer GW: The effect of differential vagal cooling on feline esophageal function. Clin Invest Med 11:452–456, 1988

    Google Scholar 

  24. Malmberg L, Ekberg O, Ekstrom J: Effects of drugs and electrical field stimulation on isolated muscle strips from rabbit pharyngoesophageal segment. Dysphagia 6:203–208, 1991

    Google Scholar 

  25. Wilson JA, Pryde A, Macintyre CCA, Maran AGD, Heading RC: The effects of age, sex and smoking on normal pharyngoesophageal motility. Am J Gastroenterol 85:686–691, 1990

    Google Scholar 

  26. Wilson JA, Pryde A, Maher L, Macintyre CCA, Binghua S, Heading RC: The influence of biological variables on pharyngeal pressure measurement. Gullet 2:116–120, 1992

    Google Scholar 

  27. Ekberg O, Lindgren S, Schultze T: Pharyngeal swallowing in patients with paresis of the recurrent nerve. Acta Radiol Diag 27:697–700, 1986

    Google Scholar 

  28. Shin T, Maeyama T, Morikawa I, Umezaki T: Laryngeal reflex mechanism during deglutition-observation of subglottal pressure and afferent discharge. Otolaryngol Head Neck Surg 99: 465–471, 1988

    Google Scholar 

  29. Maddock DJ, Clifford C, Gilbert RJ: Quantitative relationship between liquid bolus flow and laryngeal closure during deglutition (Abstract). Gastroenterology 100:A466, 1991

  30. Hwang K, Grossman MI: A note on the innervation of the cervical portion of the human esophagus. Gastroenterology 25:375–377, 1953

    Google Scholar 

  31. Cerenko D, McConnel FMS, Jackson RT: Quantitative assessment of pharyngeal bolus driving forces. Otolaryngol Head Neck Surg 100:57–63, 1989

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wilson, J.A., Pryde, A., White, A. et al. Swallowing performance in patients with vocal fold motion impairment. Dysphagia 10, 149–154 (1995). https://doi.org/10.1007/BF00260968

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00260968

Key words

Navigation