Oropharyngeal Motor Dysfunction in Patients with Oropharyngeal Dysphagia

Kim, Hyo Jung; Song, Chi wook; Choung, Rok Son; Kim, Yoon Bae; Lee, Jung Whan; Jeen, Yoon Tae; Chun, Yoon Jai; Um, Soon Ho; Kim, Chang Duck; Ryu, Ho Sang; Hyun, Jin Hai

Abstract

BACKGROUND/AIMS: It has been considered that motor abnormalities of the oropharynx might play a role in the pathogenesis of oropharyngeal dysphagia. This study aimed to evaluate the motility change in patients with oropharyngeal dysphagia using circumferential solid state manometry.
METHODS
Nineteen patients with oropharyngeal dysphagia and 12 healthy volunteers of similar age underwent circumferential solid state manometry and lateral videofluoroscopic studies to assess oropharyngeal motility. The patients were divided into 3 groups by videofluoroscopic findings: group 1, patients with delayed oral transit; group 2, patients with increased pharyngeal residue; group 3, patients with aspiration alone.
RESULTS
The group 2 showed less upper esophageal sphincter relaxation and lower amplitude of hypopharyngeal contractions. The time interval from the onset of hypopharyngeal contractions to the onset of complete upper esophageal sphincter relaxation was delayed in the group 3. Post-swallow aspiration was caused by high pharyngeal residue in patients with oropharyngeal dysphagia.
CONCLUSIONS
These results suggest that a high pharyngeal residue is related to a weak contraction of the hypopharynx, and aspiration is related to a slowed swallow response, presumably with delayed laryngeal closure.