Kagaya Hitoshi, Yokoyama Michio, Saitoh Eiichi, Kanamori Daisuke, Susa Chiaki, German Rebecca Z, Palmer Jeffrey B
Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University.
Tohoku J Exp Med. 2015 May;236(1):39-43. doi: 10.1620/tjem.236.39.
Swallowing is one of the basic activities in humans. The pharynx functions as an airway and a food channel, and a pharyngeal swallow usually occurs after bolus transport from the oral cavity. However, direct fluid infusion through a catheter into the hypopharynx produces a pharyngeal swallow without the oral stage in experimental situations. The purpose of this study was to examine whether a pharyngeal swallow, which is not accompanied by bolus transport, can occur during normal human feeding. Fifty-three healthy volunteers (25-89 years) were recorded, via videofluoroscopic examination of swallowing, during 3 different swallowing trials: command swallow of 10 ml liquid barium, chew-swallow of corned beef, and chew-swallow of a mixture of corned beef and liquid barium. Subsequently each swallow was classified as being either a consecutive pharyngeal swallow (CPS), following transport, or an isolated pharyngeal swallow (IPS), without immediately prior transport. The location of the bolus at swallow initiation was also noted. Of 307 trials, 681 swallows were identified, which included 43 IPS and 638 CPS. IPS only occurred as the first swallow of a trial, but the frequency of IPS did not differ between 28 younger (< 60 years) and 25 older (≥ 60 years) people. Of the three food types, IPS occurred more frequently with the mixed food than with liquid. These results suggest that IPS may represent an airway protective mechanism. In conclusion, IPS occurs in normal swallowing during a daily eating situation. Swallowing is more complex than a simple reflex.
吞咽是人类的基本活动之一。咽部兼具气道和食物通道的功能，通常在食团从口腔运送过来之后发生咽期吞咽。然而，在实验情况下，通过导管将液体直接注入下咽会引发不经过口腔期的咽期吞咽。本研究的目的是检验在正常人类进食过程中是否会出现不伴随食团运送的咽期吞咽。通过吞咽的视频荧光检查，记录了53名健康志愿者（年龄在25至89岁之间）在3种不同吞咽试验中的情况：10毫升液体钡剂的指令吞咽、咸牛肉的咀嚼吞咽以及咸牛肉与液体钡剂混合物的咀嚼吞咽。随后，每次吞咽被分类为连续咽期吞咽（CPS，即食团运送后）或孤立咽期吞咽（IPS，即紧接之前没有食团运送）。还记录了吞咽开始时食团的位置。在307次试验中，共识别出681次吞咽，其中包括43次IPS和638次CPS。IPS仅作为试验中的首次吞咽出现，但在28名较年轻（<60岁）和25名较年长（≥60岁）的人群中，IPS的发生频率并无差异。在三种食物类型中，混合食物引发IPS的频率高于液体。这些结果表明，IPS可能代表一种气道保护机制。总之，IPS发生在日常进食情况下的正常吞咽过程中。吞咽比简单的反射更为复杂。
