Pouderoux P, Logemann J A, Kahrilas P J
Department of Medicine, Northwestern University Medical School, Chicago, Illinois 60611, USA.
Am J Physiol. 1996 Feb;270(2 Pt 1):G347-54. doi: 10.1152/ajpgi.1996.270.2.G347.
Nonalimentary swallows minimize aspiration by clearing accumulated fluid from the pharynx. This study aimed to define 1) the pharyngeal sensory field to elicit swallowing and 2) the effect of infusion rate, volition, taste, and temperature on pharyngeal swallows. Test solutions were directed into the valleculae at 6.5, 11.5, and 32 ml/min through a catheter in eight healthy volunteers. Deglutition was signaled with electromyography and electroglottography. Spatial distribution of infusate before swallowing was studied using videofluoroscopy coupled with a video timer. Volitional control was assessed with rapid or restrained swallows. Pharyngeal swallow latency decreased as the instillation rate increased, was potently modified with volition, and was unchanged by infusate taste or temperature. Water infusion into the valleculae did not trigger pharyngeal swallowing until liquids overflowed and reached the aryepiglottic folds or pyriform sinuses. The variation in swallow latency among flow rates was mainly due to the duration of liquid containment within the valleculae. This suggests that the valleculae act to contain pharyngeal secretions and residue and prevent aspiration by diverting their contents around the larynx before swallowing.
非进食性吞咽通过清除咽部积聚的液体来减少误吸。本研究旨在确定：1）引发吞咽的咽部感觉区域；2）输注速率、自主控制、味道和温度对咽部吞咽的影响。通过导管以6.5、11.5和32毫升/分钟的速率将测试溶液注入8名健康志愿者的梨状窝。通过肌电图和电声门图记录吞咽信号。使用视频荧光透视结合视频定时器研究吞咽前注入物的空间分布。通过快速或抑制性吞咽评估自主控制能力。咽部吞咽潜伏期随滴注速率的增加而缩短，受自主控制的显著影响，而注入物的味道或温度对其没有影响。向梨状窝注入水不会引发咽部吞咽，直到液体溢出并到达杓会厌襞或梨状窦。不同流速下吞咽潜伏期的变化主要是由于液体在梨状窝内停留的时间不同。这表明梨状窝起到容纳咽部分泌物和残留物的作用，并通过在吞咽前将其内容物绕过喉部来防止误吸。
