The dynamics of deglutition during head rotation using dynamic 320-row area detector computed tomography

Area of Science:

• Deglutition dynamics
• Head rotation effects on swallowing
• Medical imaging in swallowing disorders

Background:

• Globus pharyngeus is a common condition affecting swallowing.
• Understanding deglutition dynamics is crucial for managing swallowing disorders.
• The impact of head rotation on swallowing mechanics requires further elucidation.

Purpose of the Study:

• To investigate the influence of head rotation on the dynamics of deglutition.
• To analyze changes in swallowing-related organ movement and pharyngeal volume during head rotation.
• To compare the effects of different fluid viscosities on deglutition with head rotation.

Main Methods:

• 11 patients with globus pharyngeus underwent 320-row area detector computed tomography (320-ADCT).
• Swallowing was analyzed with and without head rotation, using thin and thick viscosity fluids.
• Movement times of deglutition organs and pharyngeal volumes were measured and statistically analyzed.

Main Results:

• Head rotation significantly hastened the onset of epiglottis inversion and upper esophageal sphincter (UES) opening.
• Thick viscosity increased the bolus ratio, while head rotation increased pharyngeal volume before swallowing (PVBS).
• No significant difference in pharyngeal volume contraction ratio (PVCR) was observed regarding viscosity or head rotation.

Conclusions:

• Head rotation accelerates key aspects of the swallowing process, potentially by influencing the swallowing center, pharyngeal volume, or contraction force.
• Further research combining swallowing CT with manometry is planned to explore the relationship with pharyngeal contraction force.
• These findings offer insights into the biomechanics of swallowing and may inform therapeutic strategies.