Chewing and food consistency: Effects on bolus transport and swallow initiation
Chewing and food consistency: Effects on bolus transport and swallow initiation
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DOI：
10.1007/s00455-006-9060-5
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发表时间：
2007-04-01
期刊：
影响因子：
2.6
通讯作者：
Palmer, Jeffrey B.
中科院分区：
文献类型：
--
作者：
Saitoh, Eiichi;Shibata, Seiko;Palmer, Jeffrey B.
吞咽前团块的形成通常发生在口腔中的液体和口咽中的固体食物。我们研究了咀嚼对团剂运输和吞咽启动之间关系的影响。对15名健康受试者分别以直立和俯卧两种姿势进食液体、固体食物以及液体和固体混合食物时，进行了侧向投影视频透视成像。复习录像带以测量吞咽开始时钡的前缘的位置。咀嚼和最初的一致性都改变了食物运输和吞咽开始之间的关系。特别是，当咀嚼液体(或同时食用液体和固体相的食物)时，部分食物通常在吞咽之前很久就到达下咽。这种到下咽的运输高度依赖于重力，但到山谷的咀嚼固体食物的运输是活跃的，主要取决于舌腭部的接触。咀嚼似乎降低了舌尖后封闭的效果，使口腔内容物溢出到咽部。在呼吸道保护反射受损的吞咽困难患者中，同时食用固体和液体两相食物可能增加吸入的风险。
Preswallow bolus formation usually occurs in the mouth for liquids and in the oropharynx for solid foods. We examined the effect of chewing on the relationship between bolus transport and swallow initiation. Fifteen healthy subjects were imaged with lateral projection videofluorography while eating liquids, solid foods, and a mixture of liquid and solid foods in upright and facedown postures. Videotapes were reviewed to measure the location of the leading edge of the barium at swallow initiation. Chewing and initial consistency each altered the relationship between food transport and swallow initiation. In particular, when chewing liquid (or consuming foods with both liquid and solid phases), a portion of the food commonly reached the hypopharynx well before swallow onset. This transport to the hypopharynx was highly dependent on gravity, but transport to the valleculae for chewed solid food was active, depending primarily on tongue-palate contact. Chewing appeared to reduce the effectiveness of the posterior tongue-palate seal, allowing oral contents to spill into the pharynx. Consuming two-phase foods with both solid and liquid phases may increase the risk of aspiration in dysphagic individuals with impaired airway protective reflexes.