Evidence that an internal schema adapts swallowing to upper airway requirements
Evidence that an internal schema adapts swallowing to upper airway requirements
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DOI：
10.1113/jp272368
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发表时间：
2017-03-01
影响因子：
5.5
通讯作者：
Ludlow, Christy L.
中科院分区：
文献类型：
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作者：
Wong, Seng Mun;Domangue, Rickie J.;Ludlow, Christy L.
舌骨和喉部运动有助于喉前庭关闭和上食管括约肌打开吞咽过程中。缺乏内部感觉运动缩放系统允许个人实现这些功能目标的证据。在语音中，说话者根据达到清晰语音的发音目标所需的移动距离来调整他们的发音移动幅度。我们研究了吞咽是否相似，因为运动幅度可以通过吞咽期间气道保护的功能目标来缩放，而不是通过头部和颈部大小来缩放。我们假设健康个体通过调整舌音喉运动来适应自身的解剖结构，以实现上呼吸道的闭合。我们还调查了吞咽前头部位置改变时，个体是否会自动补偿其初始舌喉位置和区域的变化。在31名健康成人中进行了视频透视。使用逐帧运动分析，前和上级舌骨和喉位移，和舌骨喉面积测量之前和吞咽过程中。吞咽过程中的运动学测量检查与咽颈长度，和初始的舌喉位置，长度和吞咽前的面积的关系。在吞咽过程中，个人改变喉抬高幅度超过舌骨抬高的基础上，吞咽前的舌骨喉长度。喉前移位与喉与脊柱的初始距离有关，而舌骨抬高则通过咽颈长度和吞咽前舌骨与下颌骨的初始距离来预测。总之，个人自动适应舌喉运动在吞咽过程中的基础上所需的目标，关闭舌喉区安全吞咽。
Hyoid and laryngeal movements contribute to laryngeal vestibule closure and upper oesophageal sphincter opening during swallowing. Evidence of an internal sensorimotor scaling system allowing individuals to achieve these functional goals is lacking. In speech, speakers adjust their articulatory movement magnitude according to the movement distance required to reach an articulatory target for intelligible speech. We investigated if swallowing is similar in that movement amplitude may be scaled by the functional goal for airway protection during swallowing, rather than by head and neck size. We hypothesized that healthy individuals adapt to their own anatomy by adjusting hyo-laryngeal movements to achieve closure of the upper airway. We also investigated if individuals would automatically compensate for changes in their initial hyo-laryngeal positions and area when head position was changed prior to swallowing. Videofluoroscopy was performed in 31 healthy adults. Using frame-by-frame motion analysis, anterior and superior hyoid and laryngeal displacement, and hyo-laryngeal area were measured prior to and during swallowing. Kinematic measurements during swallowing were examined for relationships with pharyngeal neck length, and initial hyo-laryngeal positions, length and area before swallowing. During swallowing, individuals altered laryngeal elevation magnitude to exceed hyoid elevation based on hyo-laryngeal length before swallowing. Anterior laryngeal displacement was related to initial larynx distance from the spine, while hyoid elevation was predicted by pharyngeal neck length and initial hyoid distance from the mandible prior to the swallow. In conclusion, individuals automatically adapt hyo-laryngeal movement during swallowing based on targets required for closing the hyo-laryngeal area for safe swallowing.