Abstract
Objective : We devised a new analytical method to evaluate swallowing dynamics from videofluorography (VF). Subjects and Methods : For 2 healthy subjects and a patient with Parkinson's disease (PD), we examined VF using liquid barium. We put 9 markers on the pharynx in VFG clips using two-dimensional motion analysis software and measured movements of these markers. We assessed changes in the lower oropharynx and hypopharynx, which were surrounded by markers. Results : In healthy subjects, the lower oropharynx moved sequentially ; it first expanded, then contracted, and finally relaxed. The hypopharynx began similar movements, 0.2-0.3 seconds later than the lower oropharynx. In the PD patient, contraction of the pharynx occurred ; however, the lag between movements of the lower oropharynx and those of the hypopharynx was shorter than in healthy subjects. The PD patient did not aspirate but residue was visible in the epiglottic vallecula and piriform fossa. Conclusion : Temporally-programmed swallowing movements appeared to cause propulsion of food, allowing healthy subjects to transport liquid from the pharynx to the esophagus. In the PD patient, the local pressure gradient in the pharynx appeared to be insufficient because of impaired coordination. Our method was useful for evaluating from VFG the sequential pharyngeal movements during swallowing.
