2013 Volume 17 Issue 3 Pages 217-225
Objectives: Some articles on dysphagia have reported that laryngopharyngeal sense influences the occurrence of aspiration pneumonitis. However, propelling of the bolus into the pharynx during Stage II transport is seldom perceived. The purposes of this study were to evaluate epiglottal perception of arrived bolus during Stage II transport using actual food and to determine the effect of differences in food texture on the epiglottal perception.
Methods: Twenty healthy volunteers chewed three food samples cooked to different grades of texture (hard, soft and medium), using enzyme homogeneous permeation. The subjects made a sign when they felt that the bolus had reached the epiglottis during Stage II transport. We evaluated the actual location of the bolus using videoendoscopy when the subject perceived that the food had arrived at their epiglottis.
Results: There were statistically significant differences between soft and hard food textures for both the duration from the beginning of chewing to the sign from the subjects and to arrival of the bolus at the epiglottis. The difference between the duration from the beginning of chewing to the sign from the subjects and to actual arrival of the bolus at the epiglottis did not depend on food texture and no significant difference was observed among the three food textures. Most subjects made a sign when the food arrived at about the posterior part of the tongue and the epiglottis.
Discussion: The healthy subjects could not correctly perceive the arrival of the bolus at the epiglottis during Stage II transport. Additionally, the texture of the test food did not affect epiglottal perception.Therefore, it is speculated that variations in mastication time might make the processed bolus a similar texture before the occurrence of swallowing.
