2018 Volume 22 Issue 1 Pages 27-36
Objective: This study aimed to elucidate and evaluate the dynamics of swallowing when using a palatal augmentation prosthesis. We observed changes in pharyngeal pressure during the swallowing process according to the wearing of a palatal augmentation prosthesis (PAP) in healthy individuals using high-reso-lution manometry (HRM). Materials and Methods: Ten healthy subjects (average age 34.2±9.5 years) wearing a PAP of one of three thicknesses ingested water jelly and thin rice porridge. Pressure and timing events were recorded with a 20-sensor HRM catheter. We analyzed the maximum swallowing pressure, duration of contraction, and time of contraction to peak, at the level of the velopharynx, tongue base, and lower pharynx. We analyzed the duration of relaxation of the upper esophageal sphincter (UES), maximum pre-opening UES pressure, and maximum post-closure UES pressure. Results: Healthy individuals that wore the PAP of 10 mm and swallowed jelly and thin rice porridge showed significantly increased peak pressure at the tongue base. Healthy individuals that wore the PAP of 10 mm and swallowed jelly and thin rice porridge showed significantly decreased peak pressure at the lower pharynx. No differences were found among duration of contraction, or time of contraction to peak, at the level of the velopharynx, tongue base, or lower pharynx, and duration of relaxation of UES when comparing those with PAP and those without PAP. Maximum pre-opening UES pressure was higher with PAP than without, and maximum post-closure UES pressure was lower with PAP than without, but neither was statistically significantly different. Conclusion: The thickness of PAP enhanced the anchor of the tongue, and increased the peak pressure at the base of the tongue. Conversely, the pressure of the lower pharynx reduced to compensate. PAP did not affect contraction duration or UES. We collected data for clarifying the dynamics of swallowing in healthy individuals using PAP with HRM. The results of this study demonstrated that HRM can be used to evaluate the dynamics of swallowing with PAP.
