INFLUENCE OF COLD STIMULATION ON THE NORMAL PHARYNGEAL SWALLOW RESPONSE

We examined the potential influence of cold stimulation of the anterio r tonsillar pillars, before and after topical anesthesia, on the tempo ral linkage between the oral and pharyngeal components of the swallow. We hypothesized that if elicitation of the pharyngeal swallow were de pendent upon stimulation of faucial mucosal receptors this response wo uld be facilitated by cold tactile stimulation and inhibited by topica l anesthesia. In 14 healthy volunteers undergoing simultaneous videora diography and manometry we measured and compared regional transit and clearance times, and the timing of hyoid motion, upper esophageal sphi ncter relaxation, and opening within the swallow sequence. There was a significant, volume-dependent forward shift in timings of hyoid motio n, upper esophageal sphincter (UES) relaxation profile, and opening wh ich were influenced neither by cold stimulation nor topical anesthesia . Regional transit and clearance times and UES coordination were not i nfluenced by cold stimulation. Pharyngeal clearance time was prolonged by tonsillar pillar anesthesia due to earlier arrival of the bolus he ad at this region (p = 0.002). We conclude that the normal pharyngeal swallow response is neither facilitated nor inhibited by prior cold ta ctile stimulation or topical anesthesia to the tonsillar pillars, resp ectively. These observations do not support the hypothesis that elicit ation of the pharyngeal swallow response is dependent upon stimulation of mucosal receptors in the tonsillar arches.