SWALLOWING PERFORMANCE IN PATIENTS WITH VOCAL FOLD MOTION IMPAIRMENT

Twenty-seven patients with vocal fold motion impairment underwent deta iled pharyngoesophagel manometry with a strain gauge assembly linked t o a computer recorder. Nine were known to have lesions of the central vagal trunk or nucleus, 9 had recurrent laryngeal nerve (RLN) palsy, a nd the remainder were idiopathic. The site of the lesion was a more im portant determinant of subjective swallowing performance than the posi tion of the involved cord at laryngoscopy. Patients with cental lesion s had lower tonic and contraction upper esophageal sphincter (UES) pre ssures than 25 age-matched controls, suggesting that high cervical bra nches of the lower cranial nerves are important in UES excitatory inne rvation. RLN palsy patients showed significantly increased pharyngeal contraction amplitude and reduced pharyngoesophageal wave durations. T he results suggest that the dysphagia associated with vocal fold motio n impairment is not simply due to the disruption of laryngeal deglutit ive kinetics, but to independent effects on pharyngeal function.