Videomanometric analysis of supraglottic swallow, effortful swallow, and chin tuck in healthy volunteers

Simultaneous videoradiography and solid-state manometry (videomanometry) wa s applied in eight healthy volunteers (four women, four men; age range 25-6 4 years, mean age 41 years) without swallowing problems. Three different sw allowing techniques were tested; supraglottic swallow, effortful swallow, a nd chin tuck. Seven videoradiographic variables and six manometric variable s were analyzed. The supraglottic swallowing technique did not differ signi ficantly from that of the control swallows. The effortful swallow had a sig nificantly (p = 0.0001) reduced hyoid-mandibular distance preswallow due to an elevation of the hyoid and the larynx, which caused a significantly (p = 0.007) reduced maximal hyoid movement and a significantly (p = 0.009) red uced laryngeal elevation during swallow. The chin tuck swallow had a signif icantly (p = 0.001) reduced laryngohyoid distance and also a significantly (p = 0.004) reduced hyoid-mandibular distance. The chin tuck swallow also d isplayed significantly (p = 0.003) weaker pharyngeal contractions. Videoman ometry allows for analysis of bolus transport, movement of anatomical struc tures, and measurement of intraluminal pressures. These variables are impor tant when evaluating swallowing techniques. In the present study, we made a few observations that never have been reported before. When healthy volunt eers performed supraglottic swallow, they performed the technique somewhat differently. Therefore, we assume dysphagic patients would need a substanti al period of training to perform a technique efficiently. Chin tuck could i mpair protection of the airways in dysphagic patients with weak pharyngeal constrictor muscles.