Intraoral pressure patterns during swallowing

Swallowing disturbances are common after neurological disease and oropharyngeal tumor resection. In this case the oral stage is often affected. So far the clinical evaluation of the oral phase is limited. Recently the role of pressure changes during oropharyngeal swallowing has been pointed out, but until now there are not enough data. Thereby 52 healthy adults aged between 20 and 45 years were examined using an oral shield (Silencos(A (R)), Bredent, Senden, Germany) connected to a digital manometer (GDUSB 1000(A (R)), Greisinger electronics, Regenstauf, Germany) able to record pressures in a range of 2,000 to -1,000 mbar at a frequency of 1 kHz. Three swallowing conditions were measured: an active bolus intake (ABI) of water, a passive bolus application of a water-bolus (PWA) and a passive application of a gel-bolus (PGA). We found negative pressures with a median value of -278.9 mbar during ABI, of -24.2 mbar during PWA and of -29.4 mbar during PGA. Significant differences in pressure amplitudes and the pressure pattern were observed depending on the kind of bolus application and its consistency. The used test presents a simple and easy to handle method to assess the oral phase of swallowing.