Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website http://www.gastrores.org

Original Article

Volume 3, Number 6, December 2010, pages 245-252

Swallowing Evaluation in Patients With Unilateral Vocal Fold Immobility

Figure 1. Upper esophageal sphincter (UES) transit duration after swallows of 5 mL and 10 mL of liquid and paste barium in patients with unilateral vocal fold immobility and controls. The horizontal bar represents the mean. * p < 0.04 vs controls.

Figure 2. Timing represented by the means of oral and pharyngeal transit after swallows of a 5 mL and 10 mL liquid bolus in patients with unilateral vocal fold immobility and controls. TT – tongue tip at the maxillary incisors; TB – onset of tongue base movement; OPP – onset of pharyngeal phase, bolus head into the oropharynx; HO – onset of the hyoid movement; EOT – end of oral transit; UESO – onset of the upper esophageal sphincter opening; UESC – end of upper esophageal sphincter opening; HE – end of the hyoid movement. The horizontal thick bar represents the UES transit.

Figure 3. Timing represented by the means of oral and pharyngeal transit after swallows of 5 mL and 10 mL of a paste bolus in patients with unilateral vocal fold immobility and controls. TT – tongue tip at the maxillary incisors; TB – onset of tongue base movement; OPP – onset of pharyngeal phase, bolus head into the oropharynx; HO – onset of the hyoid movement; EOT – end of oral transit; UESO – onset of the upper esophageal sphincter opening; UESC – end of upper esophageal sphincter opening; HE – end of the hyoid movement. The horizontal thick bar represents the UES transit.

**Table 1.** Oral and Pharyngeal Transit Duration in Patients With Unilateral Vocal Fold Immobility (n = 14) and Controls (n = 11) After Swallowing 5 mL and 10 mL Liquid Bolus (Seconds)
	5 mL	10 mL
^*p = 0.03 vs patients
Oral transit	0.69 ± 0.37	0.57	0.49 ± 0.39	0.37	0.33 ± 0.10	0.31	0.51 ± 0.47	0.36
Pharyngeal Transit	0.19 ± 0.06	0.20	0.20 ± 0.05	0.20	0.22 ± 0.16	0.18	0.21 ± 0.05	0.21
Pharyngeal clearance	0.45 ± 0.19	0.42	0.46 ± 0.38	0.34	0.36 ± 0.09	0.39	0.49 ± 0.31	0.36
UES transit	0.19 ± 0.05	0.18	0.22 ± 0.06	0.21	0.23 ± 0.04*	0.24	0.27 ± 0.05	0.27
Hyoid movement	0.60 ± 0.26	0.47	0.59 ± 0.28	0.50	0.53 ± 0.24	0.42	0.65 ± 0.38	0.47

Table 1. Oral and Pharyngeal Transit Duration in Patients With Unilateral Vocal Fold Immobility (n = 14) and Controls (n = 11) After Swallowing 5 mL and 10 mL Liquid Bolus (Seconds)

5 mL

10 mL

Controls

Patients

Controls

Patients

Mean ± SD

Median

Mean ± SD

Median

Mean ± SD

Median

Mean ± SD

Median

^*p = 0.03 vs patients

Oral transit

0.69 ± 0.37

0.57

0.49 ± 0.39

0.37

0.33 ± 0.10

0.31

0.51 ± 0.47

0.36

Pharyngeal Transit

0.19 ± 0.06

0.20

0.20 ± 0.05

0.20

0.22 ± 0.16

0.18

0.21 ± 0.05

0.21

Pharyngeal clearance

0.45 ± 0.19

0.42

0.46 ± 0.38

0.34

0.36 ± 0.09

0.39

0.49 ± 0.31

0.36

UES transit

0.19 ± 0.05

0.18

0.22 ± 0.06

0.21

0.23 ± 0.04*

0.24

0.27 ± 0.05

0.27

Hyoid movement

0.60 ± 0.26

0.47

0.59 ± 0.28

0.50

0.53 ± 0.24

0.42

0.65 ± 0.38

0.47

**Table 2.** Oral and Pharyngeal Transit Duration in Patients With Unilateral Vocal Fold Immobility (n = 14) and Controls (n = 11) After Swallowing 5 mL and 10 mL Paste Bolus (Seconds)
	5 mL	10 mL
^*p = 0.01 vs patients
Oral transit	0.61 ± 0.45	0.49	0.60 ± 0.44	0.46	0.39 ± 0.18	0.36	0.70 ± 0.64	0.52
Pharyngeal Transit	0.20 ± 0.08	0.20	0.29 ± 0.22	0.22	0.20 ± 0.06	0.22	0.23 ± 0.05	0.24
Pharyngeal clearance	0.54 ± 0.32	0.58	0.44 ± 0.32	0.34	0.63 ± 0.42	0.50	0.62 ± 0.54	0.35
UES transit	0.18 ± 0.04*	0.20	0.22 ± 0.04	0.21	0.23 ± 0.06	0.24	0.24 ± 0.05	0.24
Hyoid movement	0.57 ± 0.22	0.48	0.55 ± 0.22	0.45	0.68 ± 0.26	0.70	0.56 ± 0.21	0.50

Table 2. Oral and Pharyngeal Transit Duration in Patients With Unilateral Vocal Fold Immobility (n = 14) and Controls (n = 11) After Swallowing 5 mL and 10 mL Paste Bolus (Seconds)

5 mL

10 mL

Controls

Patients

Controls

Patients

Mean ± SD

Median

Mean ± SD

Median

Mean ± SD

Median

Mean ± SD

Median

^*p = 0.01 vs patients

Oral transit

0.61 ± 0.45

0.49

0.60 ± 0.44

0.46

0.39 ± 0.18

0.36

0.70 ± 0.64

0.52

Pharyngeal Transit

0.20 ± 0.08

0.20

0.29 ± 0.22

0.22

0.20 ± 0.06

0.22

0.23 ± 0.05

0.24

Pharyngeal clearance

0.54 ± 0.32

0.58

0.44 ± 0.32

0.34

0.63 ± 0.42

0.50

0.62 ± 0.54

0.35

UES transit

0.18 ± 0.04*

0.20

0.22 ± 0.04

0.21

0.23 ± 0.06

0.24

0.24 ± 0.05

0.24

Hyoid movement

0.57 ± 0.22

0.48

0.55 ± 0.22

0.45

0.68 ± 0.26

0.70

0.56 ± 0.21

0.50

**Table 3.** Timing of Onset of Hyoid Movement and Onset of Upper Esophageal Sphincter (UES) Opening, Indexed to Propulsive Tongue Tip Movement at the Maxillary Incisors as the Zero Reference, After Swallowing a 5 mL and 10 mL Liquid and Paste Bolus in Patients With Vocal Fold Immobility and Controls (Seconds)
	Controls	Patients
p = 0.003 vs 10 mL * p = 0.049 vs 10 mL
Liquid
Hyoid movement	0.43 ± 0.36	0.35	0.22 ± 0.24	0.17	0.29 ± 0.40	0.19	0.28 ± 0.45	0.23
UES opening	0.69 ± 0.35*	0.51	0.32 ± 0.20	0.29	0.47 ± 0.39	0.35	0.45 ± 0.45	0.32
Paste
Hyoid movement	0.31 ± 0.51	0.25	0.25 ± 0.22	0.20	0.47 ± 0.56	0.38	0.50 ± 0.58	0.32
UES opening	0.63 ± 0.42**	0.50	0.37 ± 0.21	0.35	0.67 ± 0.55	0.56	0.69 ± 0.64	0.53

Table 3. Timing of Onset of Hyoid Movement and Onset of Upper Esophageal Sphincter (UES) Opening, Indexed to Propulsive Tongue Tip Movement at the Maxillary Incisors as the Zero Reference, After Swallowing a 5 mL and 10 mL Liquid and Paste Bolus in Patients With Vocal Fold Immobility and Controls (Seconds)

Controls

Patients

5 mL

10 mL

5 mL

10 mL

Mean ± SD

Median

Mean ± SD

Median

Mean ± SD

Median

Mean ± SD

Median

*p = 0.003 vs 10 mL ** p = 0.049 vs 10 mL

Liquid

Hyoid movement

0.43 ± 0.36

0.35

0.22 ± 0.24

0.17

0.29 ± 0.40

0.19

0.28 ± 0.45

0.23

UES opening

0.69 ± 0.35*

0.51

0.32 ± 0.20

0.29

0.47 ± 0.39

0.35

0.45 ± 0.45

0.32

Paste

Hyoid movement

0.31 ± 0.51

0.25

0.25 ± 0.22

0.20

0.47 ± 0.56

0.38

0.50 ± 0.58

0.32

UES opening

0.63 ± 0.42**

0.50

0.37 ± 0.21

0.35

0.67 ± 0.55

0.56

0.69 ± 0.64

0.53

**Table 4.** Pharyngeal transit duration and upper esophageal sphincter (UES) transit duration in patients with unilateral vocal fold immobility, with normal electromyographic (EMG) evaluation (n = 6) and with abnormal EMG evaluation (n = 8), after swallows of 5 mL and 10 mL of a liquid and paste bolus (seconds)
	Pharyngeal Transit	UES Transit
Liquid
5 mL	0.19 ± 0.06	0.17	0.21 ± 0.05	0.24	0.22 ± 0.08	0.22	0.22 ± 0.04	0.21
10 mL	0.20 ± 0.04	0.19	0.22 ± 0.06	0.22	0.27 ± 0.05	0.25	0.27 ± 0.05	0.28
Paste
5 mL	0.35 ± 0.34	0.22	0.24 ± 0.05	0.21	0.21 ± 0.03	0.21	0.23 ± 0.05	0.21
10 mL	0.21 ± 0.04	0.22	0.25 ± 0.06	0.24	0.22 ± 0.04	0.23	0.26 ± 0.05	0.25

Table 4. Pharyngeal transit duration and upper esophageal sphincter (UES) transit duration in patients with unilateral vocal fold immobility, with normal electromyographic (EMG) evaluation (n = 6) and with abnormal EMG evaluation (n = 8), after swallows of 5 mL and 10 mL of a liquid and paste bolus (seconds)

Pharyngeal Transit

UES Transit

Normal EMG

Abnormal EMG

Normal EMG

Abnormal EMG

Mean ± SD

Median

Mean ± SD

Median

Mean ± SD

Median

Mean ± SD

Median

Liquid

5 mL

0.19 ± 0.06

0.17

0.21 ± 0.05

0.24

0.22 ± 0.08

0.22

0.22 ± 0.04

0.21

10 mL

0.20 ± 0.04

0.19

0.22 ± 0.06

0.22

0.27 ± 0.05

0.25

0.27 ± 0.05

0.28

Paste

5 mL

0.35 ± 0.34

0.22

0.24 ± 0.05

0.21

0.21 ± 0.03

0.21

0.23 ± 0.05

0.21

10 mL

0.21 ± 0.04

0.22

0.25 ± 0.06

0.24

0.22 ± 0.04

0.23

0.26 ± 0.05

0.25