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![]() The initiation of the pharyngeal stage of swallowing was evaluated as the interval between the times at which the head of the bolus passed the anterior faucial arches and the hyoid bone started to move forward (initiation ). ![]() The video recordings also were analyzed to study the interactions between different muscle groups in the pharynx during swallowing. The videoradiography was analyzed for the following types of pharyngeal dysfunction: inability to retain the bolus of contrast in the mouth with premature leakage of contrast medium into the pharynx misdirected swallowing that is, penetration of contrast medium to the laryngeal vestibule, either to its superior portion not reaching between the false vocal cords or further down to the vocal cords or into the trachea or retention of contrast medium in the pharynx after completion of the swallowing act. In that study, 8no detailed analysis of the video recorded fluoroscopy of the pharynx, upper esophagus, and laryngeal inlet was performed.Įach contrast bolus swallow was evaluated radiographically to detect normal and abnormal swallowing patterns. ![]() In a recent study, 8we showed that mechanical adductor pollicis train-of-four (TOF) ratios less than 0.90 as a result of administration of vecuronium were associated with an impaired pharyngeal muscle coordination, a reduced resting tone in the upper esophageal sphincter (UES) muscle, and episodes of contrast penetrating to the laryngeal inlet. Recently, Berg 7showed an increased incidence of postoperative pulmonary complications in patients with residual neuromuscular block cause by pancuronium. 4–6Residual effects of anesthetic agents may have serious effects on pharyngeal function, airway protection, and pulmonary function. The method previously has been used to study normal swallowing patterns 3and to examine patients with a history of dysphagia of different origin. 3This makes it possible to detect pathologic swallowing patterns that is, dysfunction at various levels in the pharynx, laryngeal inlet, and upper esophagus by fluoroscopy, and to simultaneously monitor the muscular function in different parts of the pharynx and esophagus by manometry. Simultaneous videomanometry combines video recordings of fluoroscopically visualized contrast bolus swallows, videoradiography, and simultaneous solid-state manometry of the pharynx and upper esophagus.
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