Spatial relationships of oropharyngeal structures during respiration, chewing, and swallowing.

Abstract

Spatial relationships between oropharyngeal structures and their coordinated dynamics ensure proper adaptations in functions such as respiration, chewing, and swallowing. Thus, the aim of this study is to analyze spatial changes in the normal oropharynx during respiration and mastication. For this purpose, eight 7-8 months old Yucatan minipigs, four of each sex were used. X-ray fluoroscopy was recorded with the field of view focused on the oropharyngeal region. The x-ray video clips showing respiratory cycles and masticatory sequences were digitized and traced. Points to be digitized and traced were located on the soft palate, epiglottis, tongue base, and pharyngeal wall. An X-Y coordinate system was established to trace distances and directions of each structure (structural), and between structures (inter-structural) during phases of respiration, chewing stages, and swallowing episodes. During respiration, the soft palate showed the largest X-Y movements with the largest distance change (1.32 ± 0.64 mm). In contrast, distance changes in the tongue base were significantly smaller (0.32 ± 0.21 mm, p < 0.05). Notably, during chewing the tongue base and epiglottis showed major changes in distance and direction. Similarly, during swallowing the tongue base showed the largest changes (2.94 ± 1.28 mm) followed by the pharyngeal wall and epiglottis. Thus, although coordinated, each pharyngeal structure plays specific roles. Understanding of these spatial and specific dynamics in different oropharyngeal structures would provide the baseline to analyze the potential mechanisms of various swallowing and breathing disorders such as dysphagia and obstructive sleep apnea.