Preliminary Temporal Measurement Analysis of Normal Oropharyngeal Swallowing in Infants and Young Children

Temporal measures of normal pediatric oropharyngeal deglutition have not been studied. Knowledge of range and variation of normative temporal measures could define abnormal deglutition and assist in design of appropriate compensatory and rehabilitative treatment techniques. The purpose of this retrospective study was to determine temporal measurements for oral filling, oral transit, onset of laryngeal closure, time of bolus arrival at the valleculae, pharyngeal delay, pharyngeal transit, and UES opening. Videofluoroscopic swallow studies of 15 normally swallowing pediatric subjects were divided into three age groups and method of liquid delivery. Mean, standard deviation, percentages, and extension of the median were utilized to determine relationships of temporal measures. Mean temporal duration increased with age for oral filling, oral transit time, time of laryngeal closure, UES opening, and pharyngeal delay time. However, no significant differences were found between age groups indicating a deglutitive biomechanical adaptation to growth of the oral and pharyngeal cavity. Feeding method for bottle versus cup mean duration increased for oral transit time, laryngeal closure time, UES opening, and pharyngeal delay time. Bolus head location relative to onset of laryngeal vestibule closure changed with increased age and method of feeding. Temporal measures were not significantly different for age groups or feeding methods. Bolus location was at or fully contained in the valleculae at the onset of laryngeal closure and appeared to be a normal finding in functional pediatric swallows and is not indicative of a delay or disorder.