Reduced Coordination of Hyolaryngeal Elevation and Bolus Movement in a Pig Model of Preterm Infant Swallowing
Animal models; Baby foods; Biomechanics; Deglutition; Dysphagia; Feeding; Hogs; Infants; Medical Sciences; Pig; Premature; Suidae; Swallowing
Preterm infants often have dysphagia. Because reducing lifetime cumulative exposure to radiation in the context of diagnosis and treatment is a continuing goal of all medical fields which use X-ray imaging, efforts exist to reduce reliance on the gold standard diagnostic tool for dysphagia, VFSS. Alternatives, such as video of external hyolaryngeal movement using video recordings of the anterior surface of the neck, must be evaluated and validated against videofluoroscopy, a task for which non-human animal models are appropriate. In this study, we tested the hypotheses that (1) swallows could be identified equally well from video of external hyolaryngeal movement and bolus movement in videofluoroscopy, and that (2) the two measures would be tightly temporally linked in both term and preterm infant pigs. We recorded 222 swallows in simultaneous and precisely synchronized high-speed videofluoroscopy and high-speed camera films of 4 preterm and 3 term infant pigs drinking milk from a bottle. In term pigs, the two measures consistently identified the same swallows in each image stream. However, in preterm pigs there was a high rate of false positives (~ 10% per feeding sequence) and false negatives (~ 27% per feeding sequence). The timing of hyolaryngeal elevation (external video) and bolus movement (videofluoroscopy) was correlated and consistent in terms pigs, but not in preterm pigs. Magnitude of hyolaryngeal elevation was less in preterm pig swallows than term pig swallows. Absence of epiglottal inversion in preterm pigs was not linked to variation in the timing of the two swallow events. Video of external hyolaryngeal movement, though a reliable swallow indicator in term infant pigs, was unreliable in preterm infant pigs. The coordination of swallowing events differs in preterm and term infant pigs. More research is needed into the distinctive biomechanics of preterm infant pigs.
Catchpole Emily; Bond Laura; German Rebecca; Mayerl Christopher J; Stricklen Bethany; Gould François D H
Dysphagia
2019
2019-07
<a href="http://doi.org/10.1007/s00455-019-10033-w" target="_blank" rel="noreferrer noopener">10.1007/s00455-019-10033-w</a>
Maturation of the Coordination Between Respiration and Deglutition with and Without Recurrent Laryngeal Nerve Lesion in an Animal Model.
*Animal model; *Deglutition; *Development; *Infant; *Recurrent laryngeal nerve; *Respiration; *Sensorimotor; Animal; Animal Population Groups; Animals; Biological; Deglutition – Physiology; Deglutition Disorders; Deglutition/*physiology; Disease Models; Humans; Laryngeal Nerves – Injuries; Laryngeal Nerves – Physiology; Larynx – Physiology; Larynx/*physiology; Models; Newborn; Questionnaires; Recurrent Laryngeal Nerve Injuries/*complications; Recurrent Laryngeal Nerve/physiology; Respiration; Swine
The timing of the occurrence of a swallow in a respiratory cycle is critical for safe swallowing, and changes with infant development. Infants with damage to the recurrent laryngeal nerve, which receives sensory information from the larynx and supplies the intrinsic muscles of the larynx, experience a significant incidence of dysphagia. Using our validated infant pig model, we determined the interaction between this nerve damage and the coordination between respiration and swallowing during postnatal development. We recorded 23 infant pigs at two ages (neonatal and older, pre-weaning) feeding on milk with barium using simultaneous high-speed videofluoroscopy and measurements of thoracic movement. With a complete linear model, we tested for changes with maturation, and whether these changes are the same in control and lesioned individuals. We found (1) the timing of swallowing and respiration coordination changes with maturation; (2) no overall effect of RLN lesion on the timing of coordination, but (3) a greater magnitude of maturational change occurs with RLN injury. We also determined that animals with no surgical intervention did not differ from animals that had surgery for marker placement and a sham procedure for nerve lesion. The coordination between respiration and swallowing changes in normal, intact individuals to provide increased airway protection prior to weaning. Further, in animals with an RLN lesion, the maturation process has a larger effect. Finally, these results suggest a high level of brainstem sensorimotor interactions with respect to these two functions.
Ballester Ashley; Gould Francois; Bond Laura; Stricklen Bethany; Ohlemacher Jocelyn; Gross Andrew; DeLozier Katherine R; Buddington Randall; Buddington Karyl; Danos Nicole; German Rebecca
Dysphagia
2018
2018-10
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.1007/s00455-018-9881-z" target="_blank" rel="noreferrer noopener">10.1007/s00455-018-9881-z</a>