pharyngeal swallow stage

1) Delayed Pharyngeal Swallow

Bolus enters pharynx and pharyngeal swallow has not
triggered

Elevation of larynx and hyoid are first events that serve
as marker for triggering pharyngeal swallow

2) Nasal penetration
during swallow

Indicative of
reduced
velopharyngeal
closure

3) Pseudoepiglottis (after total laryngectomy):

Fold of mucosa at base of tongue acts as epiglottis

Cervical osteophytes:

Bony outgrowths from
cervical vertebrae

5) Unilateral pharyngeal wall weakness:

Residue on one side of pharynx. Food
clings to pharyngeal wall and collects in
pyriform sinus on that side

6)Reduced pharyngeal contraction

Leaves coating on pharyngeal walls

Impaired epiglottic function

Rigid or absent:
■ Incomplete or prolonged inversion:
■ Retroverted shape

8) Reduced tongue base movement

■ Lingual paralysis may result in reduced ability of the tongue
base to retract, resulting in decreased pressure in pharynx
■ May cause unilateral or bilateral vallecular residue following
the pharyngeal swallow

9) Reduced laryngeal elevation

• Results in residue at top of airway

10) Laryngeal penetration and/or aspiration after swallow

Reduced closure of the airway entrance

11) Aspiration DURING swallow

Reduced laryngeal closure

12) Residue in both pyriform sinuses

• May be result of reduced anterior laryngeal motion, and/or
  cricopharyngeal dysfunction or stricture

13) Residue throughout pharynx

Pharyngeal transit time
less than 1 second regardless of
patient’s age or food consistency.

14) UES Dysfunction

Reduced opening of UES resulting in pharyngeal residue