Table 1 - Postures: the change in pharyngeal dimensions or gravity's effect on food flow26, 56, 57
From the following article
Medical and rehabilitative therapy of oral, pharyngeal motor disorders
Jeri A. Logemann
GI Motility online (2006)
doi:10.1038/gimo50
| Disorder observed on fluoroscopy | Posture applied | Rationale |
|---|---|---|
| Inefficient oral transit (reduces postpropulsion of bolus by tongue) | Head back | Utilizes gravity to clear oral cavity |
| Delay in triggering the pharyngeal swallow (bolus past ramus of mandible but pharyngeal swallow is not triggered) | Chin down27, 58 | Widens valleculae, narrows airway entrance to prevent bolus entering airway |
| Reduced postpropulsion motion of tongue base (residue in valleculae) | Chin down58 | Pushes tongue base backward toward pharyngeal wall |
| Unilateral laryngeal dysfunction (aspiration during the swallow) | Head rotated to damaged side | Places extrinsic pressure on thyroid cartilage, increasing adduction |
| Reduced laryngeal closure (aspiration during the swallow) | Chin down Head rotated to damaged side | Puts epiglottis in more protective position; narrows laryngeal entrance; increases vocal fold closure by applying extrinsic pressure |
| Reduced pharyngeal contraction (residue spread throughout pharynx) | Lying down on one side55 | Eliminates gravitational effect on pharyngeal residue |
| Unilateral pharyngeal paresis (residue on one side of pharynx) | Head rotated to damaged side59 | Eliminates damaged side from bolus path |
| Unilateral oropharyngeal weakness on the same side (residue in mouth and pharynx on same side) | Head tilt to stronger side | Directs bolus down stronger side |
| Cricopharyngeal dysfunction (residue in pyriform sinuses) | Head rotated to damaged side60 | Pulls cricoid cartilage away from posterior pharyngeal wall reducing resting pressure in cp. sphincter |
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