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Disorders of Pharyngeal and Upper Esophageal Sphincter Motor Function

William J. Kilman, MD; Raj K. Goyal, MD
Arch Intern Med. 1976;136(5):592-601. doi:10.1001/archinte.1976.03630050070012.
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Buccopharyngeal motor disorders causing difficulties in swallowing are frequently encountered in clinical medicine. Affected patients manifest distinctive clinical features and pose special problems in their management. We summarize the pathogenesis, consequences, evaluation, and treatment of the motor disorders of buccopharyngeal swallowing. We also describe some selected clinical conditions that are associated with buccopharyngeal dysphagia.


Disorders of Buccal Phase of Swallowing  In the initial stages, before active deglutition, the oral cavity prepares the bolus for deglutition. The oral cavity makes room for the bolus by initial depression and grooving of the tongue, elevation of soft palate, and relaxation of the palatoglossus and palatopharyngeus muscles.1 The bolus is then pumped into the oropharynx by the progressive anteroposterior contractile sequence of the tongue. The oral phase is under voluntary control.2,3Weakness of buccal muscles, which are supplied by the seventh cranial nerve, may lead to


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