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Logo for the Journal of Rehab R&D
Vol. 35 No. 3, July 1998
Pages 327-334

Mathematical modeling of normal pharyngeal bolus transport: A preliminary study

Michael W. Chang, MD, PhD; Brigette Rosendall, MS; Bruce A. Finlayson, PhD

Departments of Rehabilitation Medicine and of Chemical Engineering, University of Washington, Seattle, WA 98195
This material is based upon work supported, in part, by a biomedical engineering research grant from the Whitaker Foundation.
Address all correspondence and requests for reprints to: Michael W. Chang, MD, PhD, University of Washington, Department of Rehabilitation Medicine, Box 356490, Seattle, WA 98195; email: mwc@u.washington.edu.

Abstract—Dysphagia (difficulty in swallowing) is a common clinical symptom associated with many diseases, such as stroke, multiple sclerosis, neuromuscular diseases, and cancer. Its complications include choking, aspiration, malnutrition, cachexia, and dehydration. The goal in dysphagia management is to provide adequate nutrition and hydration while minimizing the risk of choking and aspiration. It is important to advance the client toward oral feeding in a timely manner to enhance the recovery of swallowing function and preserve the quality of life. Current clinical assessments of dysphagia are limited in providing adequate guidelines for oral feeding.
Mathematical modeling of the fluid dynamics of pharyngeal bolus transport provides a unique opportunity for studying the physiology and pathophysiology of swallowing. Finite element analysis (FEA) is a special case of computational fluid dynamics (CFD). In CFD, the flow of a fluid in a space is modeled by covering the space with a grid and predicting how the fluid moves from grid point to grid point. FEA is capable of solving problems with complex geometries and free surfaces.
A preliminary pharyngeal model has been constructed using FEA. This model incorporates literature-reported, normal, anatomical data with time-dependent pharyngeal/upper esophageal sphincter (UES) wall motion obtained from videofluorography (VFG). This time-dependent wall motion can be implemented as a moving boundary condition in the model. Clinical kinematic data can be digitized from VFG studies to construct and test the mathematical model. The preliminary model demonstrates the feasibility of modeling pharyngeal bolus transport, which, to our knowledge, has not been attempted before. This model also addresses the need and the potential for CFD in understanding the physiology and pathophysiology of the pharyngeal phase of swallowing. Improvements of the model are underway. Combining the model with individualized clinical data should potentially improve the management of dysphagia.

Key words: mathematical modeling, pharyngeal bolus transport, swallowing.


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