The Blind Scientists and the Elephant of Swallowing: A Review of Instrumental Perspectives on Swallowing Physiology
Swallowing is a complex biomechanical process. In this review, several different techniques for measuring swallowing physiology are described, and limitations of each instrumental perspective are discussed. The techniques discussed include videofluoroscopy, endoscopy, three dimensional dynamic computed tomography imaging, ultrasound, electromagnetic articulography, electromyography, lingual and pharyngeal manometry, electropalatography, airflow measurement, and swallowing acoustics/accelerometry. It is hoped that this review will inform scientists in the food oral processing field regarding methods that may be useful for capturing relevant features of swallowing behavior across different food textures and liquid consistencies. Likewise, it is hoped that the delineation of current gaps in knowledge will reveal topics of shared interest for swallowing and food oral scientists as a first step toward future collaboration. Practical Applications Swallowing is something that we take for granted, but is actually a complicated biomechanical activity involving many muscles. The process of swallowing can be studied or measured using a variety of different clinical and instrumental techniques. In this review article, the strengths and limitations of several different instrumental approaches to measuring swallowing behaviours are discussed. An extensive reference list is provided to original articles using these different techniques.