Pharyngeal transit adaptation to bolus volume and consistency in Chagas' disease

Background: Esophageal Chagas' disease causes a longer pharyngeal bolus clearance, which may be an adaptation to the impairment of esophageal bolus transit. This adaptation should be present when we change volume or consistency of the swallowed bolus. Methods: By the videofluoroscopic method, the correlation was calculated between bolus volumes of 5 and 10mL, and consistencies liquid and paste on pharyngeal clearance duration and hyoid movement duration using the Pearson correlation coefficient (r). It was evaluated 17 patients with Chagas' disease and 15 normal volunteers. Results: In both groups, there was no correlation between the pharyngeal clearance duration and the hyoid movement duration. In pharyngeal clearance there was a positive correlation between the volumes of 5 and 10mL and between liquid and paste boluses in patients with Chagas' disease, but not in controls. In hyoid movement duration the correlation between the volumes of 5 and 10mL was positive and significant in Chagas' disease patients for liquid and paste bolus, and only for paste in controls. Conclusion: Patients with Chagas' disease have a positive correlation of bolus flow through the pharynx related to change in bolus volume and bolus consistency, which suggested that they have a more important control of pharyngeal flow related to bolus volume and consistency than normal volunteers...(AU) Justificativa: Envolvimento do esofago pela doenca de Chagas provoca aumento na duracao da depuracao da faringe, o que pode ser uma adaptacao consequente ao comprometimento do trânsito do bolo pelo esofago. Esta adaptacao deve estar presente quando variamos o volume e consistencia do bolo deglutido. Metodos: Foi realizada, com o metodo videofluoroscopico, avaliacao da duracao da depuracao faringea e da duracao do movimento do osso hioide com a degluticao de bolos de 5 e 10mL, e consistencias liquida e pastosa em 17 pacientes com doenca de Chagas e 15 voluntarios saudaveis. Foi calculada a correla­cao entre os resultados por meio do coeficiente de correlacao de Pearson (r). Resultados: Em pacientes com doenca de Chagas e voluntarios, nao houve correlacao entre a duracao da depuracao da faringe e da duracao do movimento do hioide. Em pacientes com doenca de Chagas, na depuracao da faringe, houve correlacao positiva entre os volumes de 5 e 10mL e entre bolos liquido e pastoso, o que nao foi observado nos voluntarios. Na duracao do movimento do hioide a correlacao entre os volumes de 5 e 10mL foi positiva e significativa em pacientes com doenca de Chagas para bolo liquido e pastoso, e apenas para pastoso nos voluntarios. Conclusao: Pacientes com doenca de Chagas tem correlacao positiva do fluxo pela faringe relacionada com a alteracao no volume e consistencia do bolo, o que sugere um maior controle do fluxo pela faringe do que o observado em voluntarios normais...(AU)