Protecting the airway during swallowing: what is the role for afferent surveillance?

Abstract

Mechanoreceptors are ubiquitous throughout the upper aerodigestive tract and provide spatiotemporal information on movement and stretch of muscles and connective tissues involved in feeding. Experimental studies in humans suggest that upper airway sensory signals provide important tonic and kinesthetic feedback to central neural circuits underlying upper airway perception and laryngeal closure during swallowing. These circuits include brainstem and cortical feedforward loops that facilitate swallowing function. A clinical implication of this organization is the potential to harness the sensory system for enhancing laryngeal closure during swallowing. Therapeutic sensory stimulation is a promising method for treating dysphagia and preventing aspiration pneumonia in patients with cortical lesions.