Voice and dysphagia

Abstract

The anatomical interaction between the upper respiratory and digestive tracts conditions the smooth running of their functions: breathing, swallowing, and voice articulation. The phylogenetic evolution of our species has rendered possible the optimum integration of these functions, creating the conditions for an extremely refined timing. This functional optimization has facilitated the phono-articulatory function with the possibility of highly skilled aesthetic results, as in artistic voice production. This anatomical integrity is essential for a proper and optimal functioning. Anatomical alteration may change a function, just as a functional alteration may facilitate, in the presence of comorbidity, anatomical changes. In singing, for example, the physiological adjustments required to produce a more resonant voice can alter, over time, the physiology of structures involved in swallowing. The lowering of the laryngotracheal axis, which facilitates the mechanisms of articulation and vocal projection, may affect the timing of swallowing. The pressures usually required in singing can modify the functioning of the valves between the chest and abdominal cavities. The chapter reviews the main changes in the physiology and physiopathology of the upper respiratory and digestive tracts and the impact that artistic vocal performances have on swallowing. Similar considerations are made for other voice users. The chapter concludes with a review of the literature on the topic.