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Tumani Üstdal B, Evlice B, Soydan Çabuk D, Duyan Yüksel H, Güner Akgül İ, Alkaya B, Arçay G. Evaluation of the thickness of masticatory muscles in patients with chronic periodontitis by ultrasonography. Oral Radiol 2024; 40:402-408. [PMID: 38558244 DOI: 10.1007/s11282-024-00746-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 03/06/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES Periodontitis is one of the most common chronic inflammatory diseases. It causes changes in the biting abilities of individuals. However, periodontal treatment has positive effects on masticatory function. The aim of this study is to determine the effect of periodontitis and periodontal treatment on masticatory abilities by measuring masseter and temporal muscle thicknesses with ultrasonography before and after periodontal treatment in chronic periodontitis patients. METHODS The patients included in the study were determined by clinical and radiological examination. The thickness of the masseter and temporal muscles of the patients were measured by ultrasonography. Periodontal measurements and treatments of the patients were completed by a single physician. IBM SPSS 20.0 (IBM Corp., Armonk, NY) statistical program was used for statistical analysis. RESULTS A statistically significant difference was found between the values of periodontal measurements before and after treatment (p<0.05). In the ultrasonography measurements of the thickness of masseter and anterior temporal muscles, a statistically significant increase was observed in both rest and contraction values at all time intervals (p<0.05). Muscle thicknesses of male patients were higher than female patients. CONCLUSIONS Periodontitis negatively affects the masticatory performance of individuals. Chronic periodontitis patients should be referred for periodontal treatment without wasting time.
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Affiliation(s)
- Berkhas Tumani Üstdal
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Çukurova University, Adana, Turkey.
| | - Burcu Evlice
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Çukurova University, Adana, Turkey
| | - Damla Soydan Çabuk
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Çukurova University, Adana, Turkey
| | - Hazal Duyan Yüksel
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Çukurova University, Adana, Turkey
| | - İmran Güner Akgül
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Çukurova University, Adana, Turkey
| | - Bahar Alkaya
- Department of Periodontology, Faculty of Dentistry, Çukurova University, Adana, Turkey
| | - Gökçe Arçay
- Department of Periodontology, Faculty of Dentistry, Çukurova University, Adana, Turkey
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Vander Cruyssen E, van de Ven J, Dik E, Knuijt S. The feasibility of visualizing and quantifying muscle changes in postoperative oral cancer patients using Quantitative Muscle Ultrasound (QMUS). J Ultrasound 2024:10.1007/s40477-024-00910-y. [PMID: 38896395 DOI: 10.1007/s40477-024-00910-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 04/24/2024] [Indexed: 06/21/2024] Open
Abstract
PURPOSE Quantitative muscle ultrasound (QMUS) is a patient friendly tool for examining orofacial muscles. Resection of tissue can have an effect on the architecture and function of these muscles. The aim of this study is to investigate the feasibility of visualizing and quantifying muscle changes in postoperative oral cancer patients and to relate the findings to tumor and patient characteristics. METHODS Adult patients with a resected first primary pT1 or T2 oral squamous cell carcinoma, at least one year post operatively, where included. Ultrasound data were collected of the geniohyoid muscle, digastric muscles, masseter muscle, transverse muscle and genioglossus muscle. Ultrasound images were labeled as clearly visible, questionable or unclear. Of the clear muscles, echogenicity and muscle thickness were measured. RESULTS 37 patients were included. The masseter muscle was clearly visible in all ultrasound images, both intrinsic tongue muscles had the lowest visibility (45.9%). There was a significant correlation between visibility and tumor localization for the genioglossus (p = 0.029). Age correlated with the visibility of the genioglossus muscle, BMI with the genioglossus and transverse muscles. Echogenicity and muscle thickness of the clearly identified muscles did not differ from normative values. CONCLUSION QMUS of orofacial muscles is feasible in postoperative oral cancer patients with relatively small tumor sizes. Tongue resections negatively affected the visibility of the two intrinsic tongue muscles. These preliminary results for particular muscles indicate that the use of ultrasound might be promising in oral cancer patients to help determine targeted goals in post-operative rehabilitation.
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Affiliation(s)
- Emily Vander Cruyssen
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Rehabilitation, Regional Hospital Tienen (RZ Tienen), Tienen, Belgium
| | - Jelmer van de Ven
- Faculty of Medical Sciences, Radboud University, Nijmegen, The Netherlands
| | - Eric Dik
- Department of Oral and Maxillofacial Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Simone Knuijt
- Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
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Kelly E, Nazeer S, Fazzini B, Sutt AL, Olusanya S, Campion T, Puthucheary Z. Assessing the oral and suprahyoid muscles in healthy adults using muscle ultrasound to inform the swallowing process: a proof-of-concept study. Sci Rep 2024; 14:13198. [PMID: 38851791 PMCID: PMC11162466 DOI: 10.1038/s41598-024-62032-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 05/13/2024] [Indexed: 06/10/2024] Open
Abstract
The oral and suprahyoid muscles are responsible for movements of swallowing. Our study aimed to determine the reproducibility of static and dynamic measurements of these muscles using bedside ultrasound equipment. Forty healthy participants were recruited prospectively. Primary outcomes were evaluation of mass measurements of the anterior bellies of the digastric, mylohyoid, geniohyoid and tongue in B-mode ultrasound. Secondary outcomes were evaluation of geniohyoid muscle layer thickness and function using M-mode. Muscle mass measurements demonstrated little within-participant variability. Coefficient of Variance (CoV) across muscles were: anterior belly digastric (5.0%), mylohyoid (8.7%), geniohyoid (5.0%) and tongue (3.2%). A relationship between sex (r2 = 0.131 p = 0.022) was demonstrated for the geniohyoid muscle, with males having higher transverse Cross Sectional Area (CSA) (14.3 ± 3.6 mm vs. 11.9 ± 2.5 mm, p = 0.002). Tongue size was correlated with weight (r2 = 0.356, p = 0.001), height (r2 = 0.156, p = 0.012) and sex (r2 = 0.196, p = 0.004). Resting thickness of the geniohyoid muscle layer changed with increasing bolus sizes (f = 3.898, p = 0.026). Velocity increased with bolus size (p = < 0.001, F = 8.974). However swallow time and slope distance did not, potentially influenced by higher coefficients of variation. Oral and suprahyoid muscle mass are easily assessed using bedside ultrasound. Ultrasound may provide new information about muscle mass and function during swallowing.
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Affiliation(s)
- Eileen Kelly
- Adult Critical Care Unit, The Royal London Hospital, Barts Health NHS Trust, London, E1 1BB, UK.
- Critical Care and Perioperative Medicine Research Group, William Harvey Research Institute, Queen Mary University of London, London, UK.
- Department of Speech and Language Therapy, The Royal London Hospital, Barts Health NHS Trust, London, UK.
| | - Saira Nazeer
- Adult Critical Care Unit, The Royal London Hospital, Barts Health NHS Trust, London, E1 1BB, UK
- Critical Care and Perioperative Medicine Research Group, William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Brigitta Fazzini
- Adult Critical Care Unit, The Royal London Hospital, Barts Health NHS Trust, London, E1 1BB, UK
- Critical Care and Perioperative Medicine Research Group, William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Anna-Liisa Sutt
- Department of Speech and Language Therapy, The Royal London Hospital, Barts Health NHS Trust, London, UK
- Critical Care Research Group, Institute of Molecular Bioscience, University of Queensland, Brisbane, Australia
| | - Segun Olusanya
- Consultant in Intensive Care Medicine and ECMO, Department of Perioperative Medicine, Barts Heart Centre, London, UK
| | - Thomas Campion
- Consultant Head and Neck Neck/Neuroradiologist, The Royal London Hospital, Barts Health NHS Trust, London, UK
| | - Zudin Puthucheary
- Adult Critical Care Unit, The Royal London Hospital, Barts Health NHS Trust, London, E1 1BB, UK
- Critical Care and Perioperative Medicine Research Group, William Harvey Research Institute, Queen Mary University of London, London, UK
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4
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Pauloski BR, Yahnke KM. Reliability of Measuring Geniohyoid Cross-Sectional Area with B-Mode Ultrasound. Dysphagia 2024:10.1007/s00455-024-10712-3. [PMID: 38789680 DOI: 10.1007/s00455-024-10712-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 04/19/2024] [Indexed: 05/26/2024]
Abstract
B-mode ultrasound is a safe noninvasive procedure that has been used to characterize aspects of the oropharyngeal swallow. The submental suprahyoid muscles are often investigated with ultrasound because of their contributions to hyolaryngeal elevation. There are several techniques for positioning the ultrasound transducer in the coronal plane, however, there is limited research on how reliability of measurement of the cross-sectional area (CSA) of the geniohyoid differs across transducer placement technique. This study examined three methods of transducer placement in the coronal plane by two examiners to determine the reliability of measurement of CSA of the geniohyoid muscle. Forty healthy adults participated in the study. Each participant's geniohyoid muscles were imaged using B-mode ultrasound under three transducer placement conditions in the coronal plane by two examiners. Geniohyoid CSA was measured from each ultrasound image. A three-way mixed-methods ANOVA was used to determine whether there were significant differences in geniohyoid CSA among transducer position conditions, trials, and examiners. There were significant differences among the transducer placement conditions, indicating that each condition was measuring a different portion of the muscle. There were no significant differences among repeated trials nor between examiners within each method of transducer placement. All three conditions of transducer placement were reliable at measuring geniohyoid CSA across trials and examiners. This study emphasizes the need for consistency of placement, whichever method is selected. It also highlights the need for researchers to provide a precise description of methods for positioning the transducer so that placement is reproducible.
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Affiliation(s)
- Barbara R Pauloski
- Department of Communication Sciences and Disorders, College of Health Sciences, University of Wisconsin Milwaukee, 2400 E. Hartford Avenue, Suite 840, Milwaukee, WI, 53211, USA.
| | - Kacey M Yahnke
- Department of Communication Sciences and Disorders, College of Health Sciences, University of Wisconsin Milwaukee, 2400 E. Hartford Avenue, Suite 840, Milwaukee, WI, 53211, USA
- Manhattan Star Academy, 180 Amsterdam Avenue, New York, NY, 10023, USA
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5
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Wu Y, Guo K, Chu Y, Wang Z, Yang H, Zhang J. Advancements and Challenges in Non-Invasive Sensor Technologies for Swallowing Assessment: A Review. Bioengineering (Basel) 2024; 11:430. [PMID: 38790297 PMCID: PMC11118896 DOI: 10.3390/bioengineering11050430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/20/2024] [Accepted: 04/25/2024] [Indexed: 05/26/2024] Open
Abstract
Dysphagia is a pervasive health issue that impacts diverse demographic groups worldwide, particularly the elderly, stroke survivors, and those suffering from neurological disorders. This condition poses substantial health risks, including malnutrition, respiratory complications, and increased mortality. Additionally, it exacerbates economic burdens by extending hospital stays and escalating healthcare costs. Given that this disorder is frequently underestimated in vulnerable populations, there is an urgent need for enhanced diagnostic and therapeutic strategies. Traditional diagnostic tools such as the videofluoroscopic swallowing study (VFSS) and flexible endoscopic evaluation of swallowing (FEES) require interpretation by clinical experts and may lead to complications. In contrast, non-invasive sensors offer a more comfortable and convenient approach for assessing swallowing function. This review systematically examines recent advancements in non-invasive swallowing function detection devices, focusing on the validation of the device designs and their implementation in clinical practice. Moreover, this review discusses the swallowing process and the associated biomechanics, providing a theoretical foundation for the technologies discussed. It is hoped that this comprehensive overview will facilitate a paradigm shift in swallowing assessments, steering the development of technologies towards more accessible and accurate diagnostic tools, thereby improving patient care and treatment outcomes.
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Affiliation(s)
- Yuwen Wu
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China
| | - Kai Guo
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China
| | - Yuyi Chu
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China
| | - Zhisen Wang
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China
| | - Hongbo Yang
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China
| | - Juzhong Zhang
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou 215163, China
- School of Biomedical Engineering (Suzhou), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei 230026, China
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van der Heul AMB, Nievelstein RAJ, van Eijk RPA, Asselman F, Erasmus CE, Cuppen I, Bittermann AJN, Gerrits E, van der Pol WL, van den Engel-Hoek L. Swallowing Problems in Spinal Muscular Atrophy Types 2 and 3: A Clinical, Videofluoroscopic and Ultrasound Study. J Neuromuscul Dis 2023; 10:427-438. [PMID: 37005890 DOI: 10.3233/jnd-221640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
Abstract
Background: Spinal muscular atrophy (SMA) is a hereditary motor neuron disorder, characterized by the degeneration of motor neurons and progressive muscle weakness. There is a large variability of disease severity, reflected by the classification of SMA types 1–4. Objective: The aim of this cross-sectional study was to determine the nature of swallowing problems and underlying mechanisms in patients with SMA types 2 and 3, and the relationship between swallowing and mastication problems. Methods: We enrolled patients (aged 13–67 years) with self-reported swallowing and/or mastication problems. We used a questionnaire, the functional oral intake scale, clinical tests (dysphagia limit, and timed test swallowing, the test of mastication and swallowing solids), a videofluoroscopic swallowing study (VFSS), and muscle ultrasound of the bulbar muscles (i.e. digastric, geniohyoid and tongue muscles). Results: Non-ambulant patients (n = 24) had a reduced dysphagia limit (median 13 ml (3–45), and a swallowing rate at the limit of normal (median 10 ml/sec (range 4–25 ml). VFSS revealed piecemeal deglutition and hypo-pharyngeal residue. We found pharyngo-oral regurgitation in fourteen patients (58%), i.e. they transported the residue from the hypopharynx back into the oral cavity and re-swallowed it. Six patients (25%) demonstrated impaired swallowing safety (i.e. PAS >3). Muscle ultrasound revealed an abnormal muscle structure of the submental and tongue muscles. Ambulant patients (n = 3), had a normal dysphagia limit and swallowing rate, but VFSS showed hypo-pharyngeal residue, and muscle ultrasound demonstrated an abnormal echogenicity of the tongue. Swallowing problems were associated with mastication problems (p = 0.001).
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Affiliation(s)
- A M B van der Heul
- Department of Neurology & Neurosurgery, UMC Utrecht, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R A J Nievelstein
- Department of Radiology & Nuclear Medicine, Imaging & Oncology Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R P A van Eijk
- Department of Neurology & Neurosurgery, UMC Utrecht, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Biostatistics & Research Support, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - F Asselman
- Department of Neurology & Neurosurgery, UMC Utrecht, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - C E Erasmus
- Department of Pediatric Neurology, Donders Center for Neuroscience, Radboud University Medical Center, Amalia Children's Hospital, Nijmegen, The Netherlands
| | - I Cuppen
- Department of Neurology & Neurosurgery, UMC Utrecht, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - A J N Bittermann
- Department of Otorhinolaryngology-Head and Neck Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - E Gerrits
- Department of Languages, Literature and Communication, Utrecht Institute of Linguistics OTS, Utrecht University, Utrecht, The Netherlands
| | - W L van der Pol
- Department of Neurology & Neurosurgery, UMC Utrecht, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - L van den Engel-Hoek
- Department of Rehabilitation, Donders Center for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
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Potente P, Buoite Stella A, Vidotto M, Passerini M, Furlanis G, Naccarato M, Manganotti P. Application of Ultrasonography in Neurogenic Dysphagia: A Systematic Review. Dysphagia 2023; 38:65-75. [PMID: 35556172 PMCID: PMC9873712 DOI: 10.1007/s00455-022-10459-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 04/22/2022] [Indexed: 01/28/2023]
Abstract
Swallowing disorders are common in neurological diseases, with dysphagia representing one of the most prevalent complications that may cause poor quality of life, reduce independence, and increase mortality. Rapid identification of dysphagia is necessary to reduce the risk of penetration and aspiration, and to early start rehabilitation protocols. Among the methods that can be used to evaluate dysphagia and its components, ultrasound imaging has been suggested to support the evaluation of dysphagia by providing measures of both static and dynamic anatomical components. The aim of this systematic review is to evaluate the usefulness of ultrasonography in neurogenic dysphagia according to current literature. From 2000 to 2020, 633 studies with the appropriate search terms for ultrasound and dysphagia were identified. After screening them, 10 studies were included in the qualitative analysis. Patients with the following neurologic conditions were studied with ultrasonography for dysphagia: Parkinson's disease, muscle dystrophy, amyotrophic lateral sclerosis, and stroke. The main outcomes of ultrasonography were swallowing muscles thickness (e.g., tongue), and dynamic measures such as hyoid displacement. The different protocols used in the studies, as well as their outcomes, did not allow to provide standard procedures and normative or cut-off values in the presented diseases. Because there are a variety of tools, methods, and techniques that have been used in the studies that were reviewed, it is difficult to evaluate them using established standards. However, ultrasonography correlates well with clinical evaluation of dysphagia and therefore has prognostic and rehabilitation potential. Future studies should aim to develop and utilize a common interdisciplinary protocol that includes standard procedures and outcomes to define normative values applicable in the different conditions.
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Affiliation(s)
- Paola Potente
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital of Trieste ASUGI, University of Trieste, Strada di Fiume 447, 34100, Trieste, Italy
| | - Alex Buoite Stella
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital of Trieste ASUGI, University of Trieste, Strada di Fiume 447, 34100, Trieste, Italy
| | - Monica Vidotto
- School of Speech and Language Therapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Michelle Passerini
- School of Speech and Language Therapy, Department of Medicine, Surgery and Health Sciences, University of Trieste, Trieste, Italy
| | - Giovanni Furlanis
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital of Trieste ASUGI, University of Trieste, Strada di Fiume 447, 34100, Trieste, Italy
| | - Marcello Naccarato
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital of Trieste ASUGI, University of Trieste, Strada di Fiume 447, 34100, Trieste, Italy
| | - Paolo Manganotti
- Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, University Hospital of Trieste ASUGI, University of Trieste, Strada di Fiume 447, 34100, Trieste, Italy.
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Akat B, Görür SA, Bayrak A, Eren H, Eres N, Erkcan Y, Kılıçarslan MA, Orhan K. Ultrasonographic and electromyographic evaluation of three types of occlusal splints on masticatory muscle activity, thickness, and length in patients with bruxism. Cranio 2023; 41:59-68. [PMID: 32936747 DOI: 10.1080/08869634.2020.1820685] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate occlusal splint type differences in patients with bruxism. METHODS Seventeen controls and 51 patients were divided into three subgroups, each assigned to use a different occlusal splint (hard, soft, or semi-soft) for 3 months and assessed by ultrasonography and electromyography (EMG) before (BT) and 3 months after treatment (AT). RESULTS EMG values in all of the occlusal splint groups were significantly lower AT than BT (p < 0.05). BT and AT EMG values in the control group did not differ. Mean muscle thicknesses in bruxism patients was greater than in controls, and the greatest muscle thickness changes occurred with the hard occlusal splint (p < 0.05). DISCUSSION A decrease in EMG activity occurred with all three splint types and was most prominent in the hard occlusal splint group. Ultrasonographic measurements of muscle length and thickness should be used alongside EMG to measure muscle activity in bruxism patients.
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Affiliation(s)
- Bora Akat
- Department of Prosthodontics, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - Sinem Atay Görür
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - Ayben Bayrak
- Department of Prosthodontics, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - Hakan Eren
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - Necati Eres
- Department of Prosthodontics, Faculty of Dentistry, University of Lokman Hekim, Ankara, Turkey
| | - Yezdan Erkcan
- Department of Prosthodontics, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - Mehmet Ali Kılıçarslan
- Department of Prosthodontics, Faculty of Dentistry, University of Ankara, Ankara, Turkey
| | - Kaan Orhan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, University of Ankara, Ankara, Turkey
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Zhang X, Lin F, Ma F, Cui S, OuYang G. Application Value of Flexible Endoscopic Examination of Swallowing in Acute Stoke Patients With Dysphagia. Neurologist 2022; 27:245-248. [PMID: 34873113 PMCID: PMC9439686 DOI: 10.1097/nrl.0000000000000401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND The aim was to study the application value of flexible endoscopic examination of swallowing (FEES) for the aspiration screening, the diagnosis of dysphagia and evaluation of the therapeutic effect in acute stoke patients with dysphagia. METHODS A total of 525 patients with acute stoke who were hospitalized from October 2015 to January 2021 in the Rehabilitation Medicine Department of our hospital underwent FEES for analyzing the characteristic performance. Twenty-one cases of them were examined by video fluoroscopic swallow study and compared with the results of FEES for evaluating the reliability of the FEES, the reliability of diagnosis of dysphagia, and the consistency of the 2 methods. The effect of rehabilitation was evaluated by comparing the FEES test results before and after treatment. RESULTS In 525 patients, the FEES revealed 378 cases of aspiration (139 cases were silent aspiration), showing a higher detection rate than water swallow test. Patients with potential cricopharyngeus achalasia got the same results through both of examinations. FEES can provide more positive indicators, guide clinical rehabilitation treatment and objectively assess the effect of rehabilitation. CONCLUSIONS Acute stoke patients with dysphagia have characteristic pharyngeal and laryngeal performance. FEES is simple to operate and has high application value in the diagnosis and treatment of dysphagia.
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Affiliation(s)
| | | | - Fumei Ma
- Dalian Municipal Central Hospital
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10
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Fathy S, Abdelrhman IG, Aggour RL. Ultrasonographic evaluation of the masseter muscle in temporomandibular disorders patients with myofascial pain: A case-control observational study. Cranio 2022:1-7. [PMID: 35616982 DOI: 10.1080/08869634.2022.2080961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To investigate ultrasonographic changes of masseter muscle (MM) in patients with myofascial pain disorder (MPD) and possible correlations with clinical features. METHODS The study included 20 MPD patients and 20 healthy volunteers. Masseter muscle thickness (MMT) and the echogenic pattern were ultrasonographically evaluated. The maximum interincisal opening (MIO), duration of symptoms, and pain level were evaluated for correlations with MMT. RESULTS At relaxation, MMT was greater in the test group (p < 0.05); however, the percentage of increase in MMT from relaxation to contraction was greater in controls (p < 0.05). In MPD patients, the echogenic pattern differed significantly from controls. In MPD patients, a strong positive correlation was found between MMT and pain level, while a moderate negative correlation was found between MMT and both the duration of symptoms and MIO. CONCLUSION Ultrasound is an adjunctive method for complementing the assessment of the MM condition in MPD patients.
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Affiliation(s)
- Shereen Fathy
- Department of Oral Medicine & Periodontology, Faculty of Dentistry, October 6 University, Giza, Egypt
| | | | - Reham Lotfy Aggour
- Department of Oral Medicine & Periodontology, Faculty of Dentistry, October 6 University, Giza, Egypt
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11
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Viviers M, Edwards L, Asir M, Hibberd J, Rowe R, Phillips S, Thomas V, Keesing M, Sugar A, Allen J. Enhanced rapid review of the applicability of ultrasound in the assessment of sucking, swallowing and laryngeal function in the paediatric population. INTERNATIONAL JOURNAL OF LANGUAGE & COMMUNICATION DISORDERS 2022; 57:422-440. [PMID: 35060665 DOI: 10.1111/1460-6984.12695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/26/2021] [Accepted: 12/09/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has renewed interest in the use of ultrasound (US) amongst dysphagia-trained clinicians working with infants and children. US is a portable, minimally intrusive tool which carries reduced risk of aerosol-generation provoked by other instrumental swallowing assessment tools such as fibreoptic endoscopic evaluation of swallowing (FEES). For this reason, US could be a valuable addition to the dysphagia assessment toolkit. A recently published rapid review of US evidence for the assessment of swallowing and laryngeal function in the adult population provided a framework for this neonatal and paediatric review. AIMS This enhanced rapid review aimed to establish the applicability of US as an instrumental assessment tool for sucking, swallowing and laryngeal function in the neonatal and paediatric populations. METHODS & PROCEDURES A rapid review of six electronic databases was conducted to identify articles using US to assess sucking, swallowing or laryngeal function in the selected populations, compared with varied reference tests. Abstract screening was completed according to pre-defined inclusion/exclusion criteria with 10% of articles assessed by a second screener. Data was extracted from the included studies using a pre-developed form. A modified QUADAS-2 tool was used to assess study quality. Results from the included studies were summarised and grouped into sucking, swallowing and laryngeal function data. OUTCOMES & RESULTS Twelve studies using US in the assessment of swallowing and/or laryngeal function met inclusion criteria. No studies using US for assessment of sucking met the inclusion criteria. All were peer-reviewed, primary studies across a range of clinical populations and with a wide geographical spread. Five studies had an overall low risk of bias. Seven studies had at least one domain where risk of bias was judged as high. All studies had high applicability. The two studies assessing swallowing differed in terms of aims and use of US. The studies assessing laryngeal function predominately investigated vocal fold movement and laryngeal pathology. Sensitivity and specificity data were provided or calculated from raw data for nine of the laryngeal function studies (respective ranges of 75%-100% and 80%-100%). CONCLUSIONS & IMPLICATIONS Emerging evidence exists to support the use of US as adjunct to clinical assessment of swallowing and laryngeal function in the neonatal and paediatric population. A paucity of evidence to support use of US in the assessment of sucking exists. Further research is needed to establish evidence-based assessment and analysis protocols as well as development of paediatric data.
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Affiliation(s)
- Mari Viviers
- Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | | | - Maya Asir
- Evelina London Children's Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | | | - Rebecca Rowe
- Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - Sophie Phillips
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | | | - Melissa Keesing
- Nelson Marlborough District Health Board, Nelson, New Zealand
| | - Analou Sugar
- Chelsea and Westminster Hospital, Chelsea & Westminster Hospital Foundation Trust, London, UK
| | - Jodi Allen
- The National Hospital for Neurology & Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK
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12
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Allen JE, Clunie G, Ma JKY, Coffey M, Winiker K, Richmond S, Lowell SY, Volkmer A. Translating Ultrasound into Clinical Practice for the Assessment of Swallowing and Laryngeal Function: A Speech and Language Pathology-Led Consensus Study. Dysphagia 2022; 37:1586-1598. [PMID: 35201387 PMCID: PMC8867131 DOI: 10.1007/s00455-022-10413-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/19/2022] [Indexed: 12/16/2022]
Abstract
Ultrasound (US) has an emerging evidence base for the assessment of swallowing and laryngeal function. Accessibility and technological advances support the use of US as a clinical assessment tool; however, there is insufficient evidence to support its translation into clinical practice. This study aimed to establish consensus on the priorities for translation of US into clinical practice for the assessment of swallowing and laryngeal function. Nominal Group Technique (NGT) was used as a formal method of consensus development. Clinicians and academics, all members of an international US working group, were invited to participate in the study. Two NGT meetings were held, where participants silently generated and then shared ideas. Participants anonymously ranked items. Rankings were aggregated before participants re-ranked items in order of priority. Discussions regarding rankings were recorded and transcribed to inform analysis. Member-checking with participants informed the final analysis. Participants (n = 15) were speech and language pathologists, physiotherapists and sonographers representing six countries. Fifteen items were identified and prioritised 1-13 (including two equally ranked items). Reliability, validity and normative data emerged as key areas for research while development of training protocols and engagement with stakeholders were considered vital to progressing US into practice. Analysis revealed common themes that might be addressed together in research, in addition to the ranked priority. A measured approach to the translation of US into clinical practice will enable effective implementation of this tool. Priorities may evolve as clinical and professional contexts shift, but this study provides a framework to advance research and clinical practice in this field.
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Affiliation(s)
- Jodi E. Allen
- The National Hospital for Neurology and Neurosurgery, Therapy & Rehabilitation Services, 2nd Floor 8-11 Queen Square, London, WC1N 3BG UK
| | - Gemma Clunie
- SLT Department, Imperial College Healthcare Trust, Charing Cross Hospital, London, UK
| | - Joan K.-Y. Ma
- Clinical Audiology, Speech and Language Research Centre, Queen Margaret University, Edinburgh, UK
| | - Margaret Coffey
- SLT Department, Imperial College Healthcare Trust, Charing Cross Hospital, London, UK
| | - Katharina Winiker
- Swiss University of Speech and Language Sciences SHLR, Seminarstrasse 27, 9400 Rorschach, Switzerland
| | - Sally Richmond
- Imaging Department, University College London Hospitals, London, UK
| | - Soren Y. Lowell
- Communication Sciences & Disorders Department, Syracuse University, Syracuse, NY USA
| | - Anna Volkmer
- Division of Psychology and Language Sciences, University College London, London, UK
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13
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van der Heul AMB, van Eijk RPA, Wadman RI, Asselman F, Cuppen I, Nievelstein RAJ, Gerrits E, van der Pol WL, van den Engel-Hoek L. Mastication in Patients with Spinal Muscular Atrophy Types 2 and 3 is Characterized by Abnormal Efficiency, Reduced Endurance, and Fatigue. Dysphagia 2021; 37:715-723. [PMID: 34392389 PMCID: PMC9345836 DOI: 10.1007/s00455-021-10351-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 08/02/2021] [Indexed: 11/30/2022]
Abstract
Mastication problems can have a negative impact on the intake of food and quality of life. This cross-sectional study characterizes mastication problems using clinical and instrumental assessments in patients with spinal muscular atrophy (SMA) types 2 and 3 with self-reported bulbar problems. We included 27 patients (aged 13–67 years), 18 with SMA type 2 and 9 patients with SMA type 3 (of whom three were still ambulant) and applied a questionnaire, clinical mastication tests (TOMASS and 6-min mastication test), and muscle ultrasound of the mastication muscles. Non-ambulant patients demonstrated inefficient mastication as reflected by median z scores for masticatory cycles (z = 1.8), number of swallows (z = 4.3) and time needed to finish the cracker (z = 3.4), and limited endurance of continuous mastication as demonstrated by the median z scores of the 6-min mastication test (z = − 1.5). Patients reported increased fatigue directly after the 6-min mastication test as well as 5 min after completing the test (p < 0.001; p = 0.003). Reduced maximal mouth opening was associated with mastication problems (p < 0.001). Muscle ultrasound of the mastication muscles showed an abnormal muscle structure in 90% of both ambulant and non-ambulant patients. This study aims to understand the nature and underlying mechanisms of mastication problems in patients with SMA types 2 and 3 with reported bulbar problems.
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Affiliation(s)
- A M B van der Heul
- Department of Neurology & Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R P A van Eijk
- Department of Neurology & Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.,Biostatistics & Research Support, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R I Wadman
- Department of Neurology & Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - F Asselman
- Department of Neurology & Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - I Cuppen
- Department of Neurology & Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R A J Nievelstein
- Department of Radiology & Nuclear Medicine, Imaging & Oncology Division, University Medical Center Utrecht, Utrecht, The Netherlands
| | - E Gerrits
- Department of Languages, Literature and Communication, Utrecht Institute of Linguistics OTS, Utrecht University, Utrecht, The Netherlands
| | - W L van der Pol
- Department of Neurology & Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - L van den Engel-Hoek
- Department of Rehabilitation, Donders Center for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands
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14
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Hsiao MY, Wu CH, Wang TG. Emerging Role of Ultrasound in Dysphagia Assessment and Intervention: A Narrative Review. FRONTIERS IN REHABILITATION SCIENCES 2021; 2:708102. [PMID: 36188819 PMCID: PMC9397709 DOI: 10.3389/fresc.2021.708102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 07/14/2021] [Indexed: 11/13/2022]
Abstract
Ultrasonography has gained increasing attention as a non-invasive and radiation-free instrument for the assessment of swallowing function. In the past decades, an extensive repertoire of ultrasonographic techniques, such as, B-mode dynamic scanning, pixel analysis, M-mode, Doppler, 3D reconstruction, and sonoelastography, has been applied in the evaluation of oropharyngeal structures and movement. Yet, a universal consensus on the examination protocols and clinical implications remains to be established. This review aimed to provide a brief introduction of the application of ultrasound in dysphagia assessment and intervention, encompassing the ultrasonography of swallowing-related muscles, tongue movement, and hyolaryngeal excursion, as well as ultrasound-guided interventions in the management of dysphagia. In addition to non-invasiveness, ultrasonography, a portable, easy to use, and low-cost technique, could compliment videofluoroscopic swallowing study as a first-line screening and follow-up tool for the evaluation of swallowing function, although further study is warranted to provide quantitative diagnostic and prognostic values. Finally, ultrasonography aids in the precisely targeted injection of botulinum toxin in patients exhibiting oropharyngeal muscle spasticity.
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Affiliation(s)
- Ming-Yen Hsiao
- Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Chueh-Hung Wu
- Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital Hsin-chu Branch, Hsinchu, Taiwan
| | - Tyng-Guey Wang
- Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
- *Correspondence: Tyng-Guey Wang
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15
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Allen JE, Clunie GM, Winiker K. Ultrasound: an emerging modality for the dysphagia assessment toolkit? Curr Opin Otolaryngol Head Neck Surg 2021; 29:213-218. [PMID: 33741822 PMCID: PMC7611059 DOI: 10.1097/moo.0000000000000708] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE OF REVIEW Videofluoroscopy (VFSS) and fibreoptic endoscopic evaluation of swallowing (FEES) are established instrumental techniques to support differential diagnosis and treatment of oropharyngeal dysphagia. Whilst their value is undisputed, each tool is not without limitations. The COVID-19 pandemic has restricted access to VFSS and FEES leading clinicians to explore alternative or augmentative tools to support swallowing assessment.Ultrasound (US) is an established tool for visualisation of head and neck anatomy, including structures implicated in swallowing. Although US has been utilised in swallowing research for many years, its application has not translated into common clinical practice. This review presents and debates the evidence for and against use of US for clinical swallowing assessment. RECENT FINDINGS Evaluation of swallowing muscle morphometry and measurement of isolated swallowing kinematics are two primary uses of US in swallowing assessment that have been identified in the literature. Use of US to detect bolus flow, aspiration and residues is in its early stages and needs further research. SUMMARY US shows promise as an adjunctive modality to support assessment of swallowing. With standardisation, these measurements may have potential for transition into clinical care. Reliability and validity testing and development of normative data are imperative to ensure its use as an evidence-based instrumentation.
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Affiliation(s)
- Jodi E Allen
- University College London Hospitals NHS Foundation Trust, National Hospital for Neurology & Neurosurgery
| | - Gemma M Clunie
- National Centre for Airway Reconstruction, Department of Otolaryngology, Head and Neck Surgery, Imperial College Healthcare NHS Trust
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Katharina Winiker
- Swiss University of Speech and Language Sciences SHLR, Rorschach, Switzerland
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16
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Hagiwara Y, Shimizu T, Yanagisawa T, Akasu Y, Kaburagi K, Kikuchi T, Shibata S, Matsumoto H, Soga K, Tsuchihashi Y, Nagasaka M, Sasaki N, Maki F, Shiraishi M, Akiyama H, Hasegawa Y, Yamano Y. Utility of transoral motion-mode ultrasonography to detect tongue fasciculation in patients with amyotrophic lateral sclerosis. Muscle Nerve 2021; 63:909-913. [PMID: 33675079 DOI: 10.1002/mus.27218] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 02/23/2021] [Accepted: 02/27/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Increasing evidence suggests the utility of the submandibular approach for ultrasonography to detect tongue fasciculation in amyotrophic lateral sclerosis (ALS). We hypothesized that transoral motion-mode ultrasonography (TOMU) would be useful to detect tongue fasciculation in patients with ALS. METHODS Patients with sporadic ALS showing clinically definite tongue fasciculation were enrolled, and the ultrasonography findings of patients' tongues on TOMU and ultrasonography by the conventional submandibular approach were analyzed. RESULTS Six patients with clinically definite ALS were enrolled in this study. Although small, irregular muscle movements of 5 to 10 mm in amplitude and 0.1 to 0.2 second in duration were detected in all patients by TOMU, similar muscle movements were detected in only two of the six patients by the submandibular approach. DISCUSSION TOMU appeared to be useful for detecting tongue fasciculation in ALS patients. Further study is needed to better determine its role as a diagnostic tool for ALS.
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Affiliation(s)
- Yuta Hagiwara
- Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Takahiro Shimizu
- Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Toshiyuki Yanagisawa
- Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yukari Akasu
- Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kei Kaburagi
- Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Takayuki Kikuchi
- Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Soichiro Shibata
- Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hirofumi Matsumoto
- Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Kaima Soga
- Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yoko Tsuchihashi
- Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Misako Nagasaka
- Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.,Department of Oncology, Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Naoshi Sasaki
- Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Futaba Maki
- Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Makoto Shiraishi
- Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Hisanao Akiyama
- Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yasuhiro Hasegawa
- Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
| | - Yoshihisa Yamano
- Division of Neurology, Department of Internal Medicine, St. Marianna University School of Medicine, Kawasaki, Japan
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17
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Perkisas S, Bastijns S, Sanchez-Rodriguez D, Piotrowicz K, De Cock AM. Application of ultrasound for muscle assessment in sarcopenia: 2020 SARCUS update: reply to the letter to the editor : SARCUS working group on behalf of the Sarcopenia Special Interest Group of the European Geriatric Medicine Society. Eur Geriatr Med 2021; 12:427-428. [PMID: 33595779 DOI: 10.1007/s41999-021-00462-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 01/27/2021] [Indexed: 12/19/2022]
Affiliation(s)
- Stany Perkisas
- University Center of Geriatrics, University of Antwerp, Leopoldstraat 26, 2000, Antwerp, Belgium.
| | - Sophie Bastijns
- University Center of Geriatrics, University of Antwerp, Leopoldstraat 26, 2000, Antwerp, Belgium
| | - Dolores Sanchez-Rodriguez
- Clinical Research Unit, CHU Brugmann, Brussels, Belgium.,Division of Public Health, Epidemiology and Health Economics, World Health Organization Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, Liège, Belgium.,Rehabilitation Research Group, Geriatrics Department, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Karolina Piotrowicz
- Department of Internal Medicine and Gerontology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Anne-Marie De Cock
- University Center of Geriatrics, University of Antwerp, Leopoldstraat 26, 2000, Antwerp, Belgium
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18
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Feeding difficulties in children and adolescents with spinal muscular atrophy type 2. Neuromuscul Disord 2021; 31:101-112. [PMID: 33454188 DOI: 10.1016/j.nmd.2020.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 10/15/2020] [Accepted: 12/14/2020] [Indexed: 02/04/2023]
Abstract
Disease course of feeding difficulties in spinal muscular atrophy type 2 is not well documented. Disease-modifying therapies rapidly change the trajectory of motor function and survival in spinal muscular atrophy, but effects on co-morbidities like bulbar function are unknown. We analysed data concerning feeding problems and their standard of care treatment in 146 patients with spinal muscular atrophy type 2. Data were collected from two separate cohorts: one single-centre retrospective chart review study from the United Kingdom (London), and one prospective questionnaire-based multicentre study from Italy. Cumulatively feeding difficulties were present in 88 patients (60%) in these 2 cohorts. Median age at onset of problems was 6.5years (range 0-16.5 years). Eighty-two patients (60%) showed periods of underweight according to age adjusted body mass index, and thirty-six patients (25%) showed malnourishment with a significant drop on their weight curves. Enteral feeding was indicated in 23 out of 72 patients in the UK cohort (32%) because of weight loss, oropharyngeal dysphagia or aspiration. Gastrostomy and its placement was generally well tolerated, uncomplicated in 96%, never reversed and performed without Nissen fundoplication in 66% of patients. After gastrostomy chest infections improved in 80% and nutritional status (e.g., Body Mass Index) in 84% of patients. These results show that feeding difficulties are a common problem in spinal muscular atrophy type 2. Treatment strategies should be tailor-made on the symptoms and needs of the individual patient.
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19
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Chang PH, Chen YJ, Chang KV, Wu WT, Özçakar L. Ultrasound measurements of superficial and deep masticatory muscles in various postures: reliability and influencers. Sci Rep 2020; 10:14357. [PMID: 32873849 PMCID: PMC7463001 DOI: 10.1038/s41598-020-71378-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/06/2020] [Indexed: 12/14/2022] Open
Abstract
Masticatory muscle thickness provides objective measurements of the oral motor function, which may change in patients with oral myofascial pain. In this study, we aimed to establish a reliable ultrasound (US) protocol for imaging the superficial and deep masticatory muscles and to identify the potential influencers of the measurements. Forty-eight healthy participants without orofacial pain were enrolled. The intra-and inter-rater reliabilities of US measurements for masseter, temporalis, and lateral pterygoid muscles were assessed. Intraclass correlation coefficients for all muscles were greater than 0.6. The generalised estimating equation was used to analyse the impact of age, gender, laterality, and body mass index on the measurements, whereby age and body mass index were likely to be associated with an increase in masticatory muscle thickness. The thickness tended to be lesser in females. Laterality seemed to exert minimal influence on masticatory muscle thickness. Our study shows acceptable reliability of US in the evaluation of superficial and deep masticatory muscle thickness. Future studies are warranted to validate the usefulness of US imaging in patients with oral myofascial pain syndrome.
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Affiliation(s)
- Pei-Hsuan Chang
- Department of Dentistry, School of Dentistry, National Taiwan University Hospital, Taipei, Taiwan, ROC
| | - Yunn-Jy Chen
- Department of Dentistry, School of Dentistry, National Taiwan University Hospital, Taipei, Taiwan, ROC
| | - Ke-Vin Chang
- Department of Physical Medicine and Rehabilitation and Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch and National Taiwan University College of Medicine, Taipei, Taiwan, ROC.
| | - Wei-Ting Wu
- Department of Physical Medicine and Rehabilitation and Community and Geriatric Research Center, National Taiwan University Hospital, Bei-Hu Branch and National Taiwan University College of Medicine, Taipei, Taiwan, ROC
| | - Levent Özçakar
- Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey
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20
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Voos MC, Goya PSA, de Freitas BL, Pires AMT, Favero FM, Caromano FA. Timed immersion expiration measures in patients with muscular dystrophies. Arch Physiother 2020; 10:4. [PMID: 32099666 PMCID: PMC7027248 DOI: 10.1186/s40945-020-0074-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 01/08/2020] [Indexed: 11/10/2022] Open
Abstract
Introduction Muscular dystrophies (MD) cause muscle weakness, affecting motor and respiratory functions. Aquatic activities maintain strength and ventilatory function and may require immersion expiration control. Objectives (1) To describe the evolution of timed immersion expiration in patients with MD in one-year follow-up. (2) to describe motor and respiratory outcomes in one-year follow-up. (3) to investigate possible relationships between timed immersion expiration and age, motor and respiratory functions. Method Fifty-seven patients with MD (12-35 years, Vignos scale 2-8) were evaluated twice, with one-year interval. Immersion expiration control was timed with a chronometer. Motor function was assessed by Motor Function Measure. The respiratory function was evaluated by spirometry. Analysis of variance compared assessments and Pearson tests investigated relationships between variables and age. Results Motor and respiratory functions decreased (p < 0.001) but timed immersion expiration was maintained. Timed immersion expiration was not correlated to motor and respiratory functions. Conclusion As patients maintained timed immersion expiration in the one-year follow-up, aquatic therapy might be a facilitator for people with MD.
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Affiliation(s)
- Mariana Callil Voos
- 1Physical Therapy, Speech Therapy and Occupational Therapy Department. Faculty of Medicine, University of São Paulo, Rua Cipotânea 51, São Paulo, SP 05360-000 Brazil
| | - Priscila Santos Albuquerque Goya
- 1Physical Therapy, Speech Therapy and Occupational Therapy Department. Faculty of Medicine, University of São Paulo, Rua Cipotânea 51, São Paulo, SP 05360-000 Brazil
| | - Bruna Leal de Freitas
- 1Physical Therapy, Speech Therapy and Occupational Therapy Department. Faculty of Medicine, University of São Paulo, Rua Cipotânea 51, São Paulo, SP 05360-000 Brazil
| | - Aline Moço Teixeira Pires
- 1Physical Therapy, Speech Therapy and Occupational Therapy Department. Faculty of Medicine, University of São Paulo, Rua Cipotânea 51, São Paulo, SP 05360-000 Brazil
| | - Francis Meire Favero
- 2Department of Neurology and Neurosurgery, Faculty of Medicine, Federal University of São Paulo, São Paulo, SP Brazil
| | - Fátima Aparecida Caromano
- 1Physical Therapy, Speech Therapy and Occupational Therapy Department. Faculty of Medicine, University of São Paulo, Rua Cipotânea 51, São Paulo, SP 05360-000 Brazil
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21
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Lagarde MLJ, van Alfen N, Geurts ACH, de Groot IJM, van den Engel-Hoek L. Orofacial muscles may be affected in early stages of Becker muscular dystrophy: A preliminary study. Muscle Nerve 2019; 61:213-217. [PMID: 31778229 PMCID: PMC7003962 DOI: 10.1002/mus.26771] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 11/21/2019] [Accepted: 11/23/2019] [Indexed: 12/19/2022]
Abstract
Background Dysphagia is reported in patients with Duchenne or Becker muscular dystrophy. Our clinical experience suggests that, compared with Duchenne patients, impaired mastication and swallowing occur early in Becker patients relative to their skeletal muscle involvement. The aim of this study was to assess dysphagia in Duchenne and Becker patients in relation to ambulatory capacity. Methods In patients in the early ambulatory stage, clinical symptoms, quantitative muscle ultrasound of the orofacial muscles, and maximum bite force were assessed. The 6‐Minute Walk Test (6MWT) was used to measure ambulatory capacity. Results Eleven Duchenne and 11 Becker patients were included. Although Becker patients had a greater 6MWT distance than Duchenne patients, the occurrence of mastication and swallowing difficulties was similar. The temporalis muscle was significantly thicker in Becker patients. Conclusions Clinicians should be aware of dysphagia in both groups, even when ambulation is still well preserved.
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Affiliation(s)
- Marloes L J Lagarde
- Radboud University Medical Center, Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Nens van Alfen
- Radboud University Medical Center, Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Alexander C H Geurts
- Radboud University Medical Center, Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Imelda J M de Groot
- Radboud University Medical Center, Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Lenie van den Engel-Hoek
- Radboud University Medical Center, Department of Rehabilitation, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
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A new treatment for lingual nerve injury: an anatomical feasibility study for using a buccal nerve pedicle graft. Surg Radiol Anat 2019; 42:49-53. [PMID: 31538245 DOI: 10.1007/s00276-019-02345-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 09/14/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Lingual nerve (LN) palsy is a serious complication in dentistry and repaired by direct suture or a free graft technique. To our knowledge, there has been no study using a (long) buccal nerve (BN) graft as a donor for LN repair. Therefore, we aimed to clarify the location of the BN and investigate if it is feasible to reroute the BN to the LN. METHODS Twenty-four sides from 12 fresh-frozen Caucasian cadaveric heads were used in this study. The mean age at death was 73.9 ± 13.4 years. The LN was dissected on the floor of the oral cavity medial to the third molar tooth. Next, the mucosa with the buccinator muscle, pterygomandibular raphe, and superior pharyngeal constrictor muscle on the retromolar area was retracted anteriorly to widen the pathway of the LN. Finally, the BN was cut and transposed to the LN through this widened pathway to its feasibility. RESULTS The mean diameter of the BN and vertical distance from the horizontal part of the retromolar trigone to the BN was 1.47 ± 0.32 mm and 18.53 ± 6.21 mm, respectively. On all sides, the BN was able to be transposed to the LN without tension. CONCLUSION Such a technique might be used for the patients with LN injury and who have lost sensation of the tongue.
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Swallowing in Parkinson’s disease: How is it affected? Clin Neurol Neurosurg 2019; 177:37-41. [DOI: 10.1016/j.clineuro.2018.12.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Revised: 12/13/2018] [Accepted: 12/23/2018] [Indexed: 12/17/2022]
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Rebrion C, Zhang Z, Khalifa Y, Ramadan M, Kurosu A, Coyle JL, Perera S, Sejdic E. High-Resolution Cervical Auscultation Signal Features Reflect Vertical and Horizontal Displacements of the Hyoid Bone During Swallowing. IEEE JOURNAL OF TRANSLATIONAL ENGINEERING IN HEALTH AND MEDICINE-JTEHM 2018; 7:1800109. [PMID: 30701145 PMCID: PMC6345415 DOI: 10.1109/jtehm.2018.2881468] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 10/19/2018] [Accepted: 10/29/2018] [Indexed: 12/19/2022]
Abstract
Millions of people across the globe suffer from swallowing difficulties, known as dysphagia, which can lead to malnutrition, pneumonia, and even death. Swallowing cervical auscultation, which has been suggested as a noninvasive screening method for dysphagia, has not been associated yet with any physical events. In this paper, we have compared the hyoid bone displacement extracted from the videofluoroscopy images of 31 swallows to the signal features extracted from the cervical auscultation recordings captured with a tri-axial accelerometer and a microphone. First, the vertical displacement of the anterior part of the hyoid bone is related to the entropy rate of the superior–inferior swallowing vibrations and to the kurtosis of the swallowing sounds. Second, the vertical displacement of the posterior part of the hyoid bone is related to the bandwidth of the medial–lateral swallowing vibrations. Third, the horizontal displacements of the posterior and anterior parts of the hyoid bone are related to the spectral centroid of the superior–inferior swallowing vibrations and to the peak frequency of the medial–lateral swallowing vibrations, respectively. At last, the airway protection scores and the command characteristics were associated with the vertical and horizontal displacements, respectively, of the posterior part of the hyoid bone. Additional associations between the patients’ characteristics and auscultations’ signals were also observed. The hyoid bone maximal displacement is a cause of swallowing vibrations and sounds. High-resolution cervical auscultation may offer a noninvasive alternative for dysphagia screening and additional diagnostic information.
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Affiliation(s)
- Cedrine Rebrion
- Department of Electrical and Computer EngineeringSwanson School of EngineeringUniversity of PittsburghPittsburghPA15261USA
| | - Zhenwei Zhang
- Department of Electrical and Computer EngineeringSwanson School of EngineeringUniversity of PittsburghPittsburghPA15261USA
| | - Yassin Khalifa
- Department of Electrical and Computer EngineeringSwanson School of EngineeringUniversity of PittsburghPittsburghPA15261USA
| | - Mona Ramadan
- Department of Electrical and Computer EngineeringSwanson School of EngineeringUniversity of PittsburghPittsburghPA15261USA
| | - Atsuko Kurosu
- Department of the Communication Science and DisordersSchool of Health and Rehabilitation SciencesUniversity of PittsburghPittsburghPA15260USA
| | - James L Coyle
- Department of the Communication Science and DisordersSchool of Health and Rehabilitation SciencesUniversity of PittsburghPittsburghPA15260USA
| | - Subashan Perera
- Division of Geriatric MedicineDepartment of MedicineUniversity of PittsburghPittsburghPA15261USA
| | - Ervin Sejdic
- Department of Electrical and Computer EngineeringSwanson School of EngineeringUniversity of PittsburghPittsburghPA15261USA
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How useful is muscle ultrasound in the diagnostic workup of neuromuscular diseases? Curr Opin Neurol 2018; 31:568-574. [DOI: 10.1097/wco.0000000000000589] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Díaz-Serrano KV, Dias TM, Vasconcelos P, Sousa LG, Siéssere S, Regalo S, Palinkas M. Impact of temporomandibular disorders on the stomatognathic system in children. Med Oral Patol Oral Cir Bucal 2017; 22:e723-e729. [PMID: 29053659 PMCID: PMC5813991 DOI: 10.4317/medoral.22000] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 09/12/2017] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND To evaluate the EMG activity and thickness of right masseter (RM), left masseter (LM), right temporal (RT) and left temporal (LT) muscles and bite force in children with temporomandibular disorders (TMD). MATERIAL AND METHODS Forty five children (mean age 8.8 years; 22 boys and 23 girls) were examined on the basis of the RDC/TMD and the Faces Pain Scale-Revised (FPS-R) was used to determine the level of severity of the signs and symptoms of TMD, resulting in four groups: GI - without TMD (n=10); GII - with mild TMD (n=18), GIII: with moderate TMD (n=12) and GIV: with severe TMD (n=5). The data of electromyographic activity, maximum bite force and muscle thickness were tabulated and submitted to statistical analysis (ANOVA, P≤0.05). RESULTS Children with TMD signs and symptoms had lower EMG activity than children of the control group. There was significant difference among the groups for the LT at rest (P=0.01), right (P=0.03) and left (P=0.05) laterality, and for the LM (P=0.01) and LT (P=0.03) muscles in maximum voluntary contraction. There were no statistically significant differences among the groups regarding muscle thickness. The bite force was lower in the TMD groups than children of the control group, with significant statistical difference for the right region (P=0.03). CONCLUSIONS The severity of TMD signs and symptoms affected the EMG activity and the molar bite force in children. However, structural changes in the thickness of masticatory muscles are not perceptible in children with TMD signs and symptoms.
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Affiliation(s)
- K-V Díaz-Serrano
- Avenida do Café, s/n, Ribeirão Preto Dental School, Campus University of São Paulo, 14040-904 Ribeirão Preto, São Paulo, Brazil,
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Barkmeier-Kraemer JM, Clark HM. Speech-Language Pathology Evaluation and Management of Hyperkinetic Disorders Affecting Speech and Swallowing Function. TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2017; 7:489. [PMID: 28983422 PMCID: PMC5628324 DOI: 10.7916/d8z32b30] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 08/30/2017] [Indexed: 12/13/2022]
Abstract
Background Hyperkinetic dysarthria is characterized by abnormal involuntary movements affecting respiratory, phonatory, and articulatory structures impacting speech and deglutition. Speech–language pathologists (SLPs) play an important role in the evaluation and management of dysarthria and dysphagia. This review describes the standard clinical evaluation and treatment approaches by SLPs for addressing impaired speech and deglutition in specific hyperkinetic dysarthria populations. Methods A literature review was conducted using the data sources of PubMed, Cochrane Library, and Google Scholar. Search terms included 1) hyperkinetic dysarthria, essential voice tremor, voice tremor, vocal tremor, spasmodic dysphonia, spastic dysphonia, oromandibular dystonia, Meige syndrome, orofacial, cervical dystonia, dystonia, dyskinesia, chorea, Huntington’s Disease, myoclonus; and evaluation/treatment terms: 2) Speech–Language Pathology, Speech Pathology, Evaluation, Assessment, Dysphagia, Swallowing, Treatment, Management, and diagnosis. Results The standard SLP clinical speech and swallowing evaluation of chorea/Huntington’s disease, myoclonus, focal and segmental dystonia, and essential vocal tremor typically includes 1) case history; 2) examination of the tone, symmetry, and sensorimotor function of the speech structures during non-speech, speech and swallowing relevant activities (i.e., cranial nerve assessment); 3) evaluation of speech characteristics; and 4) patient self-report of the impact of their disorder on activities of daily living. SLP management of individuals with hyperkinetic dysarthria includes behavioral and compensatory strategies for addressing compromised speech and intelligibility. Swallowing disorders are managed based on individual symptoms and the underlying pathophysiology determined during evaluation. Discussion SLPs play an important role in contributing to the differential diagnosis and management of impaired speech and deglutition associated with hyperkinetic disorders.
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