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Lu F, Okazaki T, Okuyama J, Izumi S. Impacts of body positions on the geniohyoid muscle contraction and swallowing difficulty in healthy adults. Clin Exp Dent Res 2023; 9:670-678. [PMID: 37408360 PMCID: PMC10441597 DOI: 10.1002/cre2.760] [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: 01/21/2023] [Revised: 06/01/2023] [Accepted: 06/17/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Body positions affect swallowing and gastroesophageal reflux. Swallowing impairment is one of the main causes of aspiration pneumonia. To prevent pneumonia, evaluation of body positions on gastroesophageal reflux recommended 30 degrees or higher semi-recumbent positions. The geniohypoid muscle and tongue play central roles in swallowing. However, the effects of body positions on contracting rates in the geniohyoid muscle and tongue pressure are unclear. Moreover, correlations between geniohyoid muscle contracting rates and subjective swallowing difficulties are unclear. AIMS This study aimed to identify the proper body positions on contracting rates in the geniohyoid muscle, tongue pressure, and subjective swallowing difficulties. MATERIALS & METHODS Twenty healthy adults swallowed 15- or 50 ml of water at 90 degrees sitting, 60- and 30 degrees semi-recumbent, and 0 degrees supine positions. We scored the subjective swallowing difficulties and measured the tongue pressure and the number of swallows. An ultrasound evaluated the geniohyoid muscle size and contracting rates. RESULTS At sitting and 60 degrees semi-recumbent positions, the geniohyoid muscle showed greter contracting rates than at 30 degrees semi-recumbent and supine postions (P < 0.05), which resulted in easier swalloiwng. Greater tongue pressure was weakly correlated with fewer swallows (r = -0.339, P = 0.002), whereas the body positions did not affect. CONCLUSION Considering swallowing and gastroesophageal reflux together, a trunk angle of 60 degrees or more might be beneficial for reducing the risk of aspiration.
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Affiliation(s)
- Fuwen Lu
- Department of Physical Medicine and RehabilitationTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Tatsuma Okazaki
- Department of Physical Medicine and RehabilitationTohoku University Graduate School of MedicineSendaiMiyagiJapan
- Center for Dysphagia of Tohoku University HospitalSendaiMiyagiJapan
| | - Junko Okuyama
- Department of Physical Medicine and RehabilitationTohoku University Graduate School of MedicineSendaiMiyagiJapan
| | - Shin‐Ichi Izumi
- Department of Physical Medicine and RehabilitationTohoku University Graduate School of MedicineSendaiMiyagiJapan
- Center for Dysphagia of Tohoku University HospitalSendaiMiyagiJapan
- Department of Physical Medicine and RehabilitationTohoku University Graduate School of Biomedical EngineeringSendaiMiyagiJapan
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Swan K, Cordier R, Brown T, Speyer R. Visuoperceptual Analysis of the Videofluoroscopic Study of Swallowing: An International Delphi Study. Dysphagia 2020; 36:595-613. [PMID: 32888067 DOI: 10.1007/s00455-020-10174-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 08/24/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The Videofluoroscopic Swallow Study (VFSS) is a commonly used dysphagia assessment that is routinely analysed visuoperceptually. However, no consensus exists regarding which visuoperceptual measures should be used to analyse VFSSs. Current visuoperceptual measures for VFSSs are limited by poor quality and incomplete or indeterminate psychometric properties. OBJECTIVE This study aimed to establish the content validity for a new visuoperceptual VFSS measure for oropharyngeal dysphagia in adults, by identifying relevant domains of the construct and generating items and corresponding response scales. METHODS Consensus among experts in dysphagia and VFSS from over 20 countries was achieved across three rounds of anonymous online surveys, using the Delphi technique. Participants judged relevance and comprehensiveness of definitions of visuoperceptual domains of VFSS and the relevance of various domains to the overall construct. After reaching consensus on definitions of relevant domains, consensus on items were established using the same process. RESULTS Participants achieved consensus on definitions of 32 domains recommended for analysis, and at least one item per domain (range 1-4). Domains selected by participants included both those which occur in existing measures and domains which have not been included in any measures to date. This study will form the basis for content validity of a new measure for VFSS. CONCLUSIONS This first phase of developing a visuoperceptual measure of VFSS resulted in the identification of 32 domains and 60 items for oropharyngeal dysphagia. Developers can now advance to the next phase of measure construction; prototype development and psychometric testing.
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Affiliation(s)
- Katina Swan
- School of Occupational Therapy, Speech Pathology and Social Work, Curtin University, Kent Street, Bentley, 6102, WA, Australia.
| | - Reinie Cordier
- School of Occupational Therapy, Speech Pathology and Social Work, Curtin University, Kent Street, Bentley, 6102, WA, Australia.,Northumbria University, Room B014, Coach Lane Campus, Newcastle upon Tyne, NE7 7XA, United Kingdom
| | - Ted Brown
- Department of Occupational Therapy, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University - Peninsula Campus, Frankston, 3800, VIC, Australia
| | - Renée Speyer
- School of Occupational Therapy, Speech Pathology and Social Work, Curtin University, Kent Street, Bentley, 6102, WA, Australia.,Department of Special Needs Education, University of Oslo, P.O. Box 1072 Blindern, Oslo, 0316, Norway.,Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Centre, Rapenburg 70, Leiden, 2311 EZ, The Netherlands
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3
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Pettit NJ, Auvenshine RC. Change of hyoid bone position in patients treated for and resolved of myofascial pain. Cranio 2018; 38:74-90. [DOI: 10.1080/08869634.2018.1493178] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Nathan J. Pettit
- MedCenter TMJ, PC, Houston, TX, USA
- TMD/Orofacial Pain Clinic, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Ronald C. Auvenshine
- MedCenter TMJ, PC, Houston, TX, USA
- TMD/Orofacial Pain Clinic, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
- University of Texas Health Science Center, School of Dentistry, Houston, TX, USA
- Louisiana State University, School of Dentistry, New Orleans, LA, USA
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4
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Oh BM, Lee JH, Seo HG, Lee WH, Han TR, Jeong SU, Jeong HJ, Sim YJ. Changes in Hyolaryngeal Movement During Swallowing in the Lateral Decubitus Posture. Ann Rehabil Med 2018; 42:416-424. [PMID: 29961739 PMCID: PMC6058586 DOI: 10.5535/arm.2018.42.3.416] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 09/15/2017] [Indexed: 12/23/2022] Open
Abstract
Objective To investigate the differences in hyolaryngeal kinematics at rest and during swallowing in the upright sitting (UP) and the lateral decubitus (LD) postures in healthy adults, and delineating any potential advantages of swallowing while in the LD posture. Methods Swallowing was videofluoroscopically evaluated in 20 healthy volunteers in UP and LD postures, based on the movements of hyoid bone, vocal folds, and the bolus head. Parameters included the Penetration-Aspiration Scale (PAS), horizontal and vertical displacement, horizontal and vertical initial position, horizontal and vertical peak position, time to peak position of the hyoid bone and vocal folds, and pharyngeal transit time (PTT). Results Nine participants were rated PAS 2 in the UP and 1 was rated PAS 2 in the LD (p=0.003) at least 1 out of 3 swallows each posture. The hyoid and vocal folds showed more anterior and superior peak and initial positions in the LD. In addition, swallowing resulted in greater vertical and smaller horizontal displacement of the hyoid in LD posture compared with UP. Time to peak position of the hyoid was shorter in LD. The maximal vertical and horizontal displacement of the vocal folds, and PTT were comparable between postures. Conclusion The results showed that the peak and initial positions of the hyoid and larynx and the pattern of hyoid movement varied significantly depending on the body postures. This study suggests that the LD posture was one of the safe feeding postures without any increased risk compared with UP posture.
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Affiliation(s)
- Byung-Mo Oh
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jae Hyun Lee
- Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Busan, Korea
| | - Han Gil Seo
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Woo Hyung Lee
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.,Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul, Korea
| | - Tai Ryoon Han
- Department of Rehabilitation Medicine, Gangwon-Do Rehabilitation Hospital, Chuncheon, Korea
| | - Seoung Uk Jeong
- Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Busan, Korea
| | - Ho Joong Jeong
- Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Busan, Korea
| | - Young-Joo Sim
- Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Busan, Korea
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5
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Abstract
INTRODUCTION Temporomandibular disease (TMD) etiology is multifactorial and is related to many perpetuating, predisposing, and initiating factors. The daytime parafunctions may have an important role in TMD pathogenesis. The most frequent parafunctions analyzed were the static parafunction (ie, clenching) and the dynamic parafunction (ie, grinding). In the present paper, the authors evaluated the swallowing (an oral function/parafunction) with the surface electromyography in patients with TMD. MATERIALS AND METHODS Twenty patients with TMD problems (nonhealthy patients, NHP) (mean age: 33 ± 1.994; 8 men and 12 women) and 20 healthy matched subjects (HP) (34.4 ± 2.782; 6 men and 14 women) were selected and examined. On each patient, an 8-channel surface electromyography was done during saliva swallowing. RESULTS Nonhealthy patients presented higher masseter and temporalis activation (P < 0.05) and an unbalancing of temporalis and submental muscles activation (P < 0.05) than the HP. DISCUSSION Nonhealthy patients presented a time of swallow higher than HP (P < 0.001). Nonhealthy patients presented a higher muscles activation and time of swallow than HP and a decrease of muscles balancing activation.
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Corradi AMB, Valarelli LP, Grechi TH, Eckeli AL, Aragon DC, Küpper DS, Almeida LA, Sander HH, Trawitzki LVV, Valera FCP. Swallowing evaluation after surgery for obstructive sleep apnea syndrome: uvulopalatopharyngoplasty vs. expansion pharyngoplasty. Eur Arch Otorhinolaryngol 2018; 275:1023-1030. [DOI: 10.1007/s00405-018-4898-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 02/01/2018] [Indexed: 11/28/2022]
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Rosen SP, Abdelhalim SM, Jones CA, McCulloch TM. Effect of Body Position on Pharyngeal Swallowing Pressures Using High-Resolution Manometry. Dysphagia 2017; 33:389-398. [PMID: 29218488 DOI: 10.1007/s00455-017-9866-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Accepted: 11/20/2017] [Indexed: 02/01/2023]
Abstract
The effect of body position and gravitational pull on the complex pressure-driven process of pharyngeal swallowing remains unknown. Using high-resolution manometry (HRM), this study aims to identify positional adaptations of pharyngeal physiology by evaluating swallowing pressure patterns in a series of inverted body positions. Ten healthy adults each underwent swallowing tasks with pharyngeal HRM at six body positions using an inversion table (0°[upright], 45°, 90°[supine], 110°, 135°, and 180°[fully inverted]). Repeated measures ANOVA was used to assess impact of position on pressure parameters, and pharyngeal-UES pressure gradients translate. Velopharyngeal pressures varied by position (P < 0.001), with significantly higher pressures generated with inversion ≥90°, compared with upright and 45°. Change in position did not significantly affect common mesopharyngeal pressures or swallowing pressure durations. UES valving mechanisms were preserved during inversion, with subtle variations observed in integral pressures (P = 0.011). Pharyngeal-UES pressure gradients changed with position (P < 0.01), increasing with inversion > 90° compared to upright and 45°. Mechanisms of deglutition may differ with position and relative direction of gravity, particularly when at > 45° inclination. Increased palatal pressure is generated in the upside-down position to achieve nasopharyngeal closure and prevent regurgitation. While other classically measured pressures may not consistently differ with positioning, many individuals exhibit adaptations in pressure gradients when inverted, likely due to a combination of changes in pharyngeal driving force and UES opening mechanisms. Identification of these changes, relative to position, further builds on our understanding of the adaptability of the pharyngeal swallowing system.
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Affiliation(s)
- Sarah P Rosen
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, WI, USA
| | - Suzan M Abdelhalim
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, WI, USA
| | - Corinne A Jones
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, WI, USA.,Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, USA.,Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA
| | - Timothy M McCulloch
- Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin-Madison, Madison, WI, USA. .,Department of Communication Sciences and Disorders, University of Wisconsin-Madison, Madison, WI, USA. .,University of Wisconsin-Madison, Box 7375, Clinical Science Center - H4, 600 Highland Ave, Madison, WI, 53792-7375, USA.
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8
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Iizumi T, Magara J, Tsujimura T, Inoue M. Effect of body posture on chewing behaviours in healthy volunteers. J Oral Rehabil 2017; 44:835-842. [DOI: 10.1111/joor.12555] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2017] [Indexed: 11/29/2022]
Affiliation(s)
- T. Iizumi
- Division of Dysphagia Rehabilitation; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
- Department of Communication Disorders; School of Rehabilitation Sciences; Health Sciences University of Hokkaido, Ishikari-Tobetsu; Hokkaido Japan
| | - J. Magara
- Division of Dysphagia Rehabilitation; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - T. Tsujimura
- Division of Dysphagia Rehabilitation; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
| | - M. Inoue
- Division of Dysphagia Rehabilitation; Niigata University Graduate School of Medical and Dental Sciences; Niigata Japan
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9
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Wong SM, Domangue RJ, Fels S, Ludlow CL. Evidence that an internal schema adapts swallowing to upper airway requirements. J Physiol 2017; 595:1793-1814. [PMID: 27883179 PMCID: PMC5330896 DOI: 10.1113/jp272368] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 11/22/2016] [Indexed: 11/08/2022] Open
Abstract
KEY POINTS To swallow food and liquid safely, airway protection is essential. Upward and forward movements of the hyoid and larynx in the neck during swallowing vary in magnitude between individuals. In healthy human adults, hyoid and laryngeal movements during swallowing were scaled by differences in initial upper airway area before swallowing. Individuals increased laryngeal elevation during swallowing in response to increased airway opening before swallowing. We show that when upper airway protection requirements change, individuals use an internal sensorimotor scaling system to adapt movements to maintain swallow safety. ABSTRACT Hyoid and laryngeal movements contribute to laryngeal vestibule closure and upper oesophageal sphincter opening during swallowing. Evidence of an internal sensorimotor scaling system allowing individuals to achieve these functional goals is lacking. In speech, speakers adjust their articulatory movement magnitude according to the movement distance required to reach an articulatory target for intelligible speech. We investigated if swallowing is similar in that movement amplitude may be scaled by the functional goal for airway protection during swallowing, rather than by head and neck size. We hypothesized that healthy individuals adapt to their own anatomy by adjusting hyo-laryngeal movements to achieve closure of the upper airway. We also investigated if individuals would automatically compensate for changes in their initial hyo-laryngeal positions and area when head position was changed prior to swallowing. Videofluoroscopy was performed in 31 healthy adults. Using frame-by-frame motion analysis, anterior and superior hyoid and laryngeal displacement, and hyo-laryngeal area were measured prior to and during swallowing. Kinematic measurements during swallowing were examined for relationships with pharyngeal neck length, and initial hyo-laryngeal positions, length and area before swallowing. During swallowing, individuals altered laryngeal elevation magnitude to exceed hyoid elevation based on hyo-laryngeal length before swallowing. Anterior laryngeal displacement was related to initial larynx distance from the spine, while hyoid elevation was predicted by pharyngeal neck length and initial hyoid distance from the mandible prior to the swallow. In conclusion, individuals automatically adapt hyo-laryngeal movement during swallowing based on targets required for closing the hyo-laryngeal area for safe swallowing.
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Affiliation(s)
- Seng Mun Wong
- Department of Speech TherapySingapore General HospitalSingapore
| | - Rickie J. Domangue
- Department of Mathematics and StatisticsJames Madison UniversityHarrisonburgVAUSA
| | - Sidney Fels
- Department of Electrical and Computer EngineeringUniversity of British ColumbiaVancouverCanada
| | - Christy L. Ludlow
- Department of Communication Sciences and DisordersJames Madison UniversityHarrisonburgVAUSA
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Sogawa Y, Kimura S, Harigai T, Sakurai N, Toyosato A, Nishikawa T, Inoue M, Murasawa A, Endo N. New Swallowing Evaluation Using Piezoelectricity in Normal Individuals. Dysphagia 2015; 30:759-67. [PMID: 26487065 DOI: 10.1007/s00455-015-9654-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 10/03/2015] [Indexed: 12/22/2022]
Abstract
This study aimed to elucidate the relationship between the piezoelectric waveform latency, hyoid bone movement, surface electromyogram (sEMG), and the pharyngeal transit time (PTT) during swallowing. Forty-one healthy subjects were divided into three age groups: younger (20-39 years, n = 8), middle-aged (40-59 years, n = 9), and older (60-79 years, n = 24). Motion analysis of the hyoid bone using videofluorography (VF), waveform analysis of the front neck using piezoelectric films, and sEMG of the suprahyoid muscle group were performed simultaneously. Latencies of the three movement phases were defined as upward (VFS1), forward (VFS2), and returning to starting position (VFS3). The three phases of the piezoelectric waveform-from wave initiation of the negative wave to the start of the second deep negative wave; from the start of the second deep negative wave to the start of the last positive wave (SLPW); and from the SLPW to the end of the last positive wave-were defined as PS1, PS2, and PS3, respectively. VFS1-3 and PS1-3 were significantly correlated. VFS1 and PS1 latencies were significantly longer with thick liquid than with thin liquid. VFS2, PS1, and PS2 latencies were longer in the older group than in the other two groups. The start of PS1 was nearly equal to those of sEMG and VFS1. Bolus arrival time in the valleculae was statistically equal to the end of the PS1 with both thin and thick liquids. To establish the swallowing screening using Piezoelectric film, further investigation is necessary in the dysphagia patients.
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Affiliation(s)
- Yuichiro Sogawa
- Rehabilitation Center, Niigata University Medical and Dental Hospital, 1-754, Asahimachi-Dori, Chuo-ku, Niigata-Shi, 951-8520, Japan
| | - Shinji Kimura
- Rehabilitation Center, Niigata University Medical and Dental Hospital, 1-754, Asahimachi-Dori, Chuo-ku, Niigata-Shi, 951-8520, Japan.
| | - Toru Harigai
- Rehabilitation Center, Niigata University Medical and Dental Hospital, 1-754, Asahimachi-Dori, Chuo-ku, Niigata-Shi, 951-8520, Japan
| | - Naoki Sakurai
- Division of Comprehensive Prosthodontics, Department of Tissue Regeneration and Reconstruction, Course for Oral Life Science, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata-Shi, 951-8514, Japan
| | - Akira Toyosato
- Heart Dental Clinic, 76, Kanabachiyamacho, Sekiya, Chuo-ku, Niigata-Shi, 951-8165, Japan
| | - Taro Nishikawa
- Rehabilitation Center, Niigata University Medical and Dental Hospital, 1-754, Asahimachi-Dori, Chuo-ku, Niigata-Shi, 951-8520, Japan
| | - Makoto Inoue
- Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences, 2-5274, Gakkocho-dori, Chuo-ku, Niigata-Shi, 951-8514, Japan
| | - Akira Murasawa
- Department of Rehabilitation Medicine, Niigata Rheumatic Center, 1-2-8, Honcho, Shibata-Shi, 957-0054, Japan
| | - Naoto Endo
- Rehabilitation Center, Niigata University Medical and Dental Hospital, 1-754, Asahimachi-Dori, Chuo-ku, Niigata-Shi, 951-8520, Japan
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Vorperian HK, Kurtzweil SL, Fourakis M, Kent RD, Tillman KK, Austin D. Effect of body position on vocal tract acoustics: Acoustic pharyngometry and vowel formants. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2015; 138:833-45. [PMID: 26328699 PMCID: PMC4545056 DOI: 10.1121/1.4926563] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 05/05/2015] [Accepted: 06/30/2015] [Indexed: 05/21/2023]
Abstract
The anatomic basis and articulatory features of speech production are often studied with imaging studies that are typically acquired in the supine body position. It is important to determine if changes in body orientation to the gravitational field alter vocal tract dimensions and speech acoustics. The purpose of this study was to assess the effect of body position (upright versus supine) on (1) oral and pharyngeal measurements derived from acoustic pharyngometry and (2) acoustic measurements of fundamental frequency (F0) and the first four formant frequencies (F1-F4) for the quadrilateral point vowels. Data were obtained for 27 male and female participants, aged 17 to 35 yrs. Acoustic pharyngometry showed a statistically significant effect of body position on volumetric measurements, with smaller values in the supine than upright position, but no changes in length measurements. Acoustic analyses of vowels showed significantly larger values in the supine than upright position for the variables of F0, F3, and the Euclidean distance from the centroid to each corner vowel in the F1-F2-F3 space. Changes in body position affected measurements of vocal tract volume but not length. Body position also affected the aforementioned acoustic variables, but the main vowel formants were preserved.
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Affiliation(s)
- Houri K Vorperian
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue #427, Madison, Wisconsin 53711, USA
| | - Sara L Kurtzweil
- Speech Pathology, Marshfield Center, 1000 North Oak Avenue, Marshfield, Wisconsin 54449, USA
| | - Marios Fourakis
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison, 1975 Willow Drive, Madison, Wisconsin 53706, USA
| | - Ray D Kent
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue #491, Madison, Wisconsin 53711, USA
| | - Katelyn K Tillman
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue #429, Madison, Wisconsin 53711, USA
| | - Diane Austin
- Waisman Center, University of Wisconsin-Madison, 1500 Highland Avenue #429, Madison, Wisconsin 53711, USA
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12
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Su HK, Khorsandi A, Silberzweig J, Kobren AJ, Urken ML, Amin MR, Branski RC, Lazarus CL. Temporal and Physiologic Measurements of Deglutition in the Upright and Supine Position with Videofluoroscopy (VFS) in Healthy Subjects. Dysphagia 2015; 30:438-44. [DOI: 10.1007/s00455-015-9620-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 04/25/2015] [Indexed: 10/23/2022]
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13
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Feng X, Cartwright MS, Walker FO, Bargoil JH, Hu Y, Butler SG. Ultrasonographic evaluation of geniohyoid muscle and hyoid bone during swallowing in young adults. Laryngoscope 2015; 125:1886-91. [PMID: 25739655 DOI: 10.1002/lary.25224] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2015] [Indexed: 11/07/2022]
Abstract
OBJECTIVES/HYPOTHESIS The geniohyoid muscle plays an important role in hyoid bone movement. Adequate hyoid bone movement during swallowing is important for effective bolus flow and pharyngeal clearing. The aim of this study was to estimate the relationship between the geniohyoid muscle size and function and hyoid bone movement during swallowing in healthy young adults, as measured via ultrasound, in different body positions. STUDY DESIGN Cross-sectional study. METHODS Forty young (20-40 years old) adults (20 male and 20 female) participated. The cross-sectional area of the geniohyoid muscle at rest (seated position), the geniohyoid muscle contraction velocity, and the hyoid bone displacement during swallowing 10 mL of mineral water were measured by ultrasound in seated, supine, and right lateral decubitus positions. RESULTS The size of the geniohyoid muscle correlated with body height. Males had larger geniohyoid cross-sectional area than females and greater maximal and anterior hyoid displacement during swallowing than females, and maximal and anterior hyoid bone displacement during swallowing correlated with the size of geniohyoid muscle only when the body was in the supine position; these two movements were positively correlated to each other. CONCLUSIONS Genders vary in hyoid bone movement during swallowing, and the correlation between geniohyoid muscle size and hyoid bone displacement varies among different body positions during swallowing. This investigation also illuminates the use of ultrasound in providing quantitative measures of geniohyoid muscle and hyoid bone displacement during swallowing. LEVEL OF EVIDENCE 2c.
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Affiliation(s)
- Xin Feng
- Department of Otolaryngology, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A
| | - Michael S Cartwright
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A
| | - Francis O Walker
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A
| | - Jessica H Bargoil
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A
| | - Yunping Hu
- Department of Neurosurgery, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A
| | - Susan G Butler
- Department of Otolaryngology, Wake Forest School of Medicine, Winston-Salem, North Carolina, U.S.A
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14
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Kollara L, Perry JL. Effects of Gravity on the Velopharyngeal Structures in Children Using Upright Magnetic Resonance Imaging. Cleft Palate Craniofac J 2014; 51:669-76. [DOI: 10.1597/13-107] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective The influence of gravity on the velopharyngeal structures in children is unknown. The purpose of this study is to compare the velopharyngeal mechanism in the upright and supine positions while at rest and during sustained speech production in children between 4 and 8 years old. Methods A 0.6 Tesla open-type, multipositional magnetic resonance imaging scanner was used to image subjects in the upright and supine positions. The scanning protocol included a T2 fluid attenuation inversion recovery and an oblique coronal turbo spin echo scan with short scanning durations (7.9 seconds) to enable visualization of the velopharyngeal anatomy during rest and production of sustained /i/ and /s/. Results The magnetic resonance imaging protocol used for this study enabled successful visualization of the velopharyngeal anatomy in the sagittal and oblique coronal planes at rest and during sustained phonation of /i/ and /s/. Positional differences demonstrated a small nonsignificant ( P > .05) variation for velar measures (length, thickness, and height), retrovelar space, and levator veli palatini measures (length and angles of origin). Conclusions Gravity had a negligible effect on velar length, velar thickness, velar height, retrovelar space, levator muscle length, and levator angles of origin. Supine imaging data can be translated to an upright activity such as speech. This is the first study to provide normative levator muscle lengths for children between 4 and 8 years old. Upright imaging may be a promising tool for difficult-to-test populations.
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Affiliation(s)
- Lakshmi Kollara
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC
| | - Jamie L. Perry
- Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC
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15
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Bae Y, Perry JL, Kuehn DP. Videofluoroscopic investigation of body position on articulatory positioning. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2014; 57:1135-1147. [PMID: 24167231 DOI: 10.1044/2013_jslhr-s-12-0235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE To quantitatively examine the effects of body position on the positioning of the epiglottis, tongue, and velum at rest and during speech. METHOD Videofluoroscopic data were obtained from 12 healthy adults in the supine and upright positions at rest and during speech while the participants produced 12 VCV sequences. The effects of body position, target sounds, and adjacent sounds on structural positioning and vowel formant structure were investigated. RESULTS Velar retropositioning in the supine position was the most consistent pattern observed at rest. During speech, all structures, with varying degrees of adjustment, appeared to work against the gravitational pull, resulting in no significant narrowing in the oro- and nasopharyngeal regions while in the supine position. Minimal differences in the formant data between the body positions were also observed. Overall, structural positioning was significantly dependent on the target and adjacent sounds regardless of body position. CONCLUSIONS The present study demonstrated that structural positioning in response to gravity varied across individuals based on the type of activities being performed. With varying degrees of positional adjustment across different structures, fairly consistent articulatory positioning in the anterior-posterior dimension was maintained in different body positions during speech.
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16
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Zu Y, Narayanan SS, Kim YC, Nayak K, Bronson-Lowe C, Villegas B, Ouyoung M, Sinha UK. Evaluation of swallow function after tongue cancer treatment using real-time magnetic resonance imaging: a pilot study. JAMA Otolaryngol Head Neck Surg 2014; 139:1312-9. [PMID: 24177574 DOI: 10.1001/jamaoto.2013.5444] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
IMPORTANCE Magnetic resonance imaging (MRI) has the advantage of imaging swallow function at any anatomical level without changing the position of patient, which can provide detailed information than modified barium swallow, by far the gold standard of swallow evaluation. OBJECTIVE To investigate the use of real-time MRI in the evaluation of swallow function of patients with tongue cancer. DESIGN, SETTING, AND PARTICIPANTS Real-time MRI experiments were performed on a Signa Excite HD 1.5-T scanner (GE Healthcare), with gradients capable of 40-mT/m (milli-Tesla per meter) amplitudes and 150-mT/m/ms (mT/m per millisecond) slew rates. The sequence used was spiral fast gradient echo sequence. Four men with base of tongue or oral tongue squamous cell carcinoma and 3 age-matched healthy men with normal swallowing participated in the experiment. INTERVENTIONS Real-time MRI of the midsagittal plane was collected during swallowing. Coronal planes between the oral tongue and base of tongue and through the middle of the larynx were collected from 1 of the patients. MAIN OUTCOMES AND MEASURES Oral transit time, pharyngeal transit time, submental muscle length change, and the distance change between the hyoid bone and anterior boundary of the thyroid cartilage were measured frame by frame during swallowing. RESULTS All the measurable oral transit and pharyngeal transit times of the patients with cancer were significantly longer than the ones of the healthy participants. The changes in submental muscle length and the distance between the hyoid bone and thyroid cartilage happened in concert for all 60 normal swallows; however, the pattern differed for each patient with cancer. To our knowledge, the coronal view of the tongue and larynx revealed information that has not been previously reported. CONCLUSIONS AND RELEVANCE This study has demonstrated the potential of real-time MRI to reveal critical information beyond the capacity of traditional videofluoroscopy. Further investigation is needed to fully consider the technique, procedure, and standard scope of applying MRI to evaluate swallow function of patients with cancer in research and clinic practice.
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Affiliation(s)
- Yihe Zu
- Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles
| | | | - Yoon-Chul Kim
- Viterbi School of Engineering, University of Southern California, Los Angeles
| | - Krishna Nayak
- Viterbi School of Engineering, University of Southern California, Los Angeles
| | | | - Brenda Villegas
- Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles
| | - Melody Ouyoung
- Department of Speech Pathology, Keck Hospital of University of Southern California, Los Angeles
| | - Uttam K Sinha
- Department of Otolaryngology-Head and Neck Surgery, University of Southern California, Los Angeles
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17
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Weber P, Corrêa ECR, Bolzan GDP, Ferreira FDS, Soares JC, Silva AMTD. Mastigação e deglutição em mulheres jovens com desordem temporomandibular. Codas 2013; 25:375-80. [DOI: 10.1590/s2317-17822013005000005] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2012] [Accepted: 03/21/2013] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Avaliar a mastigação e a deglutição em mulheres com e sem desordem temporomandibular (DTM) e investigar a posição da mandíbula e do osso hioide, por serem estruturas importantes para a realização destas funções. MÉTODOS: Setenta mulheres foram avaliadas quanto à presença de DTM segundo o instrumento Critérios de Diagnóstico para Pesquisa de Desordem Temporomandibular, sendo que 34 delas, com DTM, constituíram o grupo de estudo (GE) e 36 participaram do grupo controle (GC). A avaliação da mastigação e deglutição foi baseada no Protocolo de Avaliação Miofuncional Orofacial com Escores (AMIOFE). As variáveis referentes à posição da mandíbula e osso hioide aferidas pela análise cefalométrica. RESULTADOS: Os indivíduos com DTM apresentaram diferença significativa quanto à postura de língua (p=0,03) e lábios (p=0,04) durante a função de deglutição, bem como a adoção mais frequente de um padrão mastigatório unilateral crônico (p=0,03). Além disso, apresentaram posição mais baixa do osso hioide em relação à mandíbula (p=0,00). CONCLUSÃO: A presença de DTM promoveu maior frequência de alterações miofuncionais orofaciais durante as funções de mastigação e deglutição. A maior distância entre o osso hioide e a mandíbula, bem como a presença da sintomatologia álgica, podem justificar, em parte, os comportamentos atípicos da língua e dos lábios observados no grupo com DTM. A repercussão da DTM sobre as funções alimentares em uma faixa etária jovem explica a importância do diagnóstico e da intervenção terapêutica precoce nestes indivíduos.
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18
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Trevisan ME, Weber P, Ries LG, Corrêa EC. Relação da atividade elétrica dos músculos supra e infra-hióideos durante a deglutição e cefalometria. REVISTA CEFAC 2013. [DOI: 10.1590/s1516-18462013000400018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJETIVO: investigar a influência da postura habitual da cabeça, da posição mandibular e do osso hióide na atividade dos músculos supra e infra-hióideos durante deglutição de diferentes consistências de alimentos. MÉTODO: estudo observacional, transversal, com mulheres entre 19 e 35 anos, sem alterações miofuncionais de deglutição. A postura craniocervical, posição da mandíbula e osso hióide foram avaliados pela cefalometria. A atividade eletromiográfica dos músculos supra e infra-hióideos foi coletada durante a deglutição de água, gelatina e biscoito. RESULTADOS: amostra com 16 mulheres, média de idade 24,19±2,66 anos. No repouso, observaram-se correlações negativas/moderadas entre a atividade elétrica dos músculos supra-hióideos com as variáveis posturais NSL/CVT (posição da cabeça em relação às vértebras cervicais) e NSL/OPT (posição da cabeça em relação à coluna cervical) e positiva/moderada com o ângulo CVA (posição de flexão/extensão da cabeça). Durante a deglutição do biscoito, a atividade dos músculos infra-hióideos apresentou correlação negativa/moderada com o ângulo NSL/OPT. Constatou-se maior atividade elétrica dos músculos supra-hióideos durante a deglutição de todos os alimentos testados e, dos músculos infra-hióideos, no repouso. Os supra-hióideos foram mais ativos que os infra-hióideos durante a deglutição, entretanto, houve aumento da atividade eletromiográfica em ambos os grupos musculares durante a deglutição do biscoito, comparado com a deglutição de água e gelatina. CONCLUSÃO: a hiperextensão da cabeça repercutiu na menor atividade dos músculos supra-hióideos no repouso e, dos músculos infra-hióideos, na deglutição. A consistência do alimento influenciou na atividade elétrica dos músculos supra e infra-hióideos, havendo maior recrutamento muscular na deglutição de alimento sólido.
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