1
|
Aoyagi Y, Ohashi M, Ando S, Inamoto Y, Aihara K, Matsuura Y, Imaeda S, Saitoh E. Effect of Tongue-Hold Swallow on Pharyngeal Contractile Properties in Healthy Individuals. Dysphagia 2021; 36:936-943. [PMID: 33386483 PMCID: PMC8464565 DOI: 10.1007/s00455-020-10217-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 11/17/2020] [Indexed: 01/19/2023]
Abstract
Tongue-hold swallow (THS) is a swallow exercise in which an individual swallows saliva while holding the anterior portion of the tongue between the front teeth. The effect of THS on pharyngeal contractile vigor is still unclear. The purpose of this study was to quantify THS using high-resolution manometry with a contractile integral analysis. Twenty-two healthy participants performed three different saliva swallow tasks: normal swallow, weak THS (in which the tongue was protruded 1 cm outside the upper incisors), and strong THS (in which the tongue was protruded 2 cm outside the upper incisors). The participants repeated each task twice randomly. Pharyngeal and upper esophageal sphincter metrics, including the pharyngeal contractile integral, were analyzed. Both weak and strong THS enhanced the velopharyngeal contractile integral and peak pressure compared with normal swallow (P < 0.01). THS also prolonged mesopharyngeal contraction (P < 0.01). Holding the tongue anteriorly during swallow requires significant biomechanical changes to pharyngeal contractile properties at the superior and middle pharyngeal constrictor levels; thus, it may serve as a resistance exercise for the muscles that are involved in bolus propulsion.
Collapse
Affiliation(s)
- Yoichiro Aoyagi
- Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan.
| | - Miho Ohashi
- Department of Rehabilitation, Fujita Health University Bantane Hospital, Nagoya, Japan
| | - Shiori Ando
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Yoko Inamoto
- Faculty of Rehabilitation, Fujita Health University, Toyoake, Japan
| | - Keiko Aihara
- Faculty of Rehabilitation, Fujita Health University, Toyoake, Japan
| | - Yoko Matsuura
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Sayuri Imaeda
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Eiichi Saitoh
- Department of Rehabilitation Medicine, School of Medicine, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake, Aichi, 470-1192, Japan
| |
Collapse
|
2
|
Amin JD, Kallen ME, Hatten KM. Radical Tonsillectomy and Superior Pharyngeal Constrictor Anatomy: A Cadaveric and Oncologic Specimen Assessment. ORL J Otorhinolaryngol Relat Spec 2020; 82:318-326. [PMID: 32659762 DOI: 10.1159/000508136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 04/21/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION The rise in primary surgical management of oropharyngeal squamous cell carcinoma has led to varying interpretations of the histopathologic evaluation following a radical tonsillectomy. The oncologic margin may be significantly influenced by the morphologic relations and anatomic dimensions of the palatine tonsil and superior pharyngeal constrictor (SPC) muscle. OBJECTIVE The aim of this study was to characterize the gross and histologic anatomic features of the palatine tonsil and SPC muscle following an en bloc radical tonsillectomy. METHODS Radical tonsillectomy specimens were collected from cadaveric and oncologic subjects. Specimens were processed using standard histopathologic techniques and were analyzed by a board-certified head and neck pathologist. The thickness of the SPC muscle and relationship to the tonsillar carcinoma were assessed. RESULTS Six cadaveric and 10 oncologic specimens were analyzed. The mean minimum SPC width for all cadaveric specimens was 1.02 ± 0.50 mm. The mean minimum width for oncologic specimens was 0.76 ± 0.46 mm. The mean distance from tonsil carcinoma to the lateral specimen margin was 1.79 ± 1.39 mm. CONCLUSION Due to the limited width of the SPC muscle, a margin in excess of 2 mm may not be attainable in a transoral radical tonsillectomy. Margin status may be ideally determined by the integrity of the SPC muscle in future oncologic studies, rather than an adequate distance measurement.
Collapse
Affiliation(s)
- Julian D Amin
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Michael E Kallen
- Department of Pathology, University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Kyle M Hatten
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA,
| |
Collapse
|
3
|
Okada R, Muro S, Eguchi K, Yagi K, Nasu H, Yamaguchi K, Miwa K, Akita K. The extended bundle of the tensor veli palatini: Anatomic consideration of the dilating mechanism of the Eustachian tube. Auris Nasus Larynx 2017. [PMID: 28625531 DOI: 10.1016/j.anl.2017.05.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of this study was to analyze the topographical structures of the muscles surrounding the Eustachian tube. MATERIALS AND METHODS We conducted macroscopic and histological studies of 24 halves of 12 heads from Japanese cadavers. RESULTS The main findings were as follows: 1) the infero-lateral muscle bundles of the tensor veli palatini didn't turn medially at the pterygoid hamulus but were distributed laterally and continuous with the buccinator; 2) the tensor veli palatini attached laterally to the membranous part of the Eustachian tube; 3) the superior pharyngeal constrictor was not only adjacent to the buccinator at the pterygomandibular raphe but also had muscular continuation with it laterally and 4) some bundles of the superior pharyngeal constrictor adhered with the palatine aponeurosis. CONCLUSION We believe that the cooperation of the muscles contributes to the dilating mechanism of the Eustachian tube, due to the complex topographical structures of the surrounding muscles: the tensor veli palatini, the levator veli palatini, the superior pharyngeal constrictor and the buccinator.
Collapse
Affiliation(s)
- Ryuhei Okada
- Department of Clinical Anatomy, Tokyo Medical and Dental University, Tokyo, Japan
| | - Satoru Muro
- Department of Clinical Anatomy, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kohtaro Eguchi
- Department of Clinical Anatomy, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kohei Yagi
- Department of Clinical Anatomy, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hisayo Nasu
- Department of Clinical Anatomy, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kumiko Yamaguchi
- Department of Clinical Anatomy, Tokyo Medical and Dental University, Tokyo, Japan
| | - Koh Miwa
- Department of Clinical Anatomy, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keiichi Akita
- Department of Clinical Anatomy, Tokyo Medical and Dental University, Tokyo, Japan
| |
Collapse
|
4
|
Messer JA, Mohamed ASR, Hutcheson KA, Ding Y, Lewin JS, Wang J, Lai SY, Frank SJ, Garden AS, Sandulache V, Eichelberger H, French CC, Colen RR, Phan J, Kalpathy-Cramer J, Hazle JD, Rosenthal DI, Gunn GB, Fuller CD. Magnetic resonance imaging of swallowing-related structures in nasopharyngeal carcinoma patients receiving IMRT: Longitudinal dose-response characterization of quantitative signal kinetics. Radiother Oncol 2016; 118:315-22. [PMID: 26830697 PMCID: PMC4794348 DOI: 10.1016/j.radonc.2016.01.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 01/11/2016] [Accepted: 01/16/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND We aim to characterize serial (i.e., acute and late) MRI signal intensity (SI) changes in dysphagia-associated structures as a function of radiotherapy (RT) in nasopharyngeal cancer (NPC) patients. MATERIALS AND METHODS We retrospectively extracted data on 72 patients with stage III-IV NPC treated with intensity-modulated RT (IMRT). The mean T1- and T2-weighted MRI SIs were recorded for the superior pharyngeal constrictor (SPC) and soft palate (SP) at baseline, early-after IMRT, and last follow up, with normalization to structures receiving <5 Gy. RESULTS All structures had a significant increase in T2 SIs early after treatment, irrespective of the mean dose given. At last follow-up, the increase in T2 SI subsided completely for SPC and partially for SP. The T1 SI did not change significantly in early follow-up images of both structures; on late follow-up, patients with mean doses >62.25 Gy had a significant decrease in the corresponding T1 SI for SPC (1.6 ± 0.4 vs. 1.3 ± 0.4, P=0.007) but decreased non-significantly for SP. CONCLUSIONS Serial MRI acquisitions enable the identification of both early and late radiation-induced changes in swallowing structures after definitive IMRT for NPC. Dose dependent decrease in late T1 SI is associated with higher RT doses to the superior pharyngeal constrictor muscle; while dose independent increase in SI for both structures in early post-RT T2 images is observed and subsides after therapy. Further efforts will seek to elucidate the relationship between dose-dependent muscle SI changes and functional alteration of swallowing muscles.
Collapse
Affiliation(s)
- Jay A Messer
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; The University of Texas Medical School at Houston, USA.
| | - Abdallah S R Mohamed
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, University of Alexandria, Egypt.
| | - Katherine A Hutcheson
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Yao Ding
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Jan S Lewin
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Jihong Wang
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Stephen Y Lai
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Steven J Frank
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Adam S Garden
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Vlad Sandulache
- Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Hillary Eichelberger
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; The University of Texas Medical School at Houston, USA
| | - Chloe C French
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA; The University of Texas Medical School at Houston, USA
| | - Rivka R Colen
- Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Jack Phan
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | | | - John D Hazle
- Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - David I Rosenthal
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - G Brandon Gunn
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - Clifton D Fuller
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, USA.
| |
Collapse
|