scholarly journals Adaptations to Oral and Pharyngeal Swallowing Function Induced by Injury to the Mylohyoid Muscle

Dysphagia ◽  
2020 ◽  
Vol 35 (5) ◽  
pp. 814-824 ◽  
Author(s):  
Suzanne N. King ◽  
Brittany Fletcher ◽  
Bradley Kimbel ◽  
Nicholas Bonomo ◽  
Teresa Pitts
Keyword(s):  
Mylohyoid Muscle ◽  
Swallowing Function ◽  
Pharyngeal Swallowing

scholarly journals Adaptations to Oral and Pharyngeal Swallowing Function Induced by Injury to the Mylohyoid Muscle

2019 ◽  
Author(s):  
Suzanne N. King ◽  
Brittany Fletcher ◽  
Bradley Kimbel ◽  
Nicholas Bonomo ◽  
Teresa Pitts
Keyword(s):  
Muscle Injury ◽  
Radiation Treatment ◽  
Clinical Effects ◽  
Post Injury ◽  
Mylohyoid Muscle ◽  
Swallowing Function ◽  
Bolus Transit ◽  
Bolus Size ◽  
Pharyngeal Muscles ◽  
Pharyngeal Swallowing

AbstractMuscle injury is a frequent side effect of radiation treatment for head and neck cancer. To understand the pathophysiology of injury-related dysfunction, we investigated the effects of a single muscle injury to the mylohyoid on oropharyngeal swallowing function in the rat. The mylohyoid protects the airway from food/liquid via hyolaryngeal elevation and plays an active role during both oral and pharyngeal swallowing. We hypothesized (1) that fibrosis to the mylohyoid alters swallowing bolus flow and licking patterns; (2) that injury to the mylohyoid changes normal activity of submental, laryngeal, and pharyngeal muscles during swallowing. A chilled cryoprobe was applied to the rat mylohyoid muscle to create a localized injury. After 1- and 2-weeks post-injury, swallowing bolus transit was assessed via videofluoroscopy and licking behavior via an electrical lick sensor. The motor activity of five swallow-related muscles were analyzed immediately after injury using electromyography (EMG). Comparisons were made pre- and post-injury. Fibrosis was confirmed in the mylohyoid at 2-weeks post-injury by measuring collagen content. One-week after injury, bolus size decreased, swallowing rate reduced, and licking patterns were altered. Immediately post-injury, there was a significant depression in mylohyoid and thyropharyngeus EMG amplitudes during swallowing. Our results demonstrated that injury to the mylohyoid is sufficient to cause changes in deglutition. These disruptions in oral and pharyngeal swallowing were detected prior to long-term fibrotic changes, including delays in tongue movement, alterations in bolus flow, and changes in sensorimotor function. Therefore, injuring a single important swallowing muscle can have dramatic clinical effects.

Speech and Swallowing in Irradiated and Nonirradiated Postsurgical Oral Cancer Patients

1998 ◽  
Vol 118 (5) ◽  
pp. 616-624 ◽  
Author(s):  
Barbara Roa Pauloski ◽  
Alfred W. Rademaker ◽  
Jerilyn A. Logemann ◽  
Laura A. Colangelo
Keyword(s):  
Radiation Effects ◽  
Radiation Treatment ◽  
Salivary Flow ◽  
Tongue Base ◽  
Statistical Testing ◽  
Postoperative Radiation Therapy ◽  
Swallowing Function ◽  
Pharyngeal Wall ◽  
Pharyngeal Clearance ◽  
Pharyngeal Swallowing

The effect of radiation on speech and swallowing function was assessed for 18 patients surgically treated for oral and oropharyngeal cancer. Nine patients received surgical intervention and postoperative radiation therapy, and nine received surgery only. Patients were matched regarding percentage of oral tongue resected, percentage of tongue base resected, locus of resection, and method of reconstruction. Speech and swallowing function was assessed before and at 1, 3, 6, and 12 months after surgery following a standardized protocol. Speech tasks included an audio recording of a brief conversation and of a standard articulation test; swallowing function was examined with videofluoroscopy. Statistical testing indicated that overall speech function did not differ between the irradiated and nonirradiated patients. Irradiated patients had significantly reduced oral and pharyngeal swallowing performance, specifically, longer oral transit times on paste boluses, lower oropharyngeal swallow efficiency, increased pharyngeal residue, and reduced cricopharyngeal opening duration. Impaired function may be the result of radiation effects such as edema, fibrosis, and reduced salivary flow. Increased use of tongue range-of-motion exercises during and after radiation treatment may reduce the formation of fibrotic tissue in the oral cavity and may improve pharyngeal clearance by maintaining adequate tongue base-to-pharyngeal wall contact. (Otolaryngol Head Neck Surg 1998;118:616–24.)

Effect of Swallowing Rehabilitation Protocol on Swallowing Function in Patients with Esophageal Atresia and/or Tracheoesophageal Fistula

2017 ◽  
Vol 27 (06) ◽  
pp. 526-532 ◽  
Author(s):  
Selen Serel Arslan ◽  
Numan Demir ◽  
Sule Yalcın ◽  
Ayşe Karaduman ◽  
Ibrahim Karnak ◽  
...  
Keyword(s):  
Esophageal Atresia ◽  
Tracheoesophageal Fistula ◽  
Oral Intake ◽  
Control Group ◽  
Study Group ◽  
Start Time ◽  
Swallowing Function ◽  
Rehabilitation Protocol ◽  
Swallowing Rehabilitation ◽  
Pharyngeal Swallowing

Aim The aim of this study was to evaluate the results of Swallowing Rehabilitation Protocol (SRP) on swallowing function (SF) of esophageal atresia and tracheoesophageal fistula (EA-TEF) patients with pharyngeal swallowing disorder. Materials and Methods In this study, 24 children with EA-TEF who had deglutitive and respiratory problems were grouped into either study (n = 12) or control group (n = 12) by basic randomization. Study group received the SRP including neuromuscular electrical stimulation, thermal tactile stimulation, and hyolaryngeal mobilization. The control group received nonnutritive stimulations. SF was evaluated with 3 mL liquid and pudding barium by videofluoroscopic swallowing study (VFSS) before and after 20 sessions of interventions. Results No statistical differences were found between groups in terms of descriptive characteristics including age, sex, weight, height, type of atresia, repair type, repair time, and start time of oral intake (p > 0.05). There were no statistical differences between groups in term of swallowing parameters (p > 0.05), except reflux (p = 0.004) according to VFSS findings. After 20 sessions of interventions, the study group showed improvement in penetration–aspiration scale scores, oral phase dysfunction, delay in swallowing reflex, and residue in valleculae and pyriform sinuses after pudding swallow. The control group showed improvement only in oral phase dysfunction. Conclusion SRP can be recommended to improve SF in patients with EA/TEF who have pharyngeal swallowing disorders.

Swallowing Dysfunction Following Radiation to the Rat Mylohyoid Muscle is Associated with Sensory Neuron Injury

2021 ◽  
Author(s):  
Suzanne N. King ◽  
Justin Hurley ◽  
Zachary Carter ◽  
Nicholas Bonomo ◽  
Brian Wang ◽  
...  
Keyword(s):  
Animal Model ◽  
Stress Response ◽  
Sensory Neurons ◽  
Trigeminal Ganglion ◽  
Mylohyoid Muscle ◽  
Swallowing Function ◽  
Swallowing Dysfunction ◽  
Bolus Size ◽  
Radiation Induced ◽  
Neuron Injury

Radiation based treatments for oropharyngeal and hypopharyngeal cancers result in impairments in swallowing mobility, but the mechanisms behind the dysfunction are not clear. The purpose of this study was to determine if we could establish an animal model of radiation-induced dysphagia in which mechanisms could be examined. We hypothesized that (1) radiation focused at the depth of the mylohyoid muscle would alter normal bolus transport and bolus size; and (2) that radiation to the mylohyoid muscle will induce an injury/stress-like response in trigeminal sensory neurons whose input might modulate swallow. Rats were exposed to 48 or 56 Gy of radiation to the mylohyoid given 8 Gy in 6 or 7 fractions. Swallowing function was evaluated by videofluoroscopy 2- and 4-weeks following treatment. Neuronal injury/stress was analyzed in trigeminal ganglion by assessing ATF3 and GAP-43 mRNA at 2-, 4- and 8-weeks post. Irradiated rats exhibited decreases in bolus movement through the pharynx and alterations in bolus clearance. Additionally, ATF3 and GAP-43 mRNAs were upregulated in trigeminal ganglion in irradiated rats, suggesting that radiation to mylohyoid muscle induced an injury/stress response in neurons with cell bodies that are remote from the irradiated tissue. These results suggest that radiation-induced dysphagia can be assessed in the rat, and that radiation induces injury/stress-like responses in sensory neurons.

Airway Closure Delay: The Predominant Pathophysiology in Reflux-Associated Dysphagia

2019 ◽  
Vol 160 (5) ◽  
pp. 885-890 ◽  
Author(s):  
Katherine A. Kendall
Keyword(s):  
Tertiary Care ◽  
Oropharyngeal Dysphagia ◽  
Retrospective Chart Review ◽  
Upper Esophageal Sphincter ◽  
Barium Swallow ◽  
Airway Closure ◽  
Swallowing Function ◽  
Pharyngeal Transit ◽  
Pharyngeal Swallowing ◽  
The Impact

Objective Reflux disease is common in patients with oropharyngeal dysphagia, but the impact of reflux on oropharyngeal swallowing physiology is not known. This study uses objective measures of swallowing function from modified barium swallow studies to describe the pathophysiology of dysphagia in a group of patients whose only associated condition is reflux. Study Design Retrospective chart review. Setting Tertiary care voice and swallowing clinic. Subjects and Methods The Swallowing Database at the University of Utah was queried for patients with a diagnosis of reflux without additional conditions known to affect swallowing function. Pharyngeal transit time (TPT), distance of hyoid elevation (Hmax), maximum opening size of the upper esophageal sphincter (UESmax), area of pharynx at maximum constriction (PAmax), airway closure timing relative to the arrival of the bolus at the UES, and penetration/aspiration (Pen/Asp) score were assessed. Results Of the 122 patients who met inclusion criteria for the study, 42% had normal pharyngeal swallowing function, 57% had at least 1 abnormal swallowing measure, and 47.5% demonstrated a delay in airway closure relative to arrival of the bolus at the UES on at least 1 swallow. The incidence of prolonged TPT, diminished Hmax, poor UESmax, and enlarged PAmax were 2.5%, 8%, 4%, and 11.5%, respectively. Sixty percent with a delay in airway closure had a normal Pen/Asp score. Conclusion A delay in airway closure relative to the arrival of the bolus at the UES is the most common abnormality of swallowing function found in patients with reflux-associated dysphagia but may not be identified using the Pen/Asp score.

scholarly journals Investigation of Pharyngeal Swallowing Function Using High-Resolution Manometry

2008 ◽  
Vol 118 (10) ◽  
pp. 1729-1732 ◽  
Author(s):  
Kenji Takasaki ◽  
Hiroshi Umeki ◽  
Kaori Enatsu ◽  
Fujinobu Tanaka ◽  
Noriyuki Sakihama ◽  
...  
Keyword(s):  
High Resolution ◽  
Swallowing Function ◽  
High Resolution Manometry ◽  
Pharyngeal Swallowing

Effect of dentures on pharyngeal swallowing function in patients with dysphagia

2021 ◽  
Author(s):  
Daisuke Takagi ◽  
Tomohisa Ohno ◽  
Motoki Moriwaki ◽  
Norimasa Katagiri ◽  
Yoshiko Umeda ◽  
...  
Keyword(s):  
Swallowing Function ◽  
Pharyngeal Swallowing

scholarly journals Tongue thickness measured by ultrasonography is associated with tongue pressure in the Japanese elderly

2020 ◽  
Author(s):  
Masahiro Nakamori ◽  
Eiji Imamura ◽  
Masako Fukuta ◽  
Keisuke Tachiyama ◽  
Teppei Kamimura ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Thickness Measurement ◽  
Tongue Pressure ◽  
Invasive Technique ◽  
Optimal Cutoff ◽  
Mylohyoid Muscle ◽  
Swallowing Function ◽  
Japanese Elderly ◽  
The Relationship ◽  
Oral Frailty

AbstractThe term “oral frailty” reflects the fact that oral health is associated with physical frailty and mortality. Tongue thickness measurement is one of the evaluations for swallowing function. The aim of this study was to investigate the relationship between tongue thickness and tongue pressure in the Japanese elderly. We evaluated 254 elderly patients; all the participants underwent tongue ultrasonography and tongue pressure measurement. To determine tongue thickness, we measured the vertical distance from the surface of the mylohyoid muscle to the tongue dorsum using ultrasonography. Result analyses revealed that tongue thickness was linearly associated with tongue pressure in both sexes. In male participants, dyslipidemia, lower leg circumference, and tongue pressure were independently significantly associated with tongue thickness. In female participants, body mass index and tongue pressure were independently significantly associated with tongue thickness. Tongue thickness was significantly decreased by age for both men and women. The optimal cutoff for tongue thickness to predict the tongue pressure of < 20 kPa was 41.3 mm in males, and 39.3 mm in females. In the Japanese elderly, tongue thickness using ultrasonography is associated with tongue pressure. Tongue thickness and tongue pressure, which are sensitive markers for oral frailty, decrease in aging. The tongue ultrasonography provides a less invasive technique for determining tongue thickness and related aspiration risks for elderly patients.

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