The Effects of Wearing a Medical Mask on the Masticatory and Neck Muscle Activity in Healthy Young Women

The objective of this study was to analyze the influence of wearing a medical mask on masticatory and neck muscle activity in healthy young women. We recruited 66 healthy women aged from 18 to 30 years (mean 23.6 ± 2.3 years). The temporalis anterior (TA), the superficial part of the masseter muscle (MM), the anterior bellies of the digastric muscle (DA), and the middle part of the sternocleidomastoid muscle (SCM) potentials were recorded at rest and during functional activity using an eight-channel device for surface electromyography—BioEMG IIITM. There was a statistically significant decrease in mean TA activity during medical mask measurement compared to no mask examination at rest (2.16 µV vs. 2.58 µV; p = 0.05; ES = 0.2). Significant decreases in resting RMS values were also observed during the medical mask phase in comparison to no mask examination concerning the left MM (1.75 µV vs. 2.17 µV; p = 0.01; ES = 0.3), and mean bioelectrical activity of the MM (1.81 µV vs. 2.15 µV; p = 0.02; ES = 0.2). The differences between the two conditions did not reach the assumed significance level (p > 0.05) in terms of other indices. Wearing a medical mask has a small effect on decreasing the resting potentials of the temporalis anterior and masseter muscles without changing the parameters of activity and asymmetry within the stomatognathic system.

The Influence of Visual Input on Electromyographic Patterns of Masticatory and Cervical Spine Muscles in Subjects with Myopia

This study aimed to analyze the change of visual input on electromyographic patterns of masticatory and cervical spine muscles in subjects with myopia. After applying the inclusion criteria, 50 subjects (18 males and 32 females) with myopia ranging from −0.5 to −5.75 Diopters (D), were included in the study. Four muscle pairs were analyzed: the anterior part of the temporalis muscle (TA), the superficial part of the masseter muscle (MM), the anterior belly of the digastric muscle (DA), and the middle part of the sternocleidomastoid muscle belly (SCM) during resting and functional activity. Statistical analysis showed a significant decrease within functional indices (FCI) for the sternocleidomastoid muscle (FCI SCM R, FCI SCM L, FCI SCM total) during clenching in the intercuspal position with eyes closed compared to eyes open. During maximum mouth opening, a statistically significant increase of functional opening index for the left temporalis muscle (FOI TA L) was observed. Within the activity index (AcI), there was a statistically significant decrease during clenching on dental cotton rollers with eyes closed compared to eyes open.

Preemptive Utilization of Anterior Belly of the Digastric Muscle Flaps in Transoral Robotic Radical Tonsillectomy

Objective To demonstrate the use of an anterior belly of the digastric muscle flap (ABDMF) during transoral robotic radical tonsillectomy (TORRT) with concomitant neck dissection with the intent of preventing the formation of postoperative pharyngocutaneous fistulas. Study Design Retrospective study. Setting Single academic tertiary care center. Methods In this study, all patients were included who underwent TORRT plus limited pharyngectomy with concomitant neck dissection and ABDMF for the treatment of oropharyngeal squamous cell carcinoma between September 2012 and September 2020. The rate of fistula formation was assessed in patients with preemptive utilization of ABDMF. Results A total of 43 patients underwent TORRT with neck dissection and ABDMF. No patients developed a fistula in the postoperative period or associated morbidity with the use of this flap. Conclusion Preemptive use of ABDMF in TORRT with concomitant neck dissection represents a reconstructive option that may help prevent the formation of pharyngocutaneous fistula by reinforcing the posteroinferior boundary of the parapharyngeal space.

Is the 3D exoscope better than the surgical microscope in parotid surgery: a prospective, randomized single-center study

Background High-definition, three-dimensional (3D) exoscopes are being used to perform a growing number of head and neck surgeries. However, the use of the 3D exoscope in parotid gland surgery has not been previously described. Our initial experience with the VITOM 3D exoscope in the surgical treatment of parotid gland tumors is detailed here. Methods We made a prospective study of patients with benign parotid gland tumors indicated for surgical resection. Between January and December 2018, patients were randomly assigned to undergo surgery assisted with the VITOM 3D system (n = 31) or an operating microscope (n = 40). Visualization quality (greater auricular nerve, digastric muscle, tragal pointer), operating time, conversion rates, and surgical outcomes were compared. Results A total of 71 patients underwent superficial (n = 18) or total parotidectomy (n = 53). No exoscope-related complications were observed. Five patients undergoing exoscope-guided deep lobe surgery required intraoperative conversion to a microscope. No differences were observed in the subjective quality of intraoperative visualization of key anatomical structures. However, a significantly higher percentage of patients in the exoscope group developed transient facial nerve paralysis (n = 9; 29% vs. n = 4, 10%). Conclusions These findings suggest that the VITOM 3D is a valid visualization tool for parotid gland surgery, comparable to the operating microscope but with higher resolution 3D visualization, an increased degree of freedom of movement, and better ergonomics. However, the high rate of transient nerve palsy, possibly related to decreased depth perception and the brief learning curve, merits further investigation.

Ultrasound examination of swallowing disorder characteristics in patients with oncopathology of the oral cavity

The aim of the study was to compare the dynamics of oral and oropharyngeal muscles contraction during swallowing in normal individuals and in patients with malignant tumors depending on the clinical disease using ultrasound. Materials and methods. The study included 29 patients aged 38–55 years (men), normtrophic, who were treated in the Department of Head and Neck Tumors of Podolsk Regional Oncology Center for malignant tumors of the tongue, floor of the mouth and oropharynx. Among them, there were 12 patients with cancer of the lateral tongue surface, 9 - with oral mucosa cancer and 8 – with tongue base cancer. Scanning was performed in the sagittal and frontal planes with a 7.5 MHz sensor in two modes (B and M) at rest and during swallowing in several stages on the TOSHIBA device (Model USDI-A500A/EL; Serial No. ELA14Z2082). B-mode was the main one in all the studied areas where one image frame was vertically lined up. The swallowing act was assessed in M-mode (a length of the axial movement). The obtained indicators were compared with the normal ones. Results. The work was carried out to verify the musculoskeletal complex involved in the act of swallowing. Measurements of several indicators were performed revealing a violation of the swallowing act, namely a decrease in indicators in the longitudinal and lateral examination of the sublingual muscle group in B-mode and M-mode in patients diagnosed with cancer of the tongue base and mucosa of the mouth floor. In addition, a deviation and displacement of the musculoskeletal complex to the healthy contralateral side with preserved muscle function in patients diagnosed with the lateral tongue surface cancer was revealed by M-mode ultrasound of the swallowing act. Conclusions. In patients with malignant tumors of the lateral tongue surface, the longitudinal examination of the sublingual muscle group in B-mode ultrasound showed decreased indicators by 7 % and in the lateral projection of the anterior belly of the digastric muscle in M-mode – by 3.5 times. In tongue base cancer, the mentohyoid distance was merely 4 mm reduced during the act of swallowing, and in the longitudinal projection of the sublingual muscle group - by only 5 %. In oral mucosa cancer, there was the lowest reduction in the mentohyoid distance, about 4 mm when swallowing, (in healthy people 8–12 mm) and decreased indicators in longitudinal examination of the sublingual muscle group by 8 % in B-mode, in lateral M-mode ultrasound – by 2 mm.

Keyhole Endoscopic-Assisted Transcervical Approach to the Upper and Middle Retrostyloid Parapharyngeal Space: An Anatomic Feasibility Study

Objectives The aim of this study was to describe the anatomical nuances, feasibility, limitations, and surgical exposure of the parapharyngeal space (PPS) through a novel minimally invasive keyhole endoscopic-assisted transcervical approach (MIKET). Design Descriptive cadaveric study. Setting Microscopic and endoscopic high-quality images were taken comparing the MIKET approach with a conventional combined transmastoid infralabyrinthine transcervical approach. Participants Five colored latex-injected specimens (10 sides). Main Outcome Measures Qualitative anatomical descriptions in four surgical stages; quantitative and semiquantitative evaluation of relevant landmarks. Results A 5 cm long inverted hockey stick incision was designed to access a corridor posterior to the parotid gland after independent mobilization of nuchal and cervical muscles to expose the retrostyloid PPS. The digastric branch of the facial nerve, which runs 16.5 mm over the anteromedial part of the posterior belly of the digastric muscle before piercing the parotid fascia, was used as a landmark to identify the main trunk of the facial nerve. MIKET corridor was superior to the crossing of the accessory nerve over the internal jugular vein within 17.3 mm from the jugular process. Further exposure of the occipital condyle, vertebral artery, and the jugular bulb was achieved. Conclusion The novel MIKET approach provides in the cadaver straightforward access to the upper and middle retrostyloid PPS through a natural corridor without injuring important neurovascular structures. Our work sets the anatomical nuances and limitations that should guide future clinical studies to prove its efficacy and safety either as a stand-alone procedure or as an adjunct to other approaches, such as the endonasal endoscopic approach.