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For: Pearson WG, Hindson DF, Langmore SE, Zumwalt AC. Evaluating swallowing muscles essential for hyolaryngeal elevation by using muscle functional magnetic resonance imaging. Int J Radiat Oncol Biol Phys 2012;85:735-40. [PMID: 22995662 DOI: 10.1016/j.ijrobp.2012.07.2370] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 07/06/2012] [Accepted: 07/23/2012] [Indexed: 12/22/2022]

For:	Pearson WG, Hindson DF, Langmore SE, Zumwalt AC. Evaluating swallowing muscles essential for hyolaryngeal elevation by using muscle functional magnetic resonance imaging. Int J Radiat Oncol Biol Phys 2012;85:735-40. [PMID: 22995662 DOI: 10.1016/j.ijrobp.2012.07.2370] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 07/06/2012] [Accepted: 07/23/2012] [Indexed: 12/22/2022]

Number

Cited by Other Article(s)

Gawryszuk A, van der Laan HP, Vergeer MR, Veening M, Verdonck-de Leeuw IM, Rinkel RN, Steenbakkers RJHM, van den Hoek JGM, Wedman J, van der Schaaf A, Langendijk JA. Improved NTCP model for late radiation-induced aspiration based on dose delivered to specific aspiration-related OARs. Radiother Oncol 2025;207:110871. [PMID: 40157543 DOI: 10.1016/j.radonc.2025.110871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 03/21/2025] [Accepted: 03/22/2025] [Indexed: 04/01/2025]

Han Y, Zhou Y, Gao W, Wang D. A novel approach using acupuncture for dysphagia after brainstem stroke: A CARE-compliant case report. Explore (NY) 2025;21:103155. [PMID: 40139058 DOI: 10.1016/j.explore.2025.103155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2025] [Accepted: 03/16/2025] [Indexed: 03/29/2025]

Debry C, Brenet E, Martinod E, Lavalle P, Dupret-Bories A, Schultz P, Fath L. First example of airway restoration using cryopreserved aortic allograft after total laryngectomy: CARE case report. Eur Ann Otorhinolaryngol Head Neck Dis 2025;142:147-151. [PMID: 39658501 DOI: 10.1016/j.anorl.2024.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2024]

Park JS, Cho YS, Morishita M, Han NM, Yoon TH. Effect of Multidirectional Chin Tuck Against Resistance Exercise on Oropharyngeal Muscles and Swallowing Function in Subacute Stroke Patients With Dysphagia: A Randomised Controlled Trial. J Oral Rehabil 2025. [PMID: 40312765 DOI: 10.1111/joor.13972] [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: 07/26/2024] [Revised: 01/10/2025] [Accepted: 04/07/2025] [Indexed: 05/03/2025]

Arkenberg RH, Mitchell S, Venkatraman A, Sivasankar MP, Pearson WG, Malandraki GA. Maximum Vocal Pitch Elevation and Swallowing: A Secondary Data Analysis Supporting Additional Shared Biomechanics and Potential Treatment Targets. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2025:1-11. [PMID: 40299721 DOI: 10.1044/2025_jslhr-24-00749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/01/2025]

Abstract

PURPOSE

Reduced ability to raise vocal pitch has been associated with risk of aspiration in some populations. However, the mechanisms driving this association are understudied. This secondary data analysis aims to add to our knowledge on the shared and distinct biomechanics of swallowing and maximum vocal pitch elevation.

METHOD

We used existing data from the study of Venkatraman et al. (2020) on 10 healthy younger (age range: 19-23, M = 21) and eight older (age range: 65-79; M = 73) adults who completed maximum pitch elevation and swallow tasks under videofluoroscopy. A MATLAB tracking tool and computational analysis of swallowing mechanics was used to analyze five elements of pharyngeal swallowing biomechanics (anterior and superior hyoid excursion, laryngeal elevation, pharyngeal shortening, tongue base retraction, head/neck extension). Canonical variate analysis (CVA) determined differences associated with task and age. Post hoc discriminant function analyses (DFAs) compared the events between tasks in each group.

RESULTS

CVA revealed that 63.9% of variance was accounted for by task (D = 3.46, p < .0001) and 35.5% by age (D = 1.92, p < .0001). Across age, DFAs indicated similar anterior hyoid excursion and laryngeal elevation between tasks, but greater superior hyoid excursion during swallows, replicating earlier findings. We also found greater base of tongue retraction during swallows than maximum pitch and greater pharyngeal shortening during maximum pitch elevation compared to swallows across groups (D = 5.38, p < .0001).

CONCLUSIONS

Maximum pitch elevation and swallowing require similar anterior hyoid and laryngeal excursion. Added to the novel finding of greater pharyngeal shortening during pitch elevation, we indicate that pitch glides may be a mechanism for targeting pharyngeal dysphagia and warrant further investigation.

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Söyler AK, Kıylıoğlu N, Serel Arslan S, Demir N, Gök M, Ertekin E, Düger T. Do We Know the Long-Term Effects of the Most Popular Traditional Swallow Maneuvers on the Submental Muscles? J Oral Rehabil 2025;52:412-419. [PMID: 39344429 PMCID: PMC11934837 DOI: 10.1111/joor.13862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 08/19/2024] [Accepted: 09/02/2024] [Indexed: 10/01/2024]

Abstract

BACKGROUND

Various trainings focus on the submental muscles (SMs) for dysphagia rehabilitation because of their importance for swallowing safety and efficiency. According to the current literature, swallow-specific tasks may be optimal exercises for dysphagia. The effortful swallow (ES) and the Masako maneuver (MM) are the most commonly used swallow-specific tasks in the clinical settings for dysphagia for years, but long-term effects for these trainings is insufficient.

OBJECTIVES

This study aims to investigate and compare the effects of ES and MM on SM activity, strength and thickness.

METHODS

Thirty-seven healthy adults were randomised to ES, MM and control groups, and ES and MM groups completed 6 weeks of swallowing training. Participants in both training groups performed a total of 120 swallows in each session, while control group did not participate in any swallowing training. Surface electromyography was used to evaluate SM activity, digital dynamometer for SM strength and ultrasonography for SM thickness.

RESULTS

Both trainings did not change SM activity (p > 0.05), but increased SM strength (p < 0.05). MM increased the thickness of all SM (p < 0.05), and ES increased the thickness of mylohyoid (right, left) and digastric muscle (right) (p < 0.05), and there was no change in all evaluation parameters in the control group (p > 0.05). Also, trainings were not superior to each other in any parameter (p > 0.05).

CONCLUSION

The results of this study provided new evidence to the literature to show that ES and MM trainings are effective for improving SM strength and thickness. Considering that SM is important in terms of swallowing safety and effectiveness, it is thought that both trainings may be promising by increasing the strength and mass of SM, especially in individuals with reduced SM strength and mass.

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Castillo-Allendes A, Searl J, Vergara J, Ballentine N, Ebdah S, Rameau A, Hunter EJ. Voice Meets Swallowing: A Scoping Review of Therapeutic Connections. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2025;34:877-907. [PMID: 39772835 PMCID: PMC11903005 DOI: 10.1044/2024_ajslp-24-00194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 08/12/2024] [Accepted: 10/16/2024] [Indexed: 01/11/2025]

Guo Z, Wang Z, Wang Y, Huo W, Han J. Continuous Estimation of Swallowing Motion With EMG and MMG Signals. IEEE Trans Neural Syst Rehabil Eng 2025;33:787-797. [PMID: 40031587 DOI: 10.1109/tnsre.2025.3540842] [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: 03/05/2025]

Abstract

Oropharyngeal dysphagia (OD) is a symptom of swallowing dysfunction that is associated with aspiration, severe respiratory complications, and even death. OD is a highly prevalent condition in populations including the elderly and patients with neurological diseases (e.g., stroke and Parkinson's disease (PD)). Assessment of swallow function is crucial for managing OD, yet depends on devices for long-term monitoring during daily life and relevant methods for accurately assessing swallow function. The videofluoroscopic swallowing study (VFSS) is usually considered a gold standard method. However, it has several limitations, such as radiation exposure, the need for technical experts, high cost, and clinical use only. This study investigates the performances of electromyography (EMG) and mechanomyography (MMG) signals, which can be easily measured using wearable sensors, to continuously estimate swallowing movement. Meanwhile, three methods, i.e., Gaussian process regression (GPR), LSTM, and random forest (RF), are used for swallowing motion estimation based on EMG/MMG signals measured from six healthy subjects and a patient with PD, respectively. Moreover, a depth camera-based approach is proposed to provide the reference laryngeal displacement (i.e., the swallowing movement). The experimental results show that EMG models with three machine learning methods can accurately estimate swallowing movement. For the healthy subjects, the mean correlation coefficient (CC) is about 0.90 and the normalized root mean square error (NRMSE) is less than 0.15. For the PD patient, the CC is 0.804 and the NRMSE is 0.205 when using RF. The performance of the MMG model is comparable to that of EMG: CC/NRMSE of the LSTM model is 0.844/0.150 (healthy subjects); CC/NRMSE of RF model is 0.727/0.204 (PD patient). To the best of our knowledge, this is the first study proving that both EMG and MMG are two effective means for an accurate continuous estimation of swallowing motion, enabling the possibility of a safe and convenient evaluation and management of OD.

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van der Laan HP, Gawryszuk A, van der Schaaf A, Langendijk JA. Risk reduction of radiation-induced aspiration by sparing specific aspiration-related-organs at risk; an in silico feasibility study. Radiother Oncol 2025;203:110698. [PMID: 39716592 DOI: 10.1016/j.radonc.2024.110698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2024] [Revised: 12/18/2024] [Accepted: 12/19/2024] [Indexed: 12/25/2024]

Dewan K. Oral and Pharyngeal Dysphagia in Adults. Otolaryngol Clin North Am 2024;57:541-550. [PMID: 38637196 DOI: 10.1016/j.otc.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2024]

Kim HH, Park JS. Effects of effortful swallowing against kinesiology taping resistance on the swallowing function in patients with poststroke dysphagia: A randomized controlled trial. Medicine (Baltimore) 2024;103:e38344. [PMID: 38788044 PMCID: PMC11124620 DOI: 10.1097/md.0000000000038344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 05/02/2024] [Indexed: 05/26/2024] Open

Iwai K, Azuma T, Yonenaga T, Sasai Y, Komatsu Y, Tabata K, Nomura T, Sugiura I, Inagawa Y, Matsumoto Y, Nakashima S, Abe Y, Tomofuji T. Predictive Factors Associated with Future Decline in Swallowing Function among Japanese Older People Aged ≥ 75 Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024;21:674. [PMID: 38928921 PMCID: PMC11203831 DOI: 10.3390/ijerph21060674] [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: 04/23/2024] [Revised: 05/18/2024] [Accepted: 05/22/2024] [Indexed: 06/28/2024]

Affiliation(s)

Komei Iwai Department of Community Oral Health, School of Dentistry, Asahi University, 1-1851 Hozumi, Mizuho 501-0296, Gifu, Japan; (K.I.); (T.A.); (T.Y.); (Y.S.); (Y.K.); (K.T.)
Tetsuji Azuma Department of Community Oral Health, School of Dentistry, Asahi University, 1-1851 Hozumi, Mizuho 501-0296, Gifu, Japan; (K.I.); (T.A.); (T.Y.); (Y.S.); (Y.K.); (K.T.)
Takatoshi Yonenaga Department of Community Oral Health, School of Dentistry, Asahi University, 1-1851 Hozumi, Mizuho 501-0296, Gifu, Japan; (K.I.); (T.A.); (T.Y.); (Y.S.); (Y.K.); (K.T.)
Yasuyuki Sasai Department of Community Oral Health, School of Dentistry, Asahi University, 1-1851 Hozumi, Mizuho 501-0296, Gifu, Japan; (K.I.); (T.A.); (T.Y.); (Y.S.); (Y.K.); (K.T.)
Yoshinari Komatsu Department of Community Oral Health, School of Dentistry, Asahi University, 1-1851 Hozumi, Mizuho 501-0296, Gifu, Japan; (K.I.); (T.A.); (T.Y.); (Y.S.); (Y.K.); (K.T.)
Koichiro Tabata Department of Community Oral Health, School of Dentistry, Asahi University, 1-1851 Hozumi, Mizuho 501-0296, Gifu, Japan; (K.I.); (T.A.); (T.Y.); (Y.S.); (Y.K.); (K.T.)
Taketsugu Nomura Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Gifu, Japan; (T.N.); (I.S.); (Y.I.); (Y.M.); (S.N.); (Y.A.)
Iwane Sugiura Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Gifu, Japan; (T.N.); (I.S.); (Y.I.); (Y.M.); (S.N.); (Y.A.)
Yujo Inagawa Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Gifu, Japan; (T.N.); (I.S.); (Y.I.); (Y.M.); (S.N.); (Y.A.)
Yusuke Matsumoto Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Gifu, Japan; (T.N.); (I.S.); (Y.I.); (Y.M.); (S.N.); (Y.A.)
Seiji Nakashima Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Gifu, Japan; (T.N.); (I.S.); (Y.I.); (Y.M.); (S.N.); (Y.A.)
Yoshikazu Abe Gifu Dental Association, 1-18 Minamidori, Kano-cho, Gifu 500-8486, Gifu, Japan; (T.N.); (I.S.); (Y.I.); (Y.M.); (S.N.); (Y.A.)
Takaaki Tomofuji Department of Community Oral Health, School of Dentistry, Asahi University, 1-1851 Hozumi, Mizuho 501-0296, Gifu, Japan; (K.I.); (T.A.); (T.Y.); (Y.S.); (Y.K.); (K.T.)

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Buckley DP, Vojtech JM, Stepp CE. Relative Fundamental Frequency in Individuals with Globus Syndrome and Muscle Tension Dysphagia. J Voice 2024;38:612-618. [PMID: 34823980 PMCID: PMC9124719 DOI: 10.1016/j.jvoice.2021.10.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/01/2021] [Accepted: 10/05/2021] [Indexed: 12/19/2022]

Ryu YH, Kim JH, Kim D, Kim SY, Lee SJ. Diagnostic value of a deep learning-based hyoid bone tracking model for aspiration in patients with post-stroke dysphagia. Digit Health 2024;10:20552076241271778. [PMID: 39130520 PMCID: PMC11311153 DOI: 10.1177/20552076241271778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 06/20/2024] [Indexed: 08/13/2024] Open

Werden Abrams S, Petersen C, Beall J, Namasivayam-MacDonald A, Choi D, Garand KL(F. Factors Influencing Laryngeal Vestibular Closure in Healthy Adults. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023;66:3844-3855. [PMID: 37751725 PMCID: PMC10713015 DOI: 10.1044/2023_jslhr-22-00741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 03/31/2023] [Accepted: 07/06/2023] [Indexed: 09/28/2023]

Finger A, Grohmann M, Krause L, Krüll A, Petersen C, Thieme A, Rades D, Löser A. Irradiation dose to the swallowing apparatus impacts nutritional status in head and neck cancer patients-results from the prospective randomized HEADNUT trial. Strahlenther Onkol 2023;199:875-880. [PMID: 37591979 PMCID: PMC10542726 DOI: 10.1007/s00066-023-02124-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/11/2023] [Indexed: 08/19/2023]

Abstract

PURPOSE

To investigate the influence of radiation dose to the swallowing muscles on the nutritional status in patients with head and neck cancer undergoing primary or adjuvant (chemo)radiotherapy (C)RT.

METHODS

Between 2018 and 2020, 61 patients were prospectively randomized into the so-called HEADNUT trial (head and neck cancer patients undergoing nutritional intervention). Follow-up was continued until 2022. Contouring of the swallowing apparatus included the superior (scm), middle (mcm), and inferior constrictor muscle (icm), the cricopharyngeal muscle (cphm), and the esophageal inlet. Nutritional status was assessed by bioelectrical impedance analysis (BIA) at the beginning and the end of radiotherapy. The posttherapeutic nutritional status was evaluated by the BIA-derived fat-free mass index (FFMI; kg/m2). Malnutrition was assumed at FFMI values of < 15 (women) and < 17 (men) kg/m2. To find differences between dosimetric parameters in well- and malnourished patients, Mann-Whitney U test was used. To model the association between malnutrition and its potentially influencing variables, several logistic regression models were built.

RESULTS

The following parameters differed between well- and malnourished patients at the end of therapy: icm Dmean, V40Gy (%), V50Gy (%), and V60Gy (%), and sphm V40Gy (%). After entering these parameters into a multivariable logistic regression model (dosimetric model), icm Dmean (b = -0.12; Exp(b) = 0.88; 95% CI: 0.78-1.0; p = 0.06) and icm V40Gy (%; b = 0.06; Exp(b) = 1.07; 95% CI: 1-1.13; p = 0.04) proved to be independent dosimetric predictors of malnutrition. We only determined the cut-off value for predicting malnutrition for icm V40Gy (%) since it was the only parameter which met p < 0.05. The optimal cut-off value for the predictor V40Gy (%) based on the Youden Index was 85.6%. Another logistic regression model (dosimetric-clinical model) consisted of icm V40 (%) and the clinical parameters tumor localization, malnutrition before RT, gender, and combined chemotherapy. It was confirmed that both icm V40% (b = -1.9; Exp(b) = -2.7; 95% CI: 0.01-0.8; p = 0.03) and malnutrition at baseline (b = -1.9; Exp(b) = 4.4; 95% CI: 8.4-816.6; p = 0.0002) were independent predictors of subsequent malnutrition the end of RT.

CONCLUSION

Establishment of a normal nutritional status before the start of RT and adherence to dose constraints for the swallowing apparatus may prevent malnutrition in head and neck cancer patients at the end of therapy. Specifically, we suggest an icm V40Gy (%) of more than 86% to be predictive for nutritional complications.

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Ornelas G, Bueno Garcia H, Bracken DJ, Linnemeyer-Risser K, Coleman TP, Weissbrod PA. Differentiation of Bolus Texture During Deglutition via High-Density Surface Electromyography: A Pilot Study. Laryngoscope 2023;133:2695-2703. [PMID: 36734335 DOI: 10.1002/lary.30589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 10/26/2022] [Accepted: 12/03/2022] [Indexed: 02/04/2023]

Longino ES, Davis SJ, Landeen KC, Kimura KS, Sharma RK, Ortiz AS, Yang SF, Patel PN, Stephan SJ. Chemodenervation of the Posterior Belly of the Digastric Muscle in Facial Synkinesis. Facial Plast Surg Aesthet Med 2023;25:378-383. [PMID: 36067327 DOI: 10.1089/fpsam.2022.0207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open

Evaluation of morphological features of palatopharyngeus insertion into the thyroid cartilage. Anat Sci Int 2023:10.1007/s12565-023-00709-7. [PMID: 36877447 DOI: 10.1007/s12565-023-00709-7] [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: 12/10/2022] [Accepted: 02/22/2023] [Indexed: 03/07/2023]

Mialland A, Atallah I, Bonvilain A. Toward a robust swallowing detection for an implantable active artificial larynx: a survey. Med Biol Eng Comput 2023;61:1299-1327. [PMID: 36792845 DOI: 10.1007/s11517-023-02772-8] [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: 02/17/2022] [Accepted: 01/04/2023] [Indexed: 02/17/2023]

Abstract

Total laryngectomy consists in the removal of the larynx and is intended as a curative treatment for laryngeal cancer, but it leaves the patient with no possibility to breathe, talk, and swallow normally anymore. A tracheostomy is created to restore breathing through the throat, but the aero-digestive tracts are permanently separated and the air no longer passes through the nasal tracts, which allowed filtration, warming, humidification, olfaction, and acceleration of the air for better tissue oxygenation. As for phonation restoration, various techniques allow the patient to talk again. The main one consists of a tracheo-esophageal valve prosthesis that makes the air passes from the esophagus to the pharynx, and makes the air vibrate to allow speech through articulation. Finally, swallowing is possible through the original tract as it is now isolated from the trachea. Yet, many methods exist to detect and assess a swallowing, but none is intended as a definitive restoration technique of the natural airway, which would permanently close the tracheostomy and avoid its adverse effects. In addition, these methods are non-invasive and lack detection accuracy. The feasibility of an effective early detection of swallowing would allow to further develop an implantable active artificial larynx and therefore restore the aero-digestive tracts. A previous attempt has been made on an artificial larynx implanted in 2012, but no active detection was included and the system was completely mechanic. This led to residues in the airway because of the imperfect sealing of the mechanism. An active swallowing detection coupled with indwelling measurements would thus likely add a significant reliability on such a system as it would allow to actively close an artificial larynx. So, after a brief explanation of the swallowing mechanism, this survey intends to first provide a detailed consideration of the anatomical region involved in swallowing, with a detection perspective. Second, the swallowing mechanism following total laryngectomy surgery is detailed. Third, the current non-invasive swallowing detection technique and their limitations are discussed. Finally, the previous points are explored with regard to the inherent requirements for the feasibility of an effective swallowing detection for an artificial larynx. Graphical Abstract.

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McCleary SP, Moghadam S, Le C, Perez K, Nahabet E, Sim MS, Roostaeian J. Volumetric Assessment of the Anterior Digastric Muscles: A Deeper Understanding of the Volumetric Changes With Aging. Aesthet Surg J 2023;43:1-8. [PMID: 36039633 DOI: 10.1093/asj/sjac233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 08/01/2022] [Accepted: 08/03/2022] [Indexed: 01/18/2023] Open

Accuracy of High-Resolution Pharyngeal Manometry Metrics for Predicting Aspiration and Residue in Oropharyngeal Dysphagia Patients with Poor Pharyngeal Contractility. Dysphagia 2022;37:1560-1575. [PMID: 35182246 DOI: 10.1007/s00455-022-10417-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 02/07/2022] [Indexed: 12/16/2022]

Abstract

Several physiological metrics can be derived from pharyngeal high-resolution impedance manometry (HRPM), but their clinical relevance has not been well established. We investigated the diagnostic performance of these metrics in relation to videofluoroscopic (VFS) assessment of aspiration and residue in patients with oropharyngeal dysphagia. We analyzed 263 swallows from 72 adult patients (22-91 years) with diverse medical conditions. Metrics of contractility, upper esophageal sphincter (UES) opening and relaxation, flow timing, intrabolus distension pressure, and a global Swallow Risk Index (SRI) were derived from pressure-impedance recordings using pressure-flow analysis. VFS data were independently scored for airway invasion and pharyngeal residue using the Penetration-Aspiration Scale and the Normalized Residue Ratio Scale, respectively. We performed multivariate logistic regression analyses to determine the relationship of HRPM metrics with radiological outcomes and receiver-operating characteristic (ROC) analysis to evaluate their diagnostic accuracy. We identified aspiration in 25% and pharyngeal residue in 84% of the swallows. Aspiration was independently associated with hypopharyngeal peak pressure < 65 mmHg (HypoPeakP) [adjusted odds ratio (OR) 5.27; 95% Confidence Interval (CI) (0.99-28.1); p = 0.051], SRI > 15 [OR 4.37; 95% CI (1.87-10.2); p < 0.001] and proximal esophageal contractile integral (PCI) < 55 mmHg·cm·s [OR 2.30; 95% CI (1.07-4.96); p = 0.034]. Pyriform sinus residue was independently predicted by HypoPeakP < 65 mmHg [OR 7.32; 95% CI (1.93-27.7); p = 0.003], UES integrated relaxation pressure (UES-IRP) > 3 mmHg [OR 2.96; 95% CI (1.49-5.88); p = 0.002], and SRI > 15 [OR 2.17; 95% CI (1.04-4.51); p = 0.039]. Area under ROC curve (AUC) values for individual HRPM metrics ranged from 0.59 to 0.74. Optimal cut-off values were identified. This study demonstrates the diagnostic value of certain proposed and adjunct HRPM metrics for identifying signs of unsafe and inefficient bolus transport in patients with oropharyngeal dysphagia.

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Molfenter SM. The relationship between sarcopenia, dysphagia, malnutrition, and frailty: making the case for proactive swallowing exercises to promote healthy aging. Curr Opin Otolaryngol Head Neck Surg 2022;30:400-405. [PMID: 36004774 DOI: 10.1097/moo.0000000000000835] [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: 11/27/2022]

Ultrasonography as Biofeedback to Increase Muscle Activation During the Mendelsohn Maneuver in Healthy Adults. Dysphagia 2022:10.1007/s00455-022-10542-1. [DOI: 10.1007/s00455-022-10542-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022]

Alves MRM, Oliveira IC, Zica GM, Lederman H, Gonçalves MIR. Hyoid displacement patterns in healthy swallowing. EINSTEIN-SAO PAULO 2022;20:eAO6268. [PMID: 35293528 PMCID: PMC8909124 DOI: 10.31744/einstein_journal/2022ao6268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 03/04/2021] [Indexed: 11/10/2022] Open

Chanda A, Krisciunas GP, Grillone GA. Correlating muscle resection with functional swallow outcomes: An anatomic framework informed systematic review of the literature. Am J Otolaryngol 2022;43:103386. [PMID: 35158265 DOI: 10.1016/j.amjoto.2022.103386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 01/30/2022] [Indexed: 12/01/2022]

Abstract

OBJECTIVE

To perform a systematic review of studies reporting swallow-associated outcomes in patients who received surgery for head and neck cancer (HNC), informed by an anatomic and physiologic framework of pharyngeal phase of swallowing (Pearson's dual-sling model).

METHODS

PUBMED and Google Scholar databases were searched for peer-reviewed papers published between 1990 and 2019 using relevant MeSH terms. Exclusion criteria were 1) discussions comparing reconstruction techniques, 2) case-report/series (n < 10), 3) perspective articles, 4) papers comparing objective instrumental methods of swallowing evaluation, 5) animal/cadaver studies, 6) no instrumental or validated swallow assessment tools used, 7) papers that discuss/include radiotherapy treatment, 8) systematic reviews, 9) papers that discuss swallow training or rehabilitation methods. Two investigators reviewed papers meeting inclusion/exclusions criteria. Muscles resected, anatomic resection site, swallow outcomes, and patient treatment variables were collected.

RESULTS

A total of 115,020 peer-reviewed papers were identified. 74 papers were relevant to this review, 18 met inclusion and exclusion criteria, and none discussed surgical impact on the pharyngeal phase of swallowing using Pearson's dual-sling model. Most papers discussed the effect of tongue-base, supraglottic, or regional anatomic resection. Post-surgical resection Follow-up times ranged from 1 to 13 months. 67% of studies used objective instrumental swallow studies; 22% used patient reported outcome measures. Follow up time since surgical resection, time to feeding tube removal, feeding tube present/absent, aspiration severity were used to define dysphagia endpoints.

CONCLUSIONS

To date, no surgical HNC studies have used the dual-sling mechanism to guide study design, and dysphagia assessment has been inconsistent. To counsel patients on the effects of surgery on pharyngeal phase of swallow function, specialists need physiologically grounded research that correlates muscles resected with consistent measures of swallow function.

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Steidl EMDS, Gonçalves BFDT, Rockenbach NDM, Pasqualoto AS, Mancopes R. Outcomes of manual therapy on the biomechanics of swallowing in individuals with COPD. Codas 2021;33:e20200203. [PMID: 34320141 DOI: 10.1590/2317-1782/20192020203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 08/20/2020] [Indexed: 11/22/2022] Open

Adamske D, Heyduck A, Weidenmüller M, Göricke B, Frank T, Olthoff A. Dysphagia in amyotrophic lateral sclerosis: Quantification of bulbar motor dysfunction. J Oral Rehabil 2021;48:1044-1049. [PMID: 34185922 DOI: 10.1111/joor.13220] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/07/2021] [Accepted: 06/24/2021] [Indexed: 01/28/2023]

Using Ultrasound to Document the Effects of Expiratory Muscle Strength Training (EMST) on the Geniohyoid Muscle. Dysphagia 2021;37:788-799. [PMID: 34132896 DOI: 10.1007/s00455-021-10328-x] [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: 02/06/2021] [Accepted: 06/08/2021] [Indexed: 10/21/2022]

The effect of laryngeal elevation training on swallowing function in patients with dysphagia. The Journal of Laryngology & Otology 2021;135:574-578. [PMID: 34130763 DOI: 10.1017/s0022215121001481] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]

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: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]

Pu D, Lee VHF, Chan KMK, Yuen MTY, Quon H, Tsang RKY. The Relationships Between Radiation Dosage and Long-term Swallowing Kinematics and Timing in Nasopharyngeal Carcinoma Survivors. Dysphagia 2021;37:612-621. [PMID: 33909131 PMCID: PMC9072442 DOI: 10.1007/s00455-021-10311-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 04/20/2021] [Indexed: 11/16/2022]

Curtis JA, Laus J, Schneider SL, Troche MS. Examining the Relationships Between Lingual Strength, Perihyoid Strength, and Swallowing Kinematics in Dysphagic Adults: A Retrospective Cross-Sectional Analysis. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021;64:405-416. [PMID: 33439740 DOI: 10.1044/2020_jslhr-20-00143] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]

Abstract

Purpose The aim of this study was to examine the relationships of clinical measures of lingual and perihyoid strength with displacement swallowing kinematics and swallowing safety in a heterogenous group of dysphagic adults. Method A retrospective analysis was completed of videofluoroscopic swallow studies of consecutive dysphagic outpatient adults presenting to a tertiary swallowing center from January 1, 2015, to December 31, 2017. Videofluoroscopic swallow study records were included if containing displacement swallowing kinematics of a 20-ml single liquid swallow and clinical measures of anterior (L-MIPA) or posterior (L-MIPP) lingual maximal isometric press, saliva mean swallowing pressures (S-MSP), and/or open mouth-maximal isometric press (OM-MIP). Regression analyses were used to examine the relationships between clinical measures of lingual (L-MIPA, L-MIPP, S-MSP) and perihyoid (OM-MIP) strength and displacement swallowing kinematics, and binomial logistic regressions were used to examine the relationships between clinical measures of lingual and perihyoid strength and swallowing safety (Penetration-Aspiration Scale [PAS]). Results Multivariate regressions revealed significant relationships of L-MIPA, L-MIPP, S-MSP, and OM-MIP with group-level changes to the displacement swallowing kinematics. Univariate analyses revealed significant relationships of L-MIPA and L-MIPP with pharyngeal constriction ratio, maximal extent of upper esophageal segment opening, and PAS. Conclusions Weak relationships were identified of clinical measures of lingual and perihyoid strength with displacement swallowing kinematics. These findings suggest that clinical measures of lingual and perihyoid strength do not fully explain impairments in swallowing kinematics across a heterogenous group of dysphagic patients. Weak-to-moderate relationships were identified between clinical measures of lingual strength and PAS, suggesting that they may have value in predicting functional measures of swallowing safety. Further research is needed to examine how findings may differ between specific patient populations.

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Effect of Dysphagia Rehabilitation Using Kinesiology Taping on Oropharyngeal Muscle Hypertrophy in Post-Stroke Patients: A Double Blind Randomized Placebo-Controlled Trial. Healthcare (Basel) 2020;8:healthcare8040411. [PMID: 33086705 PMCID: PMC7712247 DOI: 10.3390/healthcare8040411] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/16/2020] [Accepted: 10/16/2020] [Indexed: 12/14/2022] Open

Kim H, Cho NB, Kim J, Kim KM, Kang M, Choi Y, Kim M, You H, Nam SI, Shin S. Implementation of a Home-Based mHealth App Intervention Program With Human Mediation for Swallowing Tongue Pressure Strengthening Exercises in Older Adults: Longitudinal Observational Study. JMIR Mhealth Uhealth 2020;8:e22080. [PMID: 33012704 PMCID: PMC7600016 DOI: 10.2196/22080] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/07/2020] [Accepted: 10/03/2020] [Indexed: 02/06/2023] Open

Abstract

Background

Tongue pressure is an effective index of swallowing function, and it decreases with aging and disease progression. Previous research has shown beneficial effects of swallowing exercises combined with myofunctional tongue-strengthening therapy on tongue function. Tongue exercises delivered through mobile health (mHealth) technologies have the potential to advance health care in the digital age to be more efficient for people with limited resources, especially older adults.

Objective

The purpose of this study is to explore the immediate and long-term maintenance effects of an 8-week home-based mHealth app intervention with biweekly (ie, every 2 weeks) human mediation aimed at improving the swallowing tongue pressure in older adults.

Methods

We developed an mHealth app intervention that was used for 8 weeks (3 times/day, 5 days/week, for a total of 120 sessions) by 11 community-dwelling older adults (10 women; mean age 75.7 years) who complained of swallowing difficulties. The app included a swallowing monitoring and intervention protocol with 3 therapy maneuvers: effortful prolonged swallowing, effortful pitch glide, and effortful tongue rotation. The 8-week intervention was mediated by biweekly face-to-face meetings to monitor each participant’s progress and ability to implement the training sessions according to the given protocol. Preintervention and postintervention isometric and swallowing tongue pressures were measured using the Iowa Oral Performance Instrument. We also investigated the maintenance effects of the intervention on swallowing tongue pressure at 12 weeks postintervention.

Results

Of the 11 participants, 8 adhered to the home-based 8-week app therapy program with the optimal intervention dosage. At the main trial end point (ie, 8 weeks) of the intervention program, the participants demonstrated a significant increase in swallowing tongue pressure (median 17.5 kPa before the intervention and 26.5 kPa after the intervention; P=.046). However, long-term maintenance effects of the training program on swallowing tongue pressure at 12 weeks postintervention were not observed.

Conclusions

Swallowing tongue pressure is known to be closely related to dysphagia symptoms. This is the first study to demonstrate the effectiveness of the combined methods of effortful prolonged swallowing, effortful pitch glide, and effortful tongue rotation using mobile app training accompanied by biweekly human mediation in improving swallowing tongue pressure in older adults. The mHealth app is a promising platform that can be used to deliver effective and convenient therapeutic service to vulnerable older adults. To investigate the therapeutic efficacy with a larger sample size and observe the long-term effects of the intervention program, further studies are warranted.

International Registered Report Identifier (IRRID)

RR2-10.2196/19585

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Venkatraman A, Fujiki RB, Craig BA, Sivasankar MP, Malandraki GA. Determining the Underlying Relationship Between Swallowing and Maximum Vocal Pitch Elevation: A Preliminary Study of Their Hyoid Biomechanics in Healthy Adults. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020;63:3408-3418. [PMID: 32966145 PMCID: PMC8582751 DOI: 10.1044/2020_jslhr-20-00125] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 06/21/2020] [Accepted: 07/20/2020] [Indexed: 05/04/2023]

Abstract

Purpose Deficiencies in swallowing (aspiration) and in maximum vocal pitch elevation have been shown to correlate in dysphagia. However, the underlying mechanisms that may explain this relationship are not known. In this study, we compare hyoid kinematics between swallowing and maximum vocal pitch elevation in healthy adults. Method Ten young (M = 21 ± 1.33 years) and eight older (M = 72.85 ± 5.59 years) healthy adults completed trials of maximum vocal pitch elevation (vowels /a/ and /i/) and swallowing (thin liquid and pudding) under videofluoroscopy. Superior and anterior hyoid excursions were obtained using kinematic analysis. Two-way analyses of variance and Spearman rho correlations were used to examine differences and relationships between swallowing and maximum pitch elevation biomechanics. Results Superior hyoid excursion was significantly greater for liquid swallows compared to pitch elevation tasks (/a/ and /i/; p = .002; Cohen's d = 1.28; p = .0179, Cohen's d = 1.03, respectively) and for pudding swallows compared to pitch tasks (p = .000, Cohen's d = 1.64; p = .001, Cohen's d = 1.38, respectively). Anterior hyoid excursion was not significantly different between the two functions, but was overall reduced in the older group (p = .0231, Cohen's d = .90). Furthermore, there was a moderate positive correlation between the degree of superior excursion during liquid swallows and maximum pitch elevation for both vowels (r s = .601, p = .001; r s = .524, p = .003) in young adults, and between the degree of anterior excursion during liquid swallows and pitch elevation for both vowels (r s = .688, p = .001; r s = .530, p = .008) in older adults. Conclusions Swallowing and maximum pitch elevation require similar anterior, but not superior, hyoid excursion in healthy adults. Differential correlations between the two tasks for each age group may be associated with age-related muscle changes. We provide evidence of partially shared biomechanics between swallowing and maximum pitch elevation.

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Kantarcigil C, Kim MK, Chang T, Craig BA, Smith A, Lee CH, Malandraki GA. Validation of a Novel Wearable Electromyography Patch for Monitoring Submental Muscle Activity During Swallowing: A Randomized Crossover Trial. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020;63:3293-3310. [PMID: 32910735 PMCID: PMC8060014 DOI: 10.1044/2020_jslhr-20-00171] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 06/25/2020] [Accepted: 06/30/2020] [Indexed: 06/11/2023]

Abstract

Purpose Surface electromyography (sEMG) is often used for biofeedback during swallowing rehabilitation. However, commercially available sEMG electrodes are not optimized for the head and neck area, have rigid form, and are mostly available in large medical centers. We developed an ultrathin, soft, and flexible sEMG patch, specifically designed to conform to the submental anatomy and which will be ultimately incorporated into a telehealth system. To validate this first-generation sEMG patch, we compared its safety, efficiency, and signal quality in monitoring submental muscle activity with that of widely used conventional sEMG electrodes. Method A randomized crossover design was used to compare the experimental sEMG patch with conventional (snap-on) sEMG electrodes. Participants completed the same experimental protocol with both electrodes in counterbalanced order. Swallow trials included five trials of 5- and 10-ml water. Comparisons were made on (a) signal-related factors: signal-to-noise ratio (SNR), baseline amplitude, normalized mean amplitude, and sEMG burst duration and (b) safety/preclinical factors: safety/adverse effects, efficiency of electrode placement, and satisfaction/comfort. Noninferiority and equivalence tests were used to examine signal-related factors. Paired t tests and descriptive statistics were used to examine safety/preclinical factors. Results Forty healthy adults participated (24 women, M _age = 67.5 years). Signal-related factors: SNR of the experimental patch was not inferior to the SNR of the conventional electrodes (p < .0056). Similarly, baseline amplitude obtained with the experimental patch was not inferior to that obtained with conventional electrodes (p < .0001). Finally, normalized amplitude values were equivalent across swallows (5 ml: p < .025; 10 ml: p < .0012), and sEMG burst duration was also equivalent (5 ml: p < .0001; 10 ml: p < .0001). Safety/preclinical factors: The experimental patch resulted in fewer mild adverse effects. Participant satisfaction was higher with the experimental patch (p = .0476, d = 0.226). Conclusions Our new wearable sEMG patch is equivalent with widely used conventional sEMG electrodes in terms of technical performance. In addition, our patch is safe, and healthy older adults are satisfied with it. With lessons learned from the current COVID-19 pandemic, efforts to develop optimal swallowing telerehabilitation devices are more urgent than ever. Upon further validation, this new technology has the potential to improve rehabilitation and telerehabilitation efforts for patients with dysphagia. Supplemental Material https://doi.org/10.23641/asha.12915509.

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Choi JB, Jung YJ, Park JS. Comparison of 2 types of therapeutic exercise: jaw opening exercise and head lift exercise for dysphagic stroke: A pilot study. Medicine (Baltimore) 2020;99:e22136. [PMID: 32957335 PMCID: PMC7505362 DOI: 10.1097/md.0000000000022136] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open

Choi Y, Kim M, Lee B, Yang X, Kim J, Kwon D, Lee SE, Kim H, Nam SI, Hong S, Yang G, Na DL, You H. Development of an Ultrasonic Doppler Sensor-Based Swallowing Monitoring and Assessment System. SENSORS 2020;20:s20164529. [PMID: 32823533 PMCID: PMC7472343 DOI: 10.3390/s20164529] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 08/10/2020] [Accepted: 08/12/2020] [Indexed: 12/13/2022]

Martin-Harris B, Canon CL, Bonilha HS, Murray J, Davidson K, Lefton-Greif MA. Best Practices in Modified Barium Swallow Studies. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020;29:1078-1093. [PMID: 32650657 PMCID: PMC7844340 DOI: 10.1044/2020_ajslp-19-00189] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 04/01/2020] [Accepted: 04/11/2020] [Indexed: 05/22/2023]

Abstract

Purpose The modified barium swallow study (MBSS) is a widely used videofluoroscopic evaluation of the functional anatomy and physiology of swallowing that permits visualization of bolus flow throughout the upper aerodigestive tract in real time. The information gained from the examination is critical for identifying and distinguishing the type and severity of swallowing impairment, determining the safety of oral intake, testing the effect of evidence-based frontline interventions, and formulating oral intake recommendations and treatment planning. The goal of this review article is to provide the state of the science and best practices related to MBSS. Method State of the science and best practices for MBSS are reviewed from the perspectives of speech-language pathologists (SLPs) and radiologists who clinically practice and conduct research in this area. Current quandaries and emerging clinical and research trends are also considered. Results This document provides an overview of the MBSS and standards for conducting, interpreting, and reporting the exam; the SLPs' and radiologist's perspectives on standardization of the exam; radiation exposure; technical parameters for recording and reviewing the exam; the importance of an interdisciplinary approach with engaged radiologists and SLPs; and special considerations for examinations in children. Conclusions The MBSS is the primary swallowing examination that permits visualization of bolus flow and swallowing movement throughout the upper aerodigestive tract in real time. The clinical validity of the study has been established when conducted using reproducible and validated protocols and metrics applied according to best practices to provide accurate and reliable information necessary to direct treatment planning and limit radiation exposure. Standards and quandaries discussed in this review article, as well as references, provide a basis for understanding the current best practices for MBSS.

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Labeit B, Pawlitzki M, Ruck T, Muhle P, Claus I, Suntrup-Krueger S, Warnecke T, Meuth SG, Wiendl H, Dziewas R. The Impact of Dysphagia in Myositis: A Systematic Review and Meta-Analysis. J Clin Med 2020;9:E2150. [PMID: 32650400 PMCID: PMC7408750 DOI: 10.3390/jcm9072150] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 07/01/2020] [Accepted: 07/06/2020] [Indexed: 12/14/2022] Open

Affiliation(s)

Bendix Labeit Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, 48149 Muenster, Germany; (M.P.); (T.R.); (P.M.); (I.C.); (S.S.-K.); (T.W.); (S.G.M.); (H.W.); (R.D.) Institute for Biomagnetism and Biosignalanalysis, University of Muenster, 48149 Muenster, Germany
Marc Pawlitzki Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, 48149 Muenster, Germany; (M.P.); (T.R.); (P.M.); (I.C.); (S.S.-K.); (T.W.); (S.G.M.); (H.W.); (R.D.)
Tobias Ruck Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, 48149 Muenster, Germany; (M.P.); (T.R.); (P.M.); (I.C.); (S.S.-K.); (T.W.); (S.G.M.); (H.W.); (R.D.)
Paul Muhle Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, 48149 Muenster, Germany; (M.P.); (T.R.); (P.M.); (I.C.); (S.S.-K.); (T.W.); (S.G.M.); (H.W.); (R.D.) Institute for Biomagnetism and Biosignalanalysis, University of Muenster, 48149 Muenster, Germany
Inga Claus Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, 48149 Muenster, Germany; (M.P.); (T.R.); (P.M.); (I.C.); (S.S.-K.); (T.W.); (S.G.M.); (H.W.); (R.D.)
Sonja Suntrup-Krueger Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, 48149 Muenster, Germany; (M.P.); (T.R.); (P.M.); (I.C.); (S.S.-K.); (T.W.); (S.G.M.); (H.W.); (R.D.) Institute for Biomagnetism and Biosignalanalysis, University of Muenster, 48149 Muenster, Germany
Tobias Warnecke Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, 48149 Muenster, Germany; (M.P.); (T.R.); (P.M.); (I.C.); (S.S.-K.); (T.W.); (S.G.M.); (H.W.); (R.D.)
Sven G. Meuth Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, 48149 Muenster, Germany; (M.P.); (T.R.); (P.M.); (I.C.); (S.S.-K.); (T.W.); (S.G.M.); (H.W.); (R.D.)
Heinz Wiendl Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, 48149 Muenster, Germany; (M.P.); (T.R.); (P.M.); (I.C.); (S.S.-K.); (T.W.); (S.G.M.); (H.W.); (R.D.)
Rainer Dziewas Department of Neurology with Institute of Translational Neurology, University Hospital Muenster, 48149 Muenster, Germany; (M.P.); (T.R.); (P.M.); (I.C.); (S.S.-K.); (T.W.); (S.G.M.); (H.W.); (R.D.)

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Parreira LC, Salgado-Junior W, Dantas RO. Swallowing in Obese Individuals before and after Bariatric Surgery. Obes Surg 2020;30:3522-3527. [PMID: 32410149 DOI: 10.1007/s11695-020-04675-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]

Karsten RT, Ter Beek LC, Jasperse B, van Alphen MJA, Peeters JM, van der Molen L, Hilgers FJM, Stuiver MM, Smeele LE. MRI Assessment of Swallow Muscle Activation with the Swallow Exercise Aid and with Conventional Exercises in Healthy Volunteers: An Explorative Biomechanical Study. Dysphagia 2020;36:41-53. [PMID: 32200444 DOI: 10.1007/s00455-020-10108-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 03/13/2020] [Indexed: 11/29/2022]

Moon IY, Yi CH, Park IW, Yong JH. Effects of sitting posture and bolus volume on activation of swallowing-related muscles. J Oral Rehabil 2020;47:577-583. [PMID: 31926028 DOI: 10.1111/joor.12934] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Revised: 12/10/2019] [Accepted: 12/31/2019] [Indexed: 11/28/2022]

Kusumaningsih W, Lestari NI, Harris S, Tamin S, Werdhani RA. The effectivity of pharyngeal strengthening exercise, hyolaryngeal complex range of motion exercise, and swallowing practice in swallowing function of ischemic stroke patients with neurogenic dysphagia. J Exerc Rehabil 2019;15:769-774. [PMID: 31938697 PMCID: PMC6944868 DOI: 10.12965/jer.19.38652.326] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 11/19/2019] [Indexed: 11/22/2022] Open

Kılınç HE, Arslan SS, Demir N, Karaduman A. The Effects of Different Exercise Trainings on Suprahyoid Muscle Activation, Tongue Pressure Force and Dysphagia Limit in Healthy Subjects. Dysphagia 2019;35:717-724. [DOI: 10.1007/s00455-019-10079-w] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2019] [Accepted: 11/16/2019] [Indexed: 11/25/2022]

Park JS, Hwang NK, Kim HH, Lee G, Jung YJ. Effect of neuromuscular electrical stimulation combined with effortful swallowing using electromyographic biofeedback on oropharyngeal swallowing function in stroke patients with dysphagia: A pilot study. Medicine (Baltimore) 2019;98:e17702. [PMID: 31689798 PMCID: PMC6946517 DOI: 10.1097/md.0000000000017702] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open

El Gharib AZG, Berretin-Felix G, Rossoni DF, Seiji Yamada S. Effectiveness of Therapy on Post-Extubation Dysphagia: Clinical and Electromyographic Findings. CLINICAL MEDICINE INSIGHTS. EAR, NOSE AND THROAT 2019;12:1179550619873364. [PMID: 31548797 PMCID: PMC6743190 DOI: 10.1177/1179550619873364] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Accepted: 08/04/2019] [Indexed: 11/18/2022]

Abstract

INTRODUCTION

Patients who require prolonged endotracheal intubation (>48 hours) are at risk of dysphagia. Speech-language pathologists should perform swallowing exercises after extubation due to the high probability of developing aspiration pneumonia. There are no studies describing the use of swallowing techniques employed in post-extubation therapy aided by surface electromyography.

OBJECTIVES

To evaluate the effects of swallowing function therapy in extubated patients after prolonged orotracheal intubation by means of clinical and electromyographic evaluation.

METHODS

A total of 15 patients were enrolled in this study (average age 48.6 ± 16.5 years). The study was carried out in three phases: (1) Clinical and electromyographic evaluation using the Dysphagia Risk Assessment Protocol following dysphagia scores criteria, and the measurement of the suprahyoid muscles amplitude (μV) expressed by root mean square (RMS), respectively; (2) swallowing rehabilitation program; and (3) reevaluation of patients after therapy. The Wilcoxon paired test assuming a significance level of 5% was used for statistical analysis.

RESULTS

By means of the swallowing scale, it was verified that patients suffered from severe oropharyngeal dysphagia at the first evaluation (80%), but the rehabilitation therapy reduced clinical signs, persistent only in one patient (6.7%) post-therapy, thus, improving swallowing. Significant differences, pre- and post-therapy, for suprahyoid muscles during maximal voluntary isometric contractions of right (P = .0067) and left (P = .0215), saliva swallowing by right (P = .0413) and left (P = .0151), and liquid swallowing by right (P = .0479) and left (P = .0215) sides, were found, as shown by electromyography.

CONCLUSIONS

Swallowing exercises carried out by extubated patients after prolonged orotracheal intubation increased neuromuscular recruitment of suprahyoid muscles involved with swallowing and reduced dysphagia levels.

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Pearson WG, Griffeth JV, Ennis AM. Functional Anatomy Underlying Pharyngeal Swallowing Mechanics and Swallowing Performance Goals. ACTA ACUST UNITED AC 2019. [DOI: 10.1044/2019_pers-sig13-2018-0014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]

Hosseini P, Tadavarthi Y, Martin‐Harris B, Pearson WG. Functional Modules of Pharyngeal Swallowing Mechanics. Laryngoscope Investig Otolaryngol 2019;4:341-346. [PMID: 31236469 PMCID: PMC6580054 DOI: 10.1002/lio2.273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 04/05/2019] [Accepted: 04/30/2019] [Indexed: 12/25/2022] Open

Abstract

OBJECTIVES

The present retrospective cohort study aims to test the hypothesis that elements of swallowing mechanics including hyoid movement, laryngeal elevation, tongue base retraction, pharyngeal shortening, pharyngeal constriction, and head and neck extension can be grouped into functional modules, and that these modules are predictably altered in disease states.

METHODS

Modified barium swallow video clips of a thick and a thin liquid swallow from 40 normal patients and 10 dysphagic post-treatment oropharyngeal head-and-neck cancer (HNC) patients were used in this study. Coordinate locations of 12 anatomical landmarks mapping pharyngeal swallowing mechanics were tracked on every frame during the pharyngeal phase of each swallow using a custom-made MATLAB tool. Morphometric modularity hypothesis testing was performed on these coordinate data to characterize the modular elements of swallowing function in each cohort using MorphoJ software.

RESULTS

The elements of normal swallowing can be grouped into four functional modules including bolus propulsion, pharyngeal shortening, airway protection, and head and neck posture. Modularity in HNC patient showed an intact airway protection module but altered bolus propulsion and pharyngeal shortening modules. To cross-validate the alteration in modules, a post hoc analysis was performed, which showed significantly increased vallecular (P < .04) and piriform (P < .05) residue but no significant change in aspiration status in the HNC cohort versus controls.

CONCLUSIONS

This study suggests that while pharyngeal swallowing mechanics is highly complex, the system is organized into functional modules, and that changes in modularity impacts swallowing performance. This approach to understanding swallowing function may help the patient care team better address swallowing difficulties.

LEVEL OF EVIDENCE

2b.

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