Electromyography (EMG) of the inferior pharyngeal constrictor (IC) and the cricopharyngeal (CP) muscle was recorded in 18 patients with swallowing and/or aspiration problems who were candidates for cricopharyngeal myotomy. The EMG recordings were compared to those of 13 "normal" subjects who did not suffer from such problems. Differences in EMG activity between the control group and the patient group were considered with respect to the clinical symptoms in the patient group. Recording of EMG in the CP and IC muscles is relatively safe, useful, and easily mastered. The technique may provide important information regarding the function of some of the muscles involved in deglutition.

A new type of analysis of the electromyographic spike obtained from the full interference pattern of extraocular muscles is introduced. It entails the use of a computer for the measurement and statistical analysis of the duration of onset-to-onset from one spike to the next one and the onset-to-onset immediately preceding it. The lateral, medial and superior recti muscles were examined in 13 subjects, of whom 7 were healthy, 3 were suffering from ocular myopathy and 3 from infranuclear neuropathy. Sharp, well-defined differences between healthy, myopathic and neuropathic lesions were found. The technique is simple, rapid and accurate. Its value is enhanced by the fact that no area of overlap was encountered between the 3 basic types of muscle examined. The parameter, and its statistical analysis, appears to be an additional and reliable tool in the interpretation of electromyography (EMG), especially of value in subclinical, incipient or doubtful clinical conditions involving eyeball motility.

Simultaneous recording of the electromyographic activity of the pharyngeal muscles and the intraluminal pressure in the upper sphincter zone was performed routinely in patients with swallowing problems for the first time, to our knowledge. This technique was found to be very useful for the localization of the "site of lesion." The procedure is safe, easy to master, and causes minimal inconvenience. It can reveal, in the most direct way, whether the disturbance is in the hypopharyngeal musculature (represented by the inferior constrictor muscle), in the cricopharyngeal muscle (spasm or lack of relaxation), or in the synchronization between them. Simultaneous recording of intraluminal pressure adds valuable information about the mechanical events associated with electromyographic activity. It was found that in pathologic cases there is quite often no correlation between the electrical and mechanical events. Thus, simultaneous recording of both electrical and mechanical events is essential for the understanding of the pathophysiology of disturbances of deglutition.

No abstract

No abstract