Closure of the Laryngeal Vestibule During Deglutition

Ekberg, Olle

doi:10.3109/00016488209130862

Cited by 62 publications

(51 citation statements)

References 9 publications

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“…Their role in airway protection is poorly characterized by the research literature and warrants more scientific investigation. Furthermore, LVC is a phenomenon that occurs due to epiglottic inversion (also affected the pharyngeal squeeze and the bolus), arytenoid adduction, and aryepiglottic fold bunching, not just hyo-laryngeal elevation (Ekberg, 1982;Ekberg & Sigurjonsson, 1982;Fink, 1974;Fink & Demarest, 1978;Fink et al, 1979;Logemann et al, 1992). These many mechanistic contributors cannot all be reflected in the ssEMG signal.…”

Section: Discussionmentioning

confidence: 99%

The Relationship Between Submental Surface Electromyography and Hyo-Laryngeal Kinematic Measures of Mendelsohn Maneuver Duration

Azola

Greene

Taylor-Kamara

et al. 2015

J Speech Lang Hear Res

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Purpose The Mendelsohn Maneuver (MM) is a commonly prescribed technique that is taught to individuals with dysphagia to improve swallowing ability. Due to cost and safety concerns associated with videofluoroscopy (VFS) use, submental surface electromyography (ssEMG) is commonly used in place of VFS to train the MM in clinical and research settings. However, it is unknown whether ssEMG accurately reflects the prolonged hyo-laryngeal movements required for execution of the MM. The primary goal of this study was to examine the relationship among ssEMG duration, duration of laryngeal vestibule closure, and duration of maximum hyoid elevation during MM performance. Method Participants included healthy adults and patients with dysphagia due to stroke. All performed the MM during synchronous ssEMG and VFS recording. Results Significant correlations between ssEMG duration and VFS measures of hyo-laryngeal kinematic durations during MM performance ranged from very weak to moderate. None of the correlations in the group of stroke patients reached statistical significance. Conclusion Clinicians and researchers should consider that the MM involves novel hyo-laryngeal kinematics that may be only moderately represented with ssEMG. Thus, there is a risk that these target therapeutic movements are not consistently being trained.

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Section: Discussionmentioning

confidence: 99%

The Relationship Between Submental Surface Electromyography and Hyo-Laryngeal Kinematic Measures of Mendelsohn Maneuver Duration

Azola

Greene

Taylor-Kamara

et al. 2015

J Speech Lang Hear Res

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“…However, this conformational change is thought to increase the risk of accidental aspiration during swallowing (1-3, 26, 27). To reduce this risk, the adult mode of swallowing develops in human infants, wherein the hyoid ascends, the laryngeal skeleton approximates the hyoid, the epiglottis bends, and the laryngeal orifice closes (26)(27)(28)(30)(31)(32). The approximation of the laryngeal skeleton to the hyoid contributes to the latter two movements (30,31,33,34).…”

Section: Discussionmentioning

confidence: 99%

Descent of the larynx in chimpanzee infants

Nishimura

Mikami

Suzuki

et al. 2003

Proc. Natl. Acad. Sci. U.S.A.

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The human larynx descends during infancy and the early juvenile periods, and this greatly contributes to the morphological foundations of speech development. This developmental phenomenon is believed to be unique to humans. This concept has formed a basis for paleoanthropological studies on the origin and evolution of human speech. We used magnetic resonance imaging to study the development of three living chimpanzees and found that their larynges also descend during infancy, as in human infants. This descent was completed primarily through the rapid descent of the laryngeal skeleton relative to the hyoid, but it was not accompanied by the descent of the hyoid itself. The descent is possibly associated with developmental changes of the swallowing mechanism. Moreover, it contributes physically to an increased independence between the processes of phonation and articulation for vocalization. Thus, the descent of the larynx and the morphological foundations for speech production must have evolved in part during hominoid evolution, and not in a single shift during hominid evolution. In the human neonate, the hyoid bone and larynx are positioned as high as in other mammals (1-3). However, they descend gradually during postnatal life (1-6). This descent is completed through the descent of the laryngeal skeleton relative to the hyoid and the descent of the hyoid relative to the mandible and cranial base (4-6). Thus, the human supralaryngeal vocal tract (SVT) develops to form a double resonator system with equally long horizontal [SVT H , from the posterior oropharyngeal wall (POW) to the lips] and vertical (SVT V , from the vocal folds to the velum) components (2, 6). Acoustically, such a configuration, in combination with the tongue's mobility, enables humans to produce complex speech sounds (7,8).It is commonly assumed that this developmental descent evolved as an adaptation for speech in a single shift in the human lineage, in combination with decreased prognathism and flexure of the cranial base (2, 9, 10). This concept has formed a basis for paleoanthropological studies on the origin and evolution of human speech, in which the ''unique'' morphological features related to speech have been examined through comparisons with extant primates (2,(11)(12)(13)(14)(15)(16). Thus, the evolution of the morphological basis for human speech has been regarded as synonymous with the evolution of the developmental descent of the larynx. Nonetheless, there are few comparative studies on the developmental changes of humans and non-human mammals (17-19), and it is unclear how and when the unique features of the speech apparatus of adult humans appear and develop during growth. Subjects and MethodsMagnetic Resonance Imaging (MRI) Procedures. We used MRI technology to examine the developmental changes of the SVT shape in three living chimpanzee infants, named Ayumu (male), Cleo (female), and Pal (female). They were born in 2000 and were reared by their biological mothers in the Kyoto University Primate Research Institute (KUPRI) (20,2...

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“…(1) at the true vocal folds, (2) at the entrance to the airway between the arytenoid cartilage and base of the epiglottis, and (3) at the level of the epiglottis as it is folded over the top of the airway [12, 21,22], Closure of the laryn geal entrance is accomplished by the anterior tilting of the arytenoid cartilage to the thick ening epiglottic base. This level of closure at the entryway of the airway is critical because it prevents food from getting into the larynx.…”

Section: Normal Adult Swallow Physiologymentioning

confidence: 99%

Dysphagia: Evaluation and Treatment

Logemann

1995

Folia Phoniatr Logop

131

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Normal swallowing consists of a set of physiologic behaviors which result in food, liquid or other substances moving safely and efficiently from the mouth to the stomach. Dysphagic patients may have difficulty with any one or more of the anatomic or physiologic components of the oral, pharyngeal or esophageal stages of the swallow. Evaluation of the dysphagic patient should identify the anatomic or physiologic abnormalities characterizing the patient’s swallow and include introduction and assessment of the efficacy of treatment strategies. Treatment may involve compensatory management, such as postural changes or enhancing sensory input, or active muscle exercise with or without the introduction of food. Speech-language pathologists have taken the lead in research on normal swallow and evaluation and treatment strategies for dysphagia.

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Closure of the Laryngeal Vestibule During Deglutition

Cited by 62 publications

References 9 publications

The Relationship Between Submental Surface Electromyography and Hyo-Laryngeal Kinematic Measures of Mendelsohn Maneuver Duration

The Relationship Between Submental Surface Electromyography and Hyo-Laryngeal Kinematic Measures of Mendelsohn Maneuver Duration

Descent of the larynx in chimpanzee infants

Dysphagia: Evaluation and Treatment

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