Oral and laryngeal muscle coordination during swallowing

Rendell, Jill; Spiro, Jeffrey D.

doi:10.1288/00005537-199403000-00017

Cited by 74 publications

(44 citation statements)

References 17 publications

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“…It is generally accepted that the swallowing re¯ex is controlled in the brainstem [1], However, if swallow mechanisms were controlled only at the brainstem level, we would expect to see little subject variability regarding amplitude and duration of the swallow muscles. The large subject variability in performing normal swallow and the Mendelsohn maneuver that was demonstrated by the results of this present study and previous studies [16,33] suggests that swallowing is a highly complex adaptive motor activity, which probably utilizes more than brainstem mechanisms. There are well-known cortical mechanisms important for swallowing such as the primary somatosensory cortex, premotor cortex, the primary motor cortex, and the anterior insula [34±38].…”

Section: Discussionsupporting

confidence: 65%

“…Each individual subject may have a unique way of activating orofacial and strap muscles to perform normal swallow and the Mendelsohn maneuver. These results were con®rmed by Tallgren and Tryde [16] with two oral muscles and by Gay et al [33] with oral and pharyngeal muscles. It is generally accepted that the swallowing re¯ex is controlled in the brainstem [1], However, if swallow mechanisms were controlled only at the brainstem level, we would expect to see little subject variability regarding amplitude and duration of the swallow muscles.…”

Section: Discussionsupporting

confidence: 53%

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Surface Electromyographic and Electroglottographic Studies in Normal Subjects Under Two Swallow Conditions: Normal and During the Mendelsohn Manuever

et al. 2002

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Surface electromyography (EMG) has been used successfully in teaching patients swallow maneuvers in clinical settings. The present study aims to determine if surface EMG can reliably demonstrate differences in muscle activity between the normal swallow and the Mendelsohn maneuver and whether there is a close temporal relationship between submental muscles and laryngeal elevation as demonstrated by electroglottography (EGG). Surface EMG was measured from five muscle groups (superior and inferior orbicularis oris, masseter, submental and infrahyoid) in 20 normal subjects under two swallowing conditions: normal and during performance of the Mendelsohn maneuver. A significant difference in EMG activity from the submental muscle group between the normal swallow and the Mendelsohn maneuver indicates that EMG at this location can be used reliably to differentiate between these two swallow conditions. The onset of submental activity and laryngeal elevation occurred within 10 ms of each other. The offset of submental activity and the return of the larynx to its resting position occurred within 24 ms of each other. Regarding the temporal relationship among the five muscle groups, the sequence of the most frequent muscle initiation was orbicularis oris inferior. orbicularis oris superior, masseter. submental muscle group, and infrahyoid muscle group. The sequence of the most frequent muscle termination was orbicularis oris superior, orbicularis oris inferior, masseter, submental muscle group, and infrahyoid muscle group in both normal swallow and the Mendelsohn maneuver.

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Section: Discussionsupporting

confidence: 65%

Section: Discussionsupporting

confidence: 53%

Surface Electromyographic and Electroglottographic Studies in Normal Subjects Under Two Swallow Conditions: Normal and During the Mendelsohn Manuever

et al. 2002

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“…These muscles have 2 principal roles in swallowing: the protection of the larynx by elevation, and the transportation of bolus by providing a secondary support to the tongue for its pumping action. 18,25,26 Therefore, the duration of the SM-EMG is a parameter that provides considerable information about the duration of the pharyngeal phase of swallowing that was prolonged in dysphagic patients with SBP with lacunar state. (4) The CP-EMG recordings made during swallowing revealed that the striated sphincter muscle of the upper esophageal sphincter was hyperreflexic and presumably dysinhibited like other brain stem reflexes, such as mandibular and palatopharyngeal reflexes.…”

Section: Discussionmentioning

confidence: 99%

Mechanisms of Dysphagia in Suprabulbar Palsy With Lacunar Infarct

Ertekin

Aydoğdu

Tarlacı

et al. 2000

Stroke

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Background and Purpose-The objective of the present study was to investigate the neural mechanisms of dysphagia in suprabulbar palsy (SBP) with multiple lacunar infarct. Methods-We evaluated the swallowing disorders of patients with SBP (nϭ34) and age-matched healthy control subjects (nϭ35) by means of an electrophysiological method that recorded the oropharyngeal swallowing patterns. With this method, dysphagia limit, the triggering of voluntarily initiated swallows, duration of laryngeal relocation time, and total duration of oropharyngeal swallowing were recorded and measured. In addition, the EMG behavior of the cricopharyngeal (CP) muscle of the upper esophageal sphincter was also assessed. Results-In patients with SBP, the dysphagia limit in all except 1 patient was pathological with limits of Ͻ20-mL bolus volume, which is contrary to normal subjects, in whom the dysphagia limit exceeds the 20-mL bolus volume. Either triggering of swallowing reflex was delayed (PϽ0.04), or the swallow could hardly be triggered in 7 patients on the voluntary attempts for 3 mL water. Whenever the reflex swallowing could be triggered, it was slow and prolonged (PϽ0.01). The CP muscle of the upper esophageal sphincter appeared to have become hyperreflexic and incoordinated with laryngeal movements during swallowing. Conclusions-It was proposed that the progressive involvement of the excitatory and inhibitory corticobulbar fiber systems linked with the bulbar swallowing center is mainly responsible for the triggering difficulties of the swallowing reflex and for the hyperreflexic/incoordinated nature of the CP sphincter. In addition, the dysfunction of the extrapyramidal system has a specific role in the slowing of oropharyngeal swallowing and the accumulation of saliva in the mouth.

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“…On the other hand, protective swallows can be initiated reflexively in response to the presence of the bolus either in the faucial pillars (Pommerenke, 1927) or in the pyriform sinuses (Pouderoux et al, 1996). Studies of the sequence of muscle activations in humans have demonstrated a series of activations progressing from jaw and perioral to suprahyoid, tongue, laryngeal and pharyngeal muscles during the swallowing pattern (Gay et al, 1994). Normal subjects vary in the particular sequence and timing of these muscle activations (Gay et al, 1994).…”

Section: Swallowingmentioning

confidence: 99%

“…Studies of the sequence of muscle activations in humans have demonstrated a series of activations progressing from jaw and perioral to suprahyoid, tongue, laryngeal and pharyngeal muscles during the swallowing pattern (Gay et al, 1994). Normal subjects vary in the particular sequence and timing of these muscle activations (Gay et al, 1994). This variability may depend on how the sensory input is altered by the bolus (Ertekin et al, 1997), differences in normal sensitivity (Pommerenke, 1927), and head position .…”

Section: Swallowingmentioning

confidence: 99%

Central nervous system control of the laryngeal muscles in humans

Ludlow

2005

Respiratory Physiology & Neurobiology

141

104

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Laryngeal muscle control may vary for different functions such as: voice for speech communication, emotional expression during laughter and cry, breathing, swallowing, and cough. This review discusses the control of the human laryngeal muscles for some of these different functions. Sensorimotor aspects of laryngeal control have been studied by eliciting various laryngeal reflexes. The role of audition in learning and monitoring ongoing voice production for speech is well known; while the role of somatosensory feedback is less well understood. Reflexive control systems involving central pattern generators may contribute to swallowing, breathing and cough with greater cortical control during volitional tasks such as voice production for speech. Volitional control is much less well understood for each of these functions and likely involves the integration of cortical and subcortical circuits. The new frontier is the study of the central control of the laryngeal musculature for voice, swallowing and breathing and how volitional and reflexive control systems may interact in humans.

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Oral and laryngeal muscle coordination during swallowing

Cited by 74 publications

References 17 publications

Surface Electromyographic and Electroglottographic Studies in Normal Subjects Under Two Swallow Conditions: Normal and During the Mendelsohn Manuever

Surface Electromyographic and Electroglottographic Studies in Normal Subjects Under Two Swallow Conditions: Normal and During the Mendelsohn Manuever

Mechanisms of Dysphagia in Suprabulbar Palsy With Lacunar Infarct

Central nervous system control of the laryngeal muscles in humans

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