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Conclusion:The sensitive sonotubometry and MATLAB provide a new tool to study the eustachian tube (ET) function and contribute more to reliable data and precise analysis. The levator veli palatini muscle (mLVP) and the salpingopharyngeus muscle (mSP) may, respectively, be the most important and least important muscle for ET function. Objectives:The ET lumen dilation is a result of the contraction of the paratubal muscles, the tensor veli palatini muscle (mTVP), mLVP and mSP. To trace the dynamic ET muscle/lumen activities, the present study aimed to optimize sonotubometry and achieve cross-platform data integration of electromyography (EMG) and sonotubometry using MATLAB (matrix laboratory). Method:Seventeen healthy volunteers (34 ears) were chosen for the concurrent recordings of the paratubal EMG and sonotubogram under dry and water swallowing. Results:The optimized sonotubometry based on computer sound card showed satisfied sensitivity. For both EMGs and sonotubogram, dry swallowing generated significantly greater amplitude and longer duration compared to water swallowing. Moreover, statistically significant differences (p < 0.05) were detected in the comparison of the amplitude, duration, and latency for the mTVP, mLVP, and mSP. The mSP activity was the weakest and even inactive in some cases, the mLVP presented the most powerful and long lasting activity during ET-opening. [ABSTRACT FROM PUBLISHER]

Conclusions: Protocol limitations were identified and accounted for in the analysis. Percent gradient equilibrated (PGE) was affected by driving gradient direction in a similar manner to other efficiency measures. A finer resolution of possible age-related changes in eustachian tube opening efficiency is expected with the application of more sophisticated statistical models to the complete dataset at study end. Objective: To report the results of an interim analysis for an ongoing study designed to characterize the age-related changes in eustachian tube opening efficiency measured using a pressure chamber protocol in children without a history of middle ear disease. Methods: To date, 41 children aged 3 years without a history of otitis media have been enrolled in a longitudinal study of the age-related changes in eustachian tube function and evaluated at yearly intervals between 3 and 7 years of age. Eustachian tube opening efficiency, the percent of the applied pressure gradient equilibrated by swallowing, was measured by repeat tympanometry during a pressure chamber protocol. Data (120 tests) were analyzed using an ANOVA with variance partitioned by age (3 through 6 years), gradient direction (positive/negative), and ear (left/right). Results: PGE was higher for left ears and positive driving gradients, but was not different among age groups. [ABSTRACT FROM AUTHOR]

Conclusion: All patients treated with this new lateralization technique had a good quality of life and no dyspnea at rest or upon exertion. We believe that this technique is an important addition to the many surgical techniques for the treatment of bilateral vocal cord paralysis (BVCP). Objectives: Most techniques used in the treatment of BVCP result in a prolapse of the laryngeal soft tissues into the endolarynx owing to Bernoulli's principle. We have developed a new lateralization technique to more effectively prevent this prolapse. Methods: The lateralization was initially tested on six cadaver larynges before being performed in five clinical cases with BVCP, who suffered from dyspnea at rest. Average follow-up was 17.6 months. As in type 1 thyroplasty, a rectangular piece of cartilage was excised horizontally from the thyroid lamina and placed on the defect in the vertical plane. Then, the vocal and ventricular folds were lateralized with crossing sutures, particularly in the posterior region. Results: Dyspnea was eliminated postoperatively. All patients were successfully decannulated. Postoperative voice quality was socially acceptable. Airways were improved postoperatively, as evaluated via fiberoptic laryngoscopy and CT. The mean preoperative and postoperative rima openings were 1.3 mm (range 0.5--2.6) and 6.4 mm (range 3.4--8.1), respectively. [ABSTRACT FROM AUTHOR]

Conclusion: Deglutition was infrequent and displayed unique patterns during sleep in healthy younger adults. Objectives: The deglutition, electroencephalographic arousal, and respiratory phase patterns during sleep in younger adults were investigated. Methods: Ten younger adults were examined via time-matched recordings of polysomnography and surface electromyography. Results: During sleep, swallowing was infrequent and absent for long periods. The mean number of swallows per hour during the total sleep time was 2.4 ± 1.0. The mean longest deglutition-free period was 68.8 ± 24.8 min. Most deglutition occurred in association with spontaneous electroencephalographic arousal. Deglutition was related to the sleep stage. The mean number of swallows per hour was 11.2 ± 8.1 during stage 1 sleep, 1.9 ± 1.0 during stage 2 sleep, 0.5 ± 1.5 during stage 3 sleep, and 0.2 ± 0.5 during stage 4 sleep. The deeper the sleep stage, the lower the mean deglutition frequency. The mean number of swallows per hour was 1.9 ± 1.7 during rapid eye movement sleep. The deeper the sleep stage, the lower the mean arousal frequency and the lower the mean ratio of arousal with deglutition to arousal. Approximately 60% of swallows were followed by arrested breathing and approximately 25% by expiration. [ABSTRACT FROM AUTHOR]

Conclusion: Continuous positive airway pressure (CPAP) therapy improved not only apnea-hypopnea during sleep and sleep structure but also sleep-related deglutition, especially respiratory phase patterns associated with deglutition. Objectives: Sleep-related deglutition and related respiratory phase patterns in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) under CPAP therapy were investigated. Methods: Deglutition during sleep was examined in 10 patients who had severe OSAHS under CPAP therapy via time-matched recordings of polysomnography and surface electromyography. Results: The mean number of swallows per hour during the total sleep time was 1.6 ± 1.3. The mean period of the longest absence of deglutition was 66.4 ± 19.6 min. Deglutition was related to the sleep stage. The mean number of swallows per hour was 6.8 ± 8.4 during stage 1 sleep, 1.1 ± 0.8 during stage 2 sleep, 0.1 ± 0.4 during stage 3 sleep, and 0 during stage 4 sleep. The deeper the sleep stage, the lower the mean deglutition frequency. The mean number of swallows per hour was 0.8 ± 0.5 during REM sleep. Most deglutition occurred in association with spontaneous electroencephalographic arousal. Swallows followed by inspiration were markedly reduced. Under CPAP therapy, sleep-related deglutition and its respiratory phase pattern had normalized. [ABSTRACT FROM AUTHOR]

Conclusion: In spite of no clinical signs of facial paresis, a pathological lip force (LF) will strongly influence swallowing capacity (SC). Stroke patients with impaired SC suffer a subclinical facial paresis. The results support earlier findings that LF training can be used to treat dysphagia. Objectives: Lip muscle training with an oral screen can improve both LF and SC in stroke patients, irrespective of the presence or absence of facial palsy. The aim was therefore to study the influence of LF on SC. Methods: This prospective study included 22 stroke patients, aged 38-90 years, with dysphagia, 12 with initial unilateral facial paresis and 45 healthy subjects, aged 25-87 years. All were investigated with a Lip Force Meter (LF100), and with an SC test. Results: A significant correlation was found between LF/SC ( p = 0.012) in stroke patients but not in healthy subjects. LF/SC was not age-related in stroke patients. LF was not age-dependent in healthy subjects, but SC decreased with increasing age ( p < 0.0001). However, SC did not reach a pathological value and a regression analysis showed that 73% of the variation in SC is attributable to LF and age. [ABSTRACT FROM AUTHOR]

Conclusion: We report a distinct pattern of tongue movement. This is interpreted as a compensatory mechanism after hypopharyngo-laryngectomy with reconstruction using a jejunal autograft. Passage through the oesophagus is mainly passive. Objective: Swallowing is normally initiated voluntarily, and afterwards presumed to be controlled by brainstem reflexes. Resection of the hypopharynx with reconstruction may affect this control. This study attempted to perform a biomechanical analysis of the motility in the small bowel graft and suggest possible implications for surgical management. We also analysed how oesophageal passage is affected by surgery. Methods: Five patients underwent a radiological examination of the neopharyngeal conduit and oesophagus and completed a simple questionnaire. Results: The radiological examinations revealed a distinct pattern of tongue movement in all patients, resulting in varying degrees of thrust. Passage through the jejunal graft was mainly passive, but observations of progressive reduction in diameter of the graft indicated muscular tone that may preserve pressure generated by the lingual thrust. The oesophageal transport appeared to be rather passive and largely depended upon the effect of gravity. Two of five patients were unable to eat normal food. Their impaired swallowing resulted in severely reduced quality of life. [ABSTRACT FROM AUTHOR]

Conclusion. By means of a direct, though non-invasive experiment on healthy humans we could demonstrate that middle ear (ME) pressure decreases when the eustachian tube (ET) does not open. Thus with a very simple method the basic theory of continuous gas loss from the ME into the circulation and the replenishment of the loss through the ET could be validated. Objectives. To record changes in ME pressure over a period of time in normal human ears, while the ET is kept closed. Subjects and methods. On-line tympanometry was carried out in three subjects, who refrained from swallowing for 20–120 min. Results. During the time when the ET was kept closed by refraining from swallowing, tympanometric monotonous pressure decrease was recorded. Once the tested subject could not refrain from swallowing any longer and swallowed again, ME pressure equalized immediately. [ABSTRACT FROM AUTHOR]

Conclusions. The use of custom-built magnetoelastic sensors designed for insertion in the larynx to measure the force of transverse deformation of the thyroarytenoid and cricothyroid muscles was examined. Objectives. The availability of sensors that transduce deformation force into an electrical current (measurable in millivolts) suggested that such sensors could be used to study muscle function in the canine larynx. This study aimed to obtain information about the force exercised by larynx muscles on the sensor in an experiment in vivo. Materials and methods. The results of six surgical interventions in three dogs using four magnetoelastic sensors are described. The sensor and insertion technique were atraumatic. One dog underwent surgery four times to study the morbidity, reliability and reproducibility of the technique. An electromyographic recording was made at the same time that sensor response was registered to compare results with a standardized technique. Results. We obtained 584 regular responses: 256 deglutitions (150 thyroarytenoid and 106 cricothyroid recordings) and 328 phonations (223 thyroarytenoid and 105 cricothyroid recordings). No signs of injury or functional deficit were observed after any intervention. In the dog that underwent four interventions, results were consistent after each intervention. [ABSTRACT FROM AUTHOR]