Correlation between hyoid bone position, width of pharynx and swallowing function before-after orthognathic surgery for mandibular deficiency
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Hyoid bone
Mandible (arthropod mouthpart)
The tongue and hyoid bone are responsible for the oral phase of swallowing. The purpose of this study was to assess tongue strength and endurance, and to evaluate swallowing functions in patients who underwent hyoid bone resection surgery.This was an experimental, non-randomized trial. It included participants who underwent hyoid bone resection surgery, divided into 2 groups; post-Sistrunk procedure and post-total laryngectomy. Swallowing problem history was recorded, and tongue strength and endurance were measured using the Iowa Oral Performance Instrument (IOPI). Post-Sistrunk procedure participants also underwent flexible endoscopic evaluation of swallowing (FEES) to assess objective swallowing function. Descriptive and bivariate statistics were used to analyze the association between the tongue strength and endurance, and the type of surgeries.The study involved 26 participants, including 16 males and 10 females, with a mean age of 58.4 ± 12.8 years. A total of 10 subjects underwent the Sistrunk procedure and 16 underwent total laryngectomy surgery. The average tongue strength of all participants was 40.8 ± 11.7 kPa and the average tongue endurance was 30.6 ± 13.2 s. The difference in average tongue strength between the post-Sistrunk procedure group and post-total laryngectomy group was not significantly different (37.5 ± 11.6 kPa vs. 44.1 ± 11.3kPa, P = .153). However, there was a statistically significant difference in average tongue strength between male and female participants (46.3 ± 10.0 kPa vs. 32.0 ± 8.5 kPa, P = .001). FEES did not reveal any evidence of objective swallowing abnormalities in the post-Sistrunk group.The resection of the hyoid bone, whether partial or total, did not significantly affect tongue strength and swallowing functions.
Hyoid bone
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Laryngographic, manometric and videorentgenocinematographic examinations of swallowing were conducted on 49 patients after partial laryngectomy and on 35 subjects being a control group. The results of examinations indicate that the mobility of remaining after the surgery parts of the larynx have the great influence on the efficient swallowing. The larynx mobility is closely related to the remaining of the hyoid bone. Resection of the hyoid bone or its part is the factor that causes intensified difficulty during swallowing and increase in the frequency of the occurrence of aspiration. The study of effectiveness of glottis or neoglottis performed with the use of laryngograph showed no relation between glottis/neoglottis occlusion effectiveness index and intensified swallowing disorders. This shows the lack of compensating option in swallowing disorders with the help of an mechanism based on an efficient glottis or neoglottis occlusion alone.
Hyoid bone
Electroglottograph
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Objective:To investigate the method and value of barium dynamic imaging of pharynx in patients with deglutition disor-der(DD) and normal swallowing.Methods:The study population of the normal swallowing consisted of 299 cases and the deglutition dis-order consisted of 235.In order to observe the swallowing status compared with the transporting time of pharynx measured in this study,all cases were examined with anterior-posterior and lateral projection dynamic acquisition from C7 to the skull base.The dynamic imag-ings of 235 deglutition disorder patients were studied.Results:There was no statistical difference of transporting time of pharynx between the different age and sex.The transporting time of pharynx for normal cases was(0.7273±0.2132)s.235 cases of deglutition disorder oc-curred mainly in patients of esophageal carcinoma after radiotherapy or resection,stroke,laryngeal tumor,the transporting time of pharynx for the deglutition disorders cases was(0.9288±0.1627)s.Conclusion:This method is the first choice in the examination of deglutition disorder,it can record the entire process of barium sulphate fluid flowing through the pharynx.
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연구는 직접 삼킴 치료가 삼킴 기능 회복과 삶의 질에 미치는 효과를 알아보고자 실시하였다. 연구는 뇌졸중 환자 중 삼킴장애로 진단받은 1명의 환자를 2012년 12월 3일부터 동년 12월 21일 까지 3주간 실시하였다. 연구 디자인은 개별사례 연구 방법 중 반전 설계(AB)를 이용하였다. 직접 삼킴 치료는 주 5회, 1회기에 20분씩, 총 10회기를 실시하였고, 결과는 기초선과 직접 삼킴 치료 기간의 점수 차이를 비교하여 분석하였다. 직접 삼킴 치료 후에 뇌졸중 환자의 삼킴 기능은 향상되었고 향상된 삼킴 기능은 삶의 질 향상에 긍정적인 영향을 미쳤다. 이러한 결과를 근거로 임상에서는 직접 삼킴 치료가 가능한 대상자은 조기에 구강 섭취를 통한 직접 삼킴 치료를 실시해 환자들의 삼킴 기능과 삶의 질을 향상시킬 수 있도록 노력해야 할 것이다. The purpose of this study was to investigate the effects of direct swallowing treatment on recovering swallowing functions and quality of life. The study was performed over three weeks from December 3 to 21, 2012 for one dysphagia patient who was diagnosed with a stroke. The study design was carried out using a reversal design (AB) in single-subject experimental research. The direct swallowing treatment were implemented by a total of 10 times, five times a week and 20 minutes for each treatment, and the results of the treatment were compared and analyzed based on the differences in scores during the treatment period of the baseline and swallowing treatment. After completing the direct swallowing treatment, the swallowing function in stroke patients was improved and the improved swallowing function affected the quality of life positively. Based on the results of this study, it is necessary to make efforts to improve the swallowing function and quality of life in patients through applying such early direct swallowing treatment with oral intakes for the subjects who can take direct swallowing treatment in clinics.
Stroke
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The cavity of the pharynx and hyoid bone of the shoebill (Balaeniceps rex) were examined by using the three dimensional computed tomography image analysis. The pharynx and the cranial part of the esophagus were extraordinarily bilaterally enlarged. The unfixed flexible hyoid bone and degenerated tongue were discerned. We suggest that these morphological characteristics functionally enable the species to receive the large prey item peculiar to the feeding behavior of the shoebill. The structure of the pharynx region may totally act as a flexible pouch to pass the large food to the alimentary tract. The bilateral asymmetry was also confirmed in the hyoid bone, cavities of the pharynx and cranial esophagus. We think that these asymmetrical forms may also contribute to the deglutition of large prey fish in the shoebill.
Hyoid bone
Fish bone
Pharyngeal pouch
Alimentary tract
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The pathways for air and food cross in the pharynx. In breathing, air may flow through either the nose or the mouth, it always flows through the pharynx. During swallowing, the pharynx changes from an airway to a food channel. The pharynx is isolated from the nasal cavity and lower airway by velopharyngeal and laryngeal closure during the pharyngeal swallow. During mastication, the food bolus accumulates in the pharynx prior to swallow initiation. The structures in the oral cavity, pharynx and larynx serve multiple functions in breathing, speaking, mastication and swallowing. Thus, the fine temporal coordination of feeding among breathing, mastication and swallowing is essential to provide proper food nutrition and to prevent pulmonary aspiration. This review paper will review the temporo-spatial coordination of the movements of oral, pharyngeal, and laryngeal structures during mastication and swallowing, and temporal coordination between breathing, mastication, and swallowing.
Mastication
Pharyngeal muscles
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Objective: To analyze of the pathogens composition and resistance of pharynx-mop and non- pharynx-mop sample from in-patients in chest-cardio surgery ward at Shanghai Chest Hospital, we explored the clinical meaning of pharynx-mop and non- pharynx-mop sample analyzing. Methods: The data on bacterial susceptibility testing of clinical isolates from Aug. 1,2002 to Jul. 31, 2003 were collected, and divided in two species for analysis, pharynx-mop sample and non- pharynx-mop sample. Results: A total of 386 strains were isolated from pharynx-mop sample, and 402 strains from non-pharynx-mop sample. They have more different in pathogens composition and resistance. The bacterial antibiotic-resistance from non-pharynx-mop sample is higher than from pharynx-mop sample. Conclusion: The result from pharynx-mop sample,examined immediately after in-patient, can not forecast the nosocomial infection. The increase and change of bacterial antibiotic-resistance from non-pharynx-mop sample show the usage of antibiotic unreasonable.
Sample (material)
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The purpose of this study was to investigate clinical application of SIS for mandibular prognathism with SIS (Severity Indicator of Soft tissue profile) to make differential diagnosis for orthognathic surgery.The results were as follows:1. As for the relationship between the frequency of orthognathic surgery and SIS value, the frequency of orthognathic surgery increased when SIS value decreased.2. SIS was significantly more negative in the orthognathic surgery group (P<0.001) than in the nonsurgery group. A severer concave profile was shown in this group.From the above, it was possible to use SIS for numerical analysis of soft tissue profile and to make accurate differential diagnosis for orthognathic surgery.
Mandibular prognathism
Prognathism
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Manometric analysis of swallowing was conducted on 35 subjects, aged 44 to 60. The course of physiological changes in pressure during oral and pharyngeal phase of swallowing was analysed. To objectify the evaluation of analysed phenomena, parameters that include both pressure values inside pharynx and oesophagus and time dependences connected with changes in their value were used as proposed by the authors of this paper and as applied by other authors involved with these issues.
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THE INCREASING relative and absolute incidence of bulbar poliomyelitis1-34 has provided a valuable opportunity for the study of neurologic impairment of the pharynx. The varied distribution of impairment within the musculature of the area of the pharynx is appropriate to the typical pathologic finding in this disease of discrete and focal necrosis irregularly distributed in nuclear areas.21 This variety of impairments has been utilized to evaluate the contribution of specific elements of the musculature in this area to its general motor performance. Over the period of the past 7 years, a succession of patients having poliomyelitic disability in the area of the pharynx has been observed clinically, with supplementary cinema studies of the visible pharynx and the external neck27 and fluoroscopic and rapid-sequential roentgenographic studies, in which visualization of the pharynx was facilitated by radiopaque media. A useful classification of poliomyelitic impairments of the pharynx has been derived, with recognition of the compensatory and alternative maneuvers which they invoke. This report is particularly concerned with related impairments of swallow and of speech which results from deficient motor control of the oropharyngeal and the palatopharyngeal orifices. The observations are related to general anatomic, physiologic, and neurologic studies of the pharynx.35 Normal motor function of the lower pharynx and function impaired by poliomyelitis are considered in a succeeding report.36 PATIENT MATERIAL The normal subjects include 9 children, 7 to 13 years of age, and 11 young male adults, in each of which subject an examination of the area of mouth, pharynx, and neck was performed to obviate anatomic and neurologic abnormality.
Pharyngeal muscles
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