Laryngeal elevation achieved by neuromuscular stimulation at rest
Laryngeal elevation achieved by neuromuscular stimulation at rest
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DOI：
10.1152/japplphysiol.00406.2002
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发表时间：
2003-01-01
影响因子：
3.3
通讯作者：
Ludlow, CL
中科院分区：
文献类型：
--
作者：
Burnett, TA;Mann, EA;Ludlow, CL
吞咽时，呼吸道保护部分是通过喉部抬高实现的。虽然在喉部抬高时通常有多块肌肉活动，但对选定肌肉的神经肌肉刺激进行了评估，以确定哪一块肌肉或肌肉对最好抬高喉部，并应在未来吞咽困难患者的神经肌肉刺激研究中予以考虑。15名健康男性被选为甲状腺突起高度可见的摄像对象，将钩状导线单极电极插入肌舌骨、甲状舌骨和颧舌骨肌肉区域。在单侧、双侧和联合肌肉刺激的试验中，甲状腺隆起的运动被录像、数字化，并在2毫升的水吞咽过程中相对于海拔归一化。单独的肌肉刺激引起的上升与吞咽时观察到的30%类似，与吞咽速度的50%类似，而成对肌肉刺激引起的上升类似于50%，与吞咽时产生的速度类似。成对肌肉刺激比单一肌肉刺激产生明显更大的喉部抬高，对于喉部抬高降低或延迟的吞咽困难患者，双肌刺激可以帮助喉部抬高。
During swallowing, airway protection is achieved in part by laryngeal elevation. Although multiple muscles are normally active during laryngeal elevation, neuromuscular stimulation of select muscles was evaluated to determine which single muscle or muscle pair best elevates the larynx and should be considered during future studies of neuromuscular stimulation in dysphagic patients. Hooked-wire monopolar electrodes were inserted into mylohyoid, thyrohyoid, and geniohyoid muscle regions in 15 healthy men selected for having a highly visible thyroid prominence for videotaping. During trials of single, bilateral, and combined muscle stimulations, thyroid prominence movements were video recorded, digitized, and normalized relative to elevation during a 2-ml water swallow. Individual muscle stimulation induced similar to30% of the elevation observed during a swallow and similar to50% of swallow velocity, whereas paired muscle stimulation resulted in similar to50% of the elevation and similar to80% of the velocity produced during a swallow. Paired muscle stimulation produced significantly greater elevation than single muscle stimulation and could assist with laryngeal elevation in dysphagic patients with reduced or delayed laryngeal elevation.