EFFECT OF LOW FREQUENCY STIMULATION ON SUPRAHYOID MUSCLES IN PATIENTS WITH OROPHARYNGEAL DYSPHAGIA - A PILOT STUDY OF VIDEOENDOSCOPIC INVESTIGATION

吞咽障碍康复治疗技术的可用性在严重吞咽困难的口腔和咽部阶段是有限的。按摩诱导的放松对治疗手足肌肉功能障碍很有用，也可能对治疗吞咽困难很有用。使用视频内窥镜，我们检查并验证了低频刺激作为治疗吞咽障碍的潜力。本研究考察了这种治疗是否能促进舌肌和舌骨上肌之间的协调，促进吞咽的恢复。我们在新泻康复医院观察了24例吞咽困难患者的腭咽运动和吞咽功能。低频电极被安装在两个健康成人的颈部皮肤上，在下巴和甲状腺软骨之间。刺激频率为40 Hz，强度为32 -56 V，导致舌骨上肌重复收缩。内镜下观察吞咽器官运动情况。通过这种低频治疗，可以观察到舌底轻微抬高和会厌内翻，杓状软骨内收，声门部分关闭和梨状窦打开。视频内窥镜观察有助于确定电极在促进区的最佳位置。低频治疗下吞咽肌的反复收缩可引起吞咽反射的发生。吞咽肌肉的协调表明低频治疗可能对严重的口腔和咽期吞咽困难有效。

The availability of therapeutic techniques in the rehabilitation of swallowing disorders is limited in the oral and pharyngeal phases of severe dysphagia. Massage-induced relaxation is useful in the treatment of hand and foot muscle dysfunction and may be useful in treating dysphagia. Using videoendoscopy, we examined and verified the potential of low frequency stimulation as a treatment for swallowing disorders. This research examined whether this treatment could facilitate coordination between lingual muscles and suprahyoid muscles and promote recovery of swallowing.Velopharyngeal movement and swallowing function were observed in 24 patients with dysphagia at Niigata Rehabilitation Hospital, which has a functional affiliation with our university.Low frequency electrodes were mounted on the neck skin between the chin and the thyroid cartilage in two healthy adults. Stimulation frequency of 40 Hz at intensity of 32 -56 V was applied, resulting in repetitive contraction of suprahyoid muscles. Movement of the swallowing organs was observed by videoendoscopy.With this low frequency treatment, slight elevation of the tongue base and inversion of the epiglottis, adduction of the arytenoids cartilage, partial closure of the glottis and opening of pyriform sinuses were observed. Videoendoscopic observation was useful for determining the optimal placement of electrodes in the facilitation area.Repetitive contraction of swallowing muscles by low frequency treatment can elicit the initiation of the swallowing reflex. The resulting coordination of the swallowing musculature suggests that low frequency treatment may be effective for severe oral and pharyngeal phase dysphagia.