Vaiman Michael, Eviatar Ephraim, Segal Samuel
Department of Otolaryngology, Assaf Harofeh Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Israel.
Otolaryngol Head Neck Surg. 2004 Dec;131(6):977-85. doi: 10.1016/j.otohns.2004.03.015.
Surface electromyographic studies were performed on 440 normal adults to describe and evaluate different types of normal swallows clinically useful for ENT department. Study design Prospective observational study of healthy volunteers.
EMG recordings were made using stick-on surface electrodes. Rectified and filtered EMG signals were evaluated. Parameters evaluated include the graphic configuration of activity of the orbicularis oris, masseter, submental group, and infrahyoid muscles, the last 2 covered by platysma, during single swallowing and continuous drinking. Four tests were examined: voluntary saliva swallows, voluntary separate swallows as normal, voluntary separate swallows of excessive amount of water (20 mL), drinking of 100 mL of water. Graphic recording of activity of the above-mentioned muscles during swallowing and drinking were evaluated for groups of adults of different ages.
There are several types of normal swallows as seen at the surface EMG records. There was no difference between EMG recordings of male and female swallows. Only group of elderly patients (age 70+) shows age-induced differences in recorded swallows. There are two main types of normal swallow: single-share and double-share swallows. The oral phase of swallowing, being under conscious control, is very variable and should not be taken into consideration during evaluation of records. Final oral, pharyngeal, and initial esophageal stages of swallowing can be defined and evaluated at the rectified and filtered surface EMG record.
The normal muscle activity during swallows and drinking has several graphic patterns which can be identified and described similar to EKG records when surface EMG is rectified and filtered. The method of EMG recording is quick and simple, and can be used for screening and evaluation purposes in outpatient and inpatient ENT departments. These parameters represent activities required for normal deglutition, and can be used to identify abnormalities in ENT patients, and provide a basis for comparison of swallowing performance both within and between patients. These normal data form a valuable basis for future comparison with patients in pre- and postoperative stages and in EMG monitoring during ENT treatment.
对440名正常成年人进行表面肌电图研究，以描述和评估对耳鼻喉科临床有用的不同类型的正常吞咽。研究设计：对健康志愿者进行前瞻性观察研究。
使用粘贴式表面电极进行肌电图记录。对整流和滤波后的肌电图信号进行评估。评估的参数包括口轮匝肌、咬肌、颏下肌群和舌骨下肌群（后两者被颈阔肌覆盖）在单次吞咽和连续饮水过程中的活动图形配置。检查了四项测试：自主唾液吞咽、正常自主分次吞咽、过量水（20毫升）自主分次吞咽、饮用100毫升水。对不同年龄组成年人在吞咽和饮水过程中上述肌肉活动的图形记录进行评估。
表面肌电图记录显示有几种类型的正常吞咽。男性和女性吞咽的肌电图记录之间没有差异。只有老年患者组（70岁以上）在记录的吞咽中显示出年龄引起的差异。正常吞咽主要有两种类型：单峰和双峰吞咽。吞咽的口腔期受意识控制，变化很大，在记录评估过程中不应考虑。吞咽的最终口腔、咽部和初始食管阶段可以在整流和滤波后的表面肌电图记录中定义和评估。
当表面肌电图进行整流和滤波时，吞咽和饮水过程中的正常肌肉活动有几种图形模式，这些模式可以被识别和描述，类似于心电图记录。肌电图记录方法快速简单，可用于耳鼻喉科门诊和住院患者的筛查和评估。这些参数代表正常吞咽所需的活动，可用于识别耳鼻喉科患者的异常情况，并为患者内部和患者之间吞咽性能的比较提供基础。这些正常数据为未来与术前和术后患者以及耳鼻喉科治疗期间的肌电图监测进行比较提供了有价值的基础。
