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拔牙后患者的吞咽困难:表面肌电图研究

Oynophagia in patients after dental extraction: surface electromyography study.

作者信息

Vaiman Michael, Nahlieli Oded, Eliav Eli

机构信息

Department of Otolaryngology, Assaf Harofeh Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Head Face Med. 2006 Oct 17;2:34. doi: 10.1186/1746-160X-2-34.

Abstract

OBJECTIVES

Surface electromyographic (sEMG) studies were performed on 40 adult patients following extraction of lower third and second molars to research the approach and limitations of sEMG evaluation of their odynophagia complaints.

METHODS

Parameters evaluated during swallowing and drinking include the timing, number of swallows per 100 cc of water, and range (amplitude) of EMG activity of m. masseter, infrahyoid and submental-submandibular group. The above mentioned variables (mean + standard deviation) were measured for the group of dental patients (n = 40) and control group of healthy adults (n = 40).

RESULTS

The duration of swallows and drinking in all tests showed increase in dental patients' group, in which this tendency is statistically significant. There was no statistically significant difference between male and female adults' duration and amplitude of muscle activity during continuous drinking in both groups (p = 0.05). The mean of electric activity (in muV) of m. masseter was significantly lower in the dental patients' group in comparison with control group. The electric activity of submental-submandimular and infrahyoid muscle groups was the same in both groups.

CONCLUSION

Surface EMG of swallowing is a simple and reliable noninvasive method for evaluation of odynophagia/dysphagia complaints following dental extraction with low level of discomfort of the examination. The surface EMG studies prove that dysphagia following dental extraction and molar surgery has oral origin, does not affect pharingeal segment and submental-submandibular muscle group. This type of dysphagia has clear EMG signs: increased duration of single swallow, longer drinking time, low range of electric activity of m. masseter, normal range of activity of submental-submandibular muscle group, and the "dry swalow" aftereffect. The data can be used for evaluation of complaints and symptoms, as well as for comparison purposes in pre- and postoperative stages and in EMG monitoring during treatment of post-surgical oral cavity discomfort and dysphagia.

摘要

目的

对40例成年患者在拔除下颌第三磨牙和第二磨牙后进行表面肌电图(sEMG)研究,以探讨sEMG评估其吞咽疼痛主诉的方法及局限性。

方法

在吞咽和饮水过程中评估的参数包括吞咽时间、每100毫升水的吞咽次数以及咬肌、舌骨下肌群和颏下-颌下肌群的肌电图活动范围(幅度)。对牙科患者组(n = 40)和健康成年人对照组(n = 40)测量上述变量(均值±标准差)。

结果

在所有测试中,牙科患者组的吞咽和饮水持续时间均增加,且这种趋势具有统计学意义。两组中,成年男性和女性在持续饮水过程中肌肉活动的持续时间和幅度无统计学显著差异(p = 0.05)。与对照组相比,牙科患者组咬肌的平均电活动(以微伏计)显著降低。两组中颏下-颌下肌和舌骨下肌群的电活动相同。

结论

吞咽表面肌电图是一种简单可靠的非侵入性方法,用于评估拔牙后吞咽疼痛/吞咽困难主诉,检查不适感较低。表面肌电图研究证明,拔牙和磨牙手术后的吞咽困难起源于口腔,不影响咽部节段和颏下-颌下肌群。这种类型的吞咽困难有明确的肌电图征象:单次吞咽持续时间增加、饮水时间延长、咬肌电活动范围低、颏下-颌下肌群活动范围正常以及“干吞咽”后效应。这些数据可用于评估主诉和症状,以及在手术前后阶段进行比较,以及在治疗口腔手术后不适和吞咽困难期间进行肌电图监测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/649a/1621058/87a3a5177a26/1746-160X-2-34-1.jpg

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