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扁桃体切除术前和术后吞咽功能的表面肌电图评估

Swallowing before and after tonsillectomy as evaluated by surface electromyography.

作者信息

Vaiman Michael, Krakovski Daniel, Gavriel Haim

机构信息

Department of Otolaryngology, Assaf Harofe Medical Center, Affiliated to Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Otolaryngol Head Neck Surg. 2007 Jul;137(1):138-45. doi: 10.1016/j.otohns.2007.02.013.

Abstract

OBJECTIVES

Surface electromyography (sEMG) was performed on adult patients (n = 40) following tonsillectomy to evaluate recovery by objective means.

METHODS

Evaluated parameters included timing of swallowing and continuous drinking, electric amplitude and graphic patterns of masseter (MS), and measurement of infrahyoid (INF) and submental (SUB) muscles after tonsillectomy and comparison with normative database.

RESULTS

The duration of drinking periods showed significant increase among patients; single-swallow durations remained normal. The electric activity of MS and INF muscles was significantly higher among the patients compared with normative database. It took one month until all the EMG data returned to normal.

CONCLUSION

Tonsillectomy affects muscle activity during swallowing by involving additional muscles in deglutition. EMG is a simple reliable method for postoperative evaluation and might contribute to comparative analysis of different tonsillectomy techniques. EMG can be used during pre- and postoperative stages to monitor recovery and functional improvement of throat muscles and deglutition.

SIGNIFICANCE

The reported sEMG method and obtained data might be further used: 1) As an additional tool for comparison of different methods of tonsillectomy (eg, cold vs hot dissection, laser surgery, etc); 2) For further development of objective postsurgical pain assessment; 3) As an additional tool for assessment and development of less traumatic surgical technique; and 4) For monitoring of recovery in difficult cases.

摘要

目的

对成年扁桃体切除术后患者(n = 40)进行表面肌电图(sEMG)检查,以客观评估恢复情况。

方法

评估参数包括吞咽和持续饮水的时间、咬肌(MS)的电幅度和图形模式,以及扁桃体切除术后舌骨下肌(INF)和颏下肌(SUB)的测量,并与标准数据库进行比较。

结果

患者的饮水时间显著增加;单次吞咽时间保持正常。与标准数据库相比,患者的MS和INF肌肉电活动显著更高。所有肌电图数据恢复正常需要一个月时间。

结论

扁桃体切除术通过使吞咽过程中涉及更多肌肉,影响吞咽时的肌肉活动。肌电图是一种简单可靠的术后评估方法,可能有助于不同扁桃体切除技术的比较分析。肌电图可在术前和术后阶段用于监测咽喉肌肉和吞咽功能的恢复及改善。

意义

所报道的表面肌电图方法和获得的数据可能会进一步用于:1)作为比较不同扁桃体切除方法(如冷刀与热刀切除、激光手术等)的附加工具;2)用于进一步开发客观的术后疼痛评估方法;3)作为评估和开发创伤较小的手术技术的附加工具;4)用于监测疑难病例的恢复情况。

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