Krasnodębska Paulina, Jarzyńska-Bućko Agnieszka, Szkiełkowska Agata, Bartosik Jędrzej
Audiology and Phoniatrics Clinic, Institute of Physiology and Pathology of Hearing, 02-042 Warsaw, Poland.
Audiology and Phoniatrics Faculty, Fryderyk Chopin University of Music, 00-368 Warsaw, Poland.
Audiol Res. 2021 Apr 13;11(2):167-178. doi: 10.3390/audiolres11020015.
Over the past few years, attention has been paid to the coexistence of dysphonia with dysphagia, in the context of functional disorders. The aim of this work was to objectify logopaedic examination of dysphonic patients with coexisting swallowing difficulties by surface electromyography.
The material of the work included 58 patients with muscle tension dysphonia (MTD). Each patient underwent otolaryngologic, phoniatric and logopaedic examination. We collected information about medical history and asked patients to fill out Reflux Symptom Index (RSI), Eating Assessment Tool (EAT-10), Dysphagia Handicap Index (DHI) and Swallowing Disorder Scale (SDS). The algorithm of dysphagia diagnostics in our clinic assumes parallel surface electromyography (SEMG) during Functional Endoscopic Evaluation of Swallowing.
In comparison to patients suffering from atypical swallowing, patients with muscle tension dysphagia (MTDg) obtained higher values from almost all questionnaires. Logopaedic evaluation revealed abnormalities in the structure and efficiency of the articulatory organs and in the assessment of primary functions. Patients with more abnormalities in logopaedic examination had significantly higher infrahyoid muscle activity during swallowing observed in EMG. Patients with non-normative swallowing pattern had significantly greater asymmetry of the average and maximum amplitude of masseters, as well as submental muscles. Patients with higher percent of muscles asymmetry gained higher scores in questionnaires.
Surface electromyography objectifies logopaedic examination of patients with swallowing difficulties. The results of this work showed that, apart from longer swallows, patients with MTDg differ from patients with non-normative swallowing patterns in the muscle activity measured by SEMG, abnormalities in logopaedic evaluation and the severity of complaints reported by patients.
在过去几年中，功能性障碍背景下的发音障碍与吞咽困难共存问题受到了关注。这项工作的目的是通过表面肌电图对存在吞咽困难的发音障碍患者进行言语治疗检查的客观化。
该研究资料包括58例肌肉紧张性发音障碍（MTD）患者。每位患者均接受了耳鼻喉科、语音治疗科和言语治疗科的检查。我们收集了病史信息，并要求患者填写反流症状指数（RSI）、进食评估工具（EAT - 10）、吞咽障碍指数（DHI）和吞咽障碍量表（SDS）。我们诊所吞咽障碍诊断算法假定在吞咽功能内镜评估期间进行同步表面肌电图（SEMG）检查。
与非典型吞咽患者相比，肌肉紧张性吞咽困难（MTDg）患者几乎在所有问卷中得分更高。言语治疗评估显示，发音器官的结构和效能以及主要功能评估存在异常。言语治疗检查中异常较多的患者，在吞咽过程中舌骨下肌的肌电图活动明显更高。吞咽模式不正常的患者，咬肌以及颏下肌的平均和最大振幅不对称性明显更大。肌肉不对称百分比更高的患者在问卷中得分更高。
表面肌电图使吞咽困难患者的言语治疗检查客观化。这项工作的结果表明，除了吞咽时间更长外，MTDg患者与非规范吞咽模式患者在SEMG测量的肌肉活动、言语治疗评估异常以及患者报告的主诉严重程度方面存在差异。
