Gölaç Hakan, Atalık Güzide, Gülaçtı Adnan, Cebeci Süleyman, Şansal Ebru, Ceylan Banu Tijen, Gündüz Bülent, Yılmaz Metin
Department of Speech and Language Therapy, Faculty of Health Sciences, Gazi University, Ankara, Turkey.
Department of Otolaryngology-Head and Neck Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey.
J Oral Rehabil. 2025 May;52(5):616-623. doi: 10.1111/joor.13934. Epub 2025 Jan 24.
Surface electromyography (sEMG) has been used in a wide range of studies conducted in the field of dysphagia.
The main aim of this case-control study is to obtain how submental and infrahyoid sEMG signals differ based on residue, penetration and aspiration.
A total of 100 participants (50 patients with suspected dysphagia and 50 healthy controls) were enrolled in the present study. Participants with suspected dysphagia underwent a detailed fibreoptic endoscopic evaluation of swallowing (FEES) to observe the efficiency and safety of swallowing using the Yale Pharyngeal Residue Severity Rating Scale (YPRSRS) and the Penetration-Aspiration Scale (PAS), respectively. Afterward, sEMG parameters, including submental muscle activity duration (SMM-AD), infrahyoid muscle activity duration (IM-AD), amplitude of submental muscles (A-SMM) and amplitude of infrahyoid muscles (A-IM) were obtained during three consecutive dry swallows from all study cohorts.
There were significantly higher SMM-AD values in patients with a YPRSRS score of 1-2 and a YPRSRS score of 3-5 for residue in vallecula compared to the controls (p < 0.001 and p = 0.001, respectively). Both subgroups of patients with a YPRSRS score of 1-2 and a YPRSRS score of 3-5 for residue in piriforms showed significantly higher SMM-AD values compared to the controls (p < 0.001 and p = 0.048, respectively). The same prolongation of SMM-AD was also evident for the patients with airway invasion (penetration or aspiration) compared to the controls (p = 0.042 and p < 0.001, respectively). The other measured sEMG parameters (IM-AD, A-SMM and A-IM) did not differ significantly based on FEES outcomes (p > 0.05).
Since the availability of instrumental swallowing assessment methods in clinical practice is quite challenging, specific sEMG parameters may be useful to predict possible residue, penetration, or aspiration events in patients with dysphagia. SMM-AD can be considered as a first-line assessment parameter for possible residue, penetration, and aspiration events before referring patients for further instrumental methods.
表面肌电图（sEMG）已被广泛应用于吞咽困难领域的各类研究中。
本病例对照研究的主要目的是了解颏下和舌骨下sEMG信号在残留、穿透和误吸方面的差异。
本研究共纳入100名参与者（50名疑似吞咽困难患者和50名健康对照者）。疑似吞咽困难的参与者接受了详细的纤维内镜吞咽评估（FEES），分别使用耶鲁咽残留严重程度评定量表（YPRSRS）和穿透-误吸量表（PAS）观察吞咽的效率和安全性。之后，在所有研究队列的连续三次干咽过程中获取sEMG参数，包括颏下肌肉活动持续时间（SMM-AD）、舌骨下肌肉活动持续时间（IM-AD）、颏下肌肉振幅（A-SMM）和舌骨下肌肉振幅（A-IM）。
与对照组相比，会厌谷残留的YPRSRS评分为1-2分和3-5分的患者的SMM-AD值显著更高（分别为p < 0.001和p = 0.001）。梨状窝残留的YPRSRS评分为1-2分和3-5分的患者亚组的SMM-AD值均显著高于对照组（分别为p < 0.001和p = 0.048）。与对照组相比，气道侵犯（穿透或误吸）患者的SMM-AD同样延长（分别为p = 0.042和p < 0.001）。其他测量的sEMG参数（IM-AD、A-SMM和A-IM）根据FEES结果无显著差异（p > 0.05）。
由于临床实践中仪器吞咽评估方法的可用性颇具挑战性，特定的sEMG参数可能有助于预测吞咽困难患者可能出现的残留、穿透或误吸事件。在将患者转诊至进一步的仪器检查方法之前，SMM-AD可被视为可能的残留、穿透和误吸事件的一线评估参数。
