Pub Date : 2019-12-22DOI: 10.5772/intechopen.89751
M. Basha
Oral cavity/mouth is first recipient of food. Food is broken down and prepared for initial phases of digestion. The oral preparatory phase is voluntary. In this phase, food is manipulated by the tongue and teeth. A bolus which is ready to swallow is prepared. Any disruption of oral cavity functions commonly due to oral infections, space infections, facial trauma, congenital-cleft lip and palate, temporo-mandibular joint disorders, salivary gland pathology, oral cancers, radiation therapy, etc., can cause dysphagia. In this chapter, we would explain the maxillofacial and oral aspects of dysphagia along with diagnosis and treatment aspects.
{"title":"Maxillofacial and Oral Aspects of Dysphagia","authors":"M. Basha","doi":"10.5772/intechopen.89751","DOIUrl":"https://doi.org/10.5772/intechopen.89751","url":null,"abstract":"Oral cavity/mouth is first recipient of food. Food is broken down and prepared for initial phases of digestion. The oral preparatory phase is voluntary. In this phase, food is manipulated by the tongue and teeth. A bolus which is ready to swallow is prepared. Any disruption of oral cavity functions commonly due to oral infections, space infections, facial trauma, congenital-cleft lip and palate, temporo-mandibular joint disorders, salivary gland pathology, oral cancers, radiation therapy, etc., can cause dysphagia. In this chapter, we would explain the maxillofacial and oral aspects of dysphagia along with diagnosis and treatment aspects.","PeriodicalId":409976,"journal":{"name":"Voice and Swallowing Disorders","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126753842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-12-20DOI: 10.5772/intechopen.90624
D. Vrinceanu, M. Dumitru
We review current state of the art protocols on swallowing disorders associated to cervical facial tumors. The clinician needs to translate physiology notions to bedside diagnosis. Facing such a case the ENT surgeon must follow several key steps: thorough history taking, barium transit, endoscopy evaluation of swallowing, high resolution diagnosis imaging. Afterwards surgical treatment plan should take into consideration the need to careful dissection of vascular and nervous structures. Dysphagia may present from initial diagnosis or after surgical resection of the tumor or during radiation and chemotherapy. We discuss the use of various staging scales or questionnaires for assessing quality of life. We illustrate the importance of swallowing disorders management with various cases of tumors at the level of skull base, pharynx, salivary glands, larynx, esophagus, etc. There are various solutions for dysphagia ranging from nasogastric feeding tube placement to percutaneous endoscopic gastrostomy to specially designed exercises. Sometimes the surgeon neglects these disorders and focuses on airway management. However, the rule should be to encourage swallowing as soon as possible after surgery. A good nutritional status is necessary for a positive prognosis in swallowing disorders. Team effort in tertiary oncology units is the key in supporting such complex cases.
{"title":"Swallowing Disorders in Cervical Facial Tumors","authors":"D. Vrinceanu, M. Dumitru","doi":"10.5772/intechopen.90624","DOIUrl":"https://doi.org/10.5772/intechopen.90624","url":null,"abstract":"We review current state of the art protocols on swallowing disorders associated to cervical facial tumors. The clinician needs to translate physiology notions to bedside diagnosis. Facing such a case the ENT surgeon must follow several key steps: thorough history taking, barium transit, endoscopy evaluation of swallowing, high resolution diagnosis imaging. Afterwards surgical treatment plan should take into consideration the need to careful dissection of vascular and nervous structures. Dysphagia may present from initial diagnosis or after surgical resection of the tumor or during radiation and chemotherapy. We discuss the use of various staging scales or questionnaires for assessing quality of life. We illustrate the importance of swallowing disorders management with various cases of tumors at the level of skull base, pharynx, salivary glands, larynx, esophagus, etc. There are various solutions for dysphagia ranging from nasogastric feeding tube placement to percutaneous endoscopic gastrostomy to specially designed exercises. Sometimes the surgeon neglects these disorders and focuses on airway management. However, the rule should be to encourage swallowing as soon as possible after surgery. A good nutritional status is necessary for a positive prognosis in swallowing disorders. Team effort in tertiary oncology units is the key in supporting such complex cases.","PeriodicalId":409976,"journal":{"name":"Voice and Swallowing Disorders","volume":"458 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126409377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-10-24DOI: 10.5772/intechopen.88735
N. Çomunoğlu, Ş. Batur, Ayşe Mine Önenerk
Nonneoplastic vocal fold lesions are common that can cause hoarseness and voice change. Reactive lesions of Reinke’s space can be observed in all ages and genders and comprise the majority of the benign nonneoplastic vocal fold lesions. Although clinically different terms are used to define reactive lesions of Reinke’s space, they share the same histopathologic features. In order to differentiate vocal fold polyp and nodule and Reinke’s edema, clinical findings should be considered. Epithelial changes such as pseudoepitheliomatous and verrucous hyperplasia may cause diagnostic challenge due to resemblance of squamous cell carcinoma. Evaluation of the invasion border and cellular atypia may aid in correct diagnosis.
{"title":"Pathology of Nonneoplastic Lesions of the Vocal Folds","authors":"N. Çomunoğlu, Ş. Batur, Ayşe Mine Önenerk","doi":"10.5772/intechopen.88735","DOIUrl":"https://doi.org/10.5772/intechopen.88735","url":null,"abstract":"Nonneoplastic vocal fold lesions are common that can cause hoarseness and voice change. Reactive lesions of Reinke’s space can be observed in all ages and genders and comprise the majority of the benign nonneoplastic vocal fold lesions. Although clinically different terms are used to define reactive lesions of Reinke’s space, they share the same histopathologic features. In order to differentiate vocal fold polyp and nodule and Reinke’s edema, clinical findings should be considered. Epithelial changes such as pseudoepitheliomatous and verrucous hyperplasia may cause diagnostic challenge due to resemblance of squamous cell carcinoma. Evaluation of the invasion border and cellular atypia may aid in correct diagnosis.","PeriodicalId":409976,"journal":{"name":"Voice and Swallowing Disorders","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122213030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-27DOI: 10.5772/intechopen.88779
S. Ursino, P. Cocuzza, S. Santopadre, F. Paiar, B. Fattori
In Western countries, head and neck cancers (HNCs) account for about 5% of all tumors. Due to tumor locations at the aero-digestive crossroad, patients frequently suffer from swallowing dysfunction caused both by primary cancer (baseline dysphagia) and cancer therapies (treatment-related dysphagia). In this regard, radiation-induced dysphagia represents a real “Achille’s heel” which historically occurs in more than 50% of patients and can lead to a malnutritional status and an increased risk of aspiration pneumonia. In fact radiotherapy, by restricting the driving pressure of the bolus through the pharynx and/or limiting the opening of the cricopharyngeal muscle, leads to a post-swallowing pharyngeal residue that may spill into the airway causing ab inges-tis pneumonia. On the contrary, an organ preservation strategy should provide both the highest tumor control probability (TCP) and the minimum function impairment with the subsequent maximum therapeutic index gain. In this regard, intensity-modulated RT (IMRT) might reduce the probability of postradiation dysphagia by producing concave dose distributions with better avoidance of several critical structures, such as swallowing organs at risk (SWOARs), which might result in better functional outcomes. Similarly, a prompt swallowing rehabilitation provided before, during, and soon after radiotherapy plays an important role in improving oncologic swallowing outcomes.
{"title":"Radiation-Related Dysphagia: From Pathophysiology to Clinical Aspects","authors":"S. Ursino, P. Cocuzza, S. Santopadre, F. Paiar, B. Fattori","doi":"10.5772/intechopen.88779","DOIUrl":"https://doi.org/10.5772/intechopen.88779","url":null,"abstract":"In Western countries, head and neck cancers (HNCs) account for about 5% of all tumors. Due to tumor locations at the aero-digestive crossroad, patients frequently suffer from swallowing dysfunction caused both by primary cancer (baseline dysphagia) and cancer therapies (treatment-related dysphagia). In this regard, radiation-induced dysphagia represents a real “Achille’s heel” which historically occurs in more than 50% of patients and can lead to a malnutritional status and an increased risk of aspiration pneumonia. In fact radiotherapy, by restricting the driving pressure of the bolus through the pharynx and/or limiting the opening of the cricopharyngeal muscle, leads to a post-swallowing pharyngeal residue that may spill into the airway causing ab inges-tis pneumonia. On the contrary, an organ preservation strategy should provide both the highest tumor control probability (TCP) and the minimum function impairment with the subsequent maximum therapeutic index gain. In this regard, intensity-modulated RT (IMRT) might reduce the probability of postradiation dysphagia by producing concave dose distributions with better avoidance of several critical structures, such as swallowing organs at risk (SWOARs), which might result in better functional outcomes. Similarly, a prompt swallowing rehabilitation provided before, during, and soon after radiotherapy plays an important role in improving oncologic swallowing outcomes.","PeriodicalId":409976,"journal":{"name":"Voice and Swallowing Disorders","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124941094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We studied the effects of salivary promotion of fluid secretion after hand massage, and the apparatus of vibrotactile stimulation (89 Hz frequency, 15 min) in normal humans. Personal massage cannot be performed on handicap and stroke patients, and then giving hand massage to them for 5 min massage gives a tired feeling. So, we focused 3 min stranger massage. Salivary glands can discharge the accumulated saliva by extrusion from the acinus glands’ massages as described in the recent Japanese textbook. We think that this method may not produce realistic recovery. Our aim ideas are to relieve stress and increase temperature with lightly touch massage of the skin and for a 1 cycle of 1 s. We recorded RR interval of ECG, total salivation, facial skin temperature, OxyHb of fNIRS on the frontal cortex, and amylase activity for the autonomic changes. In increased 2°C of the facial skin temperature, the hand massage had a need for 3 min and the vibrotactile stimulation for 15 min. Increase from 700 to 1000 ms of RR intervals had a need for 3 min in the hand massage and had 15 min in the vibrotactile stimulation. Although vibrotactile stimulation needs long time of 4–7 years as effective recovery, hand massage may have more effect with a repetition of day after day. somatosensory nucleus, and then parasympathetic nerves were activated and produced salivation. So, vibrotactile stimulation will be slowly recovered with the increase of facial skin temperature. Although vibrotactile stimulation spent many time for recovery of glands, hand massage might do a short time for recovery. In particular, the hand stranger massage rapidly increased the produced facial skin temperature and reducing stress. Furthermore, it will recover circulation and metabolism. This massage may be early recovered by a repetitious performing in comparison with a recovery period of the vibrotactile apparatus.
{"title":"Effect of Salivation by Facial Somatosensory Stimuli of Facial Massage and Vibrotactile Apparatus","authors":"Tsunoda Yumi, Akatuka Sumiko, Fukui Sayaka, Nakayama Enri, A. Kimiko, Sato Mituyasu, Kimura Masanori, Kato Syunnichiryou, Sakai Maho, Yamaoka Masaru, Watanabe Mao, Ueda Koichirou, Hiraba Hisao","doi":"10.5772/INTECHOPEN.88495","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.88495","url":null,"abstract":"We studied the effects of salivary promotion of fluid secretion after hand massage, and the apparatus of vibrotactile stimulation (89 Hz frequency, 15 min) in normal humans. Personal massage cannot be performed on handicap and stroke patients, and then giving hand massage to them for 5 min massage gives a tired feeling. So, we focused 3 min stranger massage. Salivary glands can discharge the accumulated saliva by extrusion from the acinus glands’ massages as described in the recent Japanese textbook. We think that this method may not produce realistic recovery. Our aim ideas are to relieve stress and increase temperature with lightly touch massage of the skin and for a 1 cycle of 1 s. We recorded RR interval of ECG, total salivation, facial skin temperature, OxyHb of fNIRS on the frontal cortex, and amylase activity for the autonomic changes. In increased 2°C of the facial skin temperature, the hand massage had a need for 3 min and the vibrotactile stimulation for 15 min. Increase from 700 to 1000 ms of RR intervals had a need for 3 min in the hand massage and had 15 min in the vibrotactile stimulation. Although vibrotactile stimulation needs long time of 4–7 years as effective recovery, hand massage may have more effect with a repetition of day after day. somatosensory nucleus, and then parasympathetic nerves were activated and produced salivation. So, vibrotactile stimulation will be slowly recovered with the increase of facial skin temperature. Although vibrotactile stimulation spent many time for recovery of glands, hand massage might do a short time for recovery. In particular, the hand stranger massage rapidly increased the produced facial skin temperature and reducing stress. Furthermore, it will recover circulation and metabolism. This massage may be early recovered by a repetitious performing in comparison with a recovery period of the vibrotactile apparatus.","PeriodicalId":409976,"journal":{"name":"Voice and Swallowing Disorders","volume":"20 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115548131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-30DOI: 10.5772/INTECHOPEN.88341
A. Osawa, S. Maeshima
Swallowing disturbance often causes by stroke and may predispose patients to malnutrition and dehydration, as well as increases the risk of such complications as suffocation and aspiration pneumonia. As an initial evaluation, the water swallowing test can be easily carried out, but not all of the aspiration can be excluded. Therefore, videofluorography (VF) and videoendoscopic examination (VE) of swallowing should be performed to find a safety method of oral intake for provid-ing visualization of the pharynx and larynx dysfunction. Clinical severity scale is important because once the severity is determined, the treatment strategy is also known. Swallowing training can be divided into indirect training without food (basic training) and direct training with food (eating training). In general, it is important to select conditions and training diets that are easy to swallow and have a low risk of aspiration while using indirect training and direct training that aim at gradually improving the level of oral intake.
{"title":"Swallowing Disorders in Patients with Stroke","authors":"A. Osawa, S. Maeshima","doi":"10.5772/INTECHOPEN.88341","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.88341","url":null,"abstract":"Swallowing disturbance often causes by stroke and may predispose patients to malnutrition and dehydration, as well as increases the risk of such complications as suffocation and aspiration pneumonia. As an initial evaluation, the water swallowing test can be easily carried out, but not all of the aspiration can be excluded. Therefore, videofluorography (VF) and videoendoscopic examination (VE) of swallowing should be performed to find a safety method of oral intake for provid-ing visualization of the pharynx and larynx dysfunction. Clinical severity scale is important because once the severity is determined, the treatment strategy is also known. Swallowing training can be divided into indirect training without food (basic training) and direct training with food (eating training). In general, it is important to select conditions and training diets that are easy to swallow and have a low risk of aspiration while using indirect training and direct training that aim at gradually improving the level of oral intake.","PeriodicalId":409976,"journal":{"name":"Voice and Swallowing Disorders","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130068902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-12DOI: 10.5772/INTECHOPEN.88108
Y. Miyaoka
Surface electromyograms (EMGs) were recorded from the masseter (Mass), one of the major muscles for chewing, and from the suprahyoid (SH) muscles , involved in swallowing. Activity patterns of these EMGs were analyzed with a T P method that was developed specifically to quantify muscle activity patterns. To compare individual EMG bursts in a participant with different amplitudes and active durations, the bursts were cumulatively integrated to standardize the amplitudes and active durations. Each T P value calculated by this method indicated a relative location of an EMG burst on a standardized time scale free from changes in the amplitudes and active durations. Both In P and D P values were derived from the T P values and also applied to the burst. A T 50 value indicated the standardized time for half of the final cumulatively integrated EMG burst. Five groups of application samples were introduced to demonstrate the usefulness of the T P method in comparing activity patterns of the Mass and SH EMGs during chewing and swallowing, while participants were in different body positions and experiencing different tastes and textures of sample foods. Finally, limitations and perspectives of the T P method are discussed.
{"title":"Quantitative Analysis of Activity Patterns in the Muscles of Mastication and Deglutition","authors":"Y. Miyaoka","doi":"10.5772/INTECHOPEN.88108","DOIUrl":"https://doi.org/10.5772/INTECHOPEN.88108","url":null,"abstract":"Surface electromyograms (EMGs) were recorded from the masseter (Mass), one of the major muscles for chewing, and from the suprahyoid (SH) muscles , involved in swallowing. Activity patterns of these EMGs were analyzed with a T P method that was developed specifically to quantify muscle activity patterns. To compare individual EMG bursts in a participant with different amplitudes and active durations, the bursts were cumulatively integrated to standardize the amplitudes and active durations. Each T P value calculated by this method indicated a relative location of an EMG burst on a standardized time scale free from changes in the amplitudes and active durations. Both In P and D P values were derived from the T P values and also applied to the burst. A T 50 value indicated the standardized time for half of the final cumulatively integrated EMG burst. Five groups of application samples were introduced to demonstrate the usefulness of the T P method in comparing activity patterns of the Mass and SH EMGs during chewing and swallowing, while participants were in different body positions and experiencing different tastes and textures of sample foods. Finally, limitations and perspectives of the T P method are discussed.","PeriodicalId":409976,"journal":{"name":"Voice and Swallowing Disorders","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133362891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：