ABSTRACT
ABSTRACT Purpose When swallowing efficiency is impaired, residue accumulates in the pharynx. Cued or spontaneous swallows in the head neutral position do not always successfully clear residue. We investigated the impact of a novel maneuver on residue clearance by combining a head turn with the chin down posture. Methods Data were collected from 26 participants who demonstrated persistent vallecular residue after an initial head neutral clearance swallow in videofluoroscopy. Participants were cued to perform a head-turn-plus-chin-down swallow, with the direction of head turn randomized. Pixel-based measures of residue in the vallecular space before and after the maneuver were made on still frame lateral images using ImageJ software. Measures of % full and the Normalized Residue Ratio Scale (NRRS) were extracted. Univariate analyses of variance were used to detect significant reductions in residue. Results On average, pre-maneuver measures showed residue filling 56-73% of the valleculae, depending on stimulus consistency (NRRS scores: 0.2-0.4). More than 80% of pre-swallow measures displayed NRRS ratios > 0.06, a threshold previously linked to increased risk of post-swallow aspiration. Conclusion The head-turn-plus-chin-down maneuver achieved significant reductions in residue for thin and nectar-thick fluids, suggesting that this maneuver can be effective in reducing persistent vallecular residue with these consistencies.
Subject(s)
Humans , Male , Female , Adult , Aged , Aged, 80 and over , Young Adult , Posture , Deglutition Disorders/physiopathology , Deglutition Disorders/prevention & control , Epiglottis/physiopathology , Pharynx/physiopathology , Fluoroscopy/methods , Reproducibility of Results , Risk Factors , Analysis of Variance , Chin/physiology , Treatment Outcome , Deglutition/physiology , Respiratory Aspiration/prevention & control , Middle AgedABSTRACT
En este trabajo se describen 5 áreas de superposición y 7 áreas de evaluación entre la telerradiografía inicial y el VTO. El objetivo de las superposiciones es poder evaluar los cambios que se producen por crecimiento y los que son factibles realizar por tratamiento. Cabe destacar que las ciencias biológicas no son exactas, por lo tanto todas estas herramientas sirven para aproximarnos al ideal y son de gran utilidad si se tiene en cuenta sus múltiples variables, si por el contrario se las propone como un método exacto llevarán al fracaso
Subject(s)
Humans , Cephalometry , Maxillofacial Development , Orthodontics, Corrective , Jaw , Chin/physiology , Molar , Patient Care Planning , Radiography, Panoramic/methods , Treatment OutcomeABSTRACT
O período de silêncio observado no eletromiograma dos músculos elevadores da mandíbula é resultante de uma inibiçäo reflexa do núcleo motor do nervo trigêmio induzida por estímulos provenientes dos fusos musculares e dos mecamorreceptores do periodonto. A partir da observaçäo de que a sua duraçäo estava aumentada nos registros eletromiográficos obtidos de pacientes com disfunçäo da ATM, o uso dessa medida passou a ser indicado como método objetivo de diagnóstico dessa disfunçäo. Entretanto, assim como alguns investigadores observaram na disfunçäo da ATM aumento significante na duraçäo do PS, outros colocaram dúvidas a respeito do uso por näo encontrarem esse aumento ou por näo o observarem em todos os pacientes com disfunçäo. Por outro lado, näo existem na literatura dados consistentes a respeito da duraçäo do PS eletromiográfico em outros tipos de disfunçöes oclusais e também näo foram encontrados relatos a respeito da duraçäo do PS eletromiográfico em pacientes portadores de fissura de lábio e de palato que apresentam grandes disfunçöes oclusais...