M-mode color Doppler ultrasonic imaging of vertical tongue movement during articulatory movement.

To observe and estimate the movement of the tongue, ultrasonic investigation is the most harmless real-time monitoring procedure for analyzing articulatory movements. Color Doppler ultrasonic imaging is special in that it can only sample a moving target, and it can indicate the velocity and direction of the target by color and brightness in real time. This study assessed and demonstrated the validity of M-mode color Doppler ultrasonic imaging to observe the movements of the tongue during syllable repetition tasks performed by normal subjects and dysarthric patients, those affected by amyotrophic lateral sclerosis, cerebellar ataxia, Parkinsonism, and polymyopathy. When the transducer was set below the jaw, upward movement was indicated by a blue signal and downward movement was indicated by a red one on the screen of the ultrasound machine. We also measured the velocity of the tongue by contrast scale classified by 15 degrees. Thus, we could observe vertical tongue movement by a color-coded pattern after quantitative analysis. The Doppler signal patterns of normal subjects were verified by simultaneous video x-ray fluorography recordings. The findings for dysarthric patients corresponded well with previously reported features analyzed by other methods. Therefore, color Doppler ultrasonic imaging of the tongue is a useful procedure to researchers for clinical speech and voice studies.

[Spontaneous dislocation of the arytenoid cartilage].

Dislocation of the arytenoid cartilage occurs following medical instrumentation involving the laryngeal cavity or laryngeal injury from outside the larynx. We reported a case of spontaneously posterior dislocation of the arytenoid cartilage. A 53 year-old man suffering from suddenly recurring aphonia and its improvement many over 3 months without laryngeal injury or inducement eventually ceased to improve. Laryngoscopic findings showed that the left vocal fold was tensely prolonged and the vocal process of the arytenoid cartilage on the left side was dislocated posterolaterally. X-ray videofluorography of the larynx on repetitive phonation of /he/ showed abnormally high and diagonal displacement of the vocal fold and the upper structure of the arytenoid cartilage on the left side. Palpating the cricoarytenoid joint on the left side showed abnormal swelling with tenderness. Electomyography of the intrinsic laryngeal muscle on the left side showed normal action potential. From these findings, we diagnosed his voice disorder as spontaneously posterior dislocation of the arytenoid cartilage. We manually reduced it by pulling up a balloon inserted from the piriform sinus of the affected side to the esophagus.