title: Laryngeal elevation achieved by neuromuscular stimulation at rest.
abstract: During swallowing, airway protection is achieved in part by laryngeal elevation. Although multiple muscles are normally active during laryngeal elevation, neuromuscular stimulation of select muscles was evaluated to determine which single muscle or muscle pair best elevates the larynx and should be considered during future studies of neuromuscular stimulation in dysphagic patients. Hooked-wire monopolar electrodes were inserted into mylohyoid, thyrohyoid, and geniohyoid muscle regions in 15 healthy men selected for having a highly visible thyroid prominence for videotaping. During trials of single, bilateral, and combined muscle stimulations, thyroid prominence movements were video recorded, digitized, and normalized relative to elevation during a 2-ml water swallow. Individual muscle stimulation induced approximately 30% of the elevation observed during a swallow and approximately 50% of swallow velocity, whereas paired muscle stimulation resulted in approximately 50% of the elevation and approximately 80% of the velocity produced during a swallow. Paired muscle stimulation produced significantly greater elevation than single muscle stimulation and could assist with laryngeal elevation in dysphagic patients with reduced or delayed laryngeal elevation.
authors.affiliation: Laryngeal and Speech Section, Medical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892-1416, USA. burnettt@ninds.nih.gov
authors.forename: Theresa A
authors.initials: TA
authors.lastname: Burnett
authors.forename: Eric A
authors.initials: EA
authors.lastname: Mann
authors.forename: Sonia A
authors.initials: SA
authors.lastname: Cornell
authors.forename: Christy L
authors.initials: CL
authors.lastname: Ludlow
mesh_terms: D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena; D003679:Deglutition / Q000502:physiology; D004558:Electric Stimulation / Q000379:methods; D006801:Humans; D007821:Laryngeal Muscles / Q000502:physiology; D007830:Larynx / Q000502:physiology*; D008297:Male; D009068:Movement / Q000502:physiology; D009469:Neuromuscular Junction / Q000502:physiology*; D013997:Time Factors