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Selective lateral laser thyroarytenoid myotomy for adductor spasmodic dysphonia

Conclusion: Selective lateral laser thyroarytenoid myotomy seems to represent a curative procedure for adductor spasmodic dysphonia, a chronic, debilitating condition. This procedure is conceptually simple, minimally invasive and repeatable. It also seems to offer a safe and lasting alternative to botulinum toxin therapy.

from the Journal of Laryngology and Otology

Identification of distinct swallowing patterns for different bolus volumes

Objective
To investigate the time interval between glottic closure and the opening of upper esophageal sphincter during swallowing, by means of the coupling of electromyographical (EMG) recordings on the thyroarytenoid (TA) and the cricopharyngeus (CP) muscles.

Methods
TA-EMG and CP-EMG pause were recorded by concentric needle electrodes using time-locked delay-line circuitry of the EMG apparatus. EMG data obtained from a total of 273 swallows of saliva, 3, 5, 10 and 15ml volumes of water, were compared.

Results
The relation between the onsets of TA-EMG activity and the CP-EMG pause demonstrated three different patterns of swallows. Pattern A was the delay of the onset of TA-EMG between 50–500ms, and pattern B was the overlap of its activity with the CP-EMG pause. Pattern C was the earlier occurrence of the TA-EMG 50-550ms before the CP-EMG pause. Pattern A was the most frequent type of swallows whereas the pattern C appeared during swallowing of larger volumes.

Conclusions
Physiologically, there is a delay of the TA activation after the onset of CP-EMG pause during swallowing of small amounts in healthy subjects.

Significance
This physiological phenomenon could be a potential risk of aspiration in patients with neurogenic dysphagia.

from Clinical Neurophysiology

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