Blog Archives

Activity Patterns in Latissimus Dorsi and Sternocleidomastoid in Classical Singers

Conclusions
LD appears to play a significant role in maintaining chest expansion and the dynamic processes underlying vibrato and coloratura singing in classically trained singers.

from the Journal of Voice

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Lung Volume Measured During Sequential Swallowing in Healthy Young Adults

Conclusions: Results show that as the physiologic demands of swallowing deviate from single, small bolus swallows, the integration of the swallowing and respiratory systems change. This may reflect obligate differences in airway protection strategy and prolonged competition for respiratory resources.

from the Journal of Speech, Language, and Hearing Research

Dysfunction of bulbar central pattern generator in ALS patients with dysphagia during sequential deglutition

Conclusions
The corticobulbar control of swallowing is insufficient in ALS, and the swallowing CPG cannot work very well to produce segmental muscle activation and sequential swallowing. CPG dysfunction can result in irregular and arhythmical sequential swallowing in ALS patients with bulbar plus pseudobulbar types.

Significance
The arhythmical SWS pattern can be considered as a kind of dysfunction of CPG in human ALS cases with dysphagia.

from Clinical Neurophysiology

Outcomes of surgery for laryngotracheal stenosis—The parents perspective

This study has given us a unique insight into the concerns of parents who have children with laryngotracheal stenosis. It has also allowed us to evaluate our post-operative results from a qualitative perspective through the eyes of the parents.

from the International Journal of Pediatric Otorhinolaryngology

Outcomes of surgery for laryngotracheal stenosis—The parents perspective

This study has given us a unique insight into the concerns of parents who have children with laryngotracheal stenosis. It has also allowed us to evaluate our post-operative results from a qualitative perspective through the eyes of the parents.

from the International Journal of Pediatric Otorhinolaryngology

Correlation between velopharyngeal closure and nasopharyngeal dimensions after pharyngeal flap surgery assessed by pressure-flow technique

CONCLUSION: Most patients with large flaps presented adequate velopharyngeal closure during speech. However, the findings show that the velopharyngeal orifice area during breathing is not a good predictor of the effectiveness of the pharyngeal flap for speech.

from Revista de Sociedade Brasileira de Fonoaudiologia

The contribution(s) of the insula to speech production: a review of the clinical and functional imaging literature

Skilled spoken language production requires fast and accurate coordination of up to 100 muscles. A long-standing concept—tracing ultimately back to Paul Broca—assumes posterior parts of the inferior frontal gyrus to support the orchestration of the respective movement sequences prior to innervation of the vocal tract. At variance with this tradition, the insula has more recently been declared the relevant “region for coordinating speech articulation”, based upon clinico-neuroradiological correlation studies. However, these findings have been criticized on methodological grounds. A survey of the clinical literature (cerebrovascular disorders, brain tumours, stimulation mapping) yields a still inconclusive picture. By contrast, functional imaging studies report more consistently hemodynamic insular responses in association with motor aspects of spoken language. Most noteworthy, a relatively small area at the junction of insular and opercular cortex was found sensitive to the phonetic-linguistic structure of verbal utterances, a strong argument for its engagement in articulatory control processes. Nevertheless, intrasylvian hemodynamic activation does not appear restricted to articulatory processes and might also be engaged in the adjustment of the autonomic system to ventilatory needs during speech production: Whereas the posterior insula could be involved in the cortical representation of respiration-related metabolic (interoceptive) states, the more rostral components, acting upon autonomic functions, might serve as a corollary pathway to “voluntary control of breathing” bound to corticospinal and -bulbar fiber tracts. For example, the insula could participate in the implementation of task-specific autonomic settings such as the maintenance of a state of relative hyperventilation during speech production.

from Brain Structure and Function

Representation of the speech effectors in the human motor cortex: Somatotopy or overlap?

Somatotopy within the orofacial region of the human motor cortex has been a central concept in interpreting the results of neuroimaging and transcranial magnetic stimulation studies of normal and disordered speech. Yet, somatotopy has been challenged by studies showing overlap among the effectors within the homunculus. In order to address this dichotomy, we performed four voxel-based meta-analyses of 54 functional neuroimaging studies of non-speech tasks involving respiration, lip movement, tongue movement, and swallowing, respectively. While the centers of mass of the clusters supported the classic homuncular view of the motor cortex, there was significant variability in the locations of the activation-coordinates among studies, resulting in an overlapping arrangement. This “somatotopy with overlap” might reflect the intrinsic functional interconnectedness of the oral effectors for speech production.

from Brain and Language

Speech Breathing in Speakers who use an Electrolarynx

Speakers who use an electrolarynx following a total laryngectomy no longer require pulmonary support for speech. Subsequently, chest wall movements may be affected; however, chest wall movements in these speakers are not well defined. The purpose of this investigation was to evaluate speech breathing in speakers who use an electrolarynx during speech and reading tasks.

Six speakers who use an electrolarynx underwent an evaluation of chest wall kinematics (e.g., chest wall movements, temporal characteristics of chest wall movement), lung volumes, temporal measures of speech, and the interaction of linguistic influences on ventilation. Results of the present study were compared to previous reports in speakers who use an electrolarynx, as well as to previous reports in typical speakers.

There were no significant differences in lung volumes used and the general movement of the chest wall by task; however, there were differences of note in the temporal aspects of chest wall configuration when compared to previous reports in both typical speakers and speakers who use an electrolarynx. These differences were related to timing and posturing of the chest wall.

The lack of differences in lung volumes and chest wall movements by task indicates that neither reading nor spontaneous speech exerts a greater influence on speech breathing; however, the temporal and posturing results suggest the possibility of a decoupling of the respiratory system from speech following a total laryngectomy and subsequent alaryngeal speech rehabilitation.

from the Journal of Communication Disorders

Respiratory-swallow phase patterns and their relationship to swallowing impairment in patients treated for oropharyngeal cancer

Conclusions.
We suggest nonexpiratory bracketed respiratory-swallowing phase patterns in patients with oropharyngeal cancer may place patients at greater risk of airway penetration or aspiration during swallowing. © 2009 Wiley Periodicals, Inc. Head Neck, 2009

from Head and Neck

Lung Volume During Swallowing: Single Bolus Swallows in Healthy Young Adults

from the Journal of Speech, Language, and Hearing Research

Purpose: This study examined the relationship between swallowing and lung volume initiation in healthy adults during single swallows of boluses differing in volume and consistency. Differences in lung volume according to respiratory phase surrounding the swallow were also assessed.

Method: Nine men and 11 women between the ages of 19 and 28 years served as study participants. Lung volume and respiratory phase data was recorded as each participant completed 5 trials each of 10mL and 20mL water boluses by cup, and thin and thick paste boluses by spoon, presented in randomized order.

Results: Significant differences in lung volume at swallow initiation were found based on bolus consistency, but not on bolus volume. No differences were found for lung volume initiation based on the respiratory phase surrounding the swallow, or for the respiratory pattern based on bolus volume or consistency.

Conclusion: Findings of this study extend the existing knowledge base regarding the interaction of the swallow and respiratory systems by identifying targeted lung volumes at swallow initiation. In addition to other swallow-related biomechanical events and respiratory phase relationships surrounding a swallow, the lung volume at swallow initiation may be an important consideration when investigating swallow physiology and physiopathy.

Respiratory Movement Patterns during Vocalizations at 7-and 11-Months of Age

from the Journal of Speech, Language, and Hearing Research

Purpose: The present investigation was designed to study the modulation of abdomen and rib cage movements during vocalization over a period of development associated with rapid decreases in the compliance of the chest wall.

Method: Rib cage and abdominal kinematics were recorded during spontaneous vocalizations in 7-and 11-month old infants. Principal component analysis (PCA) was used to represent each infant’s abdomen and rib cage traces as the weighted sum of a small number of PC waveforms.

Results: The fundamental periods of infants’ PC waveforms in the 11-month group were significantly shorter than those in the 7-month group. In addition, the variance contributed by PCs describing unidirectional patterns of respiratory movement decreased in the 11-month group while the variances contributed by PCs describing modulated patterns of movement increased. Lastly, the extent to which abdomen and rib cage movements predicted the duration of corresponding vocalizations also increased significantly in the 11-month group compared to the 7-month group.

Conclusions: The findings of the present study were consistent with the hypothesis that decreases in the compliance of the chest wall result in more rapid modulation of chest wall movements and greater control of those movements by the developing neuromuscular system.