Oynophagia in patients after dental extraction: surface electromyography study.

Oded Nahlieli,Eli Eliav,Michael Vaiman

doi:10.1186/1746-160x-2-34

Abstract

ObjectivesSurface electromyographic (sEMG) studies were performed on 40 adult patients following extraction of lower third and second molars to research the approach and limitations of sEMG evaluation of their odynophagia complaints.MethodsParameters evaluated during swallowing and drinking include the timing, number of swallows per 100 cc of water, and range (amplitude) of EMG activity of m. masseter, infrahyoid and submental-submandibular group. The above mentioned variables (mean + standard deviation) were measured for the group of dental patients (n = 40) and control group of healthy adults (n = 40).ResultsThe duration of swallows and drinking in all tests showed increase in dental patients' group, in which this tendency is statistically significant. There was no statistically significant difference between male and female adults' duration and amplitude of muscle activity during continuous drinking in both groups (p = 0.05). The mean of electric activity (in μV) of m. masseter was significantly lower in the dental patients' group in comparison with control group. The electric activity of submental-submandimular and infrahyoid muscle groups was the same in both groups.ConclusionSurface EMG of swallowing is a simple and reliable noninvasive method for evaluation of odynophagia/dysphagia complaints following dental extraction with low level of discomfort of the examination. The surface EMG studies prove that dysphagia following dental extraction and molar surgery has oral origin, does not affect pharingeal segment and submental-submandibular muscle group. This type of dysphagia has clear EMG signs: increased duration of single swallow, longer drinking time, low range of electric activity of m. masseter, normal range of activity of submental-submandibular muscle group, and the "dry swalow" aftereffect. The data can be used for evaluation of complaints and symptoms, as well as for comparison purposes in pre- and postoperative stages and in EMG monitoring during treatment of post-surgical oral cavity discomfort and dysphagia.

Highlights

For decades the investigation of dysphagia has been concentrated on evaluation of single and separate swallows of normal subjects and neurological or otolaryngological patients [1,2,3,4,5]
Numerous studies were performed in this field; yet, clinicians still indicate the need for a simple noninvasive test for assessment of postsurgical dysphagia/odynophagia complaints
We examined single swallowing and continuous drinking of 100 cc of tap water from an open cup

Summary

Introduction

For decades the investigation of dysphagia has been concentrated on evaluation of single and separate swallows of normal subjects and neurological or otolaryngological patients [1,2,3,4,5]. Head & Face Medicine 2006, 2:34 http://www.head-face-med.com/content/2/1/34 phagia, is a common symptom in dentistry as well. It can appear following dental extraction [10], bimaxillary osteotomy [11], odontogenic infection [12], and other dental problems [13]. While dysphagia can be with or without pain, odynophagia it its turn can produce secondary dysphagia as patients trying to reduce pain change their normal swallowing patterns. Numerous studies were performed in this field; yet, clinicians still indicate the need for a simple noninvasive test for assessment of postsurgical dysphagia/odynophagia complaints

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