Suprahyoid Research Articles

Impact of Thickened Liquids on Laryngeal Movement Velocity in Patients with Dysphagia.

Considering that thickened liquids are frequently used for patients with dysphagia, elucidating their impact on laryngeal dynamics is important. Although studies have investigated the impact of thickened liquids on laryngeal movement velocity among healthy young adults, no study has examined the same among patients with dysphagia. We aimed to elucidate the influence of bolus consistency on laryngeal movement velocity and surface electromyographic activity of the suprahyoid muscles in patients with dysphagia. Participants included 18 male, poststroke patients with dysphagia, whereas patients with true bulbar paralysis, head and neck cancer, neuromuscular disease, or recurrent nerve paralysis were excluded. A video fluoroscopic swallowing study (VFSS) was performed while swallowing 3 mL of moderately thick and thin liquids. Quantitative VFSS analysis, including factors such as laryngeal peak velocity, laryngeal mean velocity, laryngeal movement distance, duration of the laryngeal elevation movement, and the temporal location of laryngeal vestibule closure within the laryngeal elevation movement was performed. Muscle activity was evaluated using integrated muscles activity values obtained from electromyography (iEMG) of the suprahyoid muscle during swallowing. VFSS analysis showed that laryngeal peak velocity and laryngeal mean velocity were significantly faster while swallowing moderately thick than while swallowing thin liquids. Laryngeal movement distance was significantly greater while swallowing moderately thick than while swallowing thin liquids. iEMG was significantly higher while swallowing moderately thick liquids than while swallowing thin liquids. Compared to thin liquids, moderately thick induced an increase in laryngeal movement velocity and in suprahyoid muscle activity among patients with dysphagia, a finding consistent with that of a previous study among healthy adults.

A comparison of the head lift exercise and recline exercise in patients with chronic head and neck cancer post-radiation.

Patients who undergo surgery and adjuvant radiation treatment for head and neck cancer often develop dysphagia as a result of this treatment. Improvements in swallow function may be achieved with exercise. The goal of this pilot study was to compare the effectiveness and perceived difficulty of using the head lift exercise and the recline exercise to activate the suprahyoid musculature in 8 individuals with a history of head and neck cancer. Muscle activation using surface electromyography was examined to determine if the recline exercise activates the suprahyoid muscle groups to the same degree as the head lift exercise. Participants also rated the exertion they experienced to assess how easily patients are able to complete the exercises. The majority of participants completed both exercises in their entirety on their first attempt. However, ratings of perceived exertion were significantly lower for the recline exercise than the head lift exercise. The head lift exercise activated the suprahyoid musculature to a significantly greater degree than the recline exercise. The recline exercise, in comparison with the head lift exercise, is easier for participants to complete and results in significantly reduced perceptions of fatigue. Results of this study indicate that the recline exercise may be a good potential substitute for the head lift exercise in patient populations that are incapable of performing the head lift exercise, but that the head lift exercise should be prescribed whenever it is viable as it activates target musculature more effectively than the recline exercise.

Effect of Aging, Gender and Sensory Stimulation of TRPV1 Receptors with Capsaicin on Spontaneous Swallowing Frequency in Patients with Oropharyngeal Dysphagia: A Proof-of-Concept Study.

Spontaneous swallowing contributes to airway protection and depends on the activation of brainstem reflex circuits in the central pattern generator (CPG). We studied the effect of age and gender on spontaneous swallowing frequency (SSF) in healthy volunteers and assessed basal SSF and TRPV1 stimulation effect on SSF in patients with post-stroke oropharyngeal dysphagia (OD). The effect of age and gender on SSF was examined on 141 healthy adult volunteers (HV) divided into three groups: GI—18–39 yr, GII—40–59 yr, and GIII—>60 yr. OD was assessed by the Volume–Viscosity Swallowing Test (VVST). The effect of sensory stimulation with capsaicin 10−5 M (TRPV1 agonist) was evaluated in 17 patients with post-stroke OD, using the SSF. SSF was recorded in all participants during 10 min using surface electromyography (sEMG) of the suprahyoid muscles and an omnidirectional accelerometer placed over the cricothyroid cartilage. SSF was significantly reduced in GII (0.73 ± 0.50 swallows/min; p = 0.0385) and GIII (0.50 ± 0.31 swallows/min; p < 0.0001) compared to GI (1.03 ± 0.62 swallows/min), and there was a moderate significant correlation between age and SFF (r = −0.3810; p < 0.0001). No effect of gender on SSF was observed. Capsaicin caused a strong and significant increase in SSF after the TRPV1 stimulation when comparing to basal condition (pre-capsaicin: 0.41 ± 0.32 swallows/min vs post-capsaicin: 0.81 ± 0.51 swallow/min; p = 0.0003). OD in patients with post-stroke OD and acute stimulation with TRPV1 agonists caused a significant increase in SSF, further suggesting the potential role of pharmacological stimulation of sensory pathways as a therapeutic strategy for CPG activation in patients with OD.

Eletromiografia de Superfície dos Músculos Masseter e Supra-Hióideos na Fase Oral da Deglutição em Adultos Saudáveis

Objective: to evaluate by means of electromyographic analysis of the masseter and suprahyoid muscles the oral phase of the swallowing of different volumes of saliva and liquid in healthy adult individuals. Material and Methods: the method consisted in analyzing samples of three swallowing trials: voluntary and single swallow of saliva (dry), voluntary and single swallow of 10 ml of water, and voluntary and single swallow of 20ml of water. Statistical analysis: Through Friedman’s ANOVA test we observed a significant variation in the medium potential of the right suprahyoid muscle (p=0.010) when compared to the left suprahyoid muscle (p=0.05). Other correlations were verified by using the Nemenyi test, the Wilcoxon test and the Spearman coefficient to support the different analyses of the results. Results: the analysis found a direct relation between the electrical activity of the masseter and suprahyoid muscles when swallowing 20 ml water as regards the highest potential values, irrespective of face side – left or right; i.e., when swallowing 20ml water, the higher the potential of one muscle group, the higher the expected value of its antagonist. Conclusion: the electromyographic behavior of the masseter and suprahyoid muscles during voluntary swallowing of saliva and two standardized liquid volumes showed that the electrical activity of the masseter muscles did not vary according to the type of swallowing.

Effects of Effortful Swallowing Exercise with Progressive Anterior Tongue Press Using Iowa Oral Performance Instrument (IOPI) on the Strength of Swallowing-Related Muscles in the Elderly: A Preliminary Study.

The purpose of this study was to confirm the effect of effortful swallowing (ES) exercise programs applied to increase the swallowing-related muscle strength in the elderly. In this study, 20 healthy elderly people (76.65 ± 5.87years; 10 women and 10 men) participated and exercised for 7weeks. The experimental group performed ES exercise combined with external resistance using Iowa Oral Performance Instrument (IOPI), and the control group performed pure ES without external resistance. The exercises were performed for 20min a day, 2days a week for 7weeks in both groups. ES was repeated 60 times in weeks 1 and 2, 80 times in week 3 and 4, and 120 times in weeks 5-7. In the experimental group, the isometric and swallowing tongue pressures at week 8 were significantly improved compared to baseline. At week 8, the anterior and swallowing tongue pressures and anterior tongue endurance were significantly higher than those of the control group. In the control group, no significant change in tongue pressure-related variables was observed after 7weeks of exercise. ES exercise combined with IOPI resistance for 7weeks tended to increase the suprahyoid muscle activation level without statistical significance. For clinical application of this exercise protocol, further studies including more elderly people and patients with dysphagia are required.

Effects of rehabilitation with complete dentures on bite force and electromyography of jaw and neck muscles and the correlation with occlusal vertical dimension.

The purpose of this study was to assess the effects of oral rehabilitation with complete dentures on bite force and electromyography of the suprahyoid and sternocleidomastoid muscles, and their correlation with occlusal vertical dimension (OVD). The research questions were "What are the effects of rehabilitation with complete dentures on bite force and electromyography of suprahyoid and sternocleidomastoid muscles, and how are they correlated with OVD?" Patients who are wearers of unsatisfactory removable complete dentures were attended in three sessions (T0, T1, and T2). At T0, while the patients still wore the old dentures, they were submitted to bite force and surface electromyographic exams of the suprahyoid and sternocleidomastoid muscles. These exams were repeated, and the OVD was measured while the patients wore their old and new prostheses, 30days after insertion of the new prosthesis (T1). The exams were repeated 100days after the insertion of the new prosthesis (T2). The data were submitted to the Shapiro-Wilk normality test, analysis of variance (ANOVA), and Pearson correlation and linear regression, all with 5% significance. Fifteen patients participated in the study. No statistically significant difference was observed for bite force or electromyography in T0, T1, or T2. However, the correlation and regression tests showed important interactions between the OVD and maximum voluntary occlusal bite force, as well as the OVD and electromyography during deglutition for the suprahyoid muscles. Rehabilitation did not impact bite force nor the activity of the assessed muscles (electromyography). On the other hand, OVD was shown to be an important factor for bite force, and deglutition of water after rehabilitation. This study shows what are the influences of rehabilitation on oral functions and reinforces the importance of corrected reestablishment of OVD because it has been found to be an important factor for bite force and electromyography during deglutition.

Tongue coupling as a therapeutic strategy: electromyographic analysis of different training approaches

ABSTRACT Purpose: to compare the effect of two tongue coupling approaches on the electrical activity of the suprahyoid musculature in young women. Methods: the sample comprised 47 women aged 18 to 27 years, distributed into groups, according to exercise training time - 10 and 15 seconds. They answered an initial questionnaire and were submitted to speech-language-hearing clinical assessment, body mass index calculation, and electromyographic assessment. Two electrodes were positioned bilaterally on the skin in the region of the suprahyoid musculature to pick up the electromyographic signal. The women performed the tests with resting periods and maximum voluntary contraction, coupling the tongue with the hard palate as strongly as possible, followed by three training series coupling the tongue with the palate. The collected data regarding amplitude and frequency of the myoelectrical activity were analyzed, by comparing the performance within the two groups and one another with the Friedman and One-Way ANOVA tests, and Mann-Whitney U test, at the 5% significance level. Results: no statistical significance was observed between the groups when comparing their performance in the series, neither was there any decrease in the median frequency in each group while performing the three series. Conclusion: no effect on the electrical activity of the suprahyoid musculature was found in young women when they performed isometric tongue coupling exercise training.

The prospective evaluation and risk factors of dysphagia after surgery in patients with oral cancer

BackgroundThis prospective study investigated the change of swallowing ability using the Swallowing Ability Scale System (SASS) and swallowing-related quality of life (QOL) by Performance Status Scale for Head and Neck Cancer patients (PSS-H&N). This study also investigated the risk factors for postoperative dysphagia in patients who received reconstructive surgery for oral cancer.Subjects and MethodsThis study included 64 patients (33 men and 31 women) who underwent radical surgery with neck dissection and reconstructive surgery for oral cancers between July 2014 and February 2018. We evaluated risk factors for poor swallowing ability after treatment, including demographic factors, preoperative factors and perioperative factors, with univariate and multivariate analyses. The change of swallowing ability by the SASS and swallowing-related QOL by PSS-H&N were evaluated prospectively prior to the initiation of surgery within 1 week and at 1 and 3 months after treatment.ResultsAdvanced T stage (T3, 4) (odds ratio (OR) = 79.71), bilateral neck dissection (OR = 20.66) and the resection of unilateral or bilateral suprahyoid muscles (OR = 17.00) were associated with poor swallowing ability after treatment. The scores for time for food intake and Eating in Public were associated with decrease of QOL in the poor group.ConclusionsWe propose that clinicians consider the risk factors identified in this study and pay close attention to the management of oral cancer patients with reconstructive surgery.Graphical abstract

Breathing dystonia in Meige syndrome

BackgroundDyspnoea is rarely mentioned in the clinical description of adult-onset isolated dystonia. In this study, we present the clinical features of 13 patients with Meige syndrome (cranio-cervical dystonia) with breathing difficulties. MethodsA retrospective case note review was performed of patients presenting with Meige syndrome and shortness of breath, to a neuro-laryngology MDT clinic. ResultsSome patients were severely limited by their breathlessness, but others did not volunteer these symptoms. The majority of patients were referred with the assumption that the larynx was the cause of the problem; however half the patients did not have evidence of laryngeal involvement. Of the patients who had laryngeal involvement, injecting the larynx alone did not always relieve the dyspnoea. The majority of our patients responded to injection of the suprahyoid muscles, including genioglossus, digastric and mylohyoid. ConclusionWe recommend routinely establishing if the patient with Meige syndrome has signs or symptoms of breathlessness, and establishing the level of the problem, as this can be treated successfully.

The effects of neuromuscular joint facilitation treatment using neck patterns on the acoustic analysis of swallowing sounds in healthy adults.

[Purpose] We aimed to investigate the changes in the swallowing sounds of healthy adults during neuromuscular joint facilitation treatment using neck patterns. [Participants and Methods] A total of 20 healthy adults (10 males and 10 females; mean age, 29.2 ± 6.3 years) swallowed 10 mL of water four times under three conditions (after the neuromuscular joint facilitation neck-flexion resistance pattern, after the Shaker-type exercise, and during relaxed sitting without prior exercise [control]), randomly ordered with an interval greater than 3 days. Swallowing sounds for each water swallow were recorded using cervical auscultation. [Results] The mean amplitude of swallowing sound intensity and the mean spectral frequency were significantly higher after the neuromuscular joint facilitation neck-flexion resistance pattern and the Shaker-type exercise, in comparison with those in the control group. [Conclusion] Neuromuscular joint facilitation training with the neck-flexion resistance pattern influenced swallowing sounds to the same degree as the Shaker-type exercise, implying that this resistance pattern may enhance suprahyoid muscle contraction.

Examination of Intensity of Tongue-to-Palate Pressure Generation for Strengthening the Suprahyoid Muscles

Examination of Intensity of Tongue-to-Palate Pressure Generation for Strengthening the Suprahyoid Muscles

An Examination of the Efficacy of Head-Raising Exercise Methods for Guiding Suprahyoid Muscle Activity

An Examination of the Efficacy of Head-Raising Exercise Methods for Guiding Suprahyoid Muscle Activity

Facial EMG Activity Is Associated with Hedonic Experiences but not Nutritional Values While Viewing Food Images.

The physiological correlates of hedonic/emotional experiences to visual food stimuli are of theoretical and practical interest. Previous psychophysiological studies have shown that facial electromyography (EMG) signals were related to subjective hedonic ratings in response to food images. However, because other data showed positive correlations between hedonic ratings and objective nutritional values of food, whether the facial EMG reactions to food images could reflect the hedonic evaluation or nutritional assessment of food remains unknown. To address this issue, we measured subjective hedonic ratings (liking, wanting, valence, and arousal) and physiological signals (facial EMG of the corrugator supercilii, zygomatic major, masseter, and suprahyoid muscles, skin potential responses, and heart rates) while participants observed food images that had objective nutritional information (caloric, carbohydrate, fat, and protein contents). The results revealed that zygomatic major EMG activity was positively correlated with ratings of liking, wanting, and valence, but not with any objective nutritional value. These data indicate that facial EMG signals in response to food images reflect subjective hedonic experiences, but not objective nutritional values, associated with the food item.

Investigation of Embodied Language Processing on Command-Swallow Performance in Healthy Participants.

Purpose During videofluoroscopic examination of swallowing, patients commonly are instructed to hold a bolus in their mouth until they hear a verbal instruction to swallow, which usually consists of the word swallow and is commonly referred to as the command swallow condition. The language-induced motor facilitation theory suggests that linguistic processes associated with the verbal command to swallow should facilitate the voluntary component of swallowing. As such, the purpose of the study was to examine the linguistic influences of the verbal command on swallowing. Method Twenty healthy young adult participants held a 5-ml liquid bolus in their mouth and swallowed the bolus after hearing one of five acoustic stimuli presented randomly: congruent action word (swallow), incongruent action word (cough), congruent pseudoword (spallow), incongruent pseudoword (pough), and nonverbal stimulus (1000-Hz pure tone). Suprahyoid muscle activity during swallowing was measured via surface electromyography (sEMG). Results The onset and peak sEMG latencies following the congruent action word swallow were shorter than latencies following the pure tone and pseudowords but were not different from the incongruent action word. The lack of difference between swallow and cough did not negate the positive impact of real words on timing. In contrast to expectations, sEMG activity duration and rise time were longer following the word swallow than the pure tone and pseudowords but were not different from cough. No differences were observed for peak suprahyoid muscle activity amplitude and fall times. Conclusions Language facilitation was observed in swallowing. The clinical utility of the information obtained in the study may depend on the purposes for using the command swallow and the type of patient being assessed. However, linguistic processing under the command swallow condition may alter swallow behaviors and suggests that linguistic inducement could be useful as a compensatory technique for patients with difficulty initiating oropharyngeal swallows.

Recurrent aspiration pneumonia precipitated by obstructive sleep apnea

ObjectiveThe clearance of the pharynx by deglutition and the respiratory phase patterns associated with deglutition are important in protecting airways and lungs against aspiration. The deglutition and respiratory phase patterns during sleep in patients (without swallowing disorders while awake) with obstructive sleep apnea (OSA) precipitating recurrent intractable aspiration pneumonia were investigated. MethodsAfter videoendoscopic and videofluorographic examinations of swallowing showed subjects had no swallowing disorders while awake, two adults with recurrent intractable aspiration pneumonia precipitated by severe OSA were examined via time-matched digital recordings of polysomnography and surface electromyography of the muscles (thyrohyoid and suprahyoid muscles) related to swallowing and compared with the same patients before and under CPAP therapy. ResultsCPAP therapy cured recurrent intractable aspiration pneumonia. Swallows following and/or followed by inspiration (uncoordinated deglutition with respiration), which were frequently observed before CPAP therapy, were markedly reduced under CPAP therapy. On the other hand, swallows following and/or followed by expiration (coordinated deglutition with respiration) markedly increased under CPAP therapy. Deglutition was related to the sleep stage. The deeper the sleep stage, the lower the deglutition frequency. Before and under CPAP therapy, swallowing was infrequent and absent for long periods. However, respiratory phase patterns associated with sleep-related deglutition in patients with OSA under CPAP therapy markedly improved. ConclusionsIn patients (without swallowing disorders while awake) with OSA precipitating recurrent intractable aspiration pneumonia, the high rate of uncoordinated deglutition with respiration (swallows following and/or followed by inspiration) during sleep were markedly reduced and the rate of coordinated deglutition with respiration (swallows following and/or followed by expiration) was markedly increased under CPAP therapy.Sleep-related deglutition and respiratory phase patterns are likely to adversely influence aspiration pneumonia in patients with OSA. CPAP therapy improved not only apnea-hypopnea during sleep and sleep quality but also sleep-related deglutition, especially respiratory phase patterns associated with deglutition in patients with OSA. CPAP therapy may decrease the risk of aspiration and greatly improve aspiration-related diseases such as aspiration pneumonia.

Comparison of physical properties of voluntary coughing, huffing and swallowing in healthy subjects.

Coughing, huffing and swallowing protect the airway from aspiration. This study was conducted to compare the physical properties of voluntary coughing, huffing and swallowing in healthy subjects. Ten healthy men were asked to huff, cough and swallow repeatedly. Electromyograms (EMGs) were recorded from the left side of the external oblique (EO), sternocleidomastoid, suprahyoid (SH) and thyrohyoid muscles. Airflow was recorded using a face mask with two-way non-rebreathing valves. The expiratory velocity of huffing and coughing and the SH EMG of all actions presented high intraclass correlation coefficients (> 0.8). The inspiratory and expiratory velocities did not differ significantly between coughing and huffing. The expiratory acceleration of coughing was significantly higher than that of huffing, whereas the expiratory volume of coughing was significantly smaller than that of huffing. The EO EMG of coughing and huffing were significantly larger than that of swallowing. The EO EMG activity during the expiratory phase was significantly higher than that of the other phases of both coughing and huffing. The SH EMG of coughing and huffing were significantly smaller than that of swallowing. Correlation analysis revealed that the expiratory velocity of coughing was strongly positively correlated with that of huffing. The expiratory volume of huffing was significantly positively correlated with hand grip strength. These results suggest that EO and SH muscle activities during huffing or coughing differ those during swallowing, and huffing and coughing may work similarly in expiratory function.

The changes in strength of oropharyngeal muscles in patients with Alzheimer’s dementia and dysphagia

AbstractBackgroundAlthough dysphagia is an important health problem and one of the determinants of quality of life in patients with dementia, the neurophysiologic changes of dysphagia in dementia have not been fully uncovered, yet. we investigated the changes of strength of tongue lip and pharyngeal muscles in patients with Alzheimer’s dementia.MethodThis study included 20 subjects with Alzheimer’s dementia. In all subjects, clinical assessments consisted of the Iowa Oral Performance Instrument (IOPI) for tongue and lip, surface electromyography (sEMG) with Vital stim plus on suprahyoid muscles, the Mini‐Mental State Examination (MMSE), and Clinical Dementia Rating (CDR) scales.ResultAll subjects were classified into 3 groups according to severity; CDR1, 2, 3. There was no difference between IOPI and sEMG among all three groups. The values of tongue and lip IOPI from all three dementia groups were significantly lower than values of control. The comparisons for values of tongue and lip IOPI among three dementia group were not different from each other. The sEMG of suprahyoid muscles were not different between all three dementia groups and control.ConclusionThese findings would be useful for understandings for patho‐physiology of dementia induced by AD and making occupational therapeutic strategies for oral phase in dysphagia with AD.

Peculiarities of development of the suprahyoid muscles of the neck at an early period of human ontogenesis

Objective – of the work is to clarify the sources of germs and find out the chronological sequence of morphogenesis of the muscular structures of the suprahyoid triangles of the anterior cervical region in the embryonic and prefetal periods of human ontogenesis.Material and methods. 25 series of consecutive histological sections of human embryos and prefetuses aged from 5 till 12 weeks of development (6.0-80.0 mm parietal-coccygeal length (PCL)) using a complex methods of morphological examination (anthropometry, morphometry, microscopy, three-dimensional computer reconstruction and statistical analysis) were studied.Results. The rudiment of digastric muscle was first detected in 7-week-old prefetuses (15.5-16.0 mm PCL). The medial surface of Meckel’s cartilage is the site of attachment of the superior belly of the digastric muscle. At the 12th week of intrauterine development, the digastric muscle finally acquires its definitive attachment to the internal surface of the body of mandible. The rudiment of the mylohyoid muscle was first detected in 6-week-old embryos (10.0-12.0 mm PCL). The place of its attachment begins near the mental symphysis, the attachment of the muscle to the anlage of the hyoid bone was detected only at the end of the 7th week of intrauterine development (prefetuses 19.0-20.0 mm PCL). The anlage of the geniohyoid muscle was first determined in the 6-week-old human embryos. In prefetuses of 15.5- 40.0 mm PCL, geniohyoid muscle begins on the medial surface of Meckel’s cartilage, and from the 12th week of intrauterine development (prefetuses 75.0-77.0 mm PCL), the muscle attachment is localized on the internal surface of the body of mandible. The genioglossus muscle is found on the internal and caudal surfaces of Mekel’s cartilage, but from the middle of the 12th week of intrauterine development the site of its attachment moves to the medial-caudal surface of the body of mandible.Conclusions. 1. The anlages of all muscles that delimit the boundaries of the suprahyoid triangles of the neck were identified at the beginning of the 7 th week of intrauterine development (prefetuses 15.5-16.0 mm PCL). 2. The suprahyoid muscles attach to the medial surface of Meckel’s cartilage, but during the 8-11th weeks of intrauterine development, the attachment sites gradually move to the bony edges of the mandible, which cover Meckel’s cartilage. 3. In the prenatal period of development, bundles of the mylohyoid muscle leave the anterior region of the mental symphysis free. 4. In human prefetuses, only the geniohyoid and mylohyoid muscles were attached to the hyoid bone.

Ultrasonography Shows Age-related Changes and Related Factors in the Tongue and Suprahyoid Muscles

ObjectivesTo investigate age and other factors related to the deterioration of the muscles used for swallowing, including the tongue and suprahyoid muscles. DesignCross-sectional study. Setting and ParticipantsThis study included 146 participants: 47 younger adults (23 men and 24 women; age range 23-44 years) recruited from a dental hospital and 99 community-dwelling older adults (37 men and 62 women, age range 65-86 years). MethodsAge (<65 years or ≥65 years), body mass index (BMI), skeletal muscle mass index (SMI), and tooth loss (Eichner classification) were measured. The cross-sectional areas (CSAs) of the tongue, geniohyoid muscle, and anterior belly of the digastric muscle were measured using an ultrasonic diagnostic apparatus. The correlation between each muscle's CSA and strength was examined. Multiple regression analyses were performed separately for each sex using each muscle CSA as the dependent variable and age, BMI, SMI, and the Eichner classification as explanatory variables. ResultsOlder men had a significant positive correlation between tongue pressure and CSA (r = 0.35, P = .031). Jaw opening force was positively correlated with geniohyoid muscle CSA (r = 0.41, P = .001) in older women. In the multiple regression analysis, age, BMI, and SMI were significantly associated with tongue CSA in men. Age was significantly and inversely associated with suprahyoid muscle CSA in both men and women. No explanatory variables were significantly associated with geniohyoid muscle CSA except age. Conclusions and ImplicationsThe tongue increased in volume, and the suprahyoid muscles underwent atrophy with age. The study results suggest that interventions to prevent dysphagia associated with aging should be tailored toward specific muscles. Direct muscle training is required for the suprahyoid muscles, whereas the maintenance of tongue muscle mass and function, as well as training for the tongue, requires attention to ensure optimal nutritional status and whole-body skeletal muscle mass.

Comparison of the pattern of activation of the masticatory muscles among individuals with and without TMD: A systematic review

ABSTRACT Objective To verify the characteristics of the electromyographic signal of masticatory muscles in individuals with TMD and asymptomatic individuals. Methods A systematic review was carried out, selecting cross-sectional studies with at least one electromyographic parameter (FM; iEMG; RMS) of the masticatory muscles (anterior temporal, bilateral masseter, and suprahyoid muscles) of individuals with TMD compared to asymptomatic individuals. Results This review identified 1656 titles, of which 30 articles were included in the final analysis. It was observed that the data referring to the pattern of activation of masticatory muscles in the rest, isometry, and isotonic conditions of individuals with TMD are heterogeneous. This fact may be related to variability in the methods and analyses applied in the studies. Conclusion Data referring to the pattern of activation of masticatory muscles in the rest and isometry conditions and in the mastication cycle of individuals with TMD and asymptomatic individuals are diverse.