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Eating, drinking and swallowing in the context of older age
Published in Rebecca Allwood, Working with Communication and Swallowing Difficulties in Older Adults, 2022
A review into the timing of the swallow in older people carried out by Namasivayam et al. (2018) concluded that there is a longer reaction time between the bolus entering the pharynx and the onset of hyoid-laryngeal movement. Ney et al. (2009) agree that there is slower initiation of pharyngeal and laryngeal movement due to reduced strength or slower innervation of the suprahyoid muscle. Ney et al. (2009) also report that laryngeal penetration (where the bolus enters the larynx but does not pass below the vocal cords) occurs more frequently and to a greater depth with increasing age. Bowing of the vocal cords can arise in older age due to weakness or atrophy in either or both vocal cords. Depending on the severity of the bowing, it can lead to incomplete glottal closure, which can increase the risk of aspiration.
Anatomy overview
Published in Stephanie Martin, Working with Voice Disorders, 2020
The larynx is innervated by branches of the vague nerve on each side. Sensory innervations to the glottis and laryngeal vestibule is by the internal branch of the superior laryngeal nerve. The external branch of the superior laryngeal nerve innervates the cricothyroid muscles. There are eight extrinsic muscles, four of which lie above the level of the hyoid – the suprahyoid muscles, which act principally to elevate the larynx and support the hyoid bone. Four lie below the hyoid – the infrahyoid muscles, which act as laryngeal depressors. The latter are particularly important in lengthening the vocal tract, which has a significant effect on vocal resonance. Detailed descriptions of the extrinsic laryngeal muscles can be found in a number of texts, but for the purposes of this chapter an outline of the muscles, their function and innervation are given in Table 1.4.
Head and neck
Published in Tor Wo Chiu, Stone’s Plastic Surgery Facts, 2018
Muscles Suprahyoid muscles – digastric, stylohyoid, mylohyoid, geniohyoid and hyoglossus.Infrahyoid strap muscles – sternohyoid and omohyoid superior, thyrohyoid and sternothyroid deeper.
Does the mandibular lingual release approach impact post-operative swallowing in patients with oral cavity and/or oropharyngeal squamous cell carcinomas: a scoping review
Published in Speech, Language and Hearing, 2023
N. M. Hardingham, E. C. Ward, N. A. Clayton, R. A. Gallagher
Whilst concerns were also raised about the disturbance of the FOM and impact on mastication and lingual function, no published data made any connection between the suprahyoid muscles and their role in the hyolaryngeal excursion. The superior and anterior movement of the hyoid is enabled by contraction of the suprahyoid musculature and is vital to elevate the larynx for airway closure during swallowing, induce epiglottic deflection to further protect the airway and facilitate cricopharyngeal opening and passage of the bolus from the pharynx into the oesophagus (Logemann, 1988; Paik et al., 2008; Pisegna, Langmore, Meyer, & Pauloski, 2020). This represents a significant gap in the knowledge about how the separation of this muscle group during the MLRA may affect the pharyngeal phase of swallowing. Of note, no paper investigated the basis for the swallowing issues with any form of instrumental assessment such as videofluoroscopy which is routinely used by SLP to investigate pharyngeal phase deficits (Logemann, 1988).
Correlation between dysphonia and dysphagia evolution in amyotrophic lateral sclerosis patients
Published in Logopedics Phoniatrics Vocology, 2021
Chiara Mezzedimi, Enza Vinci, Fabio Giannini, Serena Cocca
The ESLN (External superior laryngeal nerve) innervates the cricothyroid (CT) muscle, which contributes greatly to pitch elevation, and partially the inferior pharyngeal constrictor (IPC), an important portion of the UES [24,25]. The IPC is known to contribute (with other muscles) to both the pharyngeal clearance of the bolus and entrance of the bolus to the esophagus. Because of this function of the IPC, disturbances of the ESLN could potentially cause not only reduced pitch elevation but also reduced functionality reflected in timing or range of motion disturbances of the IPC and the UES, and thus larger amounts of pharyngeal residue after the swallow. Additionally, during both these functions—pitch elevation and swallowing—anterior and superior hyolaryngeal complex displacement is achieved through contraction of extrinsic laryngeal and suprahyoid muscles and simultaneous resistance of the cricopharyngeal muscle [24].
Swallow-Induced Eyelid Myokymia: A Novel Synkinesis Syndrome
Published in Neuro-Ophthalmology, 2020
Amrita-Amanda D. Vuppala, Gregory J. Griepentrog, Ryan D. Walsh
We hypothesise that swallow-induced eyelid myokymia, as seen in our patient, is the result of aberrant regeneration involving facial nerve innervations to suprahyoid and orbicularis oculi muscles. The suprahyoid muscles include the stylohyoid, mylohyoid, geniohyoid and digastric muscles, and are involved in tongue/mouth movements and swallowing. In particular, the stylohyoid muscle and posterior belly of the digastric receive innervation from branches of the facial nerve,23 and function to open the jaw as well as acting as laryngeal elevators, thus assisting in mastication and swallowing. The mylohyoid and anterior belly of the digastric receive innervation from the mandibular branch of the fifth nerve, and the geniohyoid is supplied by the C1 nerve roots which run within the hypoglossal nerve. The orbicularis oculi, the co-innervated muscle in this patient’s proposed synkinesis, is a subcutaneous muscle that is innervated by the temporal and zygomatic branches of the facial nerve. It is a muscle of eye closure and also plays a role in tear drainage by helping to ensure proper functioning of the lacrimal pump.