Application of a barometer for assessment of oral functions: Donders space

New method of recording the functional activity pattern of the buccinator from the mucosal surface

OBJECTIVES

The buccinator (BUC) is an important muscle for oral function. Since it lies deep in the facial skin, recording its activity is difficult; thus, studies on its function are limited. We developed a method to access the deep facial muscles from the mucosal side. The aim of this study was to test the reliability of the new recording method for the BUC and to investigate the BUC behavior in typical facial functions.

METHODS

To evaluate the new method, BUC activities were recorded simultaneously with a gel-type electrode on the skin and the newly developed surface electrode on the buccal mucosa. Electromyographic (EMG) activities in function, such as chewing and swallowing, along with the activities of the lower orbicularis oris (OO), zygomaticus major, masseter, and digastric muscles, were compared using the two recording methods. EMG activities among various tasks were compared using normalized values based on those obtained during maximum lip closure (MaxLC).

RESULTS

The new surface electrode was made of gold plates on a thin plastic fixed to a stainless-steel wire frame and weighed less than 1 g. The BUC activity recorded from the mucosa was the highest during a corner-pulling task and was low during clenching. The BUC was active during MaxLC, similar to the OO, and the BUC activity pattern among tasks recorded from the mucosa was identical to that reported by previous studies using intramuscular electrodes. The new electrode evaluated the BUC activities quantitatively, and the recordings by the new electrode were free from contamination.

CONCLUSIONS

The findings of this study confirmed the reliability of the new BUC recording method. It could be easily placed correctly within seconds, without the need for cleansing or sterilizing the skin. The BUC and OO were active during a MaxLC task, indicating that the BUC assists lip closure by pulling the corners of the mouth. The basic facial functions evaluated, including chewing, were similar to those studied by intramuscular electrodes.

Orofacial muscles activity in children with swallowing dysfunction and removable functional appliances

Swallowing dysfunction is a frequent disorder among children and refers to an altered tongue posture and abnormal tongue movement during swallowing. Removable functional appliance is one of the treatments applied by dentistry to correct this disorder. The aim of this study was to evaluate any differences on orofacial muscles activity in children with swallowing dysfunction with and without removable functional appliances. 68 children were eligible for the study and divided into the orthodontic group (OG) and the no-orthodontic group (NO-OG). Both groups performed a dental occlusion-class evaluation, a swallowing function test and a myoscan analysis in order to measure perioral forces (i.e. tongue extension force, lip pressure, masseter contraction force). Our results showed a significant difference (P=0.02) between OG and NO-OG for the tongue extension force, whereas no significant differences (P>0.05) were found for the other parameters. Our findings suggest that children with swallowing dysfunction and removable functional appliance show orofacial muscles activity within the range of reference values (except for the lip pressure). However, we hypothesize that orthodontic treatment can achieve more effective results with integration of myofunctional therapy.

Use of a Novel Device to Assess Intraoral and Intrapharyngeal Baropressure during Sound Production

OBJECTIVE

We developed a novel device that simultaneously measures oral and intrapharyngeal baropressure. The transducer has the advantage that it can be placed in any region. We determined the effect of different speech samples on baropressure in these regions.

PATIENTS AND METHODS

Seven healthy individuals produced speech samples comprising vowels and consonants (e.g., /aka/, /apa/, and /ash/). Two transducers were installed into the experimental plate at the incisive papillae and center of the Ah-line; a third transducer was placed in the mid-pharyngeal cavity. During each task, 3 parameters were analyzed: peak pressure, mean pressure, and the temporal relationship between sound signals and pressure changes.

RESULTS

The mean pressure did not change during the production of a single vowel; however, the pressure transiently increased during the production of the speech samples, depending on the place of articulation. Moreover, the place of articulation affected the onset and peak timing of pressure changes.

CONCLUSIONS

These findings indicate that pressure changes during the production of speech samples reflect the functional aspects of speech production. In particular, simultaneous pressure recordings at multiple locations would provide precise information about speech production, compared to pressure studies that used a single pressure transducer.

Differential Response Pattern of Oropharyngeal Pressure by Bolus and Dry Swallows

The aim of this study was to determine if bolus and dry swallow showed similar pressure changes in the oropharynx using our newly developed device. A unique character of it includes that baropressure can be measured with the sensor being placed in the balloon and can assess the swallowing mechanics in terms of pressure changes in the oropharynx with less influences of direct contacts of boluses and oropharyngeal structures during swallow indirectly. Fifteen healthy subjects swallowed saliva (dry), 15 ml of water, 45 ml of water, and 15 ml of two different types of food in terms of viscosity (potage soup-type and mayonnaise-type foods). Suprahyoid muscle activity was recorded simultaneously. Three parameters, area under the curve (AUC), peak amplitude, and duration of pressure, were analyzed from each swallow. Almost all of the bolus swallowing events had biphasic baropressure responses consisting of an early phase and late phase (99%), whereas 90% of the saliva swallowing events had a single phase. AUC, peak, and duration displayed greater effects during the late phase than during the early phase. Baropressure of the early phase, but not of the late phase, significantly increased with increasing volume; however, small but significant viscosity effects on pressure were seen during both phases. Peak pressure of the late phase was preceded by maximum muscle activity, whereas that of the early phase was seen when muscle activity displayed a peak response. These findings indicated that our device with the ability to measure baropressure has the potential to provide additional parameter to assess the swallow physiology, and biphasic baropressure responses in the early and late phases could reflect functional aspects of the swallowing reflexes.