The Experts below are selected from a list of 3861 Experts worldwide ranked by ideXlab platform
Richard J Gilbe - One of the best experts on this subject based on the ideXlab platform.
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dynamic magnetic resonance imaging of vocal cord closure during Deglutition
Gastroenterology, 1995Co-Authors: Robe F Flaherty, Sharo Seltze, Terrence Campbell, Robe M Weisskoff, Richard J GilbeAbstract:Abstract Background & Aims: Vocal cord closure is instrumental in airway protection during Deglutition. Conventional imaging of vocal cord closure and reopening during Deglutition requires invasive and nonphysiological methods. The aim of this study was to characterize the biomechanical properties of normal vocal cord adduction/abduction during Deglutition using echoplanar magnetic resonance imaging, a technique that has the capability of imaging soft-tissue motion with real-time temporal resolution. Methods: The movements of laryngeal and vocal cord structures during swallowing were determined in 11 normal volunteers by single slice and axially reformatted multislice coronal echoplanar images. Results: During swallowing, the larynx ascended to peak elevation, maintained peak elevation for a discrete interval, and descended to its resting position. Vocal cord adduction occurred with a symmetric tent-like configuration at the midpoint of maximal laryngeal elevation, whereas vocal cord abduction occurred at the midpoint of laryngeal descent. Spatial analysis of vocal cord configuration during adduction determined that the vocal cords attained an initial parallel configuration during ascent, followed by closure at peak laryngeal elevation. Conclusions: These results show that the vocal cords adduct and abduct synchronously with laryngeal ascent and descent, respectively, during Deglutition. Echoplanar magnetic resonance imaging constitutes a novel tool used to assess clinical abnormalities of deglutitive laryngeal function.
Mario C Kagel - One of the best experts on this subject based on the ideXlab platform.
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laryngeal Deglutition movement in parkinson s disease
Neurology, 1997Co-Authors: Norma A Leopold, Mario C KagelAbstract:Article abstract-Laryngeal muscle function is defective in Parkinson9s disease (PD) patients; the intrinsic group (vocal cords) is defective during phonation and the extrinsic group (laryngeal strap muscles) is slow during Deglutition. There are no studies of vocal cord motility during Deglutition in PD. We investigated laryngeal motility during Deglutition in 71 patients with PD in a videofluoroscopic swallowing study. Patients were subdivided into two groups by the Hoehn and Yahr disability scale, stages II and III (n = 38) and stages IV and V (n = 33). At least one abnormality of laryngeal movement was present in 68 of 71 patients (95.8%); most patients had multiple abnormalities. There was statistically significant slowing of vertical laryngeal excursion; true vocal cord closure; or delayed, incomplete, or absent opening of the true vocal cords. Patients with more advanced disease manifested more deficits of laryngeal movement. Laryngeal dysmotility in PD may be related to defective descending basal ganglionic control of medullary deglutory and phonatory motor functions. NEUROLOGY 1997;48: 373-375
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dysphagia ingestion or Deglutition a proposed paradigm
Dysphagia, 1997Co-Authors: Norma A Leopold, Mario C KagelAbstract:The current classifications of dysphagia are based on local structural or central nervous system pathology causing dysfunction of the aerodigestive tract. The result is a clinical science grounded in the analysis of the swallow with its lingual, pharyngeal, and esophageal stages. Adding bolus preparation to the swallowing paradigm improves but still constrains the study of dysphagia and treatment of the dysphagic patient. Those pre-oral facets of mealtime behavior that may evoke or exacerbate dysphagia remain beyond the existing classification boundaries imposed by the conceptual swallow and anatomic aerodigestive tract. We offer a more inclusive strategy for investigating dysphagia based on a five-stage process of ingestion: pre-oral (anticipatory), preparatory, lingual, pharyngeal, and esophageal. The first stage considers the interaction of pre-oral motor, cognitive, psychosocial, and somataesthetic elements engendered by the meal. The limited literature regarding the interaction of the pre-oral stage with other ingestion stages, in both normal subjects and patients with cortical, basal ganglia, and psychogenic diseases, is reviewed. The neurophysiologic and clinical justifications for embracing a pre-oral stage, and thus for the paradigm shift from Deglutition to ingestion, are presented.
Tadashi Nakashima - One of the best experts on this subject based on the ideXlab platform.
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Deglutition and respiratory patterns during sleep in younger adults
Acta Oto-laryngologica, 2011Co-Authors: Kiminori Sato, Shunichi Chitose, Hirohito Umeno, Tadashi NakashimaAbstract:Abstract Conclusion: Deglutition was infrequent and displayed unique patterns during sleep in healthy younger adults. Objectives: The Deglutition, electroencephalographic arousal, and respiratory phase patterns during sleep in younger adults were investigated. Methods: Ten younger adults were examined via time-matched recordings of polysomnography and surface electromyography. Results: During sleep, swallowing was infrequent and absent for long periods. The mean number of swallows per hour during the total sleep time was 2.4 ± 1.0. The mean longest Deglutition-free period was 68.8 ± 24.8 min. Most Deglutition occurred in association with spontaneous electroencephalographic arousal. Deglutition was related to the sleep stage. The mean number of swallows per hour was 11.2 ± 8.1 during stage 1 sleep, 1.9 ± 1.0 during stage 2 sleep, 0.5 ± 1.5 during stage 3 sleep, and 0.2 ± 0.5 during stage 4 sleep. The deeper the sleep stage, the lower the mean Deglutition frequency. The mean number of swallows per hour was ...
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sleep related Deglutition in patients with osahs under cpap therapy
Acta Oto-laryngologica, 2011Co-Authors: Kiminori Sato, Shunichi Chitose, Hirohito Umeno, Tadashi NakashimaAbstract:Abstract Conclusion: Continuous positive airway pressure (CPAP) therapy improved not only apnea-hypopnea during sleep and sleep structure but also sleep-related Deglutition, especially respiratory phase patterns associated with Deglutition. Objectives: Sleep-related Deglutition and related respiratory phase patterns in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS) under CPAP therapy were investigated. Methods: Deglutition during sleep was examined in 10 patients who had severe OSAHS under CPAP therapy via time-matched recordings of polysomnography and surface electromyography. Results: The mean number of swallows per hour during the total sleep time was 1.6 ± 1.3. The mean period of the longest absence of Deglutition was 66.4 ± 19.6 min. Deglutition was related to the sleep stage. The mean number of swallows per hour was 6.8 ± 8.4 during stage 1 sleep, 1.1 ± 0.8 during stage 2 sleep, 0.1 ± 0.4 during stage 3 sleep, and 0 during stage 4 sleep. The deeper the sleep stage, the lower the mea...
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sleep related Deglutition in patients with sleep apnea hypopnea syndrome
Annals of Otology Rhinology and Laryngology, 2009Co-Authors: Kiminori Sato, Tadashi NakashimaAbstract:Objectives:We investigated sleep-related Deglutition in patients with obstructive sleep apnea-hypopnea syndrome (OSAHS).Methods:Deglutition during sleep was examined in 10 patients with a mean (±SD...
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sleep related Deglutition in children
Annals of Otology Rhinology and Laryngology, 2007Co-Authors: Kiminori Sato, Tadashi NakashimaAbstract:Objectives:Clearance of the pharynx by Deglutition is important in protecting the airway. The pattern of Deglutition during sleep was investigated in children.Methods:Ten normal human children (8.6...
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human adult Deglutition during sleep
Annals of Otology Rhinology and Laryngology, 2006Co-Authors: Kiminori Sato, Tadashi NakashimaAbstract:Objectives:Clearance of the pharynx by Deglutition is important in protecting the airway. The pattern of Deglutition during sleep was investigated.Methods:Deglutition during sleep was examined in 8...
Nail Ulakbasi - One of the best experts on this subject based on the ideXlab platform.
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real time balanced turbo field echo cine mri in the analysis of Deglutition events and transit times
Journal of Oral Rehabilitation, 2006Co-Authors: Seniz Karacay, Erol Aki, Mehmet Ozgu Sayi, Nail UlakbasiAbstract:summary Investigation of swallowing is an important part of oral diagnosis. It usually plays a role in the aetiology of some orofacial deformities and open-bite as well as in the relapse of treated open-bite patients. In recent years, the movements of the anatomical structures that participate in Deglutition have been investigated by several methods such as cineradiography, electromyography, electropalatography, electromagnetic articulography and ultrasonography. However, all these techniques have various disadvantages. Recently, dynamic magnetic resonance imaging has become available in the evaluation of swallowing function. In this study we intended to present this new technique to the dental literature and aimed to obtain dynamic images of the Deglutition process. We also compared the timing of events in subjects with anterior open-bite and normal overbite during swallowing 10 mL water.
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initial effects of the tongue crib on tongue movements during Deglutition a cine magnetic resonance imaging study
Angle Orthodontist, 2006Co-Authors: Mehmet Ozgu Sayi, Seniz Karacay, Erol Aki, Nail UlakbasiAbstract:The objective of this study was to investigate the initial effects of a tongue crib on tongue movements during Deglutition by using real time balanced turbo field echo (B-TFE) Cine-MR imaging. A total of 21 patients were evaluated in this study. The open-bite group (OBG) consisted of 11 patients (seven girls, four boys) who had a mean age of 11.09 +/- 2.02 years and a mean overbite of -5.14 +/- 1.83 mm. These patients were evaluated initially (T1) and while wearing a tongue crib (T2). A total of 10 patients (five girls, five boys) with a mean age of 14.5 +/- 2.6 years and with a mean overbite of 1.6 +/- 0.5 mm served as controls (CG), and only initial records were obtained from these patients. T2 was compared with T1 and CG. T1 was also compared with CG. We evaluated Deglutition during three stages matching oral (1), pharyngeal (2), and esophageal (3) stages. Our results indicated that the tongue's tip positioned more posteriorly when the crib was in place (T2) compared with both T1 and CG; the anterior portion of the tongue's dorsum was at a lower position in T2 compared with both T1 and CG at stage 3; the midportion of the tongue's dorsum was at a lower position in T2 than in T1 and CG at stages 1 and 2. To compensate for the posterior position of the tongue's tip (caused by the tongue crib), adaptive changes occurred in the anterior and midportions of the dorsum of the tongue.
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real time balanced turbo field echo cine magnetic resonance imaging evaluation of tongue movements during Deglutition in subjects with anterior open bite
American Journal of Orthodontics and Dentofacial Orthopedics, 2006Co-Authors: Erol Aki, Seniz Karacay, Mehmet Ozgu Sayi, Nail UlakbasiAbstract:Introduction: The aim of this study was to evaluate tongue movements in subjects with anterior dental open bites during Deglutition by using real-time balanced turbo field echo cine-magnetic resonance imaging. Methods: The study included 28 subjects. Two groups were formed according to the presence of anterior open bite (at least 2 mm). The open-bite group (OBG) consisted of 18 patients (14 girls, 4 boys) with a mean age of 14.5 ± 2.7 years. The control group (CG) consisted of 10 patients (5 girls, 5 boys) with a mean age of 14.5 ± 2.6 years. We evaluated Deglutition during 3 stages: oral (stage 1), pharyngeal (stage 2), and esophageal stage (3). Results: Results indicated that (1) in the OBG, from stage 2 to stage 3, the anterior portion of the tongue dorsum lowered whereas its midportion elevated; (2) in the CG, its posterior portion was elevated from stage 2 to stage 3; (3) in the CG, the tongue tip was positioned more anteriorly at stage 2 than at stage 1; (4) in the OBG, the tongue tip moved more anteriorly in all stages of Deglutition than in the CG. Conclusions: Compensatory tongue functions occur in patients with anterior dental open bites. Dynamic MRI is a promising tool for evaluating swallowing patterns in these patients.
Dia Wang - One of the best experts on this subject based on the ideXlab platform.
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dynamic mri analysis of tumor and organ motion during rest and Deglutition and margin assessment for radiotherapy of head and neck cancer
International Journal of Radiation Oncology Biology Physics, 2011Co-Authors: Julie A Adley, E S Paulso, E Ahunbay, Christophe J Schultz, Dia WangAbstract:Purpose To quantify swallowing frequency and tumor and normal structure displacements during Deglutition using dynamic magnetic resonance imaging (MRI) and to determine planning target volume (PTV) margins to account for resting and Deglutition-induced displacements in patients with head-and-neck cancer (HNC). Methods and Materials Twenty-two patients with HNC were imaged in the treatment position using dynamic MRI. Sagittal images were acquired. Two-dimensional displacement was analyzed using contours of normal structures and GTV drawn for one swallowing event. Deglutition-induced displacements were quantified based on position change during Deglutition relative to preswallow structure location for anterior (A), posterior (P), superior (S), and inferior (I) directions. Additional long-time MRI series were obtained from a subset of 11 patients while they were resting in order to determine swallowing frequency and duration. PTV margins to account for setup error, frequency and duration of Deglutition, and resting and Deglutition-induced GTV motion were calculated. Results Mean maximum resting displacements ranged from 1.5 to 3.1 mm for combined GTV subsites. Mean maximum swallowing GTV displacement for combined subsites ranged from 4.0 to 11.6 mm. Swallowing was nonperiodic, with a frequency ranging from 0 to 19 swallows over 12.8 min and mean swallow duration of 3.5 s. Based on the average swallowing characteristics in this cohort, the average PTV margins to account for setup error and tumor motion are estimated to be 4.7 mm anteriorly, 4.2 mm posteriorly, 4.7 mm inferiorly, and 6.0 mm superiorly. Conclusions The measurable mean maximum resting displacement for the GTV indicates that tumor motion occurs even when the patient is not swallowing. Nonuniform margins should be used as a standard PTV margin that accounts for setup error and tumor motion in radiotherapy of HNC unless adaptive radiotherapy with respect to intrafraction tumor motion is performed. The PTV margin can be individualized to a single patient’s swallowing characteristics or calculated as an average based on the swallowing data from the cohort.
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internal margin assessment using cine mri analysis of Deglutition in head and neck cancer radiotherapy
Medical Physics, 2011Co-Authors: E S Paulso, Julie A Adley, Dia Wang, E Ahunbay, Christope SchultzAbstract:Purpose: Intensity-modulated radiation therapy(IMRT) is a promising treatment modality for patients with head and neck cancer (HNC). The dose distributions from IMRT are static and, thus, are unable to account for variations and/or uncertainties in the relationship between the patient (region being treated) and the beam. Organ motion comprises one such source of this uncertainty, introduced by physiological variation in the position, size, and shape of organs during treatment. In the head and neck, the predominant source of this variation arises from Deglutition (swallowing). The purpose of this study was to investigate whether cinematographic MRI (cine MRI) could be used to determine asymmetric (nonuniform) internal margin (IM) components of tumor planning target volumes based on the actual Deglutition-induced tumor displacement. Methods: Five head and neck cancer patients were set up in treatment position on a 3 T MRI scanner. Two time series of single-slice, sagittal, cine images were acquired using a 2D FLASH sequence. The first time series was a 12.8 min scan designed to capture the frequency and duration of Deglutition in the treatment position. The second time series was a short, 15 s scan designed to capture the displacement of Deglutition in the treatment position. Deglutition frequency and mean swallow duration were estimated from the long time series acquisition. Swallowing and resting (nonswallowing) events were identified on the short time series acquisition and displacement was estimated based on contours of gross tumor volume (GTV) generated at each time point of a particular event. A simple linear relationship was derived to estimate 1D asymmetric IMs in the presence of resting- and Deglutition-induced displacement. Results: Deglutition was nonperiodic, with frequency and duration ranging from 2.89–24.18 mHz and from 3.86 to 6.10 s, respectively. The Deglutition frequency and mean duration were found to vary among patients. Deglutition-induced maximal GTV displacements ranged from 0.00 to 28.36 mm with mean and standard deviation of 4.72 ± 3.18 , 3.70 ± 2.81 , 2.75 ± 5.24 , and 10.40 ± 10.76 mm in the A, P, I, and S directions, respectively. Resting-induced maximal GTV displacement ranged from 0.00 to 5.59 mm with mean and standard deviation of 3.01 ± 1.80 , 1.25 ± 1.10 , 3.23 + 2.20 , and 2.47 ± 1.11 mm in the A, P, I, and S directions, respectively. For both resting and swallowing states, displacement along the S-I direction dominated displacement along the A-P direction. The calculated IMs were dependent on Deglutition frequency, ranging from 3.28–4.37 mm for the lowest Deglutition frequency patient to 3.76–6.43 mm for the highest Deglutition frequency patient. A statistically significant difference was detected between IMs calculated for P and S directions ( p = 0.0018 ) . Conclusions: Cine MRI is able to capture tumor motion during Deglutition. Swallowing events can be demarcated by MR signal intensity changes caused by anatomy containing fully relaxed spins that move medially into the imaging plane during Deglutition. Deglutition is nonperiodic and results in dynamic changes in the tumor position. Deglutition-induced displacements are larger and more variable than resting displacements. The nonzero mean maximum resting displacement indicates that some tumor motion occurs even when the patient is not swallowing. Asymmetric IMs, derived from Deglutition frequency, duration, and directional displacement, should be employed to account for tumor motion in HNC RT.
