Ann Rehabil Med.  2015 Aug;39(4):535-544. 10.5535/arm.2015.39.4.535.

Different Movement of Hyolaryngeal Structures by Various Application of Electrical Stimulation in Normal Individuals

• Kim SH
• Oh BM
• Han TR
• Jeong HJ
• Sim YJ

• KMID: 2148223
• DOI: http://doi.org/10.5535/arm.2015.39.4.535

Abstract

OBJECTIVE
To identify the differences in the movement of the hyoid bone and the vocal cord with and without electrical stimulation in normal subjects.
METHODS
Two-dimensional motion analysis using a videofluoroscopic swallowing study with and without electrical stimulation was performed. Surface electrical stimulation was applied during swallowing using electrodes placed at three different locations on each subject. All subjects were analyzed three times using the following electrode placements: with one pair of electrodes on the suprahyoid muscles and a second pair on the infrahyoid muscles (SI); with placement of the electrode pairs on only the infrahyoid muscles (IO); and with the electrode pairs placed vertically on the suprahyoid and infrahyoid muscles (SIV).
RESULTS
The main outcomes of this study demonstrated an initial downward displacement as well as different movements of the hyoid bone with the three electrode placements used for electrical stimulation. The initial positions of the hyoid bone with the SI and IO placements resulted in an inferior and anterior displaced position. During swallowing, the hyoid bone moved in a more superior and less anterior direction, resulting in almost the same peak position compared with no electrical stimulation.
CONCLUSION
These results demonstrate that electrical stimulation caused an initial depression of the hyoid bone, which had nearly the same peak position during swallowing. Electrical stimulation during swallowing was not dependent on the position of the electrode on the neck, such as on the infrahyoid or on both the suprahyoid and infrahyoid muscles.

Keyword

Dysphagia; Deglutition; Neck muscles; Hyoid bone

MeSH Terms

Deglutition
Deglutition Disorders
Depression
Electric Stimulation*
Electrodes
Hyoid Bone
Jupiter
Muscles
Neck
Neck Muscles
Vocal Cords

Figure

• 

  Fig. 1 Different placements of the surface electrodes. (A) Placement I has two pairs of surface electrodes attached to the suprahyoid and infrahyoid muscles. (B) Placement II has two pairs of electrodes attached to only the infrahyoid muscles. (C) In placement III, the suprahyoid and infrahyoid muscles receive electrical stimulation from vertically positioned surface electrodes (the hyoid bone is indicated by a line, and the surface electrodes are indicated by circles).

• 

  Fig. 2 The coordinate axes were determined as follows. The zero point was defined as the anterior-inferior margin of the fourth cervical vertebral body. The vertical axis was defined as the straight line connecting the zero point with the anterior-inferior margin of the second cervical vertebral body. The horizontal axis was the axis perpendicular to the vertical axis at the zero point. The movements of the hyoid bone (arrow) and vocal cord (arrow head) were analyzed using these coordinate axes. A, the zero point; B, the anterior-inferior margin of the second cervical vertebral body.

• 

  Fig. 3 The schematic depiction of the initial points, peak points and the movements of the hyoid bone according to the different placement patterns for the surface electrodes. (A) Placement I involves two pairs of surface electrodes attached on the suprahyoid and infrahyoid muscles. (B) Placement II involves two pairs of electrodes attached on only the infrahyoid muscles. (C) In placement III, the suprahyoid and infrahyoid muscles receive electrical stimulation from vertically positioned surface electrodes.

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