BMC Ear, Nose and Throat Disorders

Background: A clear differential diagnosis between oral and pharyngeal dysphagia remains an unsolved problem. Disorders of the oral cavity are frequently overlooked when dysphagia/ odybophagia complaints are assessed. Surface electromyographic (sEMG) studies were performed on randomly assigned patients with oral and pharyngeal pathology to evaluate their dysphagia complaints for the sake of differential diagnosis. Methods: Parameters evaluated during swallowing for patients after dental surgery (1: n = 62), oral infections (2: n = 49), acute tonsillitis (3: n = 66) and healthy controls (4: n = 50) included timing and amplitude of sEMG activity of masseter, infrahyoid and submental muscles. Results: The duration of swallows and drinking periods was significantly increased in dental patients and was normal in patients with tonsillitis. The electric activity of masseter was significantly lower in Groups 1 and 2 in comparison with the patients with tonsillitis and controls. The submental and infrahyoid activity was normal in dental patients but infrahyoid activity in patients with tonsillitis was high. Conclusion: Dysphagia following dental surgery or oral infections does not affect pharynx and submental muscles and has clear sEMG signs: increased duration of a single swallow, longer drinking time, low activity of the masseter, and normal range of submental activity. Patients with tonsillitis present hyperactivity of infrahyoid muscles. These data could be used for evaluation of symptoms when differential dental/ENT diagnosis is needed. Background For decades the investigation of dysphagia has been concentrated on evaluation of single and separate swallows of normal subjects and neurological or ENT patients [1-5]. The same tendency is traced in research activities with EMG evaluation of deglutition [6-9]. Dysphagia, or difficulty with swallowing, is defined as any defect in the intake or transport of endogenous secretions and nutriments necessary for the maintenance of life [2,3]. Odynophagia is a painful swallowing and can occur even when "the intake or transport of endogenous secretions" is not affected [2,3]. While dysphagia can be with or without pain, odynophagia it its turn can produce dysphagia secondary to odynophagia as patients trying to reduce pain change their normal swallowing patterns. When a general practitioner or a family doctor consults a patient Published: 21 May 2009 BMC Ear, Nose and Throat Disorders 2009, 9:3 doi:10.1186/1472-6815-9-3 Received: 2 October 2008 Accepted: 21 May 2009 This article is available from: http://www.biomedcentral.com/1472-6815/9/3 © 2009 Vaiman and Nahlieli; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.