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PubMed2003

[Soft palate muscles electrostimulation in treatment of children at different stages of exudative otitis media].

We studied efficacy of electrical stimulation of soft palate muscles in 180 patients (292 ears) with various stages of exudative otitis media (EOM). The analysis of the results covered 172 patients. 8 patients withdraw because of the 4th (fibrous) stage of the process (n=4) and incomplete treatment course (n=4). Normalization of audibility thresholds and tympanometric parameters was observed after 10 sessions of electrostimulation in 129 (75.0%) patients with early EOM stages. The effect persisted for 1 year. 3 (1.7%) patients with EOM stage II and 40 (23.3%) patients with stage III failed the treatment. For them bypass operation was recommended. Postoperative electrostimulation of the acoustic tube muscles and standard manipulations were made. Faster recovery of audiometric and tympanometric parameters were recorded in all the patients. Thus, electric stimulation of acoustic tube muscles can be recommended for children with EOM stage I, for most of the children with stage II and for children at stage III in postoperative period after tympanostomy with insertion of the bypass.

Child↗
PubMed1996

Influence of upper airway pressure oscillations on soft palate muscle electromyographic activity.

Snoring is characterized by high-frequency (30-50 Hz) pressure oscillations (HFPO) in the upper airway (UA). The soft palate is a major oscillating structure during snoring, and soft palate muscle (SPM) activity is an important determinant of velopharyngeal patency. Consequently, we examined the effect of artificial HFPO applied to the UA on the integrated electromyographic (EMG) activity of the SPMs in 11 supine mouth-closed anesthetized (pentobarbital sodium/chloralose) dogs breathing spontaneously via a tracheostomy. The EMGs of the palatinus (Pal; n = 11), levator veli palatini (LP; n = 9), and tensor veli palatini (TP; n = 8) were monitored with intramuscular fine-wire electrodes. Peak inspiratory and peak expiratory EMG activity was measured in arbitrary units (au) as the mean of five consecutive breaths. HFPO [+/- 4.5 +/- 0.4 (SE) cmH2O; 30 Hz] applied at the laryngeal end of the isolated UA increased peak inspiratory EMG from 3.3 +/- 2.0 to 8.4 +/- 1.7 au (P < 0.05) for Pal and from 2.0 +/- 1.1 to 7.3 +/- 2.7 au (P < 0.05) for LP. For the TP, increases were evident in four dogs, but mean values for the group did not change (5.8 +/- 2.4 to 11.0 +/- 4.1 au, P = 0.5). The peak expiratory EMG did not change for any SPM (all P > 0.3). Thus HFPO applied to the UA augments inspiratory SPM activity. Reflex augmentation of SPM activity by HFPO may serve to dilate the retropalatal airway and/or stiffen the soft palate during inspiration in an attempt to stabilize UA geometry during snoring.

Animals↗
PubMed1992

Respiratory activities in relation to palatal muscle contraction.

This study investigated the activities of the tensor and levator veli palatini muscles related to respiration. During quiet breathing, no activity was observed in either muscle. With either hypercapnic or hypoxemic condition, the tensor veli palatini muscle exhibited phasic activity during inspiration. The levator veli palatini muscle showed phasic activity during expiration with hypoxemia (PaO2 less than 40 mm Hg). NaCN perfused bilaterally through the carotid sinus induced these respiratory activities. The tensor veli palatini muscle was more sensitive than the levator veli palatini muscle to NaCN.

Animals↗
PubMed1995

Palatal muscle electromyogram activity in obstructive sleep apnea.

Eight subjects (5 men, 3 women, ages 27 to 55) with obstructive sleep apnea syndrome (OSAS) were studied to quantify and compare electromyographic (EMG) activity of levator veli palatini (LVP) and palatoglossus (PG), two velopharyngeal muscles, and genioglossus (GG) during obstructive apnea cycles in non-rapid eye movement (NREM) sleep. EMG activity of three successive preapneic breaths, first and last apneic efforts, and three successive postapneic breaths was quantified for each muscle as peak phasic inspiratory EMG normalized as percent activity of the last preapneic breath. In all subjects, apnea onset coincided with simultaneous inspiratory EMG nadir of all three muscles (LVP = 63 +/- 40%, PG = 74 +/- 53%. GG = 83 +/- 48%. mean +/- SD activity of last preapneic breath). Apnea resolution did not occur until inspiratory EMG of all three muscles simultaneously reached maximal activity, at levels significantly greater than preapneic activity as well as activity of the last preapneic effort (LVP = 215 +/- 205%, PG = 227 +/- 240+, GG = 235 +/- 202%, mean +/- SD activity of last preapneic breath, p < 0.05, Fisher's partial least-squares difference [PLSD] test for each muscle). The presence or absence of electroencephalographic arousal at apnea resolution did not influence these patterns of EMG activity. Inspiratory recruitment of velopharyngeal as well as oropharyngeal muscles appears to be associated with upper airway patency during sleep in patients with OSAS.

Adult↗
PubMed2000

Genioglossal but not palatal muscle activity relates closely to pharyngeal pressure.

The stimuli controlling pharyngeal dilator muscles are poorly defined. Local mechanoreceptors are a leading possibility. To address this, we assessed the relationship between two dilator muscle electromyograms (EMGs, i.e., genioglossus [GG-an inspiratory phasic muscle], tensor palatini [TP-a tonically active muscle]) and potential stimuli (i.e., epiglottic pressure [Pepi], airflow [V], and pharyngeal resistance [Rpha]). Fifteen normal subjects were studied, during wakefulness and stable non-rapid eye movement (NREM) sleep. The GGEMG and TPEMG were assessed during basal breathing and during inspiratory resistive loading (four loads, done in triplicate), while quantifying Pepi and choanal pressures (Pcho, Millar catheters) plus V. There was a strong correlation between Pepi and GGEMG during wakefulness in most subjects (9 of 15 had absolute R > 0.7 [p < 0.05], group mean R = -0.62, p < 0.05). These correlations were less robust during NREM sleep (8 of 15 absolute R > 0.6 [p < 0.05], group mean R = -0.39, ns). The slope of the Pepi versus GGEMG relationship was greater during wakefulness than sleep (-0.67 versus -0.39% max/ cm H(2)O, p < 0.05). No significant correlations were observed between TPEMG and any of the measured potential stimuli. We conclude that intrapharyngeal pressure may modulate genioglossus activity during wakefulness, with a fall in muscle responsiveness during sleep. The activity of the TP was not clearly influenced by any measured local stimulus either awake or asleep.

Adult↗
PubMed1991

Effects of synthetic hormone implants, singularly or in combinations, on performance, carcass traits, and longissimus muscle palatability of Holstein steers.

Seventy-two Holstein steers averaging 182 kg were assigned randomly to one of six treatment groups: 1) nonimplanted controls (C); 2) implanted with 36 mg of zeranol (Z); 3) implanted with 20 mg of estradiol benzoate and 200 mg of progesterone (EP); 4) implanted with 140 mg of trenbolone acetate (TBA); 5) implanted with 140 mg of trenbolone acetate plus 20 mg of estradiol benzoate and 200 mg of progesterone (TBA + EP); and 6) implanted with 140 mg of trenbolone acetate plus 36 mg of zeranol (TBA + Z). Each treatment group consisted of three replications of four animals per pen, which were implanted on d 0, 56, 112, and 168. Masculinity and muscling scores were assigned at 24 h preslaughter. Hide removal difficulty was scored by a plant supervisor. Quality and yield grade data were obtained at 24 h postmortem. Longissimus muscle (LM) steaks were removed and cooked for Warner-Bratzler shear (WBS) determinations and sensory panel (SP) evaluations. Over the entire feeding period (249 d), TBA + EP steers had higher (P less than .05) ADG than TBA + Z, TBA, and C steers. All treatments had higher (P less than .05) ADG than C, with the exception of TBA. The only feed efficiency differences were those following the 168-d implant time, when TBA steers were more (P less than .05) efficient than TBA + Z or C steers. The TBA + EP and TBA + Z steers were more (P less than .05) masculine and their hides were more (P less than .05) difficult to remove than those of EP and C steers. Carcass weights of TBA + EP steers were heavier (P less than .05) than those of TBA or C steers. The TBA + EP steers had larger (P less than .05) LM areas than Z, TBA, and C steers. Also, TBA + EP steers tended (P = .07) to have lower numerical yield grades than EP, Z, or C steers. Even though mean marbling scores and quality grades were similar (P greater than .05) among treatment groups, only 50% of TBA + EP carcasses graded low Choice or higher, compared with 100, 75, 82, 90, and 83% for C, TBA, Z, EP, and TBA + Z carcasses, respectively. The only meat palatability differences were that myofibrillar and overall tenderness scores tended to be lower (P = .07) for steaks from EP and TBA + Z than for steaks from Z and C groups.

Anabolic Agents↗
PubMed2006

The effects of cattle sex on carcass characteristics and longissimus muscle palatability.

Two experiments were conducted to determine the effects of sex on carcass traits and cooked beef steak palatability. In Exp. 1, steers (n = 99), heifers (n = 51), and intravaginally spayed heifers (n = 46) were fed a high-energy diet for 161 d. No implants were administered, and heifers were not fed melengestrol acetate to suppress estrus. In Exp. 2, 60 steers and 60 intact heifers from the same ranch source used in Exp. 1 were fed in 2 locations (sites 1 and 2). All management factors were equal across experiments except that intact heifers were fed melengestrol acetate to suppress estrus in Exp. 2. Steers in Exp. 1 were 25 kg heavier (P < 0.01) in HCW than heifers at comparable (P = 0.39) carcass fat thickness. Spayed heifers (Exp. 1) had a 5.7% smaller (P < 0.05) LM area compared with steers and intact heifers, which were similar. In Exp. 2, there was no difference (P = 0.2) in carcass weight, and heifers had greater (P < 0.01) 12th rib fat thickness compared with steers. Calculated yield grades were similar (P = 0.21) among treatments in Exp. 1 and tended (P = 0.08) to be greater for heifers compared with steers in Exp. 2. In Exp. 1, USDA quality grades and marbling scores were lower (P < 0.01) for steers compared with intact and spayed heifers, which were similar. The effects of sex on tenderness were examined at a common level of fat-thickness and marbling by covariate analysis. Steaks from steers, compared with those from nonimplanted, intact heifers, in the 2 experiments combined were: (a) superior (P < 0.05) in 2 of 9 palatability assessments when subcutaneous fat thickness (at the 12th rib) was adjusted to a common level, and (b) superior (P < 0.05) in 6 of 9 palatability assessments when marbling score was adjusted to a common level. In Exp. 1, steaks from nonimplanted steers compared with those from nonimplanted spayed heifers were: (a) superior (P < 0.05) in 0 of 8 palatability assessments when subcutaneous fat thickness (at the 12th rib) was adjusted to a common level, and (b) superior (P < 0.05) in 3 of 8 palatability assessments when marbling score was adjusted to a common level. These findings suggest that sex should be added to the list of antemortem factors contributing to variation in cooked beef steak tenderness. However, more research is needed to precisely identify those factors contributing to the lower tenderness observed for steaks from heifer carcasses.

Animals↗
PubMed1998

Myasthenic syndrome of snake envenomation: a clinical and neurophysiological study.

In this prospective study, 65 consecutive patients with neurological manifestations after snake envenomation, were examined in order to describe the natural history of the reversible nature of muscle weakness. Snake envenoming led to a completely reversible muscle paralysis involving the external ocular muscles with sparing of the pupils, muscles of mastication, facial muscles, palatal muscles, neck and proximal limb muscles. The deep tendon reflexes were preserved with no sensory abnormalities. The muscular weakness usually set in within an hour of envenomation and lasted up to 10 days, with fatigability lasting for 12 days. Respiratory muscle paralysis led to ventilatory failure needing ventilation in severely envenomed patients. Motor and sensory nerve conduction were normal with normal resting compound motor action potentials on electromyography. Repetitive nerve stimulation gave rise to a decremental response during high frequency stimulation. The edrophonium test gave negative results. These manifestations are due to abnormalities of neuromuscular transmission and are not typical of myasthenia gravis. As the exact pathophysiology of venom-related neurotoxicity is not known, it is suggested that the neurological manifestations of snake envenoming be designated a myasthenic syndrome. Further studies to isolate the neurotoxin and its mechanism and exact site of blocking at the neuromuscular junction would pave the way for the development of a novel long-acting neuromuscular blocking agent.

Action Potentials↗
PubMed1984

Audiological investigation of palatal myoclonus.

Palatal myoclonus, the rapid rhythmic contraction of palatal muscles, is a rare neurological disorder with many etiologies. Although most disease processes associated with this disorder affect the cerebellum, the auditory symptoms are often the first clue to diagnosis. Existing literature was reviewed in terms of auditory symptoms, pathophysiology, audiologic diagnostic procedures and rehabilitative strategies. In addition, a case study of a 34-yr-old woman who has had this highly peculiar degenerative disorder for over 20 yrs was described. Implications for appropriate rehabilitation strategies were addressed and the importance of comprehensive management was stressed.

Adult↗
PubMed1984

Unilateral palatal paralysis caused by lesion in the corticobulbar tract.

A patient with a cerebral infarct affecting the anterior limit of the superior segment of the corona radiata had unilateral paralysis of the palatal muscles without notable weakness of the extremities. The site of the lesion corresponded to the location of the corticofugal motor tract from the motor cortex to the genu of the internal capsule.

Aged↗
PubMedDate not supplied

[The efficacy of muscle electrostimulation in the combined treatment of children with congenital cleft palate].

The technique of electrostimulation of the soft palate muscles of children with cleft palate is described. Low-frequency electrostimulation courses were carried out before and after surgery in accordance with the degree of decompensation of the palatopharyngeal junction. This method was effectively used in 30 children with cleft palate. The treatment efficacy was assessed by the morphometric and electromyographic methods, that have confirmed that electrostimulation improved the morphology of soft palatal muscles.

Child↗
PubMed2001

Morphological characterization of the levator veli palatini muscle in children born with cleft palates.

OBJECTIVE: The aim of this study was to analyze, morphologically and biochemically, one of the soft palate muscles, the levator veli palatini (LVP), in children born with cleft palate. SUBJECTS AND METHODS: Biopsies were obtained from nine male and three female infants in connection with the early surgical repair of the hard and soft palate. Samples from five adult normal LVP muscles were used for comparison. The muscle morphology, fiber type and myosin heavy chain (MyHC) compositions, capillary supply, and content of muscle spindles were analyzed with different enzyme-histochemical, immunohistochemical, and biochemical techniques. RESULTS: Compared with the normal adult subjects, the LVP muscle from the infantile subjects with cleft had a smaller mean fiber diameter, a larger variability in fiber size and form, a higher proportion of type II fibers, a higher amount of fast MyHCs, and a lower density of capillaries. No muscle spindles were observed. Moreover, one-third of the biopsies from the infantile subjects with cleft LVP either lacked muscle tissue or contained only a small amount. CONCLUSIONS: The LVP muscle from children with cleft palate has a different morphology, compared with the normal adult muscle. The differences might be related to different stages in maturation of the muscles, changes in functional demands with growth and age, or a consequence of the cleft. The lack of contractile tissue in some of the cleft biopsies offers one possible explanation to a persistent postsurgical velopharyngeal insufficiency in some patients, despite a successful surgical repair.

Adenosine Triphosphatases↗
PubMed2002

The fetal cleft palate: III. Ultrastructural and functional analysis of palatal development following in utero repair of the congenital model.

The role of fetal surgery in the management of congenital anomalies and intrauterine abnormalities is appropriately restricted on the basis of feasibility and risk-to-benefit analyses of intrauterine intervention. Recently, the authors demonstrated that in utero cleft palate repair of the congenital caprine model is technically feasible and results in scarless healing of the mucoperiosteum and velum, with subsequent development of a potentially functional bilaminar palate with distinct oral and nasal mucosal layers, following single-layer repair of the fetal mucoperiosteal flaps. A slight indentation at the site of repair was the only remaining evidence of a cleft. At 6 months of age, normal palatal architecture, including that of mucosal, muscular, and glandular elements, was seen grossly and histologically. The present work investigated the ultrastructural and functional aspects of the palate following in utero cleft repair to determine what benefits might be derived from fetal intervention. Six goats pregnant with twins were gavaged twice daily for 10 days (gestational days 32 to 41; term, 145 days) with dry, ground Nicotiana glauca plant delivering between 2.4 and 14 mg/kg per day of anabasine, doses that were adjusted in response to mater-nal toxicity. At 85 days' gestation, six fetuses underwent in utero palatoplasty using a modified von Langenbeck technique with elevation of bilateral mucoperiosteal flaps and lateral relaxing incisions. A single-layer repair of the mucoperiosteal flaps was performed using interrupted 6-0 Vicryl sutures. Six fetuses remained as unrepaired clefted controls. Six months after in utero palatoplasty, each group of goats underwent nasoendoscopy to evaluate palatal function; two unclefted 6-month-old goats served as controls. Subsequently, soft palate muscle was harvested from each of the goats and was evaluated by light and electron microscopy. Velar muscle was also harvested from the unclefted control goats and was similarly studied. Nasoendoscopy demonstrated functional palates capable of dynamic velopharyngeal closure following in utero cleft repair; this motion was similar to that observed in unclefted animals. Unrepaired clefted goats did not demonstrate any evidence of velar motion or velopharyngeal closure. Soft palate muscle from this group demonstrated evidence of myofibril degeneration, atrophy, and loss compared with unclefted control velar muscle. Ultrastructural changes included sarcomere "scalloping, " partial Z-line degeneration and loss, and progressive I-band degeneration and loss. Repaired clefted soft palate muscle was remarkably similar to unclefted control muscle. Significantly less myofibril, Z-line, and I-band degeneration and loss were observed with minimal evidence of sarcomere scalloping. In utero cleft palate repair results in a functional soft palate with restoration of ultrastructural architecture of the velum. These findings were attributed to reconstitution of the velar muscular sling, which is disrupted during the clefting process and remains abnormally inserted into the posterior edge of the palatal bone and along the bony cleft. Although repaired velar muscle does demonstrate some evidence of ultrastructural change compared with control muscle, these findings are significantly less pronounced than those observed in the unrepaired clefted muscle.

Animals↗
PubMed1995

Respiratory-related control of palatoglossus and levator palatini muscle activity.

Route of respiration [nasal (NR) vs. oral (OR)] is determined by the position of the soft palate. Despite this, little is known about the respiratory-related activity of palatal muscles. We investigated the activity of two palatal muscles: palatoglossus (PG) and levator palatini (LP). Eight normal male subjects were studied during wakefulness with intramuscular electrodes placed in the PG and LP. The electromyograms (EMGs) of the PG and LP were measured during both NR and OR under 1) quiet basal respiration, 2) inspiratory resistive loading (25 cmH2O.l-1.s), and 3) progressive hypercapnia. The PG consistently demonstrated inspiratory phasic activity during NR with greater inspiratory and expiratory EMGs (P < 0.05) during basal NR compared with basal OR [3.3 +/- 0.2 (SE), 1.1 +/- 0.1, 2.3 +/- 0.4, and 1.0 +/- 0.2 arbitrary units for PG nasal inspiratory, PG oral inspiratory, PG nasal expiratory, and PG oral expiratory, respectively]. During OR, the LP was inspiratory phasic in 4 subjects and expiratory phasic in 4 subjects, with greater inspiratory and expiratory EMGs during basal OR compared with basal NR (5.5 +/- 1.1, 2.1 +/- 0.4, 6.8 +/- 1.5, and 1.8 +/- 0.4 arbitrary units for LP oral inspiratory, LP nasal inspiratory, PG oral expiratory, and PG nasal expiratory, respectively). Both muscles demonstrated significantly increased activity during both inspiratory resistive loading and hypercapnia. However, their route-specific activation pattern continued during such stimulated breathing. We conclude that 1) the route of respiration is influenced by the complex interaction of the PG and LP and 2) the response of these muscles to respiratory stimuli is dependent on the route of respiration.

Adult↗
PubMed1994

Symptomatic and essential palatal tremor. 2. Differences of palatal movements.

Palatal tremor, a rhythmic movement disorder of the soft palate, may be described as two separate entities: symptomatic palatal tremor (SPT) and essential palatal tremor (EPT). The symptomatic form is associated with brain stem or cerebellar disease, whereas the essential form has no known etiology. A cardinal symptom of EPT is the presence of ear clicks, which do not occur in SPT. Visual observation of the movements in the two disorders suggests that the difference in symptoms is due to the activation of different palatal muscles, the levator veli palatini in SPT and the tensor veli palatini in EPT. Electromyographic recording from the levator veli palatini muscle showed abnormal bursting activity time locked to the palatal movements in patients with SPT, but not in those with EPT. Because the two palatal muscles are innervated by different cranial nerves, SPT and EPT are likely to have separate origins.

Adult↗
PubMed1999

A prospective evaluation of the prevalence of submucous cleft palate in patients with isolated cleft lip versus controls.

Although there is an established relationship between cleft lip and overt cleft palate, the relationship between isolated cleft lip and submucous cleft palate has not been investigated. To test the hypothesis that patients with isolated cleft lip have a greater association with submucous cleft palate, a double-armed prospective trial was designed. A study group of 25 consecutive children presenting with an isolated cleft lip, with or without extension through the alveolus but not involving the secondary palate, was compared with a control group of 25 children with no known facial clefts. Eligible patients were examined for the presence of physical criteria associated with classic submucous cleft palate, namely, (1) bifid uvula, (2) absence of the posterior nasal spine, and (3) zona pellucida. Nasoendoscopy was subsequently performed just after induction of general anesthesia, and the findings were correlated with digital palpation of the palatal muscles. Patients who did not satisfy all three physical criteria and in whom nasoendoscopy was distinctly abnormal relative to the control group were classified as having occult submucous cleft palate. Classic submucous cleft palate was found in three study group patients (12 percent), all of whom had flattening or a midline depression of the posterior palate and musculus uvulae on nasoendoscopy and palpable diastasis of the palatal muscles under general anesthesia. An additional six study group patients (24 percent) had similar nasoendoscopic criteria and palpable diastasis of the palatal muscles; they were classified as having occult submucous cleft palate. No submucous cleft palate was identified in the control group. Seventeen patients in the study group had an alveolar cleft with a 53 percent (9 of 17) prevalence of submucous cleft palate. In the present study, classic submucous cleft palate in association with isolated cleft lip was 150 to 600 times the reported prevalence in the general population. All children with an isolated cleft lip should undergo peroral examination and speech/resonance assessment no later than the age of 3 years. Any child with an isolated cleft lip with velopharyngeal inadequacy or before an adenoidectomy should be assessed by flexible nasal endoscopy to avoid missing an occult submucous cleft palate.

Adolescent↗