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Phonation-induced Upper Esophageal Sphincter Contraction Caused by Different Phonation Types

      Summary

      Introduction

      The upper esophageal sphincter (UES) has been reported to show activity during phonation. As it is still unknown whether the phonation-induced UES contraction represents a reflex or a simultaneous activation phenomenon, i.e. co-innervation, this study aims to investigate and characterize the phonation-induced contraction of the UES in healthy individuals by analyzing the influence of various phonation tasks on pressure parameters of the UES.

      Methods

      Twenty-five healthy volunteers produced the German neutral vowel [ə] in five different phonation tasks (modal voice, whispering, voiceless speech, creaky voice, and whispery voice). Simultaneously, they underwent high resolution manometry and electroglottography for measurement of pressure parameters in the region of the UES and latencies between larynx and UES activation.

      Results

      During all types of phonation, the maximum pressures of the UES increased significantly (maximum pressure increases of 72%-132%). With regard to mean pressures this was valid for modal voice and whispering (mean pressure increases of 20%-25%). Differences concerning total pressure changes reached statistical significance when comparing whispering and voiceless speech as well as whispery voice. However, differences concerning the total pressure change between modal voices on the one hand and voiceless speech and whispery voice on the other hand turned out to be small. The averaged time delay between larynx and UES activation ranged from approximately -15 ms (whispery voice) to +15 ms (whispering).

      Conclusion

      A phonation induced pressure increase of the UES was confirmed in this study and did exist for different types of phonation. The extent of total pressure changes in the UES increases in relation with laryngeal muscle activity necessary for the phonation type. Next to varying effects of different types of phonation on UES activation, very short latencies indicate that a phonation induced contraction of the UES exists most likely due to co-innervation of UES and laryngeal muscles by the vagus nerve.

      Key Words

      Abbreviations:

      UES (upper esophageal sphincter), HRM (high-resolution manometry), EGG (electroglottography)
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      References

        • Sataloff RT
        • Heman-Ackah YD
        • Hawkshaw MJ.
        Clinical anatomy and physiology of the voice.
        Otolaryngol Clin North Am. 2007; 40: 909-929
        • Peturson M&N.
        Elementarbuch der Phonetik.
        Buske, Hamburg2002
        • Jungheim M
        • Miller S
        • Kuhn D
        • et al.
        Anatomy of the upper esophageal sphincter.
        Hno. 2014; 62 (quiz 393): 385-392
        • Perera L
        • Kern M
        • Hofmann C
        • et al.
        Manometric evidence for a phonation-induced UES contractile reflex.
        Am J Physiol Gastrointest Liver Physiol. 2008; 294: G885-G891
        • Jungheim M
        • Janhsen AM
        • Miller S
        • et al.
        Impact of neuromuscular electrical stimulation on upper esophageal sphincter dynamics: a high-resolution manometry study.
        Ann Otol Rhinol Laryngol. 2015; 124: 5-12
        • Schulte E
        • Schumacher U
        • Schünke M.
        PROMETHEUS Kopf, Hals und Neuroanatomie: LernAtlas Anatomie.
        Georg Thieme Verlag, Stuttgart2018
        • Fischer DB
        • Truog RD.
        What is a reflex? A guide for understanding disorders of consciousness.
        Neurology. 2015; 85: 543-548
        • Meisoll FJ
        • Jungheim M
        • Fast JF
        • et al.
        Upper esophageal sphincter response to laryngeal adductor reflex elicitation in humans.
        Laryngoscope. 2021; 131: E1778-E1784
        • Jungheim M
        • Schubert C
        • Miller S
        • et al.
        Swallowing function after continuous neuromuscular electrical stimulation of the submandibular region evaluated by high-resolution manometry.
        Dysphagia. 2017; 32: 501-508
        • Kallusky J
        • Zimmerer R
        • Tavassol F
        • et al.
        Deglutition in patients with hypernasality associated with unilateral cleft lip and palate evaluated with high-resolution manometry.
        Cleft Palate Craniofac J. 2020; 57: 238-244
        • Miller S
        • Ptok M
        • Jungheim M.
        Influence of Acid Swallows on the Dynamics of the Upper Esophageal Sphincter.
        Dysphagia. 2021; 36: 443-455
        • Clark JW
        • Yallop C
        • Fletcher J.
        An Introduction to Phonetics and Phonology.
        Blackwell, Oxford2006
        • Eker H
        • Laver J.
        Menschen und ihre Stimmen * Aspekte der vokalen Kommunikation.
        Beltz, Weinheim1994
        • Trask RL.
        A Dictionary of Phonetics and Phonology.
        Routledge, London1996
        • Martin F
        • Klingholz F.
        The role of the cricopharyngeal muscle in phonation.
        Laryngol Rhinol Otol (Stuttg). 1983; 62: 223-225
        • Krech E
        • Stock E
        • Hirschfeld U
        • et al.
        Deutsches Aussprachebuch.
        Walter de Gruyter, Berlin2009
        • Tsunoda K
        • Niimi S
        • Hirose H.
        The roles of the posterior cricoarytenoid and thyropharyngeus muscles in whispered speech.
        Folia Phoniatr Logop. 1994; 46: 139-151
        • Matsuda M
        • Kasuya H.
        Acoustic nature of the whisper.
        Eurospeech. 1999; 99: 133-136
        • Martin F
        • Klingholz F
        • Weikert M.
        The activity of the supraglottal sphincter during phonation.
        Laryngol Rhinol Otol (Stuttg). 1983; 62: 436-439
        • Shock LA
        • Gallemore BC
        • Hinkel CJ
        • et al.
        Improving the utility of laryngeal adductor reflex testing: a translational tale of mice and men.
        Otolaryngol Head Neck Surg. 2015; 153: 94-101
        • Ptok M
        • Schroeter S.
        Characterization of the laryngeal adductor reflex by stimulation with microdroplets impulses (Microdroplet-Impulse Testing) [Article in German].
        Laryngorhinootologie. 2016; 95: 482-489
        • Solomon NP
        • McCall GN
        • Trosset MW
        • et al.
        Laryngeal configuration and constriction during two types of whispering.
        J Speech Hear Res. 1989; 32: 161-174
        • Konnai R
        • Scherer RC
        • Peplinski A
        • et al.
        Whisper and phonation: aerodynamic comparisons across adduction and loudness.
        J Voice. 2017; 31: 773.e11-773.e20