Electrode

Electrode

4a4

4b4

Placement Guide

Functional muscle actions

Oropharyngeal "sling" - Orbicularis oris - Buccinator - Superior pharyngeal

Tongue: bolus manipulation and tongue base retraction - Intrinsics tongue - Extrinsics tongue - Superior pharyngeal constrictor

Possible signs & symptoms

- anterior spillage/leakage - premature spillage, residuals - pocketing, holding, stasis - nasal regurgitation

- AP transit - premature spillage - coating tongue base/post. pharynx - delayed swallow trigger - vallecular pooling

Velopharyngeal seal - Levator veli palatini - Superior pharyngeal constrictor

Hyolaryngeal Excursion - Laryngeal extrinsics - Suprahyoid muscles

Pharyngeal constriction - Superior, middle and inferior pharyngeal constrictors - Pharyngeal shortening mm

- nasal regurgitation - residuals - delayed pharyngeal transit

- decreased hyolaryngeal excursion - penetration, aspiration - voice abnormalities - decreased UES opening - pooling residuals

- penetration, aspiration - piecemeal deglutition - residuals - decreased pharyngeal transit time

UES seal opens and closes - Cricopharyngeus - Suprea and infrahyoid mm - Pharyngeal constrictors - Pharyngeal shortening muscles



- delayed opening UES - decreased opening UES, CP bar - premature closure UES - penetration, aspiration

- pyriform pooling, residuals

Possible VitalStim electrode placements

4a 4

2a/b 4 4a 4 3b 4 4a 4

maximum facilitation of synergists when electrodes applied bilaterally

14

Channel 1

horizontal channel facilitates recruitment of

Channel 2

muscles innervated by CN XII

increases sensory input - CN V and VII

add bottom channel over CN XII to facilitate

tongue muscle recruitment bottom channel facilitates thyrohyoid recruitment

1 Channel 1

2a4

Channel 2

maximum facilitation of synergists when

electrodes applied bilaterally

1 Hyoid

1 Thyroid 2

Cricoid 2

1 Hyoid 2 Thyroid 2

2b 4 1 4 3a 4

good facilitation of geniohoid, mylohyoid and thyrohyoid muscles facilitation supra-and infrahyoid muscles good facilitation of digastric and thyrohyoid muscles

3b 4 electrode placements on attachments of middle (hyoid) and lower (thyroid) pharyngeal contrictors

2b 4

Channel 1

2 Channel 2

1 1 Hyoid

2 Thyroid

3a4

Channel 1

1 Hyoid 2 1 Thyroid 2

Channel 2

2b 4 1 4 3a 4 3b 4

focus on hyolaryngeal excursion focus on maximal sensory input focus on hyolaryngeal excursion (TH) focus on pharyngeal constriction

Channel 1

3b 4

1 Hyoid 1 2 Thyroid 2

Channel 2

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