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2 results

  • 1 - Physiological Foundations

  • from Section I - Segmental Production
  • Edited by Rachael-Anne Knight, City, University of London, Jane Setter, University of Reading
  • Book:
    The Cambridge Handbook of Phonetics
    Published online:
    11 November 2021
    Print publication:
    02 December 2021, pp 11-39

  • Summary

    Speech physiology consists of the articulatory structures, including the respiratory system, the larynx and various vocal tract articulators, plus the sensory organs, which provide auditory, somatosensory and visual inputs that map the feature space in which speech is produced and perceived. In this chapter the focus is on the neurophysiology of the articulatory structures. The acoustic characteristics of speech sounds are determined by changes in the length and tension of muscles, coordinated, at the lowest level, by interlinked clusters of motor neurons and interneurons in the brainstem which are themselves directed by excitation from cortical and midbrain structures. This chapter provides a brief foundation to these systems and structures, taking a functional perspective. The progressive nature of research into the anatomy and physiology of speech continues to generate new discoveries, and advances in modelling and mapping of biomechanical and neural control promise new avenues for phonetic research.

  • Hyoid bone fracture identified only with nasal Valsalva manoeuvre

  • P M Spielmann, I F Hathorn, J K V Clarke, S Denholm
  • Journal:
    The Journal of Laryngology & Otology / Volume 124 / Issue 4 / April 2010
    Published online by Cambridge University Press:
    23 November 2009, pp. 431-432
    Print publication:
    April 2010
  • Objective:

    We present two cases of a hyoid bone fracture identified through careful clinical examination with a Valsalva manoeuvre during nasendoscopy.

    Method:

    Case reports and review of the literature, with emphasis on technique during nasendoscopy.

    Results:

    The first patient had sustained a blow to the neck with a stick, six months prior to presentation with a globus sensation. External examination and standard nasendoscopy were unremarkable. The second patient had been struck across the neck by a wire whilst riding a motorbike at low speed. Endoscopy revealed swelling of the supraglottis. He recovered and was asymptomatic at review one month later. Computed tomography scans on both patients were unremarkable. During nasendoscopy, both patients were asked to forcibly expire with their mouths closed (the so-called nasal Valsalva manoeuvre), and the hyoid bone was seen to swing into view on the side where the first patient complained of symptoms, and in the second case where swelling had been noticed previously.

    Conclusion:

    We would not ordinarily have reached a diagnosis in these patients, as radiography and examination were otherwise unremarkable. The use of the nasal Valsalva manoeuvre during routine nasendoscopic examination is recommended, as unusual pathology may be demonstrated and the need for direct laryngoscopy under general anaesthesia may, in some instances, be avoided.