Ultrasound analysis of tongue and palate movements during suckling, mastication and swallowing.

• Project/Area Number: 02454475
• Research Category: Grant-in-Aid for General Scientific Research (B)
• Allocation Type: Single-year Grants
• Research Field: 小児・社会系歯学
• Research Institution: Showa University
• Principal Investigator: KANEKO Yoshihiro Showa Univ. Sch. of Dent. Professor, 歯学部, 教授 (40085775)
• Co-Investigator(Kenkyū-buntansha): OMOTO Kazuhiko same as above Research Assistant, 歯学部, 助手 (70160942) ; MUKAI Yoshiharu same as above Assistant Professor, 歯学部, 助教授 (50110721)
• Project Period (FY): 1990 – 1992
• Project Status: Completed (Fiscal Year 1992)
• Budget Amount: ¥6,600,000 (Direct Cost: ¥6,600,000); Fiscal Year 1992: ¥500,000 (Direct Cost: ¥500,000); Fiscal Year 1991: ¥600,000 (Direct Cost: ¥600,000); Fiscal Year 1990: ¥5,500,000 (Direct Cost: ¥5,500,000)
• Keywords: Ultrasonotomography / Suckling / Mastication / Oral stage of swallowing / Tongue movement / Diagnosis of feeding function / Feeding functional disorders / 逆嚥下型 / 押しつけ不全型 / 摂食障害 / 粘稠性食物 / 哺乳運動 / 重度障害者 / 嚥下機能診断 / 摂食姿勢 / 前額断面 / 矢状断面 / 哺乳動運 / 吸啜 / 舌動運

Research Abstract

We examined the applicability of a noninvasive ultrasonotomographic analysis for evaluating tongue and palate movements during suckling, mastication and swallowing. Ultrasound real-time scanning was performed using ultrasonic diagnostic equipment(Toshiba SSA-250A) with a sector probe or a convex probe. The output of the scanner was recorded on video tape.
The main results were as follows :
1. Suckling in neonates: (1) A submental echo-window using a tilt-type sector probe was most suitable for visualizing the events occurring in the oral cavity during suckling. (2) On the mid-sagittal view, the nipple was taken in almost to the junction of the hard and soft palates in both cases of breast- and bottle-feeding. (3) Both in breast-and bottle-feeding, the principal tongue movements during suckling were sequential posteriorly moving peristaltic-like waves. (4) The milk was expressed posteriorly towards the pharynx when the base of the tongue moved downward and forward, simultaneously giving a space between the tongue and soft palate.
2. Tongue movements during mastication and swallowing in children: (1) We found that lateral submandibular positioning of the convex probe yielded good visualization of the tongue on the mid-sagittal view during mastication and swallowing. (2) Although the basic movement of the tongue in the oral phase of swallowing was a peristaltic wave, the base of the tongue moved downward and forward just before the bolus was conveyed to pharynx. (3) On the coronal view, the median portion of the tongue was moved inferiorly as the bolus was formed. (4) On the mid-sagittal view, the base of the tongue moved downward and forward during mastication. (5) On the coronal view, the lateral portion of the tongue was depressed at the working side of mastication.
3. Swallowing in adults: (1) Ultrasound imaging in the mid-sagittal plane of the tongue action in the oral phase of swallowing was able to be devided into 4 stages. (2) A very characteristic tongue motion was observed at the third stage (the period just before the bolus was conveyed to the pharynx), that is, the base of the tongue quickly moved downward and forward, giving a concave appearance to the base of the tongue.
4. Swallowing in handicapped children: (1) On the mid-sagittal view, tongue action disorders in the oral phase of swallowing were able to be categorized roughly into two types; "reverse-swallow type" and "upward pressure deficiency type". (2) This whole study suggests there's a definite place for ultrasound in the diagnosis and monitoring therapy of feeding and swallowing functional disorders.