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World J Otorhinolaryngol. May 28, 2015; 5(2): 58-64
Published online May 28, 2015. doi: 10.5319/wjo.v5.i2.58
Tongue dysfunction in neurological and neuromuscular disorders: A narrative literature review
George Umemoto
George Umemoto, Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University, Fukuoka 814-0180, Japan
Author contributions: Umemoto G solely contributed to this manuscript.
Conflict-of-interest: I certify that there is no conflict of interest with any financial organization regarding the material discussed in the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: George Umemoto, DDS, PhD, Department of Oral and Maxillofacial Surgery, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan. george@minf.med.fukuoka-u.ac.jp
Telephone: +81-92-8011011 Fax: +81-92-8011044
Received: September 28, 2014
Peer-review started: September 29, 2014
First decision: December 27, 2014
Revised: February 18, 2015
Accepted: March 16, 2015
Article in press: March 18, 2015
Published online: May 28, 2015
Processing time: 234 Days and 15.1 Hours
Abstract

Evaluation of oral function is useful for tracking longitudinal changes in swallowing function. Using videofluoroscopic (VF) images, we can evaluate swallowing function, but it is extremely difficult to quantitatively evaluate the oral phase. Recently, several studies have tried to quantitatively assess tongue function by analyzing tongue movement on VF images, to measure tongue thickness by ultrasonography, and to measure tongue pressure as surrogate for tongue strength. In this review article, the current state of quantitative assessments of tongue function for identification and management of dysphagia in patients with neuromuscular and other neurological disorders (NNMD) has been outlined. Disturbed bolus transport in patients with NNMD has been quantitatively measured on VF images by analyzing tongue base movement and bolus transport from the mouth to the pharynx. Enlarged tongue in Duchenne muscular dystrophy patients were observed by measuring the transverse width of the tongue on ultrasound. Tongue pressures that were measured using a handheld probe in NNMD patients were less than half of those in healthy subjects. More studies are needed to develop guidelines what types of tongue dysfunction give an indication of adjusting diet and introducing tube feeding to NNMD patients.

Keywords: Videofluoroscopy; Swallowing pressure; Tongue thickness; Tongue pressure; Neuromuscular and other neurological disorders

Core tip: Several studies have tried to quantitatively assess tongue function by analyzing tongue movement on videofluoroscopic images, to measure tongue thickness by ultrasonography, and to measure tongue pressure as surrogate for tongue strength. In this review article, the current state of quantitative assessments of tongue function for identification and management of dysphagia in patients with neuromuscular and other neurological disorders (NNMD) has been outlined. In the future, more studies are needed to develop guidelines what types of tongue dysfunction give an indication of adjusting diet and introducing tube feeding to NNMD patients.