Análise da pressão da língua em indivíduos adultos jovens brasileiros

Oropharyngeal Rehabilitation for Patients With Moderate to Severe Obstructive Sleep Apnea After Transoral Robotic Surgery

OBJECTIVE

To determine whether combined transoral robotic surgery and postoperative oropharyngeal rehabilitation are effective for reducing the severity of obstructive sleep apnea.

STUDY DESIGN

A quasi-experimental study enrolled participants without blinding between May 2019 and April 2021.

SETTING

Single-center study at National Cheng Kung University Hospital.

METHODS

Patients with moderate to severe obstructive sleep apnea who were otherwise healthy were recruited from the ear, nose, and throat department at National Cheng Kung University Hospital. The group undergoing transoral robotic surgery with oropharyngeal rehabilitation (n = 18) received a 12-week intervention consisting of home-based rehabilitation exercises following surgery; the transoral robotic surgery group (n = 17) received surgery only; and the control group (n = 15) received conservative treatment, such as continuous positive airway pressure therapy or other oral appliance therapy. Polysomnography data and tongue muscle performance were measured before and after the interventions.

RESULTS

The group that underwent transoral robotic surgery with oropharyngeal rehabilitation exhibited significantly improved tongue protrusion strength as compared with the transoral robotic surgery-only group, as well as significantly improved apnea-hypopnea index in the supine position vs the control group.

CONCLUSION

In this study, we demonstrated the synergistic effects of transoral robotic surgery and postoperative oropharyngeal rehabilitation for adult patients with obstructive sleep apnea. Objective records should be used to monitor home-based rehabilitation exercises and examine the lasting synergistic effects.

Tongue measurements and pharyngeal residue in amyotrophic lateral sclerosis

Aim: We aimed to analyze the relationship between tongue measurements and vallecular residue in patients with amyotrophic lateral sclerosis (ALS). Materials & methods: Twenty-one patients with ALS were assessed for posterior maximum tongue isometric pressure (PMTIP) and posterior tongue isometric endurance (PTIE) by the Iowa Oral Performance Instrument; vallecular residue after 10 ml of moderately thickened consistency by Fiberoptic Endoscopic Evaluation of Swallowing; and tongue thickness (TT) by ultrasonography. Results: PMTIP, PTIE and TT were decreased compared with the reference values for healthy individuals and were not different between patients with and without vallecular residue. Conclusion: In ALS, PMTIP, PTIE and TT are not good predictors of vallecular residue in the tested volume and food consistency.

Age and Sex-Related Differences in the Tongue Pressure Generated during Maximum Isometric and Swallowing Tasks by Healthy Chinese Adults

The aims of this prospective observational study were to investigate age, sex, and factors related to the tongue pressure generated. A correlational research design was used. A total of 150 Chinese people who had a normal swallowing condition were enrolled by convenience sampling. Pressure was measured for each participant during maximum isometric press tasks, as well as for saliva and water swallows (5 mL) at the anterior and posterior tongue. The results illustrated that age has an impact on anterior tongue pressure (r = −0.22), posterior tongue pressure (r = −0.26); however, it does not have an impact on the swallowing pressure (SP) of the tongue. Sex differences were noted; males demonstrated a greater strength of the anterior tongue. There was a significant correlation between BMI and the maximum isometric pressure of the anterior tongue (MIP_ant). The pressures between anterior and posterior tongue were not significantly different in the maximum isometric or swallowing tasks. There were significant differences among the maximum isometric pressure (MIP), saliva swallowing pressure, and water swallowing pressure. The MIP generated was greater than the pressure in the swallowing tasks for the younger groups of both sexes. The study supplement the exploration of age-and-sex related differences and the interaction of sex and age in tongue pressure.

Analysis of Labial and Lingual Strength among Healthy Chinese Adults in Taiwan

This study collected 11 parameters regarding the labial and lingual strength for maximum isometric and swallowing tasks among 150 healthy Chinese adults in Taiwan. Measurements were performed using the Iowa Oral Performance Instrument (IOPI). All of the labial and lingual strength parameters were measured three times. The maximal value of three trials represents the pressure of every parameter. The overall mean (±standard deviation) and maximum isometric pressures of the lips, anterior tongue, and posterior tongue were 24.81 ± 5.64, 55.95 ± 14.13, and 53.23 ± 12.24 kPa, respectively. The mean value of posterior tongue strength was less than that of the anterior tongue by approximately 5%. The percentages of maximum isometric tongue pressure during the swallowing of saliva and water were 85% and 80% for the anterior tongue and 90% and 81% for the posterior tongue, respectively. The average endurances for the anterior tongue and posterior tongue were 13.86 ± 7.08 and 10.06 ± 5.40 s, respectively. The maximum isometric pressures were greater than both the saliva and water swallowing pressures, and the saliva swallowing pressures were greater than the water swallowing pressures. A value of 33 kPa in maximum isometric pressure could serve as a demarcation of weak tongue strength for healthy Chinese adults. As for the repeated trials of labial and lingual strength, there were no statistically significant differences for any of the pressures obtained from the 11 labial and lingual strength parameters. The normative data can be used for the objective assessment of labial and lingual strength in healthy Chinese adults.

Variability in tongue pressure among elderly and young healthy cohorts: A systematic review and meta-analysis

OBJECTIVES

Tongue pressure (TP) is used for the diagnosis of oral hypofunction; however, the impact of several variables on TP is unclear. Therefore, the current systematic review and meta-analysis aimed to analyse the variability in tongue pressure among healthy individuals aged ≥60 years vs <60 years. Secondary outcomes were the influence of gender and the type of measuring device (Iowa Oral Performance Instrument (IOPI) vs JMS tongue pressure measurement device (JMS)).

METHODS

PubMed and the Japanese database Ichushi-Web were searched systematically by two independent reviewers for studies reporting TP values in healthy populations. Clinical studies published between 1959 and June 2020 with more than 10 participants, written in English, German or Japanese, were included. A random-effects meta-regression for aggregate-level data was applied (α < 0.05).

RESULTS

Sixty-eight studies reported TP for a total of 13 773 subjects aged <60 years (n = 3265) and ≥60 years (n = 10 508). TP was significantly higher in subjects <60 years (estimated weighted mean (EWM) ± standard error = 51.9 ± 1.28 kPa; 95% CI = 49.4-54.4) relative to those ≥60 (EWM = 34.7 ± 0.94 kPa; 95% CI = 32.8-36.5) (P < .001), men (EWM = 45.9 ± 2.09 kPa; 95% CI = 41.8-50.0) relative to women (EWM = 39.3 ± 1.68 kPa; 95% CI = 36.0-42.6) (P = .015) and when assessed with the IOPI (EWM = 51.9 ± 1.32 kPa; 95% CI = 49.3-54.5) compared to the JMS (EWM = 33.5 ± 0.63 kPa; 95% CI = 32.2-34.7) (P < .001). In terms of gender, there was no significant difference in TP among subjects ≥60 years (P = .282). However, in subjects younger than 60, a significant difference was observed (P = .004).

CONCLUSIONS

Healthy populations aged <60 years showed significantly higher TP than those aged ≥60 years. TP values ascertained by the IOPI are significantly higher than those obtained with the JMS.

Tongue function and swallowing in individuals with temporomandibular disorders

The tongue participates in the oral phase of swallowing by pushing the food bolus toward the oropharynx. This relationship between tongue function and swallowing is little addressed addressed in individuals with temporomandibular dysfunction (TMD).

Tongue pressure distribution of individual normal occlusions and exploration of related factors

Background

Tongue plays an important part in oral and maxillofacial system. Measurement of tongue pressure helps to evaluate the performance of tongue movement.

Objectives

To establish a system for measuring tongue pressure against hard palate and to preliminarily explore pressure distribution of individual normal occlusions and the relationship with dental arch form.

Methods

A total of 19 volunteers of individual normal occlusions out of 189 dental students met inclusion criteria (nine males, ten females, aged 25.53 ± 0.96 years). A force‐sensing resistor device was used to measure tongue pressure at rest and functional state (swallowing). We observed tongue pressure of four channel (anterior, posterior and lateral sides of hard palate) in sitting, supine position and swallowing. We analysed pressure differences according to gender and explored correlation relationship between tongue pressure and dental arch width and length using 3D digital maxillary image.

Results

In rest, tongue pressure against hard palate increased from front to back in both sitting and supine position, without gender differences. When swallowing saliva, the pressure at lateral sides of females was found significantly higher than that of males. Bivariate correlation analysis revealed duration of swallowing was positively correlated with BMI and weight at posterior region and positively correlated with palatal length at anterior palate. The greater the dental arch width, the smaller the pressure of swallowing in the anterior and lateral region.

Conclusion

In rest, there was consistent pressure of tongue against hard palate. The pressure increased significantly during swallowing, especially in females. Tongue pressure was related to dental arch length, width, BMI and weight.