Treatment Progress of 3 Patients with Tongue Protrusion

Abstract

Tongue protrusion (tongue thrust) is a characteristic symptom caused by involuntary protrusion of the tongue during speaking only. We see many reports outside Japan in which botulinum toxin injections are used to treat tongue protrusion as a type of focal dystonia. In Japan the number of reports is quite limited, however, and there have been no reports of botulinum toxin injections used in liaison with speech-language-hearing therapists. We report 3 cases of tongue protrusion for which we achieved excellent results using botulinum toxin injections in conjunction with articulation training by speech-language-hearing therapists. In stable periods, all 3 cases improved to a speech intelligibility rating of 1 and speech naturalness rating also of 1. Furthermore, "over-teeth" tongue protrusion of the kind seen at maximum prior to treatment was no longer in evidence. We concluded that tongue protrusion in our 3 cases was focal dystonia, and use of botulinum toxin injections in tandem with articulation training by speech-language-hearing therapists was an effective method of treatment.