The Relationship between Tongue Pressure and Swallowing Function in Dysphagic Patients

Abstract

Purpose:　Tongue movement in swallowing plays an important role in bolus formation and lingual bolus propulsion. Recently, tongue pressure is noted as one of the factors of tongue motor function and swallowing function. The purpose of this study was to investigate the relationship between tongue pressure and swallowing function in dysphagic patients and healthy volunteers.

Subjects and Methods:　The subjects comprised 107 healthy volunteers and 66 dysphagic patients. We evaluated tongue pressure using the JMS tongue pressure measuring instrument for all cases. Healthy volunteers were investigated in terms of gender and age, and dysphagic patients were evaluated on the dysphagia severity scale (DSS), eating status scale (ESS), and functional oral intake scale (FOIS). We also conducted a videofluoroscopic examination of swallowing (VF) findings.

Results:　Maximum tongue pressure of male subjects was larger than that of female subjects in healthy volunteers (p＜0.01), and there was a correlation between maximum tongue pressure of males and age (r＝－0.30). However, tongue pressure during swallowing did not significantly differ with gender and age. There was a significant correlation between maximum tongue pressure and DSS, ESS, FOIS in dysphagic patients (r＝0.33–0.58). Maximum tongue pressure showed a significant correlation with oral cavity residue, bolus formation, lingual bolus propulsion, and vallecular residue in VF findings (r＝0.51–0.82). Tongue pressure during swallowing also showed a significant correlation with oral cavity residue, bolus formation, lingual bolus propulsion, and vallecular residue (r＝0.45–0.75). There was a weak correlation with piriform sinus residue.

Discussion:　By evaluating tongue pressure, it is possible to measure tongue motor function easily and quantitatively. Tongue pressure reflects the severity of dysphagia, and could be used to determine diet for dysphagia patients. Furthermore, tongue pressure showed a significant correlation with the tongue motor functions of bolus formation and vallecular residue in VF findings. This study suggested that tongue pressure influences the lingual and pharyngeal phase of swallowing. In addition, tongue pressure exercises may be useful in preventing and improving swallowing function in the lingual and pharyngeal phase.