Abstract
The purpose of this study was to evaluate the mastication disorders with motor dysfunction of dependent elderly people at nursing care facilities, through observation of the feeding movement and evaluation using a videoendoscopic evaluation (VE) system.
The subjects were 29 people residing in nursing care facilities (14 men and 15 women, mean age : 80.9 years old) . The evaluation period was one year from April 2007 to March 2008. We observed the feeding movement and performed VE for subjects while they were taking daily food at dysphagia rehabilitation. These evaluations were recorded on videotapes. The five evaluation items were : firstly and secondly, by the observation of feeding movement, the jaw rotary movement and the mouth corner pulling movement during mastication. Thirdly the lateral movement of the tongue base; fourthly the food residue in the pharynx and finally the penetration/aspiration after swallowing at VE. In addition, we analyzed the relationship between these items and the appropriate food texture by a retrospective study.
Ten of the 29 subjects (34.5%) had poor lateral movement of the tongue base. Food residue in the pharynx was observed in 18 of 29 (62.1%) , and penetration/aspiration was observed in 14 of 29 (48.3%) cases. There were significant correlations between the rotary movement of the jaw and the lateral movement of the tongue base (p<0.001) , and the pulling movement of the mouth corner and the lateral movement of the tongue base (p<0.001) . In the retrospective study, we confirmed that the food texture which we had recommended to the subjects at the past dysphagia rehabilitation time was appropriate for improvement of the subjects' feeding/swallowing functions.
The results of this study suggest that the combination of tongue base movement by VE and the observation of the feeding movement during meals is very useful for appropriate evaluation of the tongue function during mastication.
