The role of the tongue in post-stroke dysphagia and obstructive sleep apnea: Correlation with sonography measurement

• Published in: Clinical neurology and neurosurgery Vol. 236; p. 108108
• Main Authors: Hsueh, Sung-Ju, Hsu, Brian, Chang, Kai-Chieh
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.01.2024; Elsevier Limited
• Subjects: Aged; Apnea; Cerebrovascular disease; Consciousness; Deglutition Disorders - complications; Deglutition Disorders - etiology; Disease; Dysphagia; Efficiency; Hospitals; Humans; Hypertension; Intubation; Ischemia; Ischemic Stroke; Obstructive Sleep Apnea; Patients; Pneumonia; Pneumonia - complications; Pneumonia - etiology; Questionnaires; Risk factors; Sleep and wakefulness; Sleep apnea; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - diagnostic imaging; Sleep disorders; Stroke; Stroke - complications; Stroke - diagnostic imaging; Swallowing; Tongue; Tongue - diagnostic imaging; Ultrasonic imaging; Ultrasound; United States > US; Taiwan; Pneumonia; Tongue; Ultrasound; Cerebrovascular disease; Obstructive Sleep Apnea
• ISSN: 0303-8467; 1872-6968
• DOI: 10.1016/j.clineuro.2023.108108

Obstructive sleep apnea (OSA) is a common risk factor for stroke, and dysphagia and pneumonia are both well-known complications of stroke. The development of these conditions is related to the oropharyngeal structures. We investigated whether specific structural features of the tongue may lead to the development of these complications. Patients with ischemic stroke who required admission and community-dwelling elderly controls were enrolled. The participants underwent tongue measurements by received hand-held ultrasound, and received questionnaires to evaluate sleep quality and daytime sleepiness. The patient group also underwent objective sleep measurement by actigraphy and the 3-Step Swallowing Test (3-SSS). Sleep parameters and outcomes were analyzed. Patient with ischemic stroke had significantly thicker tongue than controls (6.53 cm v. 6.05 cm, p = 0.002). Multiple logistic regression analysis revealed that the anatomical parameters of the tongue in patients with stroke were significantly correlated with parameters of OSA, and the thickness of the tongue was positively correlated with the development of OSA (p = 0.024) and pneumonia (p = 0.048). A thicker-than average tongue may be a risk factor for OSA and pneumonia in patient with stroke. Hand-held ultrasound can be used to identify these anatomical features. Further studies are warranted to clarify the role of the tongue in these post-stroke complications. •Dysphagia, pneumonia, and obstructive sleep apnea are common complications of stroke.•The tongue may be involved in various neurological disorders, including stroke.•Measurement of anatonomical parameters of the tongue could be measured by ultrasound.•Thickness of the tongue is related to obstructive sleep apnea and pneumonia after stroke.