Treatment of Dysphagic Patients with a Palatal Augmentation Prosthesis Based on a Tongue Movement Function Diagnosis Method by Palatography

Purpose: Many dysphagic patients show impaired tongue movements. In such patients, we evaluated a diagnostic method for tongue motor function by a palatogram method and a videofluorography (VF) method, and designed a palatal augmentation prosthesis. Methods: The subjects were patients with dysarthri...

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Published inNihon Hotetsu Shika Gakkai Zasshi Vol. 47; no. 1; pp. 135 - 144
Main Authors Kiuchi, Nobutoshi, Ueda, Koichiro, Michimi, Noboru, Ikeda, Keisuke, Kohno, Shoji
Format Journal Article
LanguageJapanese
Published Japan Prosthodontic Society 10.02.2003
Subjects
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ISSN0389-5386
1883-177X
DOI10.2186/jjps.47.135

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Abstract Purpose: Many dysphagic patients show impaired tongue movements. In such patients, we evaluated a diagnostic method for tongue motor function by a palatogram method and a videofluorography (VF) method, and designed a palatal augmentation prosthesis. Methods: The subjects were patients with dysarthria complicated by dysphagia in the preparatory and lingual phases, and normal controls without abnormalities in stomatognathic function. Palatograms were recorded during speech of “ta”, “na”, “ra”, and “ki”, as well as swallowing of saliva. In addition, using a VF apparatus, common findings between the tongue form during speech of the above 4 syllables, as well as dry swallowing, and that during eating/swallowing of barium cookies, were evaluated, to determine if tongue function diagnosis during eating/swallowing is possible by palatograms obtained during the former. Results: The tongue forms at the termination of the mastication of cookies, during food mass formation, and at the termination of food mass formation, closely resembled those during speech of “ta”, “na”, and “ra”, respectively. The tongue form at the termination of the swallowing of cookies closely resembled that during speech of “ki”, as well as during swallowing of saliva. Conclusions: Based on palatograms recorded during speech of the test syllables, and during swallowing of saliva, tongue function diagnosis during eating/swallowing was possible. In addition, a palatal augmentation prosthesis was produced based on tongue motor function diagnosed by this palatographic method for the patients. This prosthesis was useful for improving the ability to form food masses and swallowing function.
AbstractList Purpose: Many dysphagic patients show impaired tongue movements. In such patients, we evaluated a diagnostic method for tongue motor function by a palatogram method and a videofluorography (VF) method, and designed a palatal augmentation prosthesis. Methods: The subjects were patients with dysarthria complicated by dysphagia in the preparatory and lingual phases, and normal controls without abnormalities in stomatognathic function. Palatograms were recorded during speech of “ta”, “na”, “ra”, and “ki”, as well as swallowing of saliva. In addition, using a VF apparatus, common findings between the tongue form during speech of the above 4 syllables, as well as dry swallowing, and that during eating/swallowing of barium cookies, were evaluated, to determine if tongue function diagnosis during eating/swallowing is possible by palatograms obtained during the former. Results: The tongue forms at the termination of the mastication of cookies, during food mass formation, and at the termination of food mass formation, closely resembled those during speech of “ta”, “na”, and “ra”, respectively. The tongue form at the termination of the swallowing of cookies closely resembled that during speech of “ki”, as well as during swallowing of saliva. Conclusions: Based on palatograms recorded during speech of the test syllables, and during swallowing of saliva, tongue function diagnosis during eating/swallowing was possible. In addition, a palatal augmentation prosthesis was produced based on tongue motor function diagnosed by this palatographic method for the patients. This prosthesis was useful for improving the ability to form food masses and swallowing function.
Author Kiuchi, Nobutoshi
Michimi, Noboru
Ikeda, Keisuke
Kohno, Shoji
Ueda, Koichiro
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  fullname: Kiuchi, Nobutoshi
  organization: Division of Removable Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences
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  fullname: Ueda, Koichiro
  organization: Division of Dysphagia Rehabilitation, Niigata University Graduate School of Medical and Dental Sciences
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  fullname: Michimi, Noboru
  organization: Oral Surgery, Niigata Kobari Hospital
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  fullname: Ikeda, Keisuke
  organization: Division of Removable Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences
– sequence: 1
  fullname: Kohno, Shoji
  organization: Division of Removable Prosthodontics, Niigata University Graduate School of Medical and Dental Sciences
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References 3) 本多知行. 医師・歯科医師のなすべきこと. 本多知行, 溝尻源太郎編, 医師・歯科医師のための摂食嚥下障害ハンドブック12-16, 東京: 医歯薬出版, 2000.
10) 戸村嘉明. X線テレビ映画による咀嚼時の舌運動について1. 矢状方向からの観察. 歯科学報79: 2271-2303, 1979.
12) 小島千枝子. 摂食嚥下機能の減退 (高齢者) への対応.金子芳洋, 千野直一監修, 摂食嚥下リハビリテーション193-195, 東京: 医歯薬出版, 1998.
21) Shimodaira K, Yoshida H, Kanazawa T. Palatal augmentation prosthesis with alternative palatal vaults for speech and swallowing: A clinical report. J Prosthet Dent 80: 1-3, 1998.
14) 伊藤秀美. 電気的パラトグラフによる舌の調音と口蓋形態に関する基礎的研究-単音節について-. 補綴誌22: 580-598, 1978.
8) 西村亮介. X線テレビ映画による嚥下時の舌背の位置の変化に関する研究1. 正中矢状面上の舌背粘膜上の各点の位置の変化. 歯科学報77: 263-309, 1977.
11) 山縣健佑. 義歯と発音無歯顎臨床でのポイント35-62, 東京: 口腔保健協会, 1997.
13) 森田啓一. 正常者のパラトグラム. 口病誌34: 279-309, 1967.
15) 谷口秀和. 歯列を含むパラトグラムの画像処理による標準形態. 補綴誌33: 626-638, 1989.
16) 加藤一誠, 河野正司, 岩片信吾ほか. X線テレビによる顎機能運動撮影時の頭部被曝量に関して. 新潟歯学会誌25: 27-34, 1995.
19) Goyal BK, Greenstein P. Functional contouring of the palatal vault for improving speech with complete denture. J Prosthet Dent 48: 640-646, 1982.
7) Ardran GM, Kemp FH. The mechanism of swallowing. Proc R Soc Med 44: 1038-1040, 1951.
1) 佐々木啓一, 根津雄一. 在宅高齢者における歯科補綴の位置づけ. 河野正司, 渡辺誠編, 補綴臨床別冊/エイジングと歯科補綴120-130, 東京: 医歯薬出版, 1999.
2) 藤島一郎. 脳卒中の摂食嚥下障害第2版1-18, 東京: 医歯薬出版, 2000.
18) 山田好秋. よくわかる摂食・嚥下のしくみ88-93, 東京: 医歯薬出版, 1999.
5) 才藤栄一. 個人の摂食能力に応じた味わいのある食事内容・指導等に関する研究, 摂食機能減退の診断法の開発37-58平成8年度厚生省・健康政策調査研究事業分担研究報告書 (主任研究者: 金子芳洋), 1997.
9) 西村亮介. X線テレビ映画による嚥下時の舌背の位置の変化に関する研究2. 正中矢状面上の舌背粘膜上の各点の位置の変化. 歯科学報77: 629-659, 1977.
4) Groher ME (藤島一郎). Dysphagia diagnosis and management, 2nd ed.(嚥下障害その病態とリハビリテーション, 第2版. 23-63, 東京: 医歯薬出版, 1997), 1992.
6) Joseph Murray MA (道健一, 道脇幸博). Manual of dysphagia assessment in adult (摂食・嚥下機能評価マニュアル医療面接から訓練計画立案まで48-49, 東京: 医歯薬出版, 2001), 1999.
22) Feinberg MJ, Ekberg O. Videofluoroscopy in elderly patients with aspiration: Importance of evaluation both oral and pharyngeal stages of deglutition. Am J Roentgenol 156: 293-296, 1991.
20) Francis WS, Robert AK. Phonetics and swallowing to determine palatal contour of denture. J Prosthet Dent 28: 360-362, 1972.
23) Palmer JB, Nathan JR, Gustavo L et al. Coordination of mastication and swallowing. Dysphagia 7: 187-200, 2000.
17) Palmer JB, Hiiemae KM. Ingestion of oral and pharyngeal bolus propulsion;A new model for the physiology of swallowing. Jpn J Dysphagia Rehabil 1: 15-30, 1997.
References_xml – reference: 4) Groher ME (藤島一郎). Dysphagia diagnosis and management, 2nd ed.(嚥下障害その病態とリハビリテーション, 第2版. 23-63, 東京: 医歯薬出版, 1997), 1992.
– reference: 19) Goyal BK, Greenstein P. Functional contouring of the palatal vault for improving speech with complete denture. J Prosthet Dent 48: 640-646, 1982.
– reference: 9) 西村亮介. X線テレビ映画による嚥下時の舌背の位置の変化に関する研究2. 正中矢状面上の舌背粘膜上の各点の位置の変化. 歯科学報77: 629-659, 1977.
– reference: 12) 小島千枝子. 摂食嚥下機能の減退 (高齢者) への対応.金子芳洋, 千野直一監修, 摂食嚥下リハビリテーション193-195, 東京: 医歯薬出版, 1998.
– reference: 11) 山縣健佑. 義歯と発音無歯顎臨床でのポイント35-62, 東京: 口腔保健協会, 1997.
– reference: 20) Francis WS, Robert AK. Phonetics and swallowing to determine palatal contour of denture. J Prosthet Dent 28: 360-362, 1972.
– reference: 18) 山田好秋. よくわかる摂食・嚥下のしくみ88-93, 東京: 医歯薬出版, 1999.
– reference: 21) Shimodaira K, Yoshida H, Kanazawa T. Palatal augmentation prosthesis with alternative palatal vaults for speech and swallowing: A clinical report. J Prosthet Dent 80: 1-3, 1998.
– reference: 13) 森田啓一. 正常者のパラトグラム. 口病誌34: 279-309, 1967.
– reference: 23) Palmer JB, Nathan JR, Gustavo L et al. Coordination of mastication and swallowing. Dysphagia 7: 187-200, 2000.
– reference: 1) 佐々木啓一, 根津雄一. 在宅高齢者における歯科補綴の位置づけ. 河野正司, 渡辺誠編, 補綴臨床別冊/エイジングと歯科補綴120-130, 東京: 医歯薬出版, 1999.
– reference: 15) 谷口秀和. 歯列を含むパラトグラムの画像処理による標準形態. 補綴誌33: 626-638, 1989.
– reference: 17) Palmer JB, Hiiemae KM. Ingestion of oral and pharyngeal bolus propulsion;A new model for the physiology of swallowing. Jpn J Dysphagia Rehabil 1: 15-30, 1997.
– reference: 2) 藤島一郎. 脳卒中の摂食嚥下障害第2版1-18, 東京: 医歯薬出版, 2000.
– reference: 3) 本多知行. 医師・歯科医師のなすべきこと. 本多知行, 溝尻源太郎編, 医師・歯科医師のための摂食嚥下障害ハンドブック12-16, 東京: 医歯薬出版, 2000.
– reference: 7) Ardran GM, Kemp FH. The mechanism of swallowing. Proc R Soc Med 44: 1038-1040, 1951.
– reference: 22) Feinberg MJ, Ekberg O. Videofluoroscopy in elderly patients with aspiration: Importance of evaluation both oral and pharyngeal stages of deglutition. Am J Roentgenol 156: 293-296, 1991.
– reference: 5) 才藤栄一. 個人の摂食能力に応じた味わいのある食事内容・指導等に関する研究, 摂食機能減退の診断法の開発37-58平成8年度厚生省・健康政策調査研究事業分担研究報告書 (主任研究者: 金子芳洋), 1997.
– reference: 16) 加藤一誠, 河野正司, 岩片信吾ほか. X線テレビによる顎機能運動撮影時の頭部被曝量に関して. 新潟歯学会誌25: 27-34, 1995.
– reference: 10) 戸村嘉明. X線テレビ映画による咀嚼時の舌運動について1. 矢状方向からの観察. 歯科学報79: 2271-2303, 1979.
– reference: 6) Joseph Murray MA (道健一, 道脇幸博). Manual of dysphagia assessment in adult (摂食・嚥下機能評価マニュアル医療面接から訓練計画立案まで48-49, 東京: 医歯薬出版, 2001), 1999.
– reference: 14) 伊藤秀美. 電気的パラトグラフによる舌の調音と口蓋形態に関する基礎的研究-単音節について-. 補綴誌22: 580-598, 1978.
– reference: 8) 西村亮介. X線テレビ映画による嚥下時の舌背の位置の変化に関する研究1. 正中矢状面上の舌背粘膜上の各点の位置の変化. 歯科学報77: 263-309, 1977.
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Snippet Purpose: Many dysphagic patients show impaired tongue movements. In such patients, we evaluated a diagnostic method for tongue motor function by a palatogram...
SourceID jstage
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StartPage 135
SubjectTerms dysphagia
palatal augmentation prosthesis
palatogram
videofluorography
Title Treatment of Dysphagic Patients with a Palatal Augmentation Prosthesis Based on a Tongue Movement Function Diagnosis Method by Palatography
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