Pitts Laura L, Stierwalt Julie A G, Hageman Carlin F, LaPointe Leonard L
245 CAC, University of Northern Iowa, Cedar Falls, IA, 50614, USA.
Northwestern University, 400 E. Superior Street, Chicago, IL, 60611, USA.
Dysphagia. 2017 Dec;32(6):759-766. doi: 10.1007/s00455-017-9820-4. Epub 2017 Jul 7.
Tongue strength is routinely evaluated in clinical swallowing evaluations since lingual weakness is an established contributor to dysphagia. Tongue strength may be clinically quantified by the maximum isometric tongue pressure (MIP) generated by the tongue against the palate; however, wide ranges in normal performance remain to be fully explained. Although orthodontic theory has long suggested a relation between lingual function and oral cavity dimensions, little attention has been given to the potential influence of oral and palatal structure(s) on healthy variance in MIP generation. Therefore, anterior and posterior tongue strength measures and oropalatal dimensions were obtained across 147 healthy adults (aged 18-88 years). Age was confirmed as a significant, independent predictor explaining approximately 10.2% of the variance in anterior tongue strength, but not a significant predictor of posterior tongue strength. However, oropalatal dimensions predicted anterior tongue strength with over three times the predictive power of age alone (p < .001). Significant models for anterior tongue strength (R = .457) and posterior tongue strength (R = .283) included a combination of demographic predictors (i.e., age and/or gender) and oropalatal dimensions. Palatal width, estimated tongue volume, and gender were significant predictors of posterior tongue strength (p < .001). Therefore, oropalatal dimensions may warrant consideration when accurately differentiating between pathological lingual weakness and healthy individual difference.
在临床吞咽评估中,舌肌力量通常会被评估,因为舌肌无力是导致吞咽困难的一个既定因素。舌肌力量可以通过舌头抵住上颚产生的最大等长舌压(MIP)在临床上进行量化;然而,正常表现的广泛范围仍有待充分解释。尽管正畸理论长期以来一直认为舌功能与口腔尺寸之间存在关联,但口腔和上颚结构对MIP产生的健康差异的潜在影响却很少受到关注。因此,对147名健康成年人(年龄在18 - 88岁之间)进行了前后舌肌力量测量以及口腔和上颚尺寸测量。年龄被确认为一个显著的独立预测因素,可解释前舌肌力量差异的约10.2%,但不是后舌肌力量的显著预测因素。然而,口腔和上颚尺寸对前舌肌力量的预测能力是年龄单独预测能力的三倍多(p <.001)。前舌肌力量(R = 0.457)和后舌肌力量(R = 0.283)的显著模型包括人口统计学预测因素(即年龄和/或性别)与口腔和上颚尺寸的组合。上颚宽度、估计的舌体积和性别是后舌肌力量的显著预测因素(p <.001)。因此,在准确区分病理性舌肌无力和健康个体差异时,口腔和上颚尺寸可能值得考虑。