INTERNATIONAL JOURNAL OF OROFACIAL MYOLOGY

Editorial Staff
Patricia Taylor M.Ed.
Editor-in-Chief
Bloomburg, Pennsylvania
Lynda Smalec, RDH.,
Managing Editor
South Eligin, Illinois

Associate Editors

Angela Dikendil, MS, Peer Review Board/Finance
Robert Grider,MA, Circulation
Samantha Shotwell, Student Review
Dianne Lazer,MA, Peer Review Board.
Patricia Meyer,MA, COM, Peer Review Board
Jayanti Ray, Ph.D. Peer Review Board
Monique Kaye, MS, Peer Review Board/Subscriptions
Robert M. Mason, DMD,Ph.D., Peer Review Board
Betty Jo Morris, Editorial Review
Joseph B. Zimmerman, M.Ed., COM, Peer Review Board/Editorial Review

THE INTERNATIONAL JOURNAL OF OROFACIAL MYOLOGY

30th ANNIVERSARY EDITION

Volume XXX
November 2004

ASSESSMENT OF TONGUE WEAKNESS AND FATIGUE

Nancy Pearl Solomon, Ph.D., CCC-SLP

ABSTRACT

Assessment of nonspeech tongue function is common in speech-language pathology. This paper reviews techniques used to determine tongue strength and endurance, and describes a constant-effort task. These techniques are intended to reveal and quantify the presence of weakness or fatigue of the tongue. The consequences of performing these tasks with and without a bite block, used to fix jaw position, are considered. Whether nonspeech tongue impairment is associated with speech dysfunction in Parkinson's disease is another topic of interest. Past studies indicated reduced tongue strength and endurance in Parkinson's disease, but these measures did not correlate with speech measures. It was hypothesized that weakness and fatigue need to be impaired to a "critical" level before speech is perceptibly affected. To examine whether experimentally induced tongue fatigue affects speech, normal speakers performed prolonged strenuous tongue exercise. Speech deteriorated following these exercises. A new investigation examines whether 1 hour of speech like tongue exercise (rapid syllable repetitions) affects dysarthric speech. Preliminary data from 6 participants with Parkinson's disease, 1 person with bulbar ALS, and 6 neurologically normal control subjects indicate that sentences sound more precise but less natural after the exercises. Surprisingly, results did not differ significantly between the groups. Continued collection of data and refinement of tasks will contribute to our understanding of the potential relations between weakness, fatique, and speech.

KEY WORDS: Tongue strength, Endurance, Effort, Bite blocks, Parkinson's Disease, Disarrays

THE ROLE OF ANIMAL MODELS IN UNDERSTANDING FEEDING BEHAVIOR IN INFANTS

R.Z. German Ph.D.,
A.W. Crompton, D.Sc., Ph.D., A.J. Thexton, Ph.D.

ABSTRACT
The common evolutionary history humans share with mammals provides us with a
solid basis for understanding normal oropharyngeal anatomy and functions. Physiologically, feeding is a cycle of neurophysiologic activity, where sensory inputs travels to the CNS which sends motor signals out to the periphery. Research with animal models is valuable because it is possible to disrupt this cycle, and develop predictive models on the casual basis of deviation from normal. Based on work with animal models, normal mammalian infant feeding behavior consists of the tongue functioning as a pump. First, the tongue assists in acquisition of milk from the nipple into the oral cavity into the valleculae prior to the pharyngeal swallow. Starting with this basic, feeding in infant pigs was manipulated to determine the impact of variation in sensory input on behavioral output. One set of experiments suggested that chemo-or liquid sensation, in the form of milk is necessary to elicit continuing rhythmic activity. However, rates of rhythmic sucking are intrinsic to an animal, and variation in the rate cannot be entrained. Another set showed that initiation of the swallow does not purely depend on the volume of milk delivered, but also on the sensory stimulation at the mouth. These results support the idea that feeding behavior involves complex sensory integration.

KEY WORDS: Animal models, Feeding behavior, infant

LINGUAL FRENULUM:
CLASSIFICATION AND SPEECH INTERFERENCE

Irene Queiroz Marchesan PhD.,SLP

EVALUATION OF A NEW CONCEPT OF MYOFUNCTIONAL THERAPY IN CHILDREN

Heike M. Kormacher, Dr. med, Marco Schwan. Sabine Berndsen, JuliaBull, Dr.med dent, Kahl-Nieke, Dr. med dent, Ph.D

ABSTRACT

This prospective study was designed to evaluate a new concept of myofunctional therapy in comparison with conventional myofunctional therapy. 45 children aged three to sixteen years of age in need of myofuctional therapy were randomly divided into two groups: 19 children were referred to myofunctional therapy in private practices in Hamburg and served as controls. The remaining 26 children were treated with face former therapy at the Department of Orthodontics by a medical assistant specializing in myofunctional therapy.The overall observation time was six months. Every three months an overall clinical assessment was performed at the Department of Othodontics by a speech pathologist and an orthodontist, who documented the clinical situation. The clinical examination included measurement of lip strength, palatography to document the swallowing pattern, logopedic diagnosis, and an orthodontic evaluation with a reference to a standardized diagostic sheet. In all the children's orofacial functions could be improved. Children treated with the Face Former showed a statistically significantly improvement in the palatal tongue position during swallowing. They achieved stronger lip pressure within a shorter time than children who did not use the Face Former. However, at the end of the observation time there was no statistically significant difference in lip strength between the two groups. Habitual mouth closure was also achieved within a shorter time with children treated with the Face Former than children with myofunctional therapy. Longitudinal studies will follow to judge whether the established orofacial balance could be stabilized, i.e. the established physiological orofacial function becomes automatic.

KEYWORDS: Myofunctional Therapy; Face Former; Swallowing pattern; Mouth breathing; Stigmatis

DISTRIBUTION OF CAUSES AND TREATMENTS OF DYSPHAGIA AT DYSPHASIA/DYSPHAGIA REHABILITATION CLINIC OF SHOWA UNIVERSITY DENTAL HOSPITAL:
1999-2002

Fumiyo Tamura, D.D.S.,Ph.D., Rika Ayano, D.D.S.,Ph.D.Hiroyuki Haishima, D.D.S., Ryo Ishida, D.D.S.,Ph.D.

ABSTRACT

The purpose of this study was to investigate the distribution of causes of dysphagia and the types of treatments being provided at the Dysphasia/Dysphagia Rehabilitation Clinic of Showa University Dental Hospital. The subjects included 173 dysphagic patients. Fifty-three percent of the patients ranged 0-12 years of age, and 24% of them were over 60 years old. The survey results showed that diseases of the central nervous, such as cerebral palsy(CP), was a major diagnosis in young patients, and cerebrovascular accident (CVA) was a predominant cause in adult and elderly patients. Diagnosis distribution showed that swallowing dysfunction was the most frequent diagnosis for patients on their first visit when compared to other feeding dysfunctions including malfunction of lips, tongue, and mastication. Almost 40% of patients still continue to have rehabilitation for their dysphagic symptoms at the end of March 2002. This suggests that dysphagia rehabilitation is needed for many disabled individuals.

KEYWORDS: Swallowaid; Elderly; Swallowing dysfunction

EARLY LINGUAL FRENECTOMY ASSISTED BY CO2 LASER HELPS PREVENTION AND TREATMENT OF FUNCTIONAL ALTERATIONS CAUSED BY ANKYLOGLOSSIA.

Renata C. Fiorotti, MSc, Milene M. Bertolini, MSc
Jorge H. Nicola, PhD, Ester M.D. Nicola, Ph.D.

ABSTRACT

Incorrectly produced speech sounds, the presence of dentofacial alterations and acquired functional adaptations may be due to a short and inadequate lingual frenum. When frenectomy is indicated, it should be performed as early as possible to prevent functional alterations. This study presents a literature review on correct lingual positioning in relation to orthodontic and phonetic function as well as an assessment of 15 patients who underwent frenectomy utilizing the carbon dioxide laser. The results demonstrated that this technique is safe, effective and perfect for use in young children and can be performed in an out patient unit.

KEYWORD: Frenectomy, Ankyloglossia, Carbon dioxide Laser

QUESTIONNAIRE:
IAOM'S ROLE IN WORLD WIDE TREATMENT
OF HANDICAPPED PATIENTS

Dr. Stefano, Dr.ssa Roberta D'Avenia, Patricia Taylor, M.Ed. For additional information, please contact Patricia Taylor at taylor2@intergrafix.net