• 대한치과의사협회지
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• 제56권5호
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• pp.287-295
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• 2018

Eating-swallowing disorder (dysphagia) is a very important functional problem for the elderly, and it has a significant impact on the quality of their life. Because the eating and swallowing processes are affected by oral tissues including teeth, tongue, and oral muscles, it is natural that the dentist as a specialist in oro-facial region, intervenes in the diagnosis and treatment of the disorder. Nevertheless, Korean dentists still lack interest and understanding of dysphagia. In aged society, it is necessary that the dentists understand the functional disorders as well as oral diseases. The purpose of this study is to introduce the evaluation and treatment methods of eating and swallowing functional disorders in order to cope with eating-swallowing disordered patients who are frequently encountered in aged society.

• 대한기관식도과학회지
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• 제7권2호
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• pp.112-115
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• 2001

• 치위생과학회지
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• 제23권2호
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• pp.69-87
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• 2023

Background: Swallowing function deterioration is a common problem experienced by older adults worldwide. Many studies have been conducted to improve swallowing function in older adults; however, due to differences in intervention methods and study designs, it is difficult to draw a common conclusion. This study aimed to analyze trends and intervention methods in studies of swallowing function intervention for older adults conducted from 2010 to 2022, to establish a systematic approach for developing interventions to improve swallowing function in older adults and to provide evidence for this approach. Methods: Literature research was conducted for studies published between 2010 and 2022 that applied to swallow function interventions to adults aged 60 years or older. Databases including PubMed, Medline, RISS, Science On, KISS, and KCI were used. From a total of 1,164 articles searched using keywords, 20 articles were selected for final analysis. Results: The number of published articles steadily increased over time, and the intervention period was most commonly 6 or 8 weeks. The types of interventions included focused exercises to improve oral muscle strength in 12 articles and programs incorporating education, practice, and expert management in 8 articles. Among the focused exercises, tongue-strengthening exercises were most common in 4 articles. The evaluation variables for intervention effects were muscle strength evaluation, oral function evaluation, quality of life, and oral health and hygiene status. Muscle strength and oral function evaluations were statistically significant in focused exercise interventions, while the quality of life and oral health and hygiene status was significant in program interventions. Conclusion: This literature review is meaningful as a study that can be used to select the intervention period and program contents when planning an elderly swallowing intervention program.

• Journal of Yeungnam Medical Science
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• 제22권2호
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• pp.247-252
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• 2005

Tongue tumors of pediatric patients are the most common soft tissue tumor of pediatric oral and maxillofacial tumors. There are many kind of pediatric tongue lesions such as hemangioma, lymphangioma, papilloma, and cyst. Most of these lesions are benign, but malignant tumors of tongue may be occurred. Therefore, malignancy should be ruled out. Sometimes, tongue lesions are present with dyspnea, dysphagia, dysarthria, bleeding, or cosmetic problem. We experienced a case of chronic inflammatory mass on posterior 1/3 of the tongue in 4 month old female patient. Swallowing difficulty and respiratory distress symptom occurred because of tongue mass effect. The tongue mass was confirmed as granulation tissue by microscopic examination. After excision of tongue mass, she had no problem with swallowing and breathing.

• 재활치료과학
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• 제11권1호
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• pp.21-33
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• 2022

목적 : 본 연구는 치매환자의 삼킴장애 중재에 대한 체계적 고찰을 통해 치매환자의 특성에 따른 중재접근법과 효과에 대한 과학적 근거를 마련하고자 하였다. 연구방법 : 주요 검색 데이터베이스로 CINAHL, Cochrane CENTRAL, PsycINFO, PubMed, Science Direct를 사용하였으며 2010년 1월부터 2020년 5월까지 발표된 문헌을 수집하였다. 검색어는'Dementia', 'Alzheimer disease', 'Deglutition disorder', 'Swallowing disorder', 'Dysphagia'를 사용하였으며 최종 5편의 문헌을 선정하였다. 결과 : 중등도-중증 환자를 대상으로 한 연구가 1편, 중증 환자를 대상으로 한 연구가 4편 포함되었다. 중재 유형은 교정적 중재가 1편, 보상적 중재가 3편, 포괄적 중재가 1편이었다. 중등도-중증 환자를 대상으로 행동 및 심리관리를 포함한 보상적 중재가 사용되었다. 중증 환자를 대상으로는 경관식이에 대한 교정적, 보상적 중재 및 다학제적 중재를 포함한 포괄적 중재가 사용되었다. 각각의 연구에서 사용한 모든 중재 방법은 삼킴능력과 관련된 결과변수에 긍정적인 영향을 끼쳤다. 결론 : 본 연구에서는 치매환자의 진행단계에 따라 중재의 목적과 중재 요소가 달라지는 것을 확인하였다. 따라서 치매환자의 삼킴장애 중재는 치매환자의 진행단계를 고려하여 개인화된 중재를 시행했을 때 더욱 효과적임을 확인하였다. 이러한 결과는 치매환자의 삼킴장애를 위한 효과적 중재 설계에 방향을 제시해 줄 수 있을 것으로 사료된다.

• 대한기관식도과학회지
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• 제8권1호
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• pp.42-49
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• 2002

Backgroud and Objectives : Supracricoid partial laryngectomy(SCPL) has showed good functional and oncological results since it was introduced by Laccourreye in 1990. But loss of laryngeal functions, especially glottic sphincteric one, due to a wide resection of laryngeal structures is a major problem and needs a active and effective rehabilitation postperatively. Modified barium swallow(MBS) is a videofluoroscopy designed to define the etiology of the aspiration or dysphagia and simultaneously provide the therapeutic and rehabilitative method eliminating etiology of the aspiration. And we examined the effectiveness of the MBS in swallowing rehabilitation of the SCPL Patients. Materials and Methods : We reviewed the medical records of the 52 Patients who received SCPL for laryngeal squamous cell carcinoma according to the description of Laccourreye in our clinic from 1993 to 2001. Among them 21 patients were performed MBS(MBS(+) group) postoperatively and remaining 31 were not(MBS(-) group). During MBS, we selected 12 patients who showed aspiration and trained them with a swallowing rehabilitation maneuver which was identified as the most effective one eliminating the aspiration and remaining nine without aspiration were able to feed orally immediately after MBS without rehabilitation. In MBS(-) Uoup, they were received the traditional rehabilitation training with a supraglottic swallow. Results : The mean postoperative day(POD) of decannulation was earlier in MBS(+) group ($12.6{\pm}4.7$ POD) than in MBS(-) group ($19.5{\pm}11.0$ POD) (p =0.012), especially in patients showing aspiration (MBS(+) ; $12.9{\pm}5.2$ POD, MBS(-) : $22.3{\pm}9.9$ POD (p =0.008)). No significant difference was found in the mean POD of oral feeding between MBS(+) and (-) group, but in patients showing aspiration the time of oral feeding was earlier in MBS(+) group than in MBS(-) by average 10 days though it was not statistically significant. The incidence of aspiration pneumonia was lower in MBS(+) group (1/12cases) than in MBS(-) (7/12cases). Conclusions : In SCPL Patients, the Swallowing rehabilitation introduced to eliminate the aspiration during MBS after SCPL is very helpful for some patients to resume the safe oral intake more rapidly.

• 대한소아치과학회지
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• 제23권3호
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• pp.697-705
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• 1996

Ankyloglossia, or tongue-tie, is a congenital condition which occurs as a result of fusion between the tongue and the floor of the mouth. Ankyloglossia often results in malocclusion with an anterior "open bite" deformity, early prognathism, swallowing problem, speech disorder, and periodontal problem. Generally lingual frenectomy is used for treatment of ankyloglossia, but incomplete operation and simple frenectomy may produce a scar contracture resulting in a more deformed ankyloglossia than was present initially. The Z-plasty is used for the correction of scar contractures and the replacement of missing tissue and this procedure is ideally suited for the treatment of an ankylosed frenum. Most authors advise postponement of any decision for surgical correction of tongue-tie until the age of 4 years, unless the child is having much difficulty with sucking or swallowing. We treated 4 patients with ankyloglossia using Z-plasty technique. As a result, we found out that it was effective for correction of movement limitation of tongue, prevention of relapse. Further, periodic check ups are needed for evaluation of relapse, improvement of speech, and other functions of the tongue.

• Archives of Plastic Surgery
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• 제33권2호
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• pp.161-167
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• 2006

After total glossectomy, recovery of swallowing and speech function can greatly improve quality of life. The reconstructed tongue must be thick enough to contact with the hard palate for articulation. If the free flap is denervation, it may procede to have atrophy postoperatively. Therefor it is difficult to maintain the tongue volume for a long period of time. To resolve this problem, we have used a innervated rectus abdominis musculocutaneous flap and maintaining the volume through a neurorrhaphy. 7 patients underwent immediate reconstruction using a reinnervated rectus abdominis musculocutaneous free flap in which included intercostal nerve was anastomosed to the remaining hypoglossal nerve. The reinnervated rectus abdominis musculocutaneous free flap has provided good tongue contour with sufficient bulk and shown no obvious atrophy in all patients even though postoperative 9 months later. Considering swallowing and articulation, we concluded that reinnervated rectus abdominis musculocutaneous flap is a viable method after total glossectomy

• 말소리와 음성과학
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• 제2권2호
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• pp.79-83
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• 2010

As bolus enters the pharynx during the swallow, laryngeal closure takes place by approximating the epiglottis to the arytenoid Laryngeal Closure Duration(LCD) is the duration of contact between the arytenoids and the epiglottis from the first contact to the last(Logemann et al, 2000). Epiglottic inversion continues pharyngeal swallow stage is completed in order to protect the airway. The purpose of this study is to measure layrngeal closure duration (LCD) in three groups of subjects: a) 10 stroke patients who aspirate before and during the swallow(aspirators), b) 10 stroke patients who do not aspirate during the swallow c)10 normal control subjects. Means and standard deviation of LCD was analyzed in both 5ml and 10 ml thin liquids using 100msec timer in videoflouroscopic swallowing examination. The mean for each group was 0.15 seconds shorter from aspirators to control group. There was a significant difference between aspirators and normal subjects for laryngeal closure duration during the swallow. Laryngeal closure duration after a stroke lead to aspiration. However, only one of this temporal problem may not be enough to aspiration.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제30권5호
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• pp.437-446
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• 2008

Electroglottography (EGG) is a simple and non-invasive technique for analyzing the vibratory patterns of the vocal folds by detecting impedance changes across the larynx. An abnormal electroglottogram is shown in patients who have a dysphagia associated with neuromuscular disorder. Electroglottography offers reliable informations for diagnosis of swallowing disorder and gives quantitative datas. The purpose of this study is to provide the normal value of electroglottography in normal adults. We took electroglottograms of 80 adults who have no problem in swallowing and utterance. EGG data were analyzed to find out the value of Pitch, Jitter and Closed quotient with a commercially available software. There were significant differences between a usual voice and loud voice in 3 measures on the EGG signalmean pitch, Avg. jitter, mean quotient. To get a proper electroglottography, phonation of a usual voice was better than a loud voice. Four measurements- S.D pitch, Avg. Jitter, Mean closed quotient, S.D closed quotient- were independent of sex for adult. Three measurements- Mean pitch, S.D pitch, Mean closed quotient - were independent of age for adult aged twenties to fifties. The Avg. Jitter of twenties appeared to be lower than those of forties and fifties. The S.D closed quotient of twenties appeared to be lower than those of thirties, forties and fifties.