Article

While the presence of dysphagia following partial glossectomy has been
widely reported, there is insufficient quality evidence to guide clinical
decision making about the treatment of this disorder.
This study investigated a
novel dysphagia rehabilitation approach using ultrasound tongue imaging for
patient training. METHOD: Initially, a pilot study was conducted to investigate
the feasibility of ultrasound visual feedback during swallow tasks. The protocol
was then replicated using a single-case experimental designed study to
investigate therapeutic effect. Swallow, speech, and oromotor functions were
measured across multiple baselines using an A-B-A intervention study design.
RESULTS: During intervention, both participants were able to interpret ultrasound
tongue images during swallow tasks. Following intervention, positive therapeutic
effect was achieved with reduced frequency of aspiration and self-initiated
swallow strategies. Generalization of intervention was evidenced by reduced bolus
transit duration on videofluoroscopy and improved functional oral intake scores.
Speech and oromotor functions remained stable throughout the study demonstrating
experimental control. CONCLUSIONS: This study establishes that ultrasound visual
feedback is feasible in dysphagia rehabilitation following partial glossectomy.
In addition, the predicted therapeutic effect specifically to swallow but not
speech or oromotor functions were demonstrated. Implications for Rehabilitation
Partial glossectomy results in altered tongue shape, movement, and function which
negatively impact on speech and swallowing There is limited research evidence to
support previously used speech pathology interventions (in particular, tongue
range of movement exercises) to rehabilitate dysphagia following tongue cancer
surgery The tongue, and hence oral phase of swallowing, can be viewed by placing
an ultrasound probe under the chin Ultrasound scanning of the tongue is not
invasive, can be repeated without dosage side effect. It's also comfortable for
the patient and if a portable probe and monitor are used, can be performed within
a variety of clinical settings for assessment or therapy This study shows
specific therapeutic benefit following ultrasound visual feedback along with a
motor learning approach to rehabilitate swallow function following partial
glossectomy Visual and verbal feedback that focus specifically on the motor
movements undergoing adaptation (e.g., tongue wave movement, tongue elevation,
bolus clearance) following partial glossectomy are recommended Patients who are
able to see the ultrasound monitor, hear the feedback given, are cognitively able
to self-evaluate tongue movement, and remember intervention goals will most
benefit from ultrasound tongue visual feedback in therapy Clinicians also benefit
from visualizing the tongue with ultrasound during assessment and therapy as a
direct view reduces the subjectivity of rating task performance.

Langue : ANGLAIS