If the home-made cushioning appliance presented here is placed during ultrasonic examinations between the submental region and the probe head, then the problems caused by probe head movement and pressure on the submental region, as have been encountered in the past, can be solved. The use of such a cushioning appliance makes possible a more accurate B-mode ultrasonic evaluation of tongue function. The prevailing method and the cushioning method presented here were studied on 50 test patients. Comparison of the 2 methods revealed that in fact the use of the cushioning method prevented movement in the ultrasonic probe and also its use hardly impaired the patient's ability to swallow. We therefore recommend that this cushioning method be routinely applied during ultrasonic examinations of tongue function.
A 43-year-old white man presented with a 1-year history of lethargy, intermittent arthralgia affecting his hands and knees and a pruritic eruption, starting on his arms and then spreading to his neck and chest. He did not have diabetes. On physical examination, clusters of firm, shiny, translucent papules and small nodules were seen on the patient's cheeks and neck. Above his eyebrows, these papules were arranged in a line and were also prominent at periungual sites. Patches of erythema were present on his neck and torso and xanthelasma were noted bilaterally (Fig. 1). There was no mucosal involvement, lymphadenopathy or organomegaly. Radiography of the hands and knee joints did not reveal any destructive changes, and full body computed tomography did not show any evidence of internal malignancy. Autoimmune screening blood tests gave normal results, while erythrocyte sedimentation rate, uric acid levels and serum electrophoresis were all normal, and human immunodeficiency and hepatitis serology was negative. Serum angiotensin level was raised at 80 U/L (normal range 8-53 U/L) and total cholesterol and triglyceride levels were marginally raised at 5.4 mmol/L and 1.9 mmol/L, respectively (normal ranges < 5.2 mmol/L and 0.4-1.9 mmol/L, respectively). Histopathological findingsA punch biopsy taken from a nodule on the patient's neck showed a circumscribed cluster of mononuclear and multinucleate histiocytes with eosinophilic 'ground-glass' cytoplasm (Fig. 2). The cells were negative for Melan A, S100 and HMB45 but positive for periodic-acid-Schiff (PAS) and CD68.
OBJECTIVES: We sought to apply B- + M-mode ultrasonography in combination with the cushion-scanning technique (CST) in quantitative analysis of tongue movement during vowel articulation. STUDY DESIGN AND SETTING: Twenty normal persons (10 women and 10 men) were enrolled in this study. Each individual was asked to enunciate 5 vowels:/e/, /i/, /al/, /o/, and /ju/. A noninvasive diagnostic technique, computer-assisted B-mode plus M-mode ultrasonography, was used in combination with the CST to assess their tongue movement. The sonographic signals were recorded on a video recorder and then transferred to a personal computer via a frame grabber for digital assessment. RESULTS: M-mode images show an amplitude-time diagram, whereas B-mode images reveal midsagittal tongue configuration. The ranges of tongue movement in midsagittal plane in male speakers during production of the vowels /e/, /i/, /al/, /o/, and /ju/ were 8.29 ± 1.76,4.00 ± 0.78, 13.82 ± 2.86, 14.05 ± 1.63, and 6.72 ± 1.66 mm, respectively; for female speakers, the averages were 7.19 ± 0.92, 3.36 ± 1.31, 12.74 ± 2.16, 12.86 ± 2.18, and 7.11 ± 2.09 mm, respectively. CONCLUSIONS: The computer-assisted B-mode plus M-mode ultrasonography in combination with the CST provides a standardized and quantifiable ultrasonographic examination for the clinical investigation of tongue movement during vowel articulation. In our study group, there was no difference in the thickness of tongue or the range of tongue movement in midsagittal plane during articulation of the selected vowels between males and females. Further exploration can be extended in the field of speech research by this valuable tool.
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