Surface Sensibility of the Floor of the Mouth and Tongue in Healthy Controls and in Radiated Patients

Abstract

Increased areas of anesthesia in the oral cavity have been shown to significantly impair oral function in normal individuals. In patients who undergo oral cavity reconstruction, loss of sensation plays a major role in producing disturbances in postoperative oral function. Free tissue transfer techniques have permitted the problem of sensory loss to be addressed through the use of sensate cutaneous free flaps, in which microneural anastomoses are performed between a sensory nerve supplying the flap and a recipient nerve in the head and neck. To critically assess the results of such reconstructions, the effect of sensory restoration on oral cavity rehabilitation must be studied. As a first step toward this goal, normal values for sensory discrimination of the floor of mouth and tongue are needed. Previous studies of oral sensation failed to examine the ventral tongue and floor of mouth. The purpose of this study is to determine the surface sensibility of these regions in healthy patients and in patients who received radiation therapy to the oral cavity. Sensation was evaluated using static and moving two-point discrimination in 90 healthy subjects divided equally into three age groups: 20 to 40 years, 41 to 60 years, and 61 to 80 years. In addition, 20 patients who received radiation therapy were studied. The mucosa of the dorsal and ventral aspects of the lateral tongue, tongue tip, and floor of mouth was examined. The tongue tip is the most sensitive area, followed by the dorsal lateral tongue, ventral lateral tongue, and floor of mouth. The effects of age and radiation therapy on sensory discrimination are discussed.(ABSTRACT TRUNCATED AT 250 WORDS)

Sensory recovery of noninnervated free flap in oral and oropharyngeal reconstruction

“…Many authors have reported reduced, delayed or failed sensory recovery in radiated patients 1,4,15 . A tendency for better sensory recovery of the flaps is believed to occur in younger age patients 1,5,16 and in non-smokers 5 .…”

A comparison of masticatory function in patients with or without reconstruction of the mandible

“…This variability is due to the individual variation in tongue volume, tongue sensation, and tongue mobility. Tongue volume, 19 sensation, 3,20 and mobility 3,21 have been considered important to masticatory function, yet a systematic investigation of head and neck cancer patients that specifically assesses tongue function Normals had significantly higher molar and incisal biting force than did both reconstructed and nonreconstructed patients (p < .001). Significant differences were seen between all three groups with regard to tongue function (p < .002).…”

Effects of Oropharyngeal Air-Pulse Stimulation on Swallowing in Healthy Older Adults

“…Subtle age-related alterations in sensation and physiologic function have been reported in the absence of underlying disease processes [21]. For example, declines in sensation have been reported for vibratory, gustatory, and tactile stimuli at various sites in the oral cavity, such as the tongue, floor of the mouth, and hard palate [22][23][24][25][26][27][28][29], and in the laryngopharynx [5]. In contrast, age-stable responses have been demonstrated in response to thermal [23,29] and somatic stimulation of the oral cavity [23,25,30].…”

“…Diminution in sensitivity to vibrotactile stimulation of the lower lip and tongue has been demonstrated [23,24,28], and agerelated decrements in sensation have been reported for oral stereognosis tasks [23,29] and punctate pressure applications [29]. Using two-point discrimination tasks, sensitivity appears to be age-stable at anterior lingual sites [22,23,25] but prone to age-related change at distal lingual areas and the floor of the mouth [22]. Several studies have used air puffs as a somatic stimulus in sensitivity testing.…”