Tongue Pressure During Swallowing in Adults with Down Syndrome and Its Relationship with Palatal Morphology

Abstract

In individuals with Down syndrome, hypotonicity of the tongue and an underdeveloped maxilla may lead to poor oral motor coordination, which adversely affects the oral phase of swallowing. This study aimed to evaluate the characteristics of pressure produced by the tongue against the hard palate during swallowing in individuals with Down syndrome. In addition, the relationship between tongue pressure and palatal morphology was examined. We studied nine adults with Down syndrome and ten healthy adults as controls. Tongue pressure while swallowing 5 mL water was recorded by a sensor sheet system with five measuring points attached to the hard palate. Palatal length, depth, width, curvature, and slope were measured by three-dimensional digital maxillary imaging. The order of onset of tongue pressure on the median line of the hard palate was the same in all participants, except for three with Down syndrome. The duration and maximal magnitude of tongue pressure on the median line in nine participants with Down syndrome were significantly shorter and lower than those of controls. In participants with Down syndrome, significant positive correlations were observed between the duration of tongue pressure at the mid-median part of the hard palate and palatal depth and width, and between the duration and maximal magnitude of tongue pressure at the posterior-median part and palatal length. These findings suggest that impaired tongue activity, poor tongue control, and constrained tongue motion due to a short and narrow palate contribute to swallowing difficulty in individuals with Down syndrome.

Análise qualitativa e quantitativa da deglutição orofaríngea na Síndrome de Down

“…These results corroborate those in the literature, which preconizes that both the anatomical changes and the neuromotor control of swallowing in this population may negatively affect deglutition (3,11) . Posterior oral spillage Presence of premature liquid escape to the hypopharynx, surpassing the region in which pharyngeal response should occur.…”

“…Aspiration of reflux content is common in the pediatric population diagnosed with GER (14) , generating complaints about gagging during feeding, which may be mistaken for oropharyngeal symptoms. However, it is relevant to conduct an objective investigation on swallowing in this population, considering that other studies with larger samples have already demonstrated higher frequency of laryngotracheal aspiration (2,3) .…”

“…Although several previous studies have used VFSE for the qualitative analysis of oropharyngeal swallowing in DS, they investigated variables different from those proposed in this study. These studies fragmented the investigation of dysphagia: some with greater emphasis on the oral phase (3) , others on the pharyngeal phase, highlighting the presence or absence of tracheal aspiration (2) .…”

Influence of Oral Morphology on Speech Production in Subjects Wearing Maxillary Removable Partial Dentures with Major Connectors

“…Despite various reported methods for evaluating the shape of the palate and dental arch, there is no consensus standard [44, 45]. In this study, palate height, narrowing of the dental arch, and the ratio of front area space were regarded as “palate and dental arch parameters,” which could be easily measured on maxillary stone models.…”

Tongue pressure distribution of individual normal occlusions and exploration of related factors

“…It is even associated with diseases like dysphagia, obstructive sleep apnea and malocclusions as well. The measurement of tongue pressure helps to evaluate the performance of tongue in resting state and functional movement, which has been widely applied in clinical research—tongue pressure and masticatory function in dysphagia patients; tongue pressure changes in patients with tongue cancer before and after resection and reconstruction; tongue pressure in adults with Down syndrome; tongue pressure of spinal and bulbar muscular atrophy patients, etc.…”