Videogestützte dynamische B-Mode-Sonographie der Zungenfunktion während des Schluckens

Abstract

A dynamic B-mode ultrasound technique supported by video recording was employed on 51 patients between the ages of six and 45 years for the purpose of imaging the tongue at rest and in motion during swallowing. All patients either in their case histories or at clinical examination demonstrated orofacial dysfunction of the tongue or an abnormal oral phase during swallowing. The ultrasound sequences of a 5 MHz sector scanner (100 degrees, 30 images/sec) were videotaped for the purpose of analyzing the sagittal and vertical movement components during swallowing. The sagittal sector scan revealed a visceral swallowing pattern in 21 patients. Noticeably often patients with an Angle class III malocclusion also displayed an abnormal swallowing pattern. Ultrasound scanning in the coronal and sagittal plane is a noninvasive imaging technique free of the biological risks associated with radiation. The dynamic ultrasound technique may be employed for early detection and diagnosis of tongue discoordinations and is especially to be recommended for the objective imaging and identification of tongue thrust in orthodontic patients.

B-mode and M-mode Ultrasonography of Tongue Movements during Swallowing

“…The midsagittal plane was chosen as the scanning plane for the B-mode imaging in this study, as in similar trials [8,9,[21][22][23][24][25][26].…”

“…According to Fuhrmann & Diedrich [8,9] visceral swallowing is present if the shovel phase at the start of swallowing is absent in the B-mode sequence. In this study we observed that each subject had different variants of the initial movement [6].…”

“…Swallowing movements during which the middle tongue did not detach itself from the palate between swallowing acts were followed by a swallowing movement from this existing tongue-palate contact without the tongue's shovel or upward movement at the start of swallowing. When the examiner asks the subject to move the tongue away from the palate, as Stone & Shawker [36] did, or has the subject drink water between swallowing acts, as in the study by Fuhrmann & Diedrich [8,9] and Peng [24] and Peng et al [25,26], not all five movement variants of the initial phase may be observed.…”

“…According to several studies, qualitative differences between physiological and incorrect swallowing can be observed in a two-dimensional sagittal sectional scan (B-mode ultrasound): in the literature, a defective shovel movement or a delayed upward movement at the start of the swallowing act, as well as additional sagittal movements or increased contraction waves, have been described in visceral swallowers [8,9,16,40].…”

“…Qualitative Unterschiede zwischen physiologischem und fehlerhaftem Schlucken lassen sich laut mehreren Untersuchungen im zweidimensionalen sagittalen Schnittbild (sonographische B-Mode-Darstellung) beobachten: In der Literatur werden eine fehlende Aufschaufelbewegung oder eine verzögerte Aufwärtsbewegung zu Beginn des Schluckakts sowie zusätzliche sagittale Bewegungen oder vermehrte Kontraktionswellen bei viszeral schluckenden Probanden beschrieben [8,9,16,40].…”