Abstract
ABSTRACT Objective: to describe the chewing and swallowing pattern of obese individuals indicated for bariatric surgery/gastroplasty before the procedure, using standardized clinical protocols. Methods: a cross-sectional descriptive case-control study that presents preliminary data for a larger investigation. Eight participants matched for age and sex were divided into two groups (four in the research group and four as controls) and submitted to clinical speech therapy assessment using the “Questionnaire on eating behavior and the anatomofunctional conditions of the stomatognathic system” from the Expanded Protocol of Orofacial Myofunctional Evaluation with Scores (OMES-E) and the maximum tongue pressure test. Results: when compared to controls, participants from the research group exhibited a predominantly unilateral chewing preference; reported that they just “swallowed food”; repeated swallowing of liquid and solid foods, with facial muscle tension; increased cheek volume and the presence of flaccidity; shorter meal and chewing times; increased tension of the lips, mentalis and facial muscles at rest and during swallowing; predominance of insufficient ability with associated movements and/or tremors during lip, tongue, jaw and cheek movements; and lack of knowledge regarding speech therapy. Conclusion: orofacial myofunctional dysfunctions were more frequent in patients from the research group when compared to controls. A need to increase the number of participants in this case series and conduct a post-surgery reassessment, in order to provide a longitudinal description of the chewing and swallowing pattern, was verified.
Highlights
Obesity is a chronic multifactorial disease with high prevalence levels that affects 23% of the adult population in Latin America and the Caribbean, that is, around 140 million people[1].It is often accompanied by metabolic, vascular, respiratory, orthopedic, dermatological and psychological comorbidities, which affect quality of life[2].Pharmacological measures, dietary reeducation and physical exercise have been adopted to tackle obesity, but in some cases may be insufficient to maintain or lose weight, exacerbating feelings of frustration and anxiety in these individuals
The aim of this study is to describe preliminary results regarding the chewing and swallowing pattern of obese individuals indicated for bariatric surgery/gastroplasty, prior to the procedure, using standardized clinical protocols
Chewing and swallowing in bariatric surgery/gastroplasty | 7/10. The results corroborate those reported in the literature for the area[8,9], that patients with class III obesity indicated for bariatric surgery tend to exhibit abnormalities in the structures and functioning of the stomatognathic system
Summary
Obesity is a chronic multifactorial disease with high prevalence levels that affects 23% of the adult population in Latin America and the Caribbean, that is, around 140 million people[1].It is often accompanied by metabolic, vascular, respiratory, orthopedic, dermatological and psychological comorbidities, which affect quality of life[2].Pharmacological measures, dietary reeducation and physical exercise have been adopted to tackle obesity, but in some cases may be insufficient to maintain or lose weight, exacerbating feelings of frustration and anxiety in these individuals. As with all weight loss treatments, bariatric surgery and gastroplasty require monitoring by an inter- or multidisciplinary team, who provide the necessary support to change established habits and adjust to the new physical conditions, psychological impacts and adversities that emerge, in addition to favoring long-term results[3]. Postoperative negative effects such as choking, vomiting, gastroesophageal reflux, sensation of food sticking and swallowing and chewing-related complaints[4] have prompted the inclusion of speech therapists in these teams[3]. Speech therapists monitor patients before and after surgery, providing guidance and assessment as well as preventive and rehabilitative measures relevant to their field, in relation to chewing (mastication) and swallowing (deglutition), which are vital to the eating process[3]
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