Effect of Tongue-Hold Swallow on Pharyngeal Contractile Properties in Healthy Individuals

Yoichiro Aoyagi,Shiori Ando,Miho Ohashi,Eiichi Saitoh,Sayuri Imaeda,Yoko Matsuura,Yoko Inamoto,Keiko Aihara

doi:10.1007/s00455-020-10217-9

Yoichiro Aoyagi, Shiori Ando + Show 6 more

Open Access

https://doi.org/10.1007/s00455-020-10217-9

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Abstract

Tongue-hold swallow (THS) is a swallow exercise in which an individual swallows saliva while holding the anterior portion of the tongue between the front teeth. The effect of THS on pharyngeal contractile vigor is still unclear. The purpose of this study was to quantify THS using high-resolution manometry with a contractile integral analysis. Twenty-two healthy participants performed three different saliva swallow tasks: normal swallow, weak THS (in which the tongue was protruded 1 cm outside the upper incisors), and strong THS (in which the tongue was protruded 2 cm outside the upper incisors). The participants repeated each task twice randomly. Pharyngeal and upper esophageal sphincter metrics, including the pharyngeal contractile integral, were analyzed. Both weak and strong THS enhanced the velopharyngeal contractile integral and peak pressure compared with normal swallow (P < 0.01). THS also prolonged mesopharyngeal contraction (P < 0.01). Holding the tongue anteriorly during swallow requires significant biomechanical changes to pharyngeal contractile properties at the superior and middle pharyngeal constrictor levels; thus, it may serve as a resistance exercise for the muscles that are involved in bolus propulsion.

Highlights

Tongue-hold swallow (THS), which is referred to as tongue-hold maneuver/Masako maneuver, is a saliva swallowing exercise that was proposed by Fujiu et al [1, 2]
THS enhanced the velopharyngeal contractile vigor, which was in accordance with our hypothesis
Fibers of the superior pharyngeal constrictor muscle connect with fibers of the posterior portion of the transverse lingual muscle and form a ring of muscle [32]

Summary

Introduction

Tongue-hold swallow (THS), which is referred to as tongue-hold maneuver/Masako maneuver, is a saliva swallowing exercise that was proposed by Fujiu et al [1, 2]. In THS, a patient swallows saliva while holding the anterior portion of the tongue between the front teeth. THS focuses on pharyngeal contraction by physiologically increasing the anterior movement of the pharyngeal musculature, contributing to improved contact between the tongue base and the posterior pharyngeal wall during the pharyngeal stage of swallowing [1]. After the early reports by Fujiu et al using VF, in which anterior bulging of the posterior pharyngeal wall increases by THS [1, 2], few studies have reported the effect of the THS on structural movements during swallowing [3, 4]. A study that used electromyography suggested that the magnitude and duration of submental, genioglossus, and superior pharyngeal constrictor muscle activity increased during THS [5]. The duration of tongue pressure generation increased in the posterior circumferential parts of the hard palate during this exercise [6, 7]

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