Tongue Position Research Articles

Three-dimensional evaluation of the association between tongue position and upper airway morphology in adults: A cross-sectional study.

This study aimed to evaluate the association between low tongue position (LTP) and the volume and dimensions of the nasopharyngeal, retropalatal, retroglossal, and hypopharyngeal segments of the upper airway. A total of 194 subjects, including 91 males and 103 females were divided into a resting tongue position (RTP) group and a LTP group according to their tongue position. Subjects in the LTP group were divided into four subgroups (Q1, Q2, Q3, and Q4) according to the intraoral space volume. The 3D slicer software was used to measure the volume and minimum and average cross-sectional areas of each group. Airway differences between the RTP and LTP groups were analyzed to explore the association between tongue position and the upper airway. No significant differences were found in the airway dimensions between the RTP and LTP groups. For both retropalatal and retroglossal segments, the volume and average cross-sectional area were significantly greater in the patients with extremely low tongue position. Regression analysis showed that the retroglossal airway dimensions were positively correlated with the intraoral space volume and negatively correlated with A point-nasion-B point and palatal plane to mandibular plane. Males generally had larger retroglossal and hypopharyngeal airways than females. Tongue position did not significantly influence upper airway volume or dimensions, except in the extremely LTP subgroup.

Novel tongue-positioning device to reduce tongue motions during radiation therapy for head and neck cancer: Geometric and dosimetric evaluation.

This study aimed to assess the performance of a tongue-positioning device in interfractional tongue position reproducibility by cone-beam computed tomography (CBCT). Fifty-two patients treated with radiation therapy (RT) while using a tongue positioning device were included in the study. All patients were treated with 28 or 30 fractions using the volumetric modulated arc therapy technique. CBCT images were acquired at the 1st, 7th, 11th, 15th, 19th, 23th, and 27th fractions. Tongues on planning computed tomography (pCT) and CBCT images were contoured in the treatment planning system. Geometric differences in the tongue between pCT and CBCT were assessed by the Dice similarity coefficient (DSC) and averaged Hausdorff distance (AHD). Two-dimensional in vivo measurements using radiochromic films were performed in 13 patients once a week during sessions. The planned dose distributions were compared with the measured dose distributions using gamma analysis with criteria of 3%/3 mm. In all patients, the mean DSC at the 1st fraction (pCT versus 1st CBCT) was 0.80 while the mean DSC at the 27th fraction (pCT versus 27th CBCT) was 0.77 with statistical significance (p-value = 0.015). There was no statistically significant difference in DSC between the 1st fraction and any other fraction, except for the 27th fraction. There was statistically significant difference in AHD between the 1st fraction and the 19th, 23th, and 27th fractions (p-value < 0.05). In vivo measurements showed an average gamma passing rate of 90.54%. There was no significant difference between measurements at the 1st week and those at other weeks. The tongue geometry during RT was compared between pCT and CBCT. In conclusion, the novel tongue-positioning device was found to minimize interfractional variations in position and shape of the tongue.

Association between Tongue Posture, Upper Airway and Maxillary Dent alveolar Morphology in Adults with Skeletal Class II Malocclusion: A Case Control Study

Association between Tongue Posture, Upper Airway and Maxillary Dent alveolar Morphology in Adults with Skeletal Class II Malocclusion: A Case Control Study

Strategi produksi bunyi vokal oleh ventrilokuis Indonesia

Ventriloquism or voice magic illusion involves the ability of speakers to control lip and jaw movements to create the impression that sound or speech comes from a puppet being played. This study aims to analyze the strategies used by ventriloquists in producing vowel sounds in Indonesian using the acoustic analysis method (spectrography). Our research data was obtained from three Indonesian ventriloquists who appeared in a video entitled "Moveless Lips Ventriloquism Tutorial (Indonesian Ventriloquist)" on Tenggo Wicaksono's Youtube channel. The data was analyzed using Praat software version 6.2.10 and adopting Instituut voor Perceptie Onderzoek (IPO) design stages. From the analysis of formant 1 and formant 2 on the spectrogram, the three ventriloquists in this study used the same strategy in producing vowel sounds, namely by lowering the tongue position compared to when speaking normally, except for the [a] sound, which requires a higher tongue position. However, regarding horizontal tongue movement, each respondent has a different strategy. Some change the tongue's position forward, while others do it the other way around.

Articulatory and Phonatory Precision When Singing Staccato at Different Speeds

Vocal tract adjustments are important for resonatory modification of the voice and also with respect to interactions concerning the voice source production. It is not clear, however, how fast, separated notes (staccato) influence vocal tract adjustments. Twelve professional singers (four sopranos, three mezzo-sopranos, three tenors, and two baritones/basses) were recorded with dynamic real-time 2D-magnetic resonance imaging (MRI) with 25fps singing a scale in legato and different staccato speeds (60, 120, 180, and 240bps). From the MRI material, the lip opening, jaw opening, jaw protrusion, tongue position, pharynx width, and larynx position were measured. Furthermore, the fundamental frequency was analyzed from the simultaneously recorded audio signal after noise cancellation. The data show only very small differences between the legato and the staccato tasks and no great variations for different staccato speeds. During the pauses in between the staccato notes, minimal vocal tract adjustments were only detectable for the slowest staccato task. There are no great differences in the vocal tract shapes for legato singing in contrast to staccato phonation and no great differences for different staccato speeds.

WHAT ABOUT THIS?: Mouth Breathing and Tongue Position: A Risk Factor for Health

Breathing usually occurs without awareness unless there are problems such as asthma, emphysema, allergies, or viral infections. Infant and child development may affect how we breathe as adults. This article includes discussion of the benefits of nasal breathing, factors that contribute to mouth breathing, how babies’ breastfeeding and chewing decreases the risk of mouth breathing, and recommendations that parents may implement to support healthy development of a wider palate. A link to a video presentation also is included: How the Tongue Informs Healthy (or Unhealthy) Neurocognitive Development, by Karindy Ong, MA, CCC-SLP, CFT.

Anterior open bite treatment using Balters class II bionator: a case report

There are several reasons for the onset of malocclusion, which promotes disharmonious development of the craniofacial structure and may involve various factors such as incorrect positioning of teeth, maxilla, mandible, lips, tongue, and/or cheeks, possibly accompanied by deleterious oral habits. Malocclusion is a common finding that affects facial aesthetics, smile, as well as masticatory and respiratory functions, occurring in a large portion of the world’s population. Hence, a correct and early diagnosis is necessary for malocclusion treatment. There are various available treatments aiming for early correction of malocclusions. This clinical case report will describe a possible treatment for correcting an anterior open bite during the mixed dentition associated with a deleterious oral habit. The Balters’ Bionator is a functional orthopedic dento-muco-supported appliance that harmonizes the muscles of the tongue, lips, and cheeks, and treats skeletal discrepancies. At the end of this orthopedic treatment stage, the patient achieved the objectives of this work and will continue her care in a pediatric dental clinical setting at the Federal University of Amazonas-UFAM for further analysis and additional dentomuco-skeletal corrections.

L2 learners’ pronunciation of English phonetic sounds

Pronouncing English sounds correctly is not an easy task for second language (L2) learners because of the influence of their mother tongue. Empirical studies, based on first language (L1) interference, have investigated L2 learners’ pronunciation problems. However, these studies rarely focused on students’ development in pronunciation, and their results lack validity and reliability because of their mere employment of L2 English teachers as pronunciation assessors. The present study, using the acoustic software Praat as the instrument and taking a native speaker as the comparison, investigated Chinese L2 English learners’ problems and improvement in pronouncing the English sounds that do not have exact counterparts in Chinese. Data analysis revealed that the participants manifested different degrees of pronunciation accuracy with the target English sounds; their mispronunciations of consonants were mainly due to lacking voicing, wrong manners, and wrong places of articulation, while their mispronunciations of vowels were attributed to their improper tongue position, mouth opening, and diphthongization; and that higher-proficiency students tended to have greater pronunciation accuracy. The findings were discussed with reference to the literature, and pedagogical implications were provided at the end.

Effect of maxillary expansion combined with orofacial myofunctional therapy on the position of the tongue of children with mouth breathing

Objective:This study aimed to investigate the change of the position of the tongue before and after combined treatment of maxillary expansion and orofacial myofunctional therapy in children with mouth-breathing and skeletal class Ⅱmalocclusion. Methods:A total of 30 children with skeletal class Ⅱ malocclusion and unobstructed upper airway were selected. The 30 children were divided into mouth-breathing group（n=15） and nasal-breathing group（n=15） and CBCT was taken. The images were measured by Invivo5 software. The measurement results of the tongue position of the two groups were analyzed by independent samples t-test. 15 mouth-breathing children with skeletal class Ⅱ malocclusion were selected for maxillary expansion and orofacial myofunctional therapy. CBCT was taken before and after treatment, the measurements were analyzed by paired sample t test with SPSS 27.0 software package. Results:The measurement of the tongue position of the mouth-breathing and nasal-breathing groups were compared, the differences were statistically significant（P<0.05）. The measurement of the tongue position showed significant difference after the combined treatment of maxillary expansion and orofacial myofunctional therapy in children with mouth-breathing and skeletal class Ⅱmalocclusion（P<0.05）. Conclusion:Skeletal class Ⅱ malocclusion children with mouth-breathing have low tongue posture. The combined treatment of maxillary expansion and orofacial myofunctional therapy can change the position of the tongue.

Korean-speaking Learners’ Production of Mandarin Non-low Back Vowels

Vowels are the main components of Chinese syllables, and in order to produce standard Chinese pronunciation, it is essential to accurately distinguish the pronunciation of vowel variants under different conditions. Korean-speaking learners often struggle with differentiating Chinese non-low back vowels, leading to pronunciation errors. Through Praat speech analysis of formant values for the pronunciation of Chinese non-low back vowels by six participants, Korean L2 Chinese speakers and L1 Chinese speakers’ vowel spaces were compared. It was found that the distinction between /ʅ / and /ɿ / was not very clear, with both vowels overall shifting closer to /i /. In terms of /u / and /o / pronunciation, Korean L2 Chinese speakers differentiated these two vowels mainly based on the value of F2, whereas L1 Chinese speakers primarily distinguished them by the difference in F1 values, indicating variations in tongue height. Furthermore, the F1 and F3 values for /ɣ / were higher for Korean L2 Chinese speakers, suggesting an incorrect interpretation of /ɣ / as a front vowel with slightly higher tongue position, whereas it should align closely with /o / in terms of height.

Impact of orthodontic treatment on speech and phonetics: a review

Orthodontic devices, including both fixed and removable devices, have the potential to impact dental anatomy, the space within the oral cavity, the displacement of the tongue, and the production of speech. The usage of fixed labial appliances may cause transient or persistent speech and phonetics changes, particularly affecting sibilant and stopped sounds. Lingual fixed appliances, while providing aesthetic advantages, can lead to difficulties in maintaining oral hygiene, pain in the tongue, and speech disturbances. Orthodontic retainers, used post-treatment, can also affect speech and phonetics by altering the oral cavity space and tongue position. Other appliances like removable appliances, palatal expanders, and prosthetic dental appliances may also disrupt speech production. Objective, semi-objective, and subjective assessments are utilized to evaluate speech disruptions induced by orthodontic devices. Patients considering orthodontic aligners should be informed about potential temporary limitations in speech production, which can be managed by removing the device when necessary. The adaptation to orthodontic treatment may vary based on individual characteristics. Orthodontists should consider these effects and communicate them to patients. This review article explores the effect of orthodontic treatment on speech and phonetics.

Diagnosis of Obstructive Sleep Apnea Using Feature Selection, Classification Methods, and Data Grouping Based Age, Sex, and Race.

Obstructive sleep apnea (OSA) is a prevalent sleep disorder that affects approximately 3-7% of males and 2-5% of females. In the United States alone, 50-70 million adults suffer from various sleep disorders. OSA is characterized by recurrent episodes of breathing cessation during sleep, thereby leading to adverse effects such as daytime sleepiness, cognitive impairment, and reduced concentration. It also contributes to an increased risk of cardiovascular conditions and adversely impacts patient overall quality of life. As a result, numerous researchers have focused on developing automated detection models to identify OSA and address these limitations effectively and accurately. This study explored the potential benefits of utilizing machine learning methods based on demographic information for diagnosing the OSA syndrome. We gathered a comprehensive dataset from the Torr Sleep Center in Corpus Christi, Texas, USA. The dataset comprises 31 features, including demographic characteristics such as race, age, sex, BMI, Epworth score, M. Friedman tongue position, snoring, and more. We devised a novel process encompassing pre-processing, data grouping, feature selection, and machine learning classification methods to achieve the research objectives. The classification methods employed in this study encompass decision tree (DT), naive Bayes (NB), k-nearest neighbor (kNN), support vector machine (SVM), linear discriminant analysis (LDA), logistic regression (LR), and subspace discriminant (Ensemble) classifiers. Through rigorous experimentation, the results indicated the superior performance of the optimized kNN and SVM classifiers for accurately classifying sleep apnea. Moreover, significant enhancements in model accuracy were observed when utilizing the selected demographic variables and employing data grouping techniques. For instance, the accuracy percentage demonstrated an approximate improvement of 4.5%, 5%, and 10% with the feature selection approach when applied to the grouped data of Caucasians, females, and individuals aged 50 or below, respectively. Furthermore, a comparison with prior studies confirmed that effective data grouping and proper feature selection yielded superior performance in OSA detection when combined with an appropriate classification method. Overall, the findings of this research highlight the importance of leveraging demographic information, employing proper feature selection techniques, and utilizing optimized classification models for accurate and efficient OSA diagnosis.

Assessment of Changes in the Upper Airway in Children with Finger Sucking Habit Using Cephalometric Radiographs.

The persistence of the sucking beyond a certain age has been attributed to many deleterious effects on the orofacial structures. Hence, the present study evaluates the alterations in the upper airway among the children with and without the finger-sucking habits. We piloted an observational study among 58 children with malocclusion who required orthodontic treatment, in which between 7 and 12 years were selected. They were subjected to lateral cephalometric radiographs, and cephalometric analysis of craniofacial morphology, tongue posture, hyoid bone position, upper airway, and head posture was performed and analyzed using independent t-test. In the children with finger-sucking habit group, not only the maxilla was placed anteriorly in relation to the cranial base, but also increased Abstract xi in the length of the palate and the tongue posture. No significant alterations were seen in other parameters. Changes were evident among the children with finger-sucking habits for the craniofacial morphology, tongue posture, upper airway, and head posture with no alteration in the hyoid bone position.

Characteristics of Tongue Pressure and Oro-Motor Functions in Patients with Idiopathic Parkinson’s Disease

Objectives: Parkinson’s disease (PD) is a neurodegenerative disorder affecting motor control. This study aims to examine the characteristics of oromotor function and tongue pressure during 5ml water swallowing between patients with PD and normal adults. Methods: 16 patients with PD and 16 normal adults participated in this study. To evaluate oral motor function, the Korean-version of Speech Mechanism Screening Test (SMST) was used. Additionally, the tongue pressure device of Digital Swallowing Workstation&lt;sup&gt;TM&lt;/sup&gt; (Model 7120, KayPentex, USA) was used to measure three different positions (anterior, middle, posterior) of the tongue pressure during the 5 mL water swallow. Results: PD patients demonstrated significantly reduced oro-motor function, especially in the tongue and lips compared to the normal group. Moreover, significantly lower tongue pressure was detected in patients with Parkinson’s disease. Anterior tongue strength, in particular, showed greater decline in the PD group, but there were no significant differences across the different tongue positions. Conclusion: Declined tongue pressure and oromotor dysfunction can increase the risk of dysphagia in PD. Therefore, tongue pressure measurement can help detect the tongue motor disability related to swallowing and manage for oro-pharyngeal dysaphagia in patients with PD.

Edge strengthening and phonetic variability in Spanish /l/: an ultrasound study.

Previous research has shown that /l/ in Spanish displays patterns of articulatory variability that are determined by a complex interaction of phonetic, phonological and dialectal factors. In this study, we report the results of an experiment using Ultrasound Tongue Imaging (UTI) that tests /l/-articulations in a dialectal cross-section of Spanish speakers. We show that lengthening of /l/ in phrase-edge contexts is accompanied by articulatory distinctions (e.g. root/dorsum retraction) for some speakers, whereas others produce lengthened realisations of /l/ in these contexts without observable differences in tongue position. We also find acoustic evidence for reduction in utterance-medial intervocalic and preconsonantal environments (duration, intensity, F1 frequency measures are discussed). However, articulatory correlates of reduction are not consistently observed across speakers in these contexts. As well as relating the results to prosodically-driven strengthening and reduction patterns, our findings are of relevance to debates about resyllabification in Spanish. Specifically, we argue that our results cannot be straightforwardly accommodated under phonological analysis assuming that word-final consonants regularly resyllabify across word boundaries prevocalically.

The Physiological Function of Deglutition and Swallowing in Patients With Maxillary Protrusion After Mandibular Advancement.

The objective of this study was to determine the tongue-palatal contact changes in patients with skeletal maxillary protrusion after sagittal split ramus osteotomy (SSRO) during swallowing. In this study, 15 patients with maxillary protrusion and 10 normal subjects participated. Before and 3 months after surgery, tongue-palatal contact patterns during swallowing of patients with maxillary protrusion as well as controls were evaluated by electropalatography. The electrode contact number in the alveolar, palatal, and velar parts was examined. The swallowing duration of each phase was also evaluated. In the lateral area of the velar part, incomplete electrode contact was shown at 0.3 seconds in patients with maxillary protrusion. The electrode contact number in the velar part at 0.3 seconds before tongue-palatal complete contact was significantly less in the preoperative patients compared with the controls ( P < 0.05). A small increase in the electrode contact number of the velar part was shown in the postoperative patients at 0.3 and 0.2 seconds before tongue-palatal complete contact ( P < 0.05). The pharyngeal phase duration was significantly larger in the patients with maxillary protrusion before SSRO compared with the controls ( P < 0.05). After SSRO, the pharyngeal phase duration was significantly shortened. It was shown that the tongue-palatal contact pattern during swallowing in patients with maxillary protrusion improved after orthognathic surgery, and the pharyngeal phase duration was also shortened. It is suggested that the changes in the mesiodistal mandibular position by orthognathic surgery can improve tongue posture and movement during swallowing.

Palatine Tonsil Measurements among Healthy Sudanese Children Using Ultrasonography

Background: Palatine tonsils (PT) reach their maximum normal size in early childhood; after puberty and with other body lymphatic tissue, they gradually atrophy. PT are usually easily seen in the oropharynx during the oral examination. However, clinical size assessment is difficult since the tongue's posture may significantly alter its appearance. The aim of this study was to evaluate normal PT size in healthy children by ultrasound using the anteroposterior and transverse diameters and correlate them with age, weight, and gender. Methods and Results: This cross-sectional study was conducted at different nurseries and schools in Khartoum. A random sample of 79 Sudanese children and adolescents (39 males and 40 females) aged 1–15 years, without PT pathology, was examined. The anteroposterior diameter (APD) and transverse diameter (TD) for both tonsils were measured by ultrasound. APD and TD were 1.46±0.16 cm and 1.38±0.16 cm, respectively, for the right PT and 1.51±0.15 cm and 1.40±0.16 cm for the left PT. The APD was significantly higher than the TD on both sides (P&lt;0.01 in both cases). In addition, L(left)PT-APD was significantly greater than R(right)PT-APD (1.51±0.15 vs. 1.46±0.16, P=0.0044). We found a low-to-moderate positive correlation between all PT measurements with children's age and weight (P&lt;0.01). There was no significant association between PT size and gender. Conclusion: Ultrasound is a reliable, simple, noninvasive procedure for estimating PT size in children. Normal PT size correlates with age and weight; however, no correlation is present for gender. Normal PT sizes (APD and TD) in children and adolescents may be predicted based on age and weight using developed equations.

Simultaneous rehabilitation of the tongue and breathing: a physiological necessity

Pr. Delaire has understood since 2005 that functional therapy shouldn’t try to rehabilitate a praxis but instead focus on the whole created by different oro-facial functions to ensure the creation of a global dynamic balance. That’s why rehabilitation of the right tongue posture is a necessary condition for automation as nasal breathing; in the same meaning that rehabilitation of nasal breathing is a necessary condition for automation of the right tongue posture. Fortunately, nature can help us if we respect and follow physiological processes that take into account key points of «connectionism». As a reminder that «learning isn’t only the ability to produce an action, a behaviour that was unknown before, it’s a process that need to inhibate automatical mental processes». The author will develop his philosophy of «connectionism», based on his personal research, his readings on neuroscience and oro-facial functions and his forty years of clinical practice. Orofacial functions influence each other and inhibition of each dysfunction is necessary to automate the newly obtained myofunctional balance.

Acoustics of long vowels in Arabic-speaking children with hearing impairments

The present study investigates formant frequencies and vowel space area in Jordanian hearing-impaired individuals who received cochlear implants. To achieve this task, they were compared with their hearing aids and normal-hearing peers. The study involved 60 participants aged between 7 and 11 years, consisting of 20 cochlear implant (CI) users, 20 hearing aid (HA) users, and 20 normal-hearing (NH) children. All participants were native speakers of Jordanian Arabic. The study measured the fundamental frequency (F0), the first, second, and third formant frequencies (F1–F3) of the five long vowels: /i:/, /e:/, /a:/, /o:/, and /u:/ using Praat software (version 6.1.05). One-way repeated measure (ANOVA) and post hoc Tukey tests were used to compare the differences between the three groups. The results revealed significant differences between the three groups in the degree of vowel height and backness for all the long vowels. The vowel space in HA users was found to be smaller than in CI users. HA users had difficulty varying their tongue position in both the high–low and the front–back dimensions, while CI users had difficulty varying their tongue position only in the front–back dimension. The study also examined errors in long vowels and diphthongs. The findings indicated that after cochlear implantation, the formants of the vowels produced by hearing-impaired speakers shifted closer to those produced by their NH peers, and CI users had a greater vowel space compared to HA users. This research could potentially contribute to the development of effective interventions for hearing-impaired individuals and could provide insights for the design of speech therapy programs that aim to improve vowel production abilities.

Agreement between telerehabilitation and face-to-face orofacial myofunctional assessment in persons with acquired brain injury

ABSTRACT Background and objective Orofacial myofunctional disorders are common in persons with acquired brain injury. A new way for early detection of orofacial myofunctional disorders via information and communication technologies may improve accessibility. The purpose of this study was to evaluate the level of agreement between face-to-face and tele-assessment of an orofacial myofunctional protocol in a sample of persons with acquired brain injury. Methods A masked comparative evaluation was conducted in a local association of patients with acquired brain injury. Twenty-three participants (39.1% female, mean age of 54 years) with a diagnosis of acquired brain injury were included in the study. The patients followed a face-to-face and a real-time online assessment using the Orofacial Myofunctional Evaluation with Scores protocol. This is a protocol for evaluation with numerical scales that assess the physical characteristics and the main orofacial functions of patients including appearance, posture, and mobility of lips, tongue, cheeks, and jaws, respiration, mastication, and deglutition. Results The analysis showed excellent interrater reliability (ρ ≥ 0.85) for all the categories. In addition, most confidence intervals were narrow. Conclusions This study reveals excellent interrater reliability of an orofacial myofunctional tele-assessment in patients with acquired brain injury in comparison with a traditional face-to-face evaluation.