Tongue Prosthesis Research Articles

Start of the Seventh Volume in 2023 and Analysis of Publishing Achievements of 2022

Starting the 7th volume of the Journal of Diagnostics and Treatment of Oral and Maxillofacial Pathology we are becoming stronger, more mature, and resilient. Even though the Journal has been published for essentially 11 months of 2022 of large-scale war of Russia against Ukraine and Europe, the editorial and publishing staff demonstrated the ability to withstand the impact of war and continue to publish peer-reviewed achievements. In total, 32 articles were published in the volume 6. Among which, 10 articles were devoted to wartime challenges and gunshot wounds. Two papers presented cutting-edge microvascular and prosthetic techniques. Massarelli and Meloni reported a unique technique in a paper titled The “beveled one-and-a-half-barrel” fibula transplant with virtual surgical planning and CT-guided implant surgery for prosthetic rehabilitation in posterior mandible defects: a pictorial essay. Le and colleagues manufactured an exclusive tongue prosthesis which was well-described in an article titled Patient-specific prosthetic appliance for interim management of chronic orocutaneous fistula in the irradiated and vessel-depleted head and neck patient – a case report and technical note. Geographical distribution of authors in 2022 included five countries—Italy, Slovak Republic, Qatar, Ukraine, and United States of America (USA). The first quarter of year 2022 was also marked by the establishment of the resident ambassador position and the appointment of John M. Le, DDS, MD, as a real leader, to this founding position. Also, we were honored to see Michael T. Kase, DMD, a true expert in maxillofacial prosthetics as a new board member who can bring a lot of expertise to the Journal in this growing direction.6 Thus, by the end of 2022, the Journal’s editorial board has grown to 30 experts, enhancing Journal’s international vision and approaches.

Newly designed flat surface artificial tongue system for speech improvement in glossectomy patients: A preliminary study.

To design an efficient tongue prosthesis with reproducibility and to objectively evaluate improvement in speech function. A silicon anatomical artificial tongue (AT) and a flat surface artificial tongue system (FTS) were used in our study. Twenty healthy participants (10 males and 10 females, 26.3 ± 1.8 years) were fitted with a tongue movement suppression appliance (TSA) that fit the dental arch to simulate the glossectomy condition. TSA, TSA + FTS, and TSA + AT simulated the state of glossectomy patients without artificial tongue, with normal artificial tongue, and newly designed artificial tongue, respectively. Three speech intelligibility tests were performed for each of the following conditions: pronouncing 100 Japanese monosyllables, 40 Japanese words, and reading a short story. One-way ANOVA, Wilcoxon signed-rank test, and Tukey-Kramer post-hoc test were used for statistical analyses. Significant differences were observed for 100 Japanese monosyllables and 40 Japanese words between the TSA + FTS, TSA, and TSA + AT conditions (p < 0.05). Regarding the speech intelligibility test for reading a short story, the TSA + FTS condition resulted in a significantly higher speech intelligibility than the TSA and TSA + AT conditions (p < 0.05). A flat surface artificial tongue system contributed to the improvement in speech function. This structure can be easily used in cases where conventional artificial tongue are applicable, regardless of variation in the oral condition; thus, making it a widely applicable treatment option for glossectomy patients.

Palatal Drop Augmentation and Tongue Prostheses: A Case Report

Background: After a total glossectomy, one lost the ability to speak and swallow due to the loss of tongue mobility and the increase of space between the palate and tongue remnants. To improve swallowing by creating negative pressure, tongue and palatal drop prostheses can be utilized. This prosthesis does not restore other tongue functions such as mastication, speech articulation and resonance because the prosthesis cannot reproduce natural tongue movements. Purpose: To rehabilitate the tongue deformity due to the gun shot wound. Methods and Materials: The case report revealed the total lost of tongue of a Bangladeshi patient who cannot be able to swallow and speak. The remaining teeth still fully intact but the palatal drop and tongue prosthesis was fabricated with the silicone prosthesis. Results: Both palatal drop prosthesis and tongue prosthesis allowed the patient to increase the capacity to swallow and reduce the remaining odondus space. The speech appeared to be more intelligiable but cannot fully restore. Conclusion: The quality of life of a patient after post operative follow-up appeared to be better; however, the physiologic function of the missing organ cannot fully restored.DOI: http://dx.doi.org/10.3329/cdcj.v10i1.13828City Dent. Coll. J Volume-10, Number-1, January-2013 Retracted: Due to complain

Appraisal of Function After Rehabilitation With Tongue Prosthesis.

Prosthetic rehabilitation following total glossectomy is very complex procedure from clinical as well as laboratory point of view. The basic objective of prosthodontic rehabilitation is to deliver a comfortable as well as esthetically suitable prosthesis, which restores the impaired speech and deglutition function. Prosthetic rehabilitation of patients after total glossectomy with tongue prosthesis to evaluate improvement in speech as well as swallowing function. Tongue prostheses were fabricated with high-temperature vulcanizing silicone and heat-polymerizing acrylic to restore the functions affected after surgical resection of tongue. Patient's speech was evaluated with Dr Speech software version 4. The speech software was used to assess different speech parameters such as maximum phonation time, fundamental frequency, intensity, jitter, and shimmer. Deglutition assessment was done subjectively by using a standardized questionnaire designed by the speech pathologist. Speech was recorded for assessment before prosthetic rehabilitation and 2 weeks after delivery of the tongue prosthesis. After analysis of various speech parameters frequency range was improved with prosthesis (ie, 172.19 Hz) as compared to without prosthesis (ie, 111.47 Hz). Speech intelligibility was improved with tongue prosthesis. Deglutition assessment revealed that patient's deglutition abilities were improved. Tongue prosthesis helps to improve speech and articulation in patients with total glossectomy. Apart from that deglutition capability is also significantly improved. Total glossectomy affects speech, mastication, and swallowing to a greater proportion. It may also lead to psychological impairment of the patient. Tongue prosthesis efficiently improves speech and deglutition abilities of the patient leading to a better quality of life.

Rehabilitation of Glossectomy Cases with Tongue Prosthesis: A Literature Review.

Tongue is the only movable muscular organ without any bone in the human body. It has very important role in perception of taste and sensations like touch, pressure, heat and cold. The purpose of the article is to review various types of tongue prosthesis and their clinical applications. This review helps the clinician to choose the appropriate type of tongue prosthesis for different clinical situations, retention of tongue prosthesis and material selection for each type of prosthesis. A broad search of published literature was performed using the keyword glossectomy, glossal prosthesis and tongue prosthesis from 1980 to 2014 in Medline, Google scholar, internet and text book. This review gives basic knowledge of glossal prosthesis and selection of the same for various clinical conditions.

Prosthetic rehabilitation for a glossectomy patient - a clinical report

Malignant tumours of the oral cavity that require resection of the tongue result in severe deficiencies in speech and deglutition. In such patients, improvements in mastication, swallowing, and speech may be reasonable goals for treatment. The viability of a prosthodontic approach to treatment depends on the type and extent of surgery. In a total glossectomy, a mandibular tongue prosthesis is the treatment of choice. Mandibular tongue prosthesis occupies the space in the floor of the oral cavity. It provides the patients with a platform for directing food into the esophagus and aids in speaking. This type of prosthesis can achieve that protection of the underlying fragile tissue and improvement in appearance and psychosocial adjustment. This case report describes the technical steps involved in prosthetic rehabilitation for a glossectomy patient. (J Korean Acad Prosthodont 2013;51:347-52)

Prosthodontic Rehabilitation for Total Glossectomy with a Magnetic Detachable Mandibular Tongue Prosthesis: A Clinical Report

Total glossectomy can result in significant functional impairments in mastication, swallowing, and speech. In addition to these functional problems, severe psychological problems may follow complete loss of the tongue. Placement of a mandibular tongue prosthesis obturates this large defect, increases the patient's ability to produce intelligible sounds, and assists with a return to a normal diet. Prosthetic rehabilitation can also improve the user's appearance and psychosocial adjustment. This clinical report describes a magnetically attached two-piece tongue prosthesis used to treat a patient who underwent total glossectomy.

Technical Considerations in Rehabilitation of an Edentulous Total Glossectomy Patient

The technician by virtue of his profession plays an important role in fabricating silicone tongue prosthesis for a total glossectomy patient. The technician, with his skills and specialized knowledge in handling material, plays a valuable role as a member of the oncology team. A patient with total glossectomy can be rehabilitated by silicone tongue prosthesis as an aid to improve his speech and swallowing. This paper describes the technical steps involved in fabricating a silicone tongue prosthesis for an edentulous total glossectomy patient.

Long Term Rehabilitation of a Total Glossectomy Patient

Malignant tumours of the oral cavity that require resection of the tongue result in severe deficiencies in speech and deglutition. Speech misarticulation leads to loss of speech intelligibility, which can prevent or limit communication. Prosthodontic rehabilitation involves fabrication of a Palatal Augmentation Prosthesis (PAP) following partial glossectomy and a mandibular tongue prosthesis after total glossectomy [1]. Speech analysis of a total glossectmy patient rehabilitated with a tongue prosthesis was done with the help of Dr. Speech Software Version 4 (Tiger DRS, Inc., Seattle) twelve years after treatment. Speech therapy sessions along with a prosthesis helped him to correct the dental sounds by using the lower lip and upper dentures (labio-dentals). It was noticed that speech intelligibility, intonation pattern, speech articulation and overall loudness was noticeably improved.

Tongue prostheses for articulation

A 48-year-old male with normal speech underwent 6 years ago a total glossectomy with myocutaneous flap reconstruction. The voice control is natural in this patient. Prosthodontic devices have been made to test feasibility of improving speech intelligibility. All American English vowels (except retroflexed vowels) are articulated with virtually perfect identifiability with the use of a solid tongue prosthesis fixed on the lower teeth. Spring-loaded rotatable prostheses were deviced for consonantal articulations. The prosthesis is moved under the contraction of the muscle in the reconstructed flap in the posterior oral cavity, raising the ‘‘back of the tongue’’ or the ‘‘tip of the tongue’’ in combination with mandibular and labial control. X-ray microbeam recordings were obtained to observe the extent of controlled movements. The result is almost perfect intelligibility of most of speech sounds including apical and dorsal obstruents. The patient, as one of the coauthors of this paper, will demonstrate the use of the prosthesis as part of the presentation. [This work has been supported in part by Shannon Award (NIDCD ♯1 R55 DC00015-01A1) and by a research fund from ATR, International, both given to O. Fujimura.]

Tongue Prosthesis for Total Glossectomy Patient

A clinical report of the prosthetic restoration of an edentulous patient with a total glossectomy is presented. A soft acrylic tongue prosthesis that is attached to the mandibular denture but removable for hygiene is described.

Adenocarcinoma of the tongue complicated by a hemimandibulectomy: Soft tissue support for a tongue prosthesis in an edentulous glossectomy patient

Adenocarcinoma of the tongue complicated by a hemimandibulectomy: Soft tissue support for a tongue prosthesis in an edentulous glossectomy patient

Speech considerations in prosthodontic rehabilitation of the glossectomy patient

A knowledge of normal articulation is needed before the prosthodontist can assess the compensatory articulation used by glossectomy patients. The amount and portion of tongue resected is directly correlated with speech intelligibility. The loss of the tip of the tongue is more critical to intelligibility than a hemiglossectomy. Partial glossectomy speakers can often use the residual tongue stump to perform adaptive movements that approximate normal movements and should be treated as an articulation problem. The compensatory articulation used by the total glossectomy patient was reviewed. The prosthodontic management of patients with partial tongue resection often includes lowering the palatal vault, while the management of the total glossectomy patient usually requires a mandibular tongue prosthesis. These prostheses can be refined with the use of multiview videofluoroscopy, videotaping, and spectrographic analysis.

Prosthodontic rehabilitation for glossectomy patients

Patients with oral carcinomas often have resection of the tongue, the floor of the mouth, or the bone of the mandible. Postoperatively, these patients encounter chewing, swallowing, and speech problems. Oral rehabilitation through prosthetic management can aid in alleviating these problems. Designs of the prosthesis vary according to patient needs. A “snap-on” tongue prosthesis or palatal augmentation prosthesis can be constructed. Total glossectomy patients require prosthetic intervention on a mandibular framework. Partial glossectomy patients require prosthetic augmentation on a maxillary framework. Through prosthetic management of this type, articulation and resonance are improved, food is more easily directed into the esophagus, tissues are protected and socialization is enhanced through improved appearance.

Prosthetic reconstruction of mandibular tongue prostheses

T h e patient requiring a total glossectomy and a total laryngectomy presents an unusual problem to the prosthodontist. The more radical the surgery, the greater the postsurgical rehabilitation problems. The tongue is of prime importance in the mechanism of human p1~ysiology for a variety of essential functions. The extrinsic and the intrinsic muscles of the tongue, which are supplied by the hypoglossal nerve, aid the tongue in speech, mastication, deglutition, and the cleansing of the soft tissue in the mouth. A total glossectomy and laryngectomy results in a loss of basic vital functions and a complete anatomic and physiologic deformity which, with the loss of speech, presents one of the most difficult challenges to the rehabilitation team. The maxillofacial surgical team consists of a radiotherapist, head and neck surgeon, oral surgeon, and prosthodontist. The prosthodontist plays a decisive role in the presurgical and postsurgical treatment of the glossectomy patient. It is essential that the patient be psychologically prepared to accept the postoperative condition regarding loss of speech and compromised nutritional status due to difficulty in swallowing. The patient should be made aware of the limitations of speech and swallowing after the construction of the tongue prosthesis.

Swallowing and speech after radical total glossectomy with tongue prosthesis

Radical total glossectomy is now accepted as a useful procedure for the management of advanced cancer of the tongue. This article records our study of speech and swallowing without the tongue. An artificial tongue prosthesis has been developed and found to greatly improve these functions after total glossectomy. The special operative factors to be considered in order to permit a smooth and rapid rehabilitation regarding speech and swallowing have been stressed.

Evaluation and rehabilitation of glossectomy speech behavior

Current methods of evaluation and rehabilitation of glossectomy speech behavior are reviewed. These methods include the application of articulatory compensations, phoneme substitution consistency and manipulation of vocal parameters on certain aspects of glossectomy intelligibility. This selective review indicates the need for utilizing objectively based methods of evaluating postoperative changes in speech intelligibility. Only then will clinicians be able to effectively plan therapy, indicate progress and predict ultimate communicative potential for their clients. In addition to the clinical rehabilitation methods, two procedures involving the restoration of lost tongue functions by using a mandibular tongue prosthesis and oral reconstructive surgery are included.

Reconstruction of the Tongue

Total or subtotal glossectomy for carcinomas of the tongue results in severe dysfunction of speech and swallowing. In such cases the larynx is frequently removed to prevent aspiration. In our experience the larynx may be preserved and intelligible speech and swallowing, without aspiration, may be achieved. Two patients were rehabilitated following total glossectomy by means of a tongue prosthesis. In two other patients in whom over one-half of the anterior tongue was removed the tongue was reconstructed by means of a deltopectoral flap.

Glossectomy rehabilitation by mandibular tongue prosthesis

Abstract In the rehabilitation of patients following complete glossectomy, the early placement of an obturator to assist in deglutition and articulation has proved to be effective. The tongue is not absolutely necessary in the production of speech. In all glossectomy patients, though, there seems to be a reluctance to try to speak or take oral fluids after the operation. Tongue prostheses constructed in conjunction with mandibular removable partial dentures, with the tongue portion in an elevated position, give patients the additional help needed to overcome this initial reluctance. The patients are able to quickly regain their speech and swallowing abilities. A tongue prosthesis can speed the recovery of patients and return them to society to enjoy a nearly normal diet and speak understandably without a tongue.

Glossectomy rehabilitation by mandibular tongue prosthesis

In the rehabilitation of patients following complete glossectomy, the early placement of an obturator to assist in deglutition and articulation has proved to be effective. The tongue is not absolutely necessary in the production of speech. In all glossectomy patients, though, there seems to be a reluctance to try to speak or take oral fluids after the operation. Tongue prostheses constructed in conjunction with mandibular removable partial dentures, with the tongue portion in an elevated position, give patients the additional help needed to overcome this initial reluctance. The patients are able to quickly regain their speech and swallowing abilities. A tongue prosthesis can speed the recovery of patients and return them to society to enjoy a nearly normal diet and speak understandably without a tongue.