Development of evaluation system for mastication and swallowing using tongue pressure, jaw movement and swallowing sound

1.我们开发了基于触觉传感器系统（I-Scan，Nitta Co，东京，日本）的传感器片来测量舌头对硬腭的压力，可以无创地定量评估咀嚼和吞咽过程中的舌头活动。它是厚度为0.1 mm的T形传感器片，五个测量点，额定容量为70 kPa in，测量精度为0.27 kPa。为每个受试者选择小、中或大的传感器片，以标准化硬腭上每个测量点的位置。2.为了确保传感器片的有效性，我们评估了中风后患者和舌切除术后吞咽困难患者的舌压力大小。这些患者的舌活动特征可能会影响吞咽能力，通过测量 关于我们 舌头压力使用新开发的传感器片。通过观察舌压的变化，探讨腭裂修复对脑卒中患者吞咽功能的影响。3.研究自主触发吞咽时舌与口咽肌协调的正常时序模式，建立神经源性吞咽障碍的定量诊断标准。7名健康受试者在自主吞咽15ml水时，同时记录舌压（Tp）、二腹肌前腹（Da）、咬肌（Ms）和胸骨舌骨肌（St）的肌电图和吞咽音（Ss）。统计分析硬腭前正中部舌压产生顺序、各肌肌电活动和吞咽音的差异。Da的肌电爆发起始时间明显早于Ms、St和Tp。Ms的肌电爆发产生时间明显早于St和Tp。MS的肌电爆发几乎与Ss同时停止，且明显早于Da、St和Tp。Da的肌电图爆发一直持续到Tp的失望，然后St的肌电图爆发终于停止。这些结果表明，从安全管理食团的角度来看，自主触发吞咽过程中舌压和口咽肌之间的时间协调模式是合理的，可以作为吞咽障碍定量评估的标准。从这些结果中，我们得出结论，我们的传感器片有望成为一个有用的装置，口咽吞咽障碍的诊断系统可以开发。少

1.We developed the sensor sheet to measure the tongue pressure against the hard palate based on the tactile sensor system (I-Scan, Nitta Co, Tokyo, Japan), which enabled the non-invasive and quantitative evaluation of tongue activity during mastication and swallowing. It was T-shaped sensor sheet with 0.1 mm of thickness, five measuring points, a rated capacity of 70 kPa in and a measuring accuracy of 0.27 kPa. A small, medium or large sensor sheet was selected for each subject so as to standardize the location of each measuring point on the hard palate. It was attached to the palatal surface of the maxillary denture or to the palatal mucosa directory with a sheet-type denture adhesive2.To secure the usefulness of the sensor sheet, we evaluated the magnitude of tongue pressure in the post-stroke patient and glossectomy patients with dysphagia. The characteristics of tongue activity in those patients that were likely to influence swallowing ability were elucidated through measurement of … More tongue pressure using the newly developed sensor sheet. The effect of palatal augmentation prosthesis on the swallowing ability in the post-stroke patient was also described in the change of the magnitude of tongue pressure.3.The normal temporal pattern of coordination between tongue and oro-pharyngeal muscles during voluntarily triggered swallowing was investigated for developing the quantitative diagnostic criteria of neurogenic dysphagia. Simultaneous recording of tongue pressure(Tp) which was measured using pressure sensors installed in palatal plate, electromyography of anterior belly of digastric muscles(Da), masseter muscles(Ms) and sternohyoid muscles(St), and swallowing sound(Ss) was performed during voluntary swallowing 15 ml water by seven healthy subjects. The differences in the order of tongue pressure production at the anteriomedian part of hard palate, EMG activity of each muscle and swallowing sound were analyzed statistically. The EMG burst of Da generated initially and significantly earlier than those of Ms and St, and Tp. Then the EMG burst of Ms generated significantly earlier than those of St and Tp. The EMG burst of Ms ceased almost at the same time of Ss, and significantly earlier than those of Da and St, and Tp. The EMG burst of Da continued until the disappointment of Tp, and then that of St ceased finally. These results suggested that a temporal coordination pattern between tongue pressure and oro-pharyngeal muscles during voluntarily triggered swallow was rational from the view point of safety management of bolus, and could be a criterion for the quantitative evaluation of swallowing disorder.From these results we concluded that our sensor sheet was expected to be a useful apparatus by which the diagnostic system for oro-pharyngeal dysphagia could be developed. Less