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

1.基于触觉传感器系统(I-SCAN，NITTA公司，日本东京)，我们开发了测量舌压对硬腭的传感器片，从而实现了对咀嚼和吞咽过程中舌头活动的非侵入性和定量评估。该传感器为T型传感器，厚度0.1 mm，5个测点，额定容量70kPain，测量精度0.27kPa.为每个受试者选择一个小、中或大的传感器片，以标准化每个测量点在硬腭上的位置。用片状义齿粘接剂将其附着在上颌义齿的腭面或腭部粘膜上。2.为了确保传感器片的有效性，我们评估了中风后患者和伴有吞咽困难的舌切除患者的舌压大小。通过对…的测量，阐明了可能影响吞咽能力的舌活动特征使用最新开发的传感片可以增加舌头压力。通过舌压大小的变化描述了腭部假体对卒中后患者吞咽能力的影响。3.研究了主动触发吞咽时舌与口咽肌协调的正常时间模式，建立了神经源性吞咽困难的定量诊断标准。对7名健康受试者在自愿吞咽15ml水时，同时记录舌压(TP)、二腹肌前腹肌电(Da)、咬肌前腹肌电(Ms)和胸骨舌骨肌电图(ST)和吞咽声(SS)。统计分析硬腭部前中段舌压产生顺序、各肌肌电活动及吞咽音的差异。Da的肌电爆发起始时间明显早于ms、ST和Tp。MS的肌电爆发发生时间明显早于ST和TP。MS的EMG爆发几乎与SS同时停止，且明显早于Da、ST和TP。Da的肌电爆发一直持续到TP的失望，然后ST的EMG终于停止。这些结果表明，从安全管理的角度来看，主动触发吞咽时舌压和口咽肌之间的时间协调模式是合理的，可以作为定量评估吞咽障碍的标准。这些结果表明，该传感器片有望成为开发口咽吞咽困难诊断系统的有用仪器。较少

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