Determination of the Relationships Between intra- and Extraoral Tongue Hardness, Thickness, and Pressure Using Ultrasonic Elastography

Dysphagia. 2021 Aug;36(4):623-634. doi: 10.1007/s00455-020-10176-1. Epub 2020 Sep 1.

Abstract

Involved with various bodily functions, including ingestion and swallowing, the tongue is an important organ. We measured resting tongue hardness using real-time tissue elastography (RTE) to establish a simple tongue evaluation for patients who may have limited capacities to follow commands. Relationships between tongue hardness, thickness, and pressure were investigated, using both intra- and extraoral probes. Assessments were performed for a total of 27 healthy adults (11 male, 16 female, average age 26.4 ± 1.8 years). Measurements of tongue hardness and thickness were made using strain ratios (SR), and averaged across nine images. Maximum tongue pressure was determined using a tongue pressure device. A negative correlation was observed between intraorally measured tongue hardness and maximum tongue pressure (r = -0.76, p < 0.01). A positive correlation between extraorally measured tongue thickness and maximum tongue pressure was observed (r = 0.59, p < 0.01). Additionally, significant differences were observed between males and females with regards to intraorally measured tongue hardness (p = 0.02), maximum tongue pressure (p = 0.02), and extraorally measured tongue thickness (p < 0.01). The results of this study demonstrated the clinical applicability of RTE-based tongue hardness measurements, and suggest the feasibility of predicting tongue strength based on extraoral tongue thickness measurements.

Keywords: Deglutition; Maximum tongue pressure; Real-time tissue elastography; Strain elastography; Tongue hardness; Tongue thickness.

MeSH terms

  • Adult
  • Deglutition
  • Elasticity Imaging Techniques*
  • Female
  • Hardness
  • Humans
  • Male
  • Pressure
  • Tongue / diagnostic imaging
  • Ultrasonics
  • Young Adult