[Dysphagia] Masako, tongue contraction and other misperceptios.

[eripley at yahoo.com (Irene Campbell-Taylor)]

Okay, I can't stand it any longer. The wealth of outdated, inaccurate and misperceived information that still seems to be prevalent is frightening. For those of you who feel that you don't have time to read the relevant material and, by implication, feel that you don't need the information, stop here.
Tongue retraction. This is still one of my "Where did you ever get that idea? mysteries. Many years ago, David Curtis proved that the "open swallow" is far more common than contact with the PPW. See below.
The Masako: If you don't believe me, maybe you'll believe Michael Crary - also below.And, in the original article find the following:
 
However, the use of the maneuver per se, which inhibits posterior retraction of the base of tongue (BOT), resulted in increasing the pharyngeal (specifically vallecular) residue after the swallow. 
 

   Subject: The Masako maneuver? -Forwarded 
   From: mcrary.hrp@mail.health.ufl.edu (Michael Crary) 
   Date: Mon, 09 Jun 1997 09:43:57 -0400 

---------------------------------


Re:  The "Masako"  maneuver.

 

Please don't over interpret limited publications.  My impression (and that

shared by others) is that this was never intended to be a clinical rehab

technique.  It was a very nice demonstration of swallowing adaptation in

H/N cancer patients and in normal controls (different observations). 

Much additional information is needed before this should be considered a

valid rehab technique.  My recollection is that the normal adults in the

AJSLP article demonstrated increased residue in valleculae and piriforms

when swallowing with this adaptation.  I am developing a growing

concern that we (as a profession) are too willing to accept information

as clinically valid and important based on limited support.

 

I'll go back into the cybershadows now....thanks for listening.

 

Mike Crary

University of Florida Health Science Center
American Journal of Speech-Language Pathology
Volume 5 (1996), Issue 1

February 1996
Clinical Focus
Effect of a Tongue-Holding Maneuver on Posterior Pharyngeal Wall Movement During Deglutition
Masako Fujiu and Jeri A. Logemann.
Page: 23


Effects of a tongue-holding maneuver on anterior bulging of the posterior pharyngeal wall (PPW) during swallowing were investigated in 10 young adult normal subjects. Videofluorographic images of 3-ml liquid barium swallows were digitized to quantify the extent of anterior bulge of the PPW with and without the maneuver at the mid and the inferior levels of the second cervical vertebra. A significant increase in PPW bulging was seen with the maneuver at both pharyngeal levels. These findings indicate potential for developing new treatment techniques to facilitate compensatory anterior movement of the PPW, which has not been a target for direct treatment in the past. At present, the tongue-holding maneuver can be employed clinically as an easy method for testing the compliance of the PPW videofluorographically. However, the use of the maneuver per se, which inhibits posterior retraction of the base of tongue (BOT), resulted in increasing the pharyngeal (specifically vallecular) residue
 after the swallow. The results also indicate the importance of tongue movement in triggering the pharyngeal swallow.


Videofluoroscopic identification of two types of swallowing.

 

Radiology 1984 Aug;152(2):305-8   

 

Curtis DJ; Cruess DF 

Two forms of swallowing were observed during videofluoroscopy in 166 asymptomatic patients, consisting of an air-containing ("open") pharynx in 120 (72%) and an occluded ("closed") pharynx in 46 (28%). 

 

 



Dr I Campbell-Taylor
Clinical Neuroscientist
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