Effect of Tactile Stimulation on Lingual Motor Function in Pediatric Lingual Dysphagia

Excerpt

The study by Lamm et al. [1] consisted of 45 patients who did not swallow because of multiple congenital anomalies and gastroenterologic dysfunctions before and after corrective surgery and who also had histories of unsuccessful traditional feeding intervention. The purpose of their study was to “(1) isolate the specific regional mechanical functions of the tongue during swallowing; (2) identify the specific controlling variables that induce physiologic mechanical actions as varied tongue positions and tone during a swallow in young children fed through artificial means who had not swallowed food before treatment; (3) replicate (our) 26 preliminary results of inducing and maintaining a swallow reflex across a large number of young children with lingual dysphagia; and (4) provide an alternative procedure to surgical gastrostomy placement and removal of gastrostomy button or nasogastric tube.” The various procedures implemented were found to be “useful across the board for all patients with severe dysphagia.” The various procedures employed resulted in independent swallows in 96% or 43 of 45 of the patients studied, with 42 of the 45 patients also demonstrating a 100% transfer from gastrostomy or nasogastric tube feedings to oral hydration and nutrition. Lamm et al. concluded that the various procedures they implemented “although intense and lengthy in systematic components, yield prudent results in 5–7 days of inpatient treatment. They are feasible for patients with lingual dysphagia who do not swallow and for whom aspiration is a real danger. These outcomes provide an empiric preventative procedure to surgical gastrostomy placement and may facilitate the timely removal of a gastrostomy button and nasogastric tube in candidate patients.” …