Association between aspects of clinical assessment of the tongue accomplished in children

Nascimento, Izabela Marques; Silva, Luana Cristina de Sousa; Amaral, Mariana Souza; Motta, Andréa Rodrigues; Furlan, Renata Maria Moreira Moraes

Acessibilidade / Reportar erro

Brasil

Audiology - Communication Research

Español English

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original Article • Audiol., Commun. Res. 24 • 2019 • https://doi.org/10.1590/2317-6431-2018-2079 copy

Association between aspects of clinical assessment of the tongue accomplished in children

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Purpose

Investigate the possible association between myofunctional aspects of the tongue clinical evaluation.

Methods

Observational, cross-sectional study conducted with 80 healthy Brazilian schoolchildren aged 8-12 years: 36 (45%) males and 44 (55%) females. The following aspects of the tongue were assessed: morphology, frenulum, mobility, praxis, and force. Association between the aspects of clinical evaluation was obtained considering a statistical significance level of 5%.

Results

The following associations were observed: between tongue width and height; between frenulum length and the tasks of sucking the tongue on palate, tongue vibration, tongue protrusion/retraction, and touching right and left commissures and upper and lower lips; between frenulum attachment to the floor of the mouth and the tasks of sucking tongue on palate and tongue vibration. In the snap task, tongue apex snap was associated with tongue body snap. Tongue snap (apex or body) was associated with sucking the tongue on palate, tongue vibration, tongue protrusion/retraction, touching right and left commissures and upper and lower lips, and tongue force. Sucking tongue on palate was associated with tongue vibration, tongue protrusion/retraction, touching right and left commissures and upper and lower lips, and tongue force. Tongue vibration was associated with tongue protrusion/retraction and tongue force. Association was also observed between the tongue protrusion/retraction task and touching right and left commissures and upper and lower lips.

Conclusion

Association between tongue aspects was verified in the clinical evaluation.

Keywords:
Tongue; Evaluation; Speech, Language and hearing sciences; Stomatognathic system; Muscle strength

Task	Tongue width				Tongue height
	Normal		Altered		p-value	Normal		Altered		p-value
	n	%	n	%	p-value	n	%	n	%	p-value
Tongue height
Normal	70	90.9	7	9.1	0.002^ Fisher’s exact test	-	-	-	-	-
Altered	1	33.3	2	66.7	0.002^ Fisher’s exact test	-	-	-	-	-
Frenulum length
Adequate	62	89.9	7	10.1	0.366^* * Chi-squared test;	66	95.6	3	4.3	0.508*
Short	8	80	2	20	0.366^* * Chi-squared test;	10	100	0	0	0.508*
Frenulum attachment to the tongue
At midline	65	91.5	6	8.5	0.337*	69	97.2	2	2.8	0.237*
Between midline and apex	4	80.0	1	20.0		5	100	0	0
At the apex	1	33.3	2	66.7		2	66.7	1	33.3
Frenulum attachment to the floor of the mouth
Visible from the caruncles	58	90.6	6	9.4	0.249**	64	100.0	0	0	0.237**
Visible from the crest	12	80.0	3	20.0	0.249**	12	80.0	3	20	0.237**
Tongue apex snap
Adequate	59	86.8	9	13.2	0.185*	65	95.6	3	4.41	0.465*
Altered	6	100.0	0	0		6	100.0	0	0
Absent	6	100.0	0	0		6	100.0	0	0
Tongue body snap
Adequate	60	87.0	9	13.0	0.208*	66	95.6	3	4.35	0.487*
Altered	5	100.0	0	0		5	100	0	0
Absent	6	100.0	0	0		6	100	0	0
Sucking the tongue on palate
Adequate	59	86.8	9	13.2	0.185*	65	95.6	3	4.4	0.465*
Altered	7	100.0	0	0		7	100.0	0	0
Absent	5	100.0	0	0		5	100.0	0	0
Tongue vibration
Adequate	55	88.7	7	11.3	0.983*	61	98.4	1	1.61	0.063*
Altered	9	81.8	2	18.2		10	90.9	1	9.1
Absent	7	100.0	0	0		6	85.7	1	14.3
Tongue protrusion/retraction
Adequate	67	88.2	9	11.8	0.471*	73	96.0	3	3.95	0.690*
Altered	3	100.0	0	0		3	100.0	0	0
Lip movement	1	100.0	0	0		1	100.0	0	0
Touching the right and left commissures and upper and lower lips
Adequate	62	87.3	9	12.7	0.263*	68	95.8	3	4.2	0.536*
Altered	6	100.0	0	0		6	100.0	0	0
Lip movement	1	100.0	0	0		1	100.0	0	0
Mandible movement	2	100.0	0	0		2	100.0	0	0
Tongue force
Adequate	33	94.3	2	5.7	0.171*	33	94.3	2	5.7	0.421*
Reduced	18	85.7	3	14.3		20	95.2	1	4.8
Reduced at the apex	20	83.3	4	16.7		24	100.0	0	0

Task	Frenulum length					Frenulum attachment to the tongue									Frenulum attachment to the floor of the mouth
	Adequate		Short		p- value	At midline			Between midline and apex		At the apex			p-value	Visible from the caruncles			Visible from the crest		p- value
	n	%	n	%	p- value	n	%		n	%	n	%		p-value	n	%		n	%	p- value
Frenulum attachment to the tongue
At midline	63	88.7	8	11.3	0.139	-		-	-	-	-		-	-	-		-	-	-	-
Between midline and apex	3	60.0	2	40.0		-		-	-	-	-		-		-		-	-	-
At the apex	3	100.0	0	0		-		-	-	-	-		-		-		-	-	-
Frenulum attachment to the floor of the mouth
Visible from the caruncles	58	90.6	6	9.4	0.071	60		93.7	3	4.7	1		1.6	0.285	-		-	-	-	-
Visible from the crest	11	73.3	4	26.7	0.071	11		73.3	2	13.3	2		13.3	0.285	-		-	-	-	-
Tongue apex snap
Adequate	61	91.0	6	9.0	0.065	61		91.0	4	6.0	2		3.0	0.224	56		83.6	11	16.4	0.173
Altered	4	66.7	2	33.3		6		100.0	0	0	0		0		5		83.3	1	16.7
Absent	4	66.7	2	33.3		4		66.6	1	16.7	1		16.7		3		50.0	3	50.0
Tongue body snap
Adequate	61	89.7	7	10.3	0.119	62		91.2	4	5.9	2		2.9	0.226	56		82.4	12	17.6	0.457
Altered	4	80	1	20		5		100.0	0	0	0		0		5		100.0	0	0
Absent	4	66.7	2	33.3		4		66.6	1	16.7	1		16.7		3		50.0	3	50.0
Sucking the tongue on palate
Adequate	61	91.0	6	9.0	0.019	60		89.5	4	6.0	3		4.5	0.233	55		82.1	12	17.9	0.028
Altered	6	85.7	1	14.3		7		100.0	0	0	0		0		7		100.0	0	0
Absent	2	40.0	3	60.0		4		80.0	1	20.0	0		0		2		40.0	3	60.0
Tongue vibration
Adequate	56	91.8	5	8.2	0.028	56		91.8	3	4.9	2		3.3	0.276	53		86.9	8	13.1	0.014
Altered	9	81.8	2	18.2		10		90.9	1	9.1	0		0		9		81.8	2	18.2
Absent	4	57.1	3	42.9		5		71.4	1	14.3	1		14.3		2		28.6	5	71.4
Tongue protrusion/retraction
Adequate	67	89.3	8	10.7	0.021	67		89.3	5	6.7	3		4.0	0.420	61		81.3	14	18.7	0.757
Altered	1	33.3	2	66.7		3		100	0	0	0		0		2		66.7	1	33.3
Lip movement	1	100.0	0	0		1		100	0	0	0		0		1		100.0	0	0
Touching the right and left commissures and upper and lower lips
Adequate	64	91.4	6	8.6	0.002	63		90.0	4	5.7	3		4.3	0.724	57		81.4	13	18.6	0.796
Altered	2	33.3	4	66.7		5		83.3	1	16.7	0		0		4		66.7	2	33.3
Lip movement	1	100	0	0		1		100	0	0	0		0		1		100.0	0	0
Mandible movement	2	100	0	0		2		100	0	0	0		0		2		100.0	0	0
Tongue force
Adequate	34	97.1	1	2.9	0.063	34		97.1	1	2.9	0		0	0.192	30		85.7	5	14.3	0.348
Reduced	18	78.3	5	21.7		20		87.0	1	4.3	2		8.7		17		73.9	6	26.1
Reduced at the apex	17	80.9	4	19.1		17		80.9	3	14.3	1		4.8		17		80.9	4	19.1

Task	Tongue apex snap
	Normal		Altered		Absent		p-value	Normal		Altered		Absent		p-value
	n	%	n	%	n	%	p-value	n	%	n	%	n	%	p-value
Tongue body snap
Adequate	67	97.1	2	2.9	0	0	<0.001	-	-	-	-	-	-	-
Altered	1	20.0	4	80.0	0	0		-	-	-	-	-	-
Absent	0	0	0	0	6	100		-	-	-	-	-	-
Sucking the tongue on palate
Adequate	61	89.7	5	7.4	2	2.9	0.005	63	92.7	3	4.4	2	2.9	<0.001
Altered	5	71.4	1	14.3	1	14.3		4	57.1	2	28.6	1	14.3
Absent	2	40.0	0	0	3	60.0		2	40.0	0	0	3	60.0
Tongue vibration
Adequate	57	91.9	3	4.8	2	3.2	0.001	57	91.9	3	4.8	2	3.2	0.006
Altered	8	72.7	2	18.2	1	9.1		9	81.8	1	9.1	1	9.1
Absent	3	42.9	1	14.3	3	42.9		3	42.9	1	14.3	3	42.9
Tongue protrusion/retraction
Adequate	68	89.5	4	5.3	4	5.3	<0.001	69	90.8	3	3.9	4	5.3	<0.001
Altered	0	0	1	33.3	2	66.7		0	0	1	33.3	2	66.7
Lip movement	0	0	1	100.0	0	0		0	0	1	100.0	0	0
Touching the right and left commissures and upper and lower lips
Adequate	64	90.1	3	4.2	4	5.6	<0.001	64	90.1	3	4.2	4	5.6	0.004
Altered	2	33.3	2	33.3	2	33.3		3	50.0	1	16.7	2	33.3
Lip movement	0	0	1	100.0	0	0		0	0	1	100.0	0	0
Mandible movement	2	100.0	0	0	0	0		2	100.0	0	0	0	0
Tongue force
Adequate	35	100.0	0	0	0	0	0.001	35	100	0	0	0	0	0.001
Reduced	15	62.5	3	12.5	6	25.0		15	62.5	3	12.5	6	25.0
Reduced at the apex	18	85.7	3	14.3	0	0		19	90.5	2	9.5	0	0

Task	Sucking the tongue on palate
	Normal		Altered		Absent		p-value	Normal		Altered		Absent		p-value
	n	%	n	%	n	%	p-value	n	%	n	%	n	%	p-value
Tongue vibration
Adequate	57	91.9	4	6.5	1	1.6	0.001	-	-	-	-	-	-	-
Altered	8	72.7	2	18.2	1	9.1		-	-	-	-	-	-
Absent	3	42.9	1	14.3	3	42.9		-	-	-	-	-	-
Tongue protrusion/retraction
Adequate	66	86.8	7	9.2	3	4.0	0.045	61	80.3	9	11.8	6	7.9	0.009
Altered	1	33.3	0	0	2	66.7		1	33.3	1	33.3	1	33.3
Lip movement	1	100.0	0	0	0	0		0	0	1	100.0	0	0
Touching the right and left commissures and upper and lower lips
Adequate	63	88.7	5	7.0	3	4.2	0.008	57	80.3	8	11.3	6	8.4	0.097
Altered	4	66.7	0	0	2	33.3		3	50.0	2	33.3	1	16.7
Lip movement	1	100.0	0	0	0	0		0	0	1	100.0	0	0
Mandible movement	0	0	2	100.0	0	0		2	100	0	0	0	0
Tongue force
Adequate	35	100	0	0	0	0	0.001	31	88.6	3	8.6	1	2.9	0.037
Reduced	14	58.3	6	25.0	4	16.7		14	58.3	5	20.8	5	20.8
Reduced at the apex	19	90.5	1	4.8	1	4.8		17	80.9	3	14.3	1	4.8

Task	Tongue protrusion/retraction
	Normal		Altered		Absent		p- value	Normal		Altered		Lip movement		Mandible movement				p-value
	n	%	n	%	n	%	p- value	N	%	n	%	n	%	n		%		p-value
Touching the right and left commissures and upper and lower lips
Adequate	71	100	0	0	0	0	<0.001	-	-	-	-	-	-	-	-		-
Altered	3	50.0	3	50.0	0	0		-	-	-	-	-	-	-	-
Lip movement	0	0	0	0	1	100.0		-	-	-	-	-	-	-	-
Mandible movement	2	100.0	0	0	0	0		-	-	-	-	-	-	-	-
Tongue force
Adequate	35	100	0	0	0	0	0.072	34	97.1	1	2.9	0	0	0	0		0.466
Reduced	22	91.7	2	8.3	0	0		21	87.5	2	8.3	0	0	1	4.2
Reduced at the apex	19	90.5	1	4.8	1	4.8		16	76.2	3	14.3	1	4.8	1	4.8

Academia Brasileira de Audiologia Rua Itapeva, 202, conjunto 61, CEP 01332-000, Tel.: (11) 3253-8711, Fax: (11) 3253-8473 - São Paulo - SP - Brazil
E-mail: revista@audiologiabrasil.org.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] Conflict of interests: No.