Quantitative imaging of tongue kinematics during infant feeding and adult swallowing reveals highly conserved patterns

Abstract

Tongue motility is an essential physiological component of human feeding from infancy through adulthood. At present, it is a challenge to distinguish among the many pathologies of swallowing due to the absence of quantitative tools. We objectively quantified tongue kinematics from ultrasound imaging during infant and adult feeding. The functional advantage of this method is presented in several subjects with swallowing difficulties. We demonstrated for the first time the differences in tongue kinematics during breast‐ and bottle‐feeding, showing the arrhythmic sucking pattern during bottle‐feeding as compared with breastfeeding in the same infant with torticollis. The method clearly displayed the improvement of tongue motility after frenotomy in infants with either tongue‐tie or restrictive labial frenulum. The analysis also revealed the absence of posterior tongue peristalsis required for safe swallowing in an infant with dysphagia. We also analyzed for the first time the tongue kinematics in an adult during water bolus swallowing demonstrating tongue peristaltic‐like movements in both anterior and posterior segments. First, the anterior segment undulates to close off the oral cavity and the posterior segment held the bolus, and then, the posterior tongue propelled the bolus to the pharynx. The present methodology of quantitative imaging revealed highly conserved patterns of tongue kinematics that can differentiate between swallowing pathologies and evaluate treatment interventions. The method is novel and objective and has the potential to advance knowledge about the normal swallowing and management of feeding disorders.

Newfound features associated with Hennekam Syndrome (Intestinal Lymphangiectasia-Lymphedema-Intellectual-Disability Syndrome) complicated with comorbid Waldmann’s disease resulting in celiac disease

“…HS causes poor feeding due to alveolar/oral structural abnormalities or abdominal lymphangiectasias (WD), which would both cause swelling in the abdomen. 3,4,5,43 He recently had a bout of diarrhea that was loose in nature and then progressed onto sticky, hard stools and then normalized. The patient's mother reported such episodes to have often occurred throughout the years.…”

“…The monosyllabic speech and alveolar clicks comprised most of our patient's responses; both have been associated with previously reported HS patients. 43,44,45 The clicks are part of an array of reflexes babies initially do before complete tongue muscle functionality develops. 43 They have been reported with developmental delay.…”

“…43,44,45 The clicks are part of an array of reflexes babies initially do before complete tongue muscle functionality develops. 43 They have been reported with developmental delay. Therefore, if the alveolar clicks in our patient were due to developmental delay, it would also explain why HS patients present with feeding problems since muscle functionality and coordination are incomplete or absent.…”

“…Therefore, if the alveolar clicks in our patient were due to developmental delay, it would also explain why HS patients present with feeding problems since muscle functionality and coordination are incomplete or absent. 43 However, one of the features of HS includes hypertrophic alveolar ridges, which could also be part of the reason he produced alveolar clicks. 44 HS has been reported to present with scoliosis, other musculoskeletal issues, and habitus abnormalities.…”

Relationship Between Infant Tongue-Tie and Maternal Wellbeing

“…Prevalence of tongue-tie has recently been estimated to be approximately 8% (Hill et al, 2020). The immediate consequences of tonguetie are diffi culty feeding related to limited tongue mobility and improper sucking and swallowing (Genna et al, 2020). Once diagnosed, tongue-tie can be treated with a minor surgical procedure to release the tight frenulum, known as frenotomy (Todd & Hogan, 2015).…”