• 재활치료과학
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• 제11권3호
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• pp.7-22
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• 2022

목적 : 본 연구는 연하장애를 가진 뇌졸중 환자에게 적용된 혀 운동을 체계적으로 분석한 논문이다. 혀 운동에 대한 전반적인 효과를 검증하고, 현재 이루어지고 있는 혀 운동에 대한 경향을 파악하는데 그 목적을 가지고 근거를 제공하고자 한다. 연구방법 : PRISMA(Preferred Reporting Items for Systematic Reviews and Meta-Analysis) 체크리스트 및 흐름도를 이용하여 체계적 고찰을 시행하였다. 데이터베이스는 PubMed, MEDLINE, CINAHL, RISS, e-article 을 통해 문헌 검색을 진행하였다. 본 연구에 사용된 문헌의 수는 총 6편이었고, 문헌의 질을 평가하기 위하여 PEDro scale(Physiotherapy Evidence Database scale)을 사용하였다. 결과 : 분석된 논문 6편에서 3가지의 중재 방법이 포함되었다. 혀 운동의 종류로는 혀 근력훈련 3편, 혀 근력 및 정확도 훈련 2편으로 모두 아이오와 구강 수행 도구를 통한 중재를 시행하였고, 혀 신장훈련을 적용한 논문이 1편이었다. 조사된 문헌에서 시행한 중재 별 치료 효과는 모두 효과가 있는 것으로 확인되었다. 하지만 대부분 표본수가 적어 일반화 시키기는 어려울 것으로 생각되며, 실험군과 대조군 비교 시 몇몇 그룹 간에 유의한 차이가 발견되지 않은 결과들이 있는 만큼 전통적 연하재활치료도 구강기 연하장애를 가지고 있는 환자들에게 적절한 치료 방법으로 판단된다. 결론 : 본 연구는 작업치료사들이 연하장애를 가진 뇌졸중 환자들에게 혀 운동을 적용함에 있어 효율적인 연하재활치료를 제공하는데 도움을 줄 수 있을 것이며, 혀 운동의 효과를 알아보기 위해 더 많은 연구축적이 이루어져야 할 것으로 생각된다.

• 대한소아치과학회지
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• 제36권4호
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• pp.568-574
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• 2009

설유착증(tongue-tie)은 비정상적으로 짧은 설소대로 인하여 혀의 움직임이 제한되는 것을 의미한다. 영유아에서 심한 설유착증은 수유곤란을 야기하기도 하고, 증상이 지속적으로 존재할 때는 혀의 운동범위가 제한되어 발음문제를 야기할 수 있다. 또한 비정상적인 혀의 위치로 인해 여러 가지 교정적인 문제를 초래 할 뿐만 아니라, 기능적, 사회적 장애요소로 작용할 수도 있다. 설유착증의 치료방법으로는 관찰, 언어치료, 단순절개술 그리고 절제술 등이 있는데, 수술시기에 대한 논란은 있지만 정도가 심하여 장기간 언어장애가 지속되거나 교정적인 문제를 야기 할 것으로 판단되는 경우 조기수술이 권장되고 있다. 진정요법은 조기치료가 필요한 나이가 어리고 비협조적인 환아들이나, 신체적, 정신적 이유로 통상적 인 치과진료에 어려움이 있는 환아들에게 효과적으로 사용될 수 있는 방법이다. 본 증례는 설유착증으로 수술이 필요하나 협조전단계인 환아를 대상으로 경구투여를 이용한 진정요법으로 소대절제술을 시행하여 양호한 결과를 얻었기에 이를 보고하는 바이다.

• 한국한의학연구원논문집
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• 제14권3호
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• pp.97-102
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• 2008

The tongue diagnosis is a diagnostic method in the oriental medicine that uses shape, substance, coating, and movement of the tongue to determine the condition of health and disease characteristics in human. Since this information, however, could be affected by subjective sense and visual information, it is difficult to obtain the objective and reproducible results. This research aims at building a reproducible tongue diagnosis system using color chart that is attached close to the face contact region. The picture of color chart is taken simultaneously with a tongue and applied to color revision. The system, in addition, is focused on providing a clear tongue image through securing a sufficient photographing distance with a surface coating mirror. The lightning part which can suppress the reflection by sputum in maximum is implemented for the objectification and quantification of the tongue diagnosis system. The face contact region is designed for consideration of a testee's convenience. To evaluate the reproducibility of the system, the CVs (coefficient of variance, %) of $L{\ast}$, $a{\ast}$ and $b{\ast}$ of red, green and blue regions in color chart are calculated, respectively. The results of all CVs shows that the tongue diagnosis system is re liable and those consequences contribute to the objectification and quantification of the tongue diagnosis system.

• 말소리와 음성과학
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• 제2권4호
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• pp.119-127
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• 2010

Recently, we have launched a large-scale articulatory study to investigate how the three-way contrastive stops (i.e., lenis, fortis, and aspirated) in Korean are kinematically expressed (i.e., in terms of articulatory movement characteristics) in various contexts, using a magnetometer (Electromagnetic Articulography). In this paper, we report some preliminary results about how the three-way bilabial series /p,$p^h,p^*$/ produced in /Ca/ context in isolation are kinematically characterized not only during the lip closure but also during the following vocalic articulation. Some important notes could be made from the results. First, the degree of lip constriction (as measured by the lip aperture between the upper and lower lips) was smaller for the lenis /p/ and larger for the fortis/aspirated /$p^*,p^h$/, showing a two-way distinction during the closure. Second, the tongue lowering for the following vowel was more extreme after the lenis /p/ than after the fortis/aspirated /$p^*,p^h$/. Regarding this vocalic articulatory difference in the tongue height, we discussed the possibility that the articulatory tension associated with the fortis/aspirated stops is further reflected in the lingual vocalic movement maintaining the tongue position to a certain level for the following vowel /a/, while the lenis consonant does not impose such articulatory constraints, resulting in more tongue lowering. Finally, the temporal relationship between the release of the stop closure and the lowest tongue position of the following vowel remained constant, suggesting that CV coordination is invariantly maintained across the consonant type. This pattern was interpreted as supporting the view that the consonant and vowel gestures are coordinated in much the same way across languages.

• 대한심미치과학회지
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• 제9권1호
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• pp.20-36
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• 2000

The movements of oral surrounding muscles, lips, and tongue play a very important role while masticating, swallowing, and speaking. In case of the edentulous patient wearing dentures as well, every movement of the tongue can be seen almost the same as that of the dentulous jaw. The crushed food during mastication is swallowed and sent to pharynx. At this course, the contact of the posterior portion of tongue with dentures affects the stabilization of denture. The retention and stability of the complete dentures are related with buccinator muscles of buccal parts, lips in front, and tongue of the lingual sides. Strack(1946) insisted that the arrangement of artificial teeth in the same place as that of the natural dentition is the best way to maintain the stability of denture. In this report, I would like to introduce the several advantages of a new impression method taken simultaneously, and its procedures and clinical cases.

• 한국임상수의학회지
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• 제25권6호
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• pp.545-548
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• 2008

A 3-year-old castrated male Siberian husky was presented for evaluation after being hit by a car. On physical examination, the dog showed open-mouth, displacement of mandible and hypersalivation with blood ting. The base of tongue was transected almost 80% on the bias from right dorsal side to the left ventral side. Radiography demonstrated separation of mandible symphysis, and fracture of right condyle and vertical ramus. After debridement of the necrotic tissue, tongue apposition with simple interrupted suture was performed. Mandibular symphysis, condyle and mandibular vertical ramus fractures were fixed using pin, cerclage wire, T-plate, and K-wires. The mouth was irrigated daily using chlorhexidine after surgery. The sutures that were loose here or untied at tongue were re-sutured under sedation. The transected tongue was healed and recovered its normal movement after 6 weeks.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권2호
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• pp.164-171
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• 2000

Purpose : This study was aimed at measuring the changes in the hyoid bone position, tongue position, and pharyngeal airway space in subjects with mandibular setback osteotomies. Methods : Twenty patients were evaluated retrospectively for their changes in pharyngeal airway space, tongue and hyoid bone positions. All patients underwent surgical mandibular setback using bilateral sagittal split osteotomies. The cephalometric analysis was performed preoperatively, and 1 week, 3-6 months, and 1 year postoperatively. Result : The hyoid bone moved inferiorly and posteriorly immediately after surgery, and it returned to the preoperative position during follow-up period. The nasopharyngeal airway space was not significantly changed after surgery. A considerable decrease in the oropharyngeal and hypopharyngeal airway spaces following mandibular setback surgery was found. The upper and lower tongue was posteriorly repositioned immediately after surgery. During follow-up period, the hypopharyngeal airway space and lower tongue posture returned to the preoperative positions, but the oropharyngeal airway space and upper tongue posture were not significantly changed. The position of pogonion remarkably changed to backward immediately after surgery, but slightly anterior advancement was found during follow-up period. Conclusion : Immediately after mandibular setback surgery, the oropharyngeal and hypopharyngeal airway spaces obviously decreased due to posterior and inferior repositions of the tongue and hyoid bone. During follow-up period, lower tongue and hyoid bone returned to the preoperative positions, it was related to advancement of the pogonion in this period. The narrowing of the oropharyngeal airway space and posterior movement of the upper tongue posture were relatively permanent after mandibular setback surgery. We suspected this phenomenon had an influence on maintaining the total volume of oral cavity against mandibular setback.

• 대한소아치과학회지
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• 제23권3호
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• pp.697-705
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• 1996

Ankyloglossia, or tongue-tie, is a congenital condition which occurs as a result of fusion between the tongue and the floor of the mouth. Ankyloglossia often results in malocclusion with an anterior "open bite" deformity, early prognathism, swallowing problem, speech disorder, and periodontal problem. Generally lingual frenectomy is used for treatment of ankyloglossia, but incomplete operation and simple frenectomy may produce a scar contracture resulting in a more deformed ankyloglossia than was present initially. The Z-plasty is used for the correction of scar contractures and the replacement of missing tissue and this procedure is ideally suited for the treatment of an ankylosed frenum. Most authors advise postponement of any decision for surgical correction of tongue-tie until the age of 4 years, unless the child is having much difficulty with sucking or swallowing. We treated 4 patients with ankyloglossia using Z-plasty technique. As a result, we found out that it was effective for correction of movement limitation of tongue, prevention of relapse. Further, periodic check ups are needed for evaluation of relapse, improvement of speech, and other functions of the tongue.

• 말소리와 음성과학
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• 제3권3호
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• pp.27-33
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• 2011

This paper explores two articulatory characteristics of inter-consonantal coordination observed in lingual-lingual (/kt/, /ks/) and labial-lingual (/pt/) sequences. Using electromagnetic articulometry (EMMA), temporal aspects of the lip movement and lingual movement (of the tongue tip and the tongue dorsum) were examined. Three sequences (/ks/, /kt/, /pt/) were investigated in two respects: gestural overlap in C1C2 and formation duration of coronals in C2 (/t/ or /s/). Results are summarized as follows. First, in a sequence of two stop consonants gestural overlap did not vary with order contrast or a low-level motor constraint on lingual articulators. Gestural overlap between two stop consonants was similar in both /kt/ (lingual-lingual; back-to-front) and /pt/ (labial-lingual; front-to-back). Second, gestural overlap was not simply constrained by place of articulation. Two coronals (/s/ and /t/) shared the same articulator, the tongue tip, but they showed a distinctive gestural overlap pattern with respect to /k/ in C1 (/ks/ (less overlap) < /kt/ (more overlap)). Third, temporal duration of the tongue tip gesture varied as a function of manner of articulation of the target segment in C2 (/ks/ (shorter) < /kt/ (longer)) as well as a function of place of articulation of the segmental context in C1 (/pt/ (shorter) < /kt/ (longer)). There are several implications associated with the results from Korean non-assimilating contexts. First, Korean can be better explained in the way of its language-specific gestural pattern; gestural overlap in Korean is not simply attributed to order contrast (front-to-back vs. back-to-front) or a physiological motor constraint on lingual articulators (lingual-lingual vs. nonlingual-lingual). Taking all factors into consideration, inter-gestural coordination is influenced not only by C1 (place of articulation) but also C2 (manner of articulation). Second, the jaw articulator could have been a factor behind a distinctive gestural overlap pattern in different C1C2 sequences (/ks/ (less overlap) vs. /kt/ and /pt/ (more overlap)). A language-specific gestural pattern occurred with reference to a physiological motor constraint on the jaw articulator.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제26권2호
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• pp.115-131
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• 2000

In the study of craniofacial deformity, it is very important that identifying the factor which can affect the morphology and which is closely related to the morphology, because it can not only improve the comprehension of growth and developmental process but also be applied in growth prediction and treatment modality. Several investigators have already mentioned the characterstics of head posture and airway space in relations to morphologic difference. But it is very meaningful work in clarifying the correlation between morphology, head posture and airway space that observing the change of head posture after morplologic change caused by operation and the change of airway space after same procedure. To investigate above correlation, I selected normal group which is consisted of 43 adults and mandibular prognathism group which is consisted of 47 adults who had been operated by sagittal split ramus osteotomy and were followed up more than 1 year. With their lateral skull radiograghs, reference lines which can evaluate each measuring points and areas without effect of postural change were first determined. And using above reference lines, change of airway space, positional change of tongue and hyoid, change of cranial and cervical angulations were measured. The results obtained from the study were as follows 1. In the change of head posture, the position of tongue and hyoid neighboring to pharynx is more closely related to the reference line of cervical column than to reference line of cranium. 2. After mandibular setback operation, the airway dimension was decreased to 81.6% of preoperative state at 1 month postoperatively and was slightly increased to 89.7% at 1 year postoperatively. 3. Posterior movement of tongue plays important role in decrease of airway dimension and inferior movement of hyoid was closely correlated with posterior movement of tongue. 4. Postoperative anterior movement of mandible, namely, morphologic relapse had correlation with relapse phenomenon of airway dimension. 5. Craniocervical angulation increased postoperatively. Especially in the postoperative early state, there was increased foreward inclination of cervical angulation rather than increase of cranial angulation. But at postoperative 1 year it was observed that cervical inclination was returned to preoperative state and cranial angulation was increased gradually. 6. Increase rate of airway dimension was correlated with the increase of cranial angulation from postoperative 1 month to 1 year. In conclusion, relapse tendency of airway dimension following increase of cranial angulation was found after mandibular setback operation and it is considered that increase of cranial angulation is one of compensatory mechanism in airway maintenance.