[Dysphagia] Masako, tongue contraction and other misperceptios.

[mbuckie at dmc.org (Buckie,Marcia)]

I have been to conferences and read posts by Drs. Sonies and Crary and while the content of the message may be  the same, the tone is not.

I choose to stay on the list because I benefit from the free exchange of information and theory, however, it can be a bit of shark tank at times. Thankfully, I have thick skin. However, imagine how much better the forum could be for everyone if there wasn't the pejorative undercurrent. I can only imagine how many unasked questions there are out there by inexperienced clinicians, who have sought out this forum, but have been daunted by the occasional tone of the exchanges on this listserv.

In a different vein, I don't think clinicians are using the Masako or interdental swallow as a swallow compensation but as an exercise. However, I know there is not sufficient research to support its efficacy.

Marcia Peterson Buckie, M.A.
Senior Speech Langauge Pathologist
Sinai-Grace Hospital
Detroit, Mi






-----Original Message-----
From: dysphagia-bounces@b9.com [mailto:dysphagia-bounces@b9.com]On
Behalf Of Irene Campbell-Taylor
Sent: Wednesday, May 18, 2005 4:01 PM
To: Genefer Behamdouni; dysphagia@b9.com
Subject: Re: [Dysphagia] Masako, tongue contraction and other
misperceptios.




Genefer Behamdouni <BEHAMG@stjoe.on.ca> wrote:
You know if you won't stand for people being rude to you, I'm not sure
why you feel the need to be so rude to others. The information is
interesting, but you won't solve anything by putting people down first.

Grow up.

*** One of the reasons that I frequently stay away from this list - over the ten years in which I have been a contributor - is responses like this. My comment was a repeat of what Barbara Sonies said in her talk at ASHA in Chicago - outdated, incorrect information etc.  Should she "Grow up" as well? And Michael Crary? Do the published facts mean nothing? And what, exactly, was rude? I am on record as indicating that every insulting message I receive on this list - and over the years there have been hundreds- will be posted to the membership. If one doesn't have the courage to say something publicly, please keep quiet and know that these communications have no effect on me whatsoever.

>>> Irene Campbell-Taylor 05/18 9:44 AM >>>
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 The wealth of outdated, inaccurate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
Exclusive Distributor:
www.interactivetherapy.com 
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Dr I Campbell-Taylor
Clinical Neuroscientist
Exclusive Distributor:
www.interactivetherapy.com
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