Tongue base augmentation to improve swallow function in a cadaveric model

Abstract

Abstract Objectives To evaluate the feasibility of using Calcium Hydroxylapatite (CaHA) to augment the tongue base for patients with swallowing impairment due to tongue base atrophy. Methods A fresh human cadaver was obtained through the institution's body donation program and baseline lateral fluoroscopic images were obtained. A total of 2 mL of CaHA (Prolaryn Plus) were injected into three sites of the base of tongue under flexible endoscopic guidance with a 22G, 1.5‐inch needle (Monoject, Cardinal Health). Post‐lateral fluoroscopic images were obtained and pharyngeal area (cm2) and tongue base to pharyngeal wall distance (cm) was measured pre‐ and postinjection using SwallowTail fluoroscopic measurement software (Belldev Medical). Results The procedure was easily performed and the CaHA flowed easily into the cadaveric tongue without evidence of extrusion. The pre‐procedural pharyngeal area decreased from 24.36 to 23.14 cm after augmentation. The base of tongue to pharyngeal wall distance decreased from 2.21 to 1.32 cm after augmentation. Conclusion Tongue base augmentation with CaHA may be a feasible adjuvant therapy for the management of swallowing impairment secondary to tongue base atrophy. Further investigation is necessary to evaluate the clinical safety and efficacy. Level of Evidence 4

Keywords

• aspiration pneumonia
• dysphagia
• lingual atrophy
• radiation toxicity
• swallow impairment