People treated for tongue cancer with partial glossectomy, reconstruction, and postoperative chemoradiation often have oral dysphagia due to the significant changes to lingual anatomy affecting the oral phase of the swallow, specifically, bolus formation manipulation and oral transit. In this AB, criterion-changing, single-subject experimental design (SSED) study, three participants who were 4-20 months post-partial glossectomy, reconstruction, and chemoradiation treatment completed a daily intensive tongue strengthening protocol for five weeks using the Iowa Oral Performance Instrument (IOPI). The use of the IOPI involved visual feedback, and the participants had high adherence to the intensive daily lingual exercises. Post-intervention data, when compared to pre-intervention control data, revealed significant improvement in lingual strength (measured in kPa lingual pressures) and in the efficiency of food intake (as measured by an increase in grams of food eaten in a 15-minute time period). Participants in this study also reported a perceived improvement in their ability to eat more challenging foods, which may positively affect the overall quality of life post-cancer treatment. The results of this study indicate that a surgically resected and radiated tongue can be exercised, and a tongue strengthening exercise protocol could improve or impact the variety, efficiency, and amount of food consumed. Findings of this initial SSED add to the breadth of the literature regarding improvements in swallowing function through interventions that affect the overall quality of life post multimodal tongue cancer treatment.
Keywords: lingual pressures, swallowing, head and neck cancer, lingual SCC