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The aim of this study was to evaluate the dosimetric characteristics of a semi-customized tongue displacement device (SCTDD) fabricated using a 3D printer for patients receiving unilateral head and neck irradiation with intensity-modulated proton therapy (IMPT) and assess its feasibility as a proton beam stopper compared to a standard mouthpiece (SMP). Seven consecutive patients, three with tonsil cancer, and four with oral cavity cancer were included in this retrospective study. Planning computed tomography (CT) images of each patient were acquired for each device. Both the SCTDD and SMP plans were generated using a single-field optimized IMPT. The clinically relevant dose-volume parameters for the organs at risk (OARs), especially the tongue, were compared between the SCTDD and SMP plans. Additionally, to assess the feasibility of SCTDD as a proton beam stopper, the dose to the contralateral oral mucosa (COM) was compared with that from sMP use. The use of scTDD resulted in a statistically significant decrease in the radiation dose to the tongue and COM compared to sMP. The median mean dose to the tongue was significantly reduced with SCTDD (18.3 Gy(RBE)) compared to the SMP (22.9 Gy(RBE)) (p = 0.016). The percentages of tongue volume receiving doses between 15 and 60 Gy(RBE) were significantly lower with SCTDD. In the COM, SCTDD resulted in a significantly lower median mean (2.9 Gy(RBE) vs. 7.9 Gy(RBE), p = 0.018) and maximum dose (39.1 Gy(RBE) vs. 41.6 Gy(RBE), p = 0.018) doses compared to SMP. The SCTDD effectively decreased the radiation dose to the tongue compared to SMP in patients undergoing unilateral head and neck irradiation with IMPT and acted as a proton beam stopper to protect normal tissues located behind the target volume, such as the COM.

BackgroundRadiotherapy for head and neck cancer may cause various oral sequelae, such as radiation-induced mucositis. To protect healthy tissue from irradiation, intraoral devices can be used. Current tissue retraction devices (TRDs) have to be either individually manufactured at considerable cost and time expenditure or they are limited in their variability. In this context, a 3D-printed, tooth-borne TRD might further facilitate clinical use.MethodsA novel approach for the manufacturing of TRDs is described and its clinical application is analysed retrospectively. The devices were virtually designed for fabrication by 3D-printing technology, enabling—in only a single printing design—caudal or bi-lateral tongue displacement, as well as stabilization of a tongue-out position. For a total of 10 patients undergoing radiotherapy of head and neck tumors, the devices were individually adapted after pre-fabrication. Technical and clinical feasibility was assessed along with patient adherence. Tissue spacing was calculated by volumetric analysis of tongue retraction. In one exemplary case, radiotherapy treatment plans before and after tissue displacement were generated and compared. The reproducibility of maxillomandibular relation at device re-positioning was quantified by repeated intraoral optical scanning in a voluntary participant.Results3D-printing was useful for the simplification of TRD manufacture, resulting in a total patient treatment time of less than 30 min. The devices were tolerated well by all tested patients over the entire radiation treatment period. No technical complications occurred with the devices. The TRDs caused an effective spacing of the healthy adjacent tissue, e.g., the tongue. Position changes of maxillomandibular relation were limited to a mean value of 98.1 µm ± 29.4 µm root mean square deviation between initial reference and follow-up positions.ConclusionsThe presented method allows a resource-efficient fabrication of individualized, tooth-bourne TRDs. A high reproducibility of maxillomandibular relation was found and the first clinical experiences underline the high potential of such devices for radiotherapy in the head and neck area.

This paper investigates the articulatory–acoustical relationship in the production of the Cantonese long point vowels [iː uː aː] in CV syllables and shortened equivalents [i u a] in checked CVC syllables, through an analysis of the tongue positions and corresponding formant frequencies for the vowels. The articulatory and acoustical data from four Cantonese speakers, two male and two female, show that: (i) the shortened high vowels [i] and [u], relative to the long [iː] and [uː], undergo formant undershoot in the acoustical vowel space and [u] also undergoes target reduction in the articulatory vowel space, and (ii) the effect of shortened vowel duration is not observed in the low [a]. The data on the articulatory–acoustical relationship show that: (i) the levels of sensitivity of F1 and F2 to the variations in tongue displacement are low in each of the vowels [iː uː aː] and [i u a], suggesting that the Cantonese point vowels are quantal, and (ii) the sensitivity of the formant frequencies is lower to the...

Outcomes of articulation therapy for rhotic errors are usually assessed perceptually. However, our understanding of associated changes of tongue movement is limited. This study described perceptual, durational and tongue displacement changes over 10 sessions of articulation therapy for /ɹ/ in six children. Four of the participants also received ultrasound biofeedback of their tongue shape. Speech and tongue movement were recorded pre-therapy, after 5 sessions, in the final session and at a one month follow-up. Perceptually, listeners perceived improvement and classified more productions as /ɹ/ in the final and follow-up assessments. The durations of VɹV syllables at the midway point of the therapy were longer. Cumulative tongue displacement increased in the final session. The average standard deviation was significantly higher in the middle and final assessments. The duration and tongue displacement measures illustrated how articulation therapy affected tongue movement and may be useful for outcomes research about articulation therapy.

Bilabial stops often show a lowering of the tongue in symmetrical VCVsequences. The causes of this phenomenon, sometimes called the ‘trough effect’,are unknown. However, it could have important implications for the study of timevaryingaspects of speech events. Ultrasound is a non-invasive technique that hasallowed us to image the shape of the tongue in real time and measure the actualtongue displacement that occurs in the C of a VCV sequence. Five repetitions ofsymmetrical V1CV2 sequences with the bilabial stops /b, p/ were obtained from 10British English speakers. Results showed not only differences in the direction anddegree of the tongue displacement but also differences in the tongue contour configurationbetween subjects. This study demonstrates the effectiveness of ultrasoundas a technique in phonetic research, making possible the analysis of tonguesurface movement for large amounts of data from multiple subjects.

Background This paper describes the use of real-time magnetic resonance imaging in visualizing and quantifying oral cavity motor strategies employed by 6 healthy, elite horn players and 5 horn players with embouchure dystonia. Methods Serial images with an acquisition time of 33.3 ms were obtained from each performer during execution of an 11-note harmonic series encompassing 2.5 octaves on a magnetic resonance imaging-compatible horn. A customized MATLAB toolkit was employed for the extraction of line profiles from magnetic resonance imaging films allowing comparative analyses between elite and dystonic horn players. Results The data demonstrate differing motor strategies, particularly in moving from the 6th through 9th harmonics. The elite horn player strategy features elevation and anterior displacement of the tongue during ascending sequences, whereas dystonic players showed significantly less movement. The elite horn players thus narrowed the air channel on higher notes, presumably affording faster airflow for vibration of the lips at higher frequencies. Conclusions We postulate that failure to employ this strategy by dystonic horn players may require greater tension in the embouchure muscles to compensate for slower air speed. Though this may simply be an expression of or adaptation for dystonia, the possibility that it may be a contributing factor in the development of embouchure dystonia is suggested. Electronic supplementary material The online version of this article (doi:10.1186/s40734-015-0027-2) contains supplementary material, which is available to authorized users.

Purpose The primary purpose of this study was to determine the strength of interspeaker and intraspeaker articulatory-to-acoustic relations of vowel contrast produced by talkers with dysarthria and controls. Methods Six talkers with amyotrophic lateral sclerosis (ALS), six talkers with Parkinson's disease (PD), and 12 controls repeated a sentence at typical, slow, and fast rates. Tongue displacements and acoustic vowel distances were measured to determine articulatory and acoustic vowel contrasts. Results Interspeaker articulatory-to-acoustic relations were strong for talkers with PD and controls but weak for talkers with ALS and controls. Further, predominantly moderate and strong intraspeaker articulatory-to-acoustic relations were found in response to rate modulations; however, correlation coefficients were significantly lower in talkers with ALS than in controls. Conclusions The findings on interspeaker articulatory-to-acoustic relations suggested that the degree of tongue displacement can be accurately inferred from the degree of acoustic vowel contrast in talkers with PD but not in talkers with ALS. Findings on intraspeaker articulatory-to-acoustic relations generally supported the longstanding notion that speaking rate–induced changes in tongue displacement evoke similar changes in acoustic vowel contrast. Differential effects of the pathophysiology on inter- and intraspeaker articulatory-to-acoustic relations are discussed.

The study evaluates the quantal theory (Stevens, 1972, 1989) through investigating the articulatory-acoustic relations in two sets of Cantonese point vowels, the long [i: u:] and the medium-long [i u]. It determines the sensitivity of vowel formant frequencies to variations in linguo-palatal constriction location and constriction size along the vocal tract length. The articulatory and acoustic data on the vowels obtained in this study show non-linear relations between the acoustic consequences and the up-down and front-back displacements in linguo-palatal constriction, as what the quantal theory predicts. Moderate displacements in constriction location and constriction size bring about large perturbation in acoustic parameter. The level of sensitivity of formant frequencies to variation in tongue displacement is lower in [i: u:] than [i u], suggesting that the quantal nature is more apparent in [i: u:] than [i u]. For the Cantonese point vowels, F1 is more sensitive to variation in constriction location than constriction size, whereas F2 is more sensitive to variation in constriction size than constriction location. A difference between Cantonese and English is that, in English, both F1 and F2 are relatively more sensitive to variation in constriction size than constriction location.

Formants are useful components to be used in order to recognize some meaningful contents from any sound. By using formants, vowel sounds in a speech can be recorded and categorized as a reference in a speech training system for the hearing impaired. The recorded sound then can be analyzed and the sound's formant values can be obtained. By using PRAAT system, the vowel speech is recorded and up-to three values of formants were gained. These formant values from five vowels (A, E, I, O, U) from three subjects were analyzed and characterized as a reference for a speech training system. The results shows that pronounced vowels' characteristics can be distinguished but may defer a little from a person to another.

Flamingos are filter feeders that only rarely ingest larger food items. Their bill anatomy is adapted to the suction, filtration, and ejection of a fluid medium. This case report documents a rare case of bill impaction in a group of Caribbean flamingos (Phoenicopterus ruber) that were kept in a mixed exhibit together with roseate spoonbills (Platalea ajaja) and scarlet ibis (Eudocimus ruber). The latter species received fatty minced meat as part of their diet, which was also accessible to the flamingos. Weakness and poor body condition of one flamingo were noted. On clinical examination, the animal was emaciated, hypoglycemic, and showed a severe impaction of the bill with a mixture of lard, mud, and sand. This mixture had compressed the tongue and eventually had most likely prevented further food intake. In five additional flamingos, a bulging of the gular area, similar to the extension of this area during the tongue-retraction stage of the feeding cycle, was noted and interpreted as a sign of tongue displacement by similar masses in their bills. All animals were caught and the masses removed. All animals resumed food intake immediately, and the emaciated animal rapidly improved in condition. Food presentation was changed so that the trays for the other species were no longer accessible to the flamingos, and no similar problems have been observed since that time.

The goals of this study were to characterize tongue surface displacement during production of bilabial stops and to refine current estimates of vocal-tract wall impedance using direct measurements of displacement in the vocal tract during closure. In addition, evidence was obtained to test the competing claims of passive and active enlargement of the vocal tract during voicing. Tongue displacement was measured and tongue compliance was estimated in four subjects during production of /aba/ and /apa/. All subjects showed more tongue displacement during /aba/ than during /apa/, even though peak intraoral pressure is lower for /aba/. In consequence, compliance estimates were much higher for /aba/, ranging from 5.1 to 8.5 x 10(-5) cm3/dyn. Compliance values for /apa/ ranged from 0.8 to 2.3 x 10(-5) cm3/dyn for the tongue body, and 0.52 x 10(-5) for the single tongue tip point that was measured. From combined analyses of tongue displacement and intraoral pressure waveforms for one subject, it was concluded that smaller tongue displacements for /p/ than for /b/ may be due to active stiffening of the tongue during /p/, or to intentional relaxation of tongue muscles during /b/ (in conjunction with active tongue displacement during /b/).

We have previously shown that caudal tracheal displacement alters the airflow dynamics of the upper airway. In the present study, we specifically examined the effects of tongue and tracheal displacement on upper airway airflow dynamics. To determine how tongue and tracheal displacement modulate maximal inspiratory airflow (VImax), we analyzed the pressure-flow relationships obtained in the isolated upper airway of paralyzed cats. VImax and its determinants, the pharyngeal critical pressure (Pcrit) and the nasal resistance (Rn) upstream to the flow-limiting site, were measured as tongue displacement and tracheal displacement were systematically varied. Four results were obtained: 1) there was no independent effect of tongue displacement on VImax, Pcrit, or Rn; 2) there was an increase in VImax with 2 cm of tracheal displacement, which was associated with a decrease in Pcrit and an increase in Rn; 3) there was an interactive effect of tongue and tracheal displacement on VImax and Pcrit but not on Rn; and 4) there was a large increase in VImax with tongue displacement > 2.5 cm with the trachea nondisplaced, which was associated with a large decrease in Pcrit and a large increase in Rn. We conclude that tongue and tracheal displacement exert differing influences on airflow dynamics and present a mechanical model of the upper airway that explains these results.

The authors describe a technique to depict tongue muscle displacement with tagged magnetization-prepared gradient-recalled echo magnetic resonance imaging. Three Japanese volunteers (three men, aged 31-36 years) were studied while they articulated specific sounds. Each image was obtained in less than 2 seconds without need for gating. Displacement and alteration of the tags within the tongue muscle during phonation were clearly visible. The technique may prove useful in the study of phoniatric pathophysiology.

Movement of palatine shelves in living mouse embryos after tongue displacement was evaluated by direct observation and by re-examination of the shelves after freezing or submersion in fixative. Effect on shelf function of suspending the embryos in saline or plasma was compared with manipulations in air. Measurements were made of head dimensions and residual space between the palatine shelves in embryos fixed in the cornua or after experimental manipulation. All methods of evaluating palatine shelf behavior indicated movement toward the midline by the anterior portions of the shelves after tongue displacement. Experiments with complete detachment of the tongue demonstrated that the tongue contributes to the flattening of the shelves into a horizontal plane by exerting pressure from below. The same techniques applied to embryos treated with cortisone, vitamin A and x-ray demonstrated reduced movement of palatine shelves toward the midline when compared with untreated embryos. The reduction was greatest with x-irradiation and least with hypervitaminosis A.

The effect of cervical extension, cervical flexion, mandible displacement, tongue displacement, and effortful increase in intrathoracic pressure on the pharyngeal airway of ten normal adults is described from radiographic observations. Maintenance of the airway is viewed as being effected by interaction between cervical postural and pharyngeal muscles. Identification of the function of these mechanisms might provide new criteria for evaluation of pharyngeal impairment. The performance of extension was especially remarkable because of the consistency of the subjects' postural and pharyngeal responses to spoken command. The pharyngeal airway of each subject was distinctively expanded. The relationship between postural and pharyngeal structures has procedural implications for speech investigations. Submitted on August 14, 1961

The potential for palatine shelf fusion in cortisone-treated mouse fetuses was tested by mechanically displacing the tongue from between the shelves. Fusion occurred in 51 per cent of 135 fetuses so treated, compared to 19 per cent of 117 fetuses released from the uterus without tongue displacement. Thus, the ability of a substantial number of palatine shelves to fuse after cortisone treatment, as originally demonstrated by tongue excision, was confirmed by a less traumatic technique.

The x‐ray microbeam installation at the University of Tokyo was used to compare supralaryngeal kinematic patterns of fluent utterances produced by a control subject and two stutterers. For the control subject, trial‐to‐trial variability in individual and combined tongue‐jaw peak displacement for alveolar obstruent closure and release was equivalent to the variability in lip and jaw displacement for bilabial stop closure and release by a larger group of normal subjects [V. L. Gracco and J. H. Abbs, Exp. Brain Res. (in press)]. The stutterers demonstrated greater variability than the control in individual tongue and jaw displacement, and the combined tongue‐jaw displacement variability was not less than the individual articulator variability. In contrast to the control, the stutterers achieved closure and release primarily by jaw displacement with little, and occasionally paradoxical, tongue displacement. The lack of covariability in tongue‐jaw displacement, coupled with the dominance of a single member of ...

A comparison between tense and lax vowel pairs was undertaken using simultaneous recordings of tongue movements via glossometry and audio signals. A normal speaker recorded five repetitions each of three pairs of tense‐lax vowels (i‐i, ae‐ɛ, u‐o) in pipsire context (əpvp, ətvt, əkvk). Measures for maximum tongue displacement, durations and velocities of physiological onglide, and target and offglide movements relative to the acoustic release of the initial plosive were taken. Greater maximal displacement from a central position was noted for all tense vowels. In pvp contexts, consistent preplosive anticipatory positioning was found for all vowels, and maximal tongue positioning for the lax vowels was achieved 50 ms prior to the tense vowels. For both lingual plosive contexts, tense vowel movements had longer total durations but slower onglide and offglide velocities than their lax counterparts. These results will be discussed in terms of biomechanical restrictions for production and the effects of perceptual saliancy and coarticulation. [Work supported by NIH Grant NS24697.]