, Volume 33, Issue 6, pp 778–788 | Cite as

Impaired Tongue Function as an Indicator of Laryngeal Aspiration in Adults with Acquired Oropharyngeal Dysphagia: A Systematic Review

  • Martin Checklin
  • Tania Pizzari
Original Article


Tongue function assessment typically forms part of a clinical bedside swallowing evaluation (CBSE). The predictive value of lingual function for calculating aspiration risk in isolation is not known. The aim of this systematic review was to collate current evidence on the utility of assessing lingual deficits for predicting aspiration. Health databases Medline, CINAHL, Cochrane Library, SpeechBITE, AMED and Embase were searched from inception to November 2016. Studies were included if there was a comparison between a clinical lingual assessment (index test) and aspiration on instrumental assessments (reference test) in adults who had been diagnosed with oropharyngeal dysphagia. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to assess the quality of the studies. Sensitivity, specificity, predictive values, likelihood ratios and odds ratios were extracted or calculated where possible. A best evidence synthesis and receiver operator curve (ROC) analysis for sensitivity and specificity were conducted. Twelve studies were included, of which only one had a low risk of bias. The ROC curve, predictive values and likelihood ratios did not show a relationship between lingual function and aspiration. Best evidence synthesis showed moderate evidence that when motility and strength are jointly assessed, they are not associated with aspiration. Other lingual assessment variables indicated either limited or conflicting evidence of an association. There is currently no evidence to indicate that there is a predictive relationship between lingual deficits as part of a CBSE and aspiration in adults with acquired oropharyngeal dysphagia. Recommendations for clinical practice and future research are made.


Swallowing Deglutition Deglutition disorders Prediction Tongue Assessment Aspiration 



No funding or Grants were obtained for this study.

Compliance with Ethical Standards

Conflict of interest

For this systematic review no grants or other financial support was received or supplied.

Ethical Approval

This article does not contain any studies with human participants performed by any of the authors.


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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Speech Pathology, Epworth Rehabilitation, RichmondEpworth HealthcareRichmondAustralia
  2. 2.La Trobe Sport and Exercise Medicine Research CentreLa Trobe UniversityBundooraAustralia

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