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Medical tongue piercing - development and evaluation of a surgical protocol and the perception of procedural discomfort of the participants.

Bentsen B, Gaihede M, Lontis R, Andreasen Struijk LN - J Neuroeng Rehabil (2014)

Bottom Line: The piercings were all successfully inserted in less than 5 min and the pain level was moderate compared with oral injections.The procedure proved simple, fast, and safe for insertion of tongue piercings for tetraplegic subjects in a clinical setting.No serious complications were encountered, and the procedure was found tolerable to the participants.

View Article: PubMed Central - HTML - PubMed

Affiliation: Center for Sensory Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, DK-9220 Aalborg, Denmark. lontis@hst.aau.dk.

ABSTRACT

Background: A system providing disabled persons with control of various assistive devices with the tongue has been developed at Aalborg University in Denmark. The system requires an activation unit attached to the tongue with a small piercing. The aim of this study was to establish and evaluate a safe and tolerable procedure for medical tongue piercing and to evaluate the expected and perceived procedural discomfort.

Methods: Four tetraplegic subjects volunteered for the study. A surgical protocol for a safe insertion of a tongue barbell piercing was presented using sterilized instruments and piercing parts. Moreover, post-procedural observations of participant complications such as bleeding, edema, and infection were recorded. Finally, procedural discomforts were monitored by VAS scores of pain, changes in taste and speech as well as problems related to hitting the teeth.

Results: The piercings were all successfully inserted in less than 5 min and the pain level was moderate compared with oral injections. No bleeding, infection, embedding of the piercing, or tooth/gingival injuries were encountered; a moderate edema was found in one case without affecting the speech. In two cases the piercing rod later had to be replaced by a shorter rod, because participants complained that the rod hit their teeth. The replacements prevented further problems. Moreover, loosening of balls was encountered, which could be prevented with the addition of dental glue. No cases of swallowing or aspiration of the piercing parts were recorded.

Conclusions: The procedure proved simple, fast, and safe for insertion of tongue piercings for tetraplegic subjects in a clinical setting. The procedure represented several precautions in order to avoid risks in these susceptible participants with possible co-morbidity. No serious complications were encountered, and the procedure was found tolerable to the participants. The procedure may be used in future studies with tongue piercings being a prerequisite for similar systems, and this may include insertion in an out-patient setting.

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Related in: MedlinePlus

The piercing procedure: (A) Penetration of the tongue from the upside by the Venflon needle; (B) After removal of the needle, the plastic tube remains in situ while the valve section is cut off and discharged; (C) The metal rod is guided through the tissue by means of the plastic tube; (D) The balls are tigthened onto the rod of the piercing by a needle holder while holding the tongue with the forceps; (E) Relaxed tongue muscles immidiately after the insertion, where the piercing is loosely attachted to the tongue; and (F) Contraction of the tongue muscles causes the piercing to become more firmly embedded (written consent for publication of these photos was obtained from the participant).
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Figure 4: The piercing procedure: (A) Penetration of the tongue from the upside by the Venflon needle; (B) After removal of the needle, the plastic tube remains in situ while the valve section is cut off and discharged; (C) The metal rod is guided through the tissue by means of the plastic tube; (D) The balls are tigthened onto the rod of the piercing by a needle holder while holding the tongue with the forceps; (E) Relaxed tongue muscles immidiately after the insertion, where the piercing is loosely attachted to the tongue; and (F) Contraction of the tongue muscles causes the piercing to become more firmly embedded (written consent for publication of these photos was obtained from the participant).

Mentions: At the insertion of the piercing, the tip of the tongue was held firmly with the tongue holder and a piece of cloth. Thus, a midline translingual canal could be prepared by penetrating the tongue with the canula of the venflon (Figure 4A). The canula was surrounded by a thin plastic tube. After the withdrawal of the canula and cutting off the valve section, a 30–40 mm piece of this plastic tube was left inside the tongue tissue (Figure 4B). This plastic tube subsequently served as a guide canal to insert the piercing rod, and the rod with the ball attached at one end was easily introduced through the plastic tube (Figure 4C). Finally, the plastic tube was removed and the second ball was screwed onto the rod and tightened by the needle holder (Figure 4D).


Medical tongue piercing - development and evaluation of a surgical protocol and the perception of procedural discomfort of the participants.

Bentsen B, Gaihede M, Lontis R, Andreasen Struijk LN - J Neuroeng Rehabil (2014)

The piercing procedure: (A) Penetration of the tongue from the upside by the Venflon needle; (B) After removal of the needle, the plastic tube remains in situ while the valve section is cut off and discharged; (C) The metal rod is guided through the tissue by means of the plastic tube; (D) The balls are tigthened onto the rod of the piercing by a needle holder while holding the tongue with the forceps; (E) Relaxed tongue muscles immidiately after the insertion, where the piercing is loosely attachted to the tongue; and (F) Contraction of the tongue muscles causes the piercing to become more firmly embedded (written consent for publication of these photos was obtained from the participant).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4230317&req=5

Figure 4: The piercing procedure: (A) Penetration of the tongue from the upside by the Venflon needle; (B) After removal of the needle, the plastic tube remains in situ while the valve section is cut off and discharged; (C) The metal rod is guided through the tissue by means of the plastic tube; (D) The balls are tigthened onto the rod of the piercing by a needle holder while holding the tongue with the forceps; (E) Relaxed tongue muscles immidiately after the insertion, where the piercing is loosely attachted to the tongue; and (F) Contraction of the tongue muscles causes the piercing to become more firmly embedded (written consent for publication of these photos was obtained from the participant).
Mentions: At the insertion of the piercing, the tip of the tongue was held firmly with the tongue holder and a piece of cloth. Thus, a midline translingual canal could be prepared by penetrating the tongue with the canula of the venflon (Figure 4A). The canula was surrounded by a thin plastic tube. After the withdrawal of the canula and cutting off the valve section, a 30–40 mm piece of this plastic tube was left inside the tongue tissue (Figure 4B). This plastic tube subsequently served as a guide canal to insert the piercing rod, and the rod with the ball attached at one end was easily introduced through the plastic tube (Figure 4C). Finally, the plastic tube was removed and the second ball was screwed onto the rod and tightened by the needle holder (Figure 4D).

Bottom Line: The piercings were all successfully inserted in less than 5 min and the pain level was moderate compared with oral injections.The procedure proved simple, fast, and safe for insertion of tongue piercings for tetraplegic subjects in a clinical setting.No serious complications were encountered, and the procedure was found tolerable to the participants.

View Article: PubMed Central - HTML - PubMed

Affiliation: Center for Sensory Motor Interaction, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, DK-9220 Aalborg, Denmark. lontis@hst.aau.dk.

ABSTRACT

Background: A system providing disabled persons with control of various assistive devices with the tongue has been developed at Aalborg University in Denmark. The system requires an activation unit attached to the tongue with a small piercing. The aim of this study was to establish and evaluate a safe and tolerable procedure for medical tongue piercing and to evaluate the expected and perceived procedural discomfort.

Methods: Four tetraplegic subjects volunteered for the study. A surgical protocol for a safe insertion of a tongue barbell piercing was presented using sterilized instruments and piercing parts. Moreover, post-procedural observations of participant complications such as bleeding, edema, and infection were recorded. Finally, procedural discomforts were monitored by VAS scores of pain, changes in taste and speech as well as problems related to hitting the teeth.

Results: The piercings were all successfully inserted in less than 5 min and the pain level was moderate compared with oral injections. No bleeding, infection, embedding of the piercing, or tooth/gingival injuries were encountered; a moderate edema was found in one case without affecting the speech. In two cases the piercing rod later had to be replaced by a shorter rod, because participants complained that the rod hit their teeth. The replacements prevented further problems. Moreover, loosening of balls was encountered, which could be prevented with the addition of dental glue. No cases of swallowing or aspiration of the piercing parts were recorded.

Conclusions: The procedure proved simple, fast, and safe for insertion of tongue piercings for tetraplegic subjects in a clinical setting. The procedure represented several precautions in order to avoid risks in these susceptible participants with possible co-morbidity. No serious complications were encountered, and the procedure was found tolerable to the participants. The procedure may be used in future studies with tongue piercings being a prerequisite for similar systems, and this may include insertion in an out-patient setting.

Show MeSH
Related in: MedlinePlus