UC Davis

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.