I have no tongue but I must eat

April 25, 2012 9:21 AM

So cutting out someone's tongue as punishment, or to create a mute (and therefore trusted to hear and not leak secrets) guard has some historic basis, and appears as a troupe in many stories. My question: Can you actually still eat with out choking, if someone cut your tongue out ?

Sure a liquid diet would make sense, but eating solid foods with out a tongue sounds like a recipe for the Heimlich.

(yes, ok, I picked up the Hunger Games, and the punished-slaves-with-no-tongue helped prompt this question.. )

posted by k5.user to health & fitness (4 answers total)

Probably depends on what is left, but this article leads me to believe that if it's gone, it would be impossible. "It stops food and liquids going down into the lungs."

I'm also never going to feel the same way about canker sores ever again.
posted by General Malaise at 9:26 AM on April 25, 2012

I'm a speech therapist, and we as a profession also work with people with swallowing issues (mostly tongue mobility/swallowing anatomy paralysis or weakness from strokes).

I'm a bit out of practice in the swallowing field, having worked in the schools for a while, but yeah, it would totally depend on what is left of the tongue, and also possibly food textures.

The tongue assists in moving food in a controlled motion down to your esophagus (food pipe) and out of your airway (windpipe). The epiglottus is actually a covering over your airway beyond the base of the tongue, but it's triggered (usually, hopefully, in a healthy person) by swallowing. It's a reflex that you probably weren't even aware of, but it helps guard your airway when you swallow.

Without a tongue, food would just be kind of shoved to the back of your throat with less control, and this might not let the epliglottus do its thing. (It might not be enough time to sense that food is heading toward it, with the whole sequence of chewing/tongue motion it has been used to.)

But, a person could maybe, with swallowing therapy, learn to control this with some food textures. I would imagine liquids would be challenging, but then think about the mechanics of getting just the right size of a bite of food down your throat, and mixing it with saliva to aid digestion, without your tongue. Hard to imagine! But food thickeners are available, and thickened liquids are available, too.

So...an educated guess is that a person might be able to learn to control how to eat some textures of food with the help of a speech/swallow therapist (or OT, or even PT, or even some nurses).
posted by shortyJBot at 9:36 AM on April 25, 2012

Here's an article about someone who lost his tongue because of cancer that talks briefly about his swallowing technique.
posted by Sidhedevil at 9:43 AM on April 25, 2012

Another speech therapist here - I do work with adults with swallowing problems.

You can actually test this out (well, you personally can't!) by looking at people who have had their tongues removed due to cancer. I don't work with this client group, but as I understand it, it entirely depends on how much and which bit of the tongue is gone. It also depends on whether anything about your condition has affected other structures involved in swallowing in your throat.

I suspect that if your tongue was entirely removed, swallowing safely would be very unlikely for all the reasons listed above. If it's mostly gone, you can swallow liquids by pouring them into your mouth and tipping your head back to move them backwards. Food is more difficult because it doesn't flow. If you only have one side of your tongue removed you can tip your head to one side to use gravity to keep the food and drink on that side. The very base of your tongue helps push the food down your throat, so losing that would likely compromise your ability to clear food or drink away before your airway opens up again, but I haven't got experience of anyone with this part of their tongue removed.

If you're interested in reading further, removing the tongue is called 'glossectomy', or 'hemiglossectomy' for removing half of it. Difficulty swallowing is called 'dysphagia'. Good search terms might be 'dysphagia after radical glossectomy', which results in articles such as:
http://www.sciencedirect.com/science/article/pii/003042207590078X

I find this area fascinating.
posted by kadia_a at 9:53 AM on April 25, 2012