Ann Rehabil Med.  2016 Apr;40(2):190-196. 10.5535/arm.2016.40.2.190.

Assessment of Oropharyngeal Dysphagia in Patients With Parkinson Disease: Use of Ultrasonography

Affiliations
  • 1Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center, Seoul, Korea. khojing@hanmail.net

Abstract


OBJECTIVE
To compare tongue thickness, the shortest hyoid-thyroid approximation (distance between the hyoid bone and thyroid cartilage), and the time interval between the initiation of tongue movement and the time of the shortest hyoid-thyroid approximation, by using ultrasonography in healthy controls and patients with Parkinson disease (PD).
METHODS
Healthy controls and PD patients with dysphagia were compared. Ultrasonography was performed 3 times for the evaluation of tongue thickness, the shortest hyoid-thyroid approximation, and the time between the initiation of tongue movement and the shortest hyoid-thyroid approximation.
RESULTS
A total of 24 healthy controls and 24 PD patients with dysphagia were enrolled. No significant differences were demonstrated between the two groups for the shortest hyoid-thyroid approximation (controls, 1.19±0.34 cm; PD patients, 1.37±0.5 cm; p=0.15) and tongue thickness (controls, 4.42±0.46 cm; PD patients, 4.27±0.51 cm; p=0.3). In contrast, the time to the shortest hyoid-thyroid approximation was significantly different between the two groups (controls, 1.53±0.87 ms; PD patients, 2.4±1.4 ms, p=0.048).
CONCLUSION
Ultrasonography can be useful in evaluating dysphagia in patients with PD by direct visualization and measurement of the hyoid bone. Moreover, ultrasonography might contribute to a greater understanding of the pathophysiology of dysphagia in PD.

Keyword

Parkinson disease; Dysphagia; Ultrasonography; Hyoid bone; Tongue

MeSH Terms

Deglutition Disorders*
Humans
Hyoid Bone
Parkinson Disease*
Thyroid Gland
Tongue
Ultrasonography*

Figure

  • Fig. 1 Longitudinal ultrasonographic images of hyoid-thyroid approximation at rest and during the swallowing state. (A) Longitudinal approach of ultrasonographic probe, anterior view. (B) Longitudinal approach of ultrasonographic probe, lateral view. (C) At rest, the thickest area of the tongue ('To') is shown by the dotted line, and the hyoid-thyroid approximation, which is the distance between the hyoid bone ('H') and the thyroid cartilage ('Th'), is shown by the solid line. (D) During swallowing, hyoid-thyroid approximation occurs with laryngeal elevation. The shortest distance of hyoid-thyroid approximation is shown by the solid line.


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