Ann Rehabil Med.  2016 Apr;40(2):197-205. 10.5535/arm.2016.40.2.197.

Usefulness of Submental Ultrasonographic Evaluation for Dysphagia Patients

• Lee YS
• Lee KE
• Kang Y
• Yi TI
• Kim JS

• KMID: 2309917
• DOI: http://doi.org/10.5535/arm.2016.40.2.197

Abstract

OBJECTIVE
To investigate the usefulness of ultrasonographic measurement of hyoid bone movement during swallowing.
METHODS
Fifty-two patients who had swallowing dysfunction were enrolled in this study. When a patient swallowed 5 mL of water while maintaining an upright sitting position, hyoid bone movement during swallowing was measured with ultrasonography. Recorded images were analyzed to measure the maximum change in hyoid bone displacement. Mandible was used as reference point to calculate hyoid bone displacement. The farthest distance from resting position and the nearest distance during swallowing were measured and their differences were recorded. Participants also underwent videofluoroscopic swallowing study (VFSS). Based on penetration-aspiration scale (PAS), they were grouped to non-aspirators (PAS 1), penetrators (PAS 2-5), or aspirators (PAS 6-8). Measured hyoid bone displacements by submental ultrasonography were compared among groups.
RESULTS
The mean hyoid bone displacement in non-aspirators group (n=21, 15.9±2.7 mm) was significantly (p<0.05) greater than that in penetrators group (n=20, 11.5±2.8 mm) or aspirators group (n=11, 8.0±1.0 mm). Hyoid bone displacement below 13.5 mm as a cutoff point for detecting penetration or aspiration had a sensitivity and specificity of 83.9% and 81.0%, respectively.
CONCLUSION
Submental ultrasonographic evaluation was well correlated with PAS measured by VFSS. Therefore, submental ultrasonographic evaluation could be a useful screening tool for dysphagic patients.

Keyword

Ultrasonography; Deglutition disorders; Deglutition; Hyoid bone

MeSH Terms

Deglutition
Deglutition Disorders*
Humans
Hyoid Bone
Mandible
Mass Screening
Sensitivity and Specificity
Ultrasonography
Water

Figure

• 

  Fig. 1 Submental ultrasonographic evaluation. (A) A vertical line is drawn from superior thyroid notch to mandible for probe placement. (B) Probe was placed at midsagittal plane of submental area.

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  Fig. 2 Hyoid bone displacement. (A) Distance between the mandible and the hyoid bone at rest, (B) during swallowing. White arrow, shadow behind the mandible; black arrow, shadow behind the hyoid bone; asterisk, suprahyoid muscles.

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