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Evaluation of swallowing movement using ultrasonography


The aim of this study is to develop an index to assess swallowing function by ultrasonography to evaluate the relationship between movements of the hyoid bone and the larynx while swallowing water. Forty-two younger participants (mean age, 20.3 ± 3.4 years) and 42 older participants (mean age, 75.1 ± 10.6 years) with normal swallowing function were included in the study. Movements of the hyoid bone and the larynx while swallowing 5 mL of water were observed using ultrasonography. Two-dimensional distances from the starting points of the hyoid bone and the larynx to their points of maximum movement were measured as displacements. The hyoid bone–laryngeal motion ratio was defined as the hyoid bone displacement divided by the laryngeal displacement. Parameters were compared among four groups: younger male, younger female, older male, and older female. The hyoid bone displacement differed significantly between the younger and older groups, and the laryngeal displacement differed significantly between age groups and sexes. The hyoid bone–laryngeal motion ratio was not significantly correlated with age, height, or body weight, and did not show a significant difference between the four groups. Thus, the hyoid bone–laryngeal motion ratio is an index that evaluates swallowing movement and is independent of physique and physiological changes associated with aging.

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  1. Logemann JA, Pauloski BR, Rademaker AW, Colangelo LA, Kahrilas PJ, Smith CH. Temporal and biomechanical characteristics of oropharyngeal swallow in younger and older men. J Speech Lang Hear Res. 2000;43(5):1264–74.

    CAS  Article  Google Scholar 

  2. Martino R, Pron G, Diamant N. Screening for oropharyngeal dysphagia in stroke: insufficient evidence for guidelines. Dysphagia. 2000;15(1):19–30.

    CAS  Article  Google Scholar 

  3. Ekberg O. The normal movements of the hyoid bone during swallow. Investig Radiol. 1986;22(1):92.

    Article  Google Scholar 

  4. Bours GJ, Speyer R, Lemmens J, Limburg M, de Wit R. Bedside screening tests vs. videofluoroscopy or fibreoptic endoscopic evaluation of swallowing to detect dysphagia in patients with neurological disorders: systematic review. J Adv Nurs. 2009;65(3):477–93.

    Article  PubMed  Google Scholar 

  5. Shanley C, O’Loughlin G. Dysphagia among nursing home residents: an assessment and management protocol. J Gerontol Nurs. 2000;26(8):35–48.

    CAS  Article  Google Scholar 

  6. Sonies BC, Wang C, Sapper DJ. Evaluation of normal and abnormal hyoid bone movement during swallowing by use of ultrasound duplex-Doppler imaging. Ultrasound Med Biol. 1996;22(9):1169–75.

    CAS  Article  Google Scholar 

  7. Kuhl V, Eicke BM, Dieterich M, Urban PP. Sonographic analysis of laryngeal elevation during swallowing. J Neurol. 2003;250(3):333–7.

    CAS  Article  Google Scholar 

  8. Yabunaka K, Sanada H, Sanada S, Konishi H, Hashimoto T, Yatake H, Yamamoto K, Katsuda T, Ohue M. Sonographic assessment of hyoid bone movement during swallowing: a study of normal adults with advancing age. Radiol Phys Technol. 2011;4(1):73–7.

    Article  PubMed  Google Scholar 

  9. Hsiao MY, Chang YC, Chen WS, Chang HY, Wang TG. Application of ultrasonography in assessing oropharyngeal dysphagia in stroke patients. Ultrasound Med Biol. 2012;38(9):1522–8.

    Article  PubMed  Google Scholar 

  10. Lee YS, Lee KE, Kang Y, Yi TI, Kim JS. Usefulness of submental ultrasonographic evaluation for dysphagia patients. Ann Rehabil Med. 2016;40(2):197–205.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Steele CM, Bailey GL, Chau T, Molfenter SM, Oshalla M, Waito AA, Zoratto DC. The relationship between hyoid and laryngeal displacement and swallowing impairment. Clin Otolaryngol. 2011;36(1):30–6.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  12. Chi-Fishman G, Sonies BC. Effects of systematic bolus viscosity and volume changes on hyoid movement kinematics. Dysphagia. 2002;17(4):278–87.

    Article  Google Scholar 

  13. Chen Y-C, Hsiao M-Y, Wang Y-C, Fu C-P, Wang T-G. Reliability of ultrasonography in evaluating hyoid bone movement. J Med Ultrasound. 2017;25:90–5.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Dodds WJ, Stewart ET, Logemann JA. Physiology and radiology of the normal oral and pharyngeal phases of swallowing. AJR Am J Roentgenol. 1990;154(5):953–63.

    CAS  Article  Google Scholar 

  15. Okada T, Aoyagi Y, Inamoto Y, Saitoh E, Kagaya H, Shibata S, Ota K, Ueda K. Dynamic change in hyoid muscle length associated with trajectory of hyoid bone during swallowing: analysis using 320-row area detector computed tomography. J Appl Physiol. 2013;115(8):1138–45.

    Article  PubMed  Google Scholar 

  16. Kim Y, McCullough GH. Maximum hyoid displacement in normal swallowing. Dysphagia. 2008;23(3):274–9.

    Article  Google Scholar 

  17. Dantas RO, Kern MK, Massey BT, Dodds WJ, Kahrilas PJ, Brasseur JG, Cook IJ, Lang IM. Effect of swallowed bolus variables on oral and pharyngeal phases of swallowing. Am J Physiol. 1990;258(5 Pt 1):G675–G681681.

    CAS  PubMed  Google Scholar 

  18. Sundgren P, Maly P, Gullberg B. Elevation of the larynx on normal and abnormal cineradiogram. Br J Radiol. 1993;66(789):768–72.

    CAS  Article  Google Scholar 

  19. Kahrilas PJ, Dodds WJ, Dent J, Logemann JA, Shaker R. Upper esophageal sphincter function during deglutition. Gastroenterology. 1988;95(1):52–62.

    CAS  Article  Google Scholar 

  20. Leonard R, Kendall KA, McKenzie S. Structural displacements affecting pharyngeal constriction in nondysphagic elderly and nonelderly adults. Dysphagia. 2004;19(2):133–41.

    Article  Google Scholar 

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This study was supported by the Japan Society for the Promotion of Science Grant-in-Aid for Young Scientists (B) Grant Number JP17K18264.

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Correspondence to Takao Matsuo.

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All procedures performed in studies involving human participants were performed in accordance with the Research Ethics Committee of Kansai University of Welfare Sciences (Approval number: 17-64) and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Matsuo, T., Matsuyama, M., Nakatani, K. et al. Evaluation of swallowing movement using ultrasonography. Radiol Phys Technol 13, 62–68 (2020).

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  • Ultrasonography
  • Hyoid bone
  • Laryngeal movement
  • Swallowing movement
  • Hyoid bone–laryngeal motion ratio