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An Exploratory Study of Hyoid Visibility, Position, and Swallowing-Related Displacement in a Pediatric Population

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A Correction to this article was published on 10 September 2020

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Abstract

Hyoid position and swallowing-related displacement has been studied in healthy adults and adults with dysphagia, but research is limited in children. The aim of this study was to investigate feasibility of visualizing and measuring position and swallowing-related displacement of the hyoid bone in children. We explored relationships between hyoid displacement, age and aspiration risk scores. Pediatric swallowing data were extracted from a videofluoroscopy database containing recordings from 133 children aged 9 days to 21 years (mean 36 months, SD 3 years) referred for videofluoroscopy due to concerns regarding their feeding. Children presented with varying etiologies: neurological, structural, respiratory, and other diagnoses. Still shot images were extracted for the frame of hyoid peak position and a frame showing the hyoid at rest. Pixel-based image analysis software was used to measure hyoid position in three directions (X = anterior, Y = superior, XY = hypotenuse) relative to C4 vertebra. Difference between rest and peak position was used to measure hyoid displacement (X, Y and XY). The hyoid was not visible in children < 9 months, but could be reliably visualized and measured in 49 children. Descriptive statistics were collected for hyoid parameters. Age was significantly associated with rest (Y and XY) and peak (Y and XY) hyoid position parameters as well as anterior displacement. No significant associations were observed between hyoid parameters and aspiration risk scores. This study successfully explored hyoid visibility, position and swallowing-related displacement in a pediatric population. Hyoid can be reliably visualized and tracked through videofluoroscopy in children > 9 months of age.

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Change history

  • 10 September 2020

    This letter notifies the readers of the Dysphagia journal of an error in the original published version of this manuscript, describing hyoid position during swallowing in children using an available pediatric dataset. A previously available open source spreadsheet tool had been used to calculate the position of the hyoid bone on lateral view videofluoroscopic images. An error in the mathematical formula built into the spreadsheet resulted in a reversal of reported results for measures of peak hyoid position in the X and Y planes of measurement. This erratum provides corrections to the results and interpretations of the original manuscript.

References

  1. Newman LA. Infant swallowing and dysphagia. Curr Opin Otolaryngol Head Neck Surg. 1996;4(3):182–6.

    Article  Google Scholar 

  2. Goldfield EC, Smith V. Preterm infant swallowing and respiration coordination during oral feeding: relationship to dysphagia and aspiration. Curr Pediatr Rev. 2010;6(2):143–50.

    Article  Google Scholar 

  3. Arslan SS, Demir N, Dolgun BA, Karaduman AA. Development of a new instrument for determining the level of chewing function in children. J Oral Rehabil. 2016;43(7):488–95.

    Article  Google Scholar 

  4. Arvedson JC, Lefton-Greif MA. Pediatric videofluoroscopic swallow studies: a professional manual with caregiver guidelines. San Antonio: Communication Skill Builders/Psychological Corporation; 1998.

    Google Scholar 

  5. Kidder TM, Langmore S, Martin B. Indications and techniques of endoscopy in evaluation of cervical dysphagia: comparison with radiographic techniques. Dysphagia. 1994;9(4):256–61.

    Article  CAS  Google Scholar 

  6. Fuller S, Leonard R, Aminpour S, Belafsky P. Validation of the pharyngeal squeeze maneuver. Otolaryngology. 2009;140(3):391–4.

    Article  Google Scholar 

  7. Duncan DR, Larson K, Hester L, McSweeney ME, Rosen R. The clinical feeding evaluation has poor reliability in the assessment of pediatric swallow function and causes delays in the diagnosis of aspiration. Gastroenterology. 2017;152(5):S708–9.

    Article  Google Scholar 

  8. Newman LA, Cleveland RH, Blickman JG, Hillman RE, Jaramillo D. Videofluoroscopic analysis of the infant swallow. Invest Radiol. 1991;26(10):870–3.

    Article  CAS  Google Scholar 

  9. Logemann JA, Kahrilas PJ, Cheng J, et al. Closure mechanisms of laryngeal vestibule during swallow. Am J Physiol. 1992;262(2):G338–41.

    CAS  PubMed  Google Scholar 

  10. Mendelsohn MS, McConnel FM. Function in the pharyngoesophageal segment. Laryngoscope. 1987;97:483–9.

    Article  CAS  Google Scholar 

  11. Leonard R, Kendall K. Dysphagia assessment and treatment planning—a team approach. London: Singular Publishing Ltd; 2018.

    Google Scholar 

  12. Cook IJ, Dodds WJ, Dantas RO, et al. Opening mechanisms of the human upper esophageal sphincter. Am J Physiol. 1989;257:G748–59.

    CAS  PubMed  Google Scholar 

  13. Choi KH, Ryu JS, Kim MY, Kang JY, Yoo SD. Kinematic analysis of dysphagia: significant parameters of aspiration related to bolus viscosity. Dysphagia. 2011;26(4):392–8.

    Article  Google Scholar 

  14. Perlman A, Booth B, Grayhack J. Videofluoroscopic predictors of aspiration in patients with oropharyngeal dysphagia. Dysphagia. 1994;9(2):90–5.

    Article  CAS  Google Scholar 

  15. Molfenter SM, Steele CM. Kinematic and temporal factors associated with penetration-aspiration in swallowing liquids. Dysphagia. 2014;29(2):269–76.

    Article  Google Scholar 

  16. Molfenter SM, Steele CM. Use of an anatomical scalar to control for sex-based size differences in measures of hyoid excursion during swallowing. J Speech Lang Hear Res. 2014;57:768–78.

    Article  Google Scholar 

  17. Newman LA, Keckley C, Petersen MC, Hamner A. Swallowing function and medical diagnoses in infants suspected of dysphagia. Pediatrics. 2001;108(6):e106–9.

    Article  CAS  Google Scholar 

  18. Henderson M, Miles A, Holgate V, Peryman S, Allen J. Development and validation of quantitative objective videofluoroscopic swallowing measures in children. J Pediatr. 2016;178:202–5. https://doi.org/10.1016/j.jpeds.2016.07.050.

    Article  Google Scholar 

  19. Tutor JD, Gosa MM. Dysphagia and aspiration in children. Pediatr Pulmonol. 2012;47(4):321–37.

    Article  Google Scholar 

  20. Stoeckli SJ, Huisman TAGM, Seifert BAGM, Gosa MM, Martin-Harris BJW. Interrater reliability of videofluoroscopic swallow evaluation. Dysphagia. 2003;18(1):53–7.

    Article  Google Scholar 

  21. Lee JW, Randall DR, Evangelista LM, Kuhn MA, Belafsky PC. Subjective assessment of videofluoroscopic swallow studies. Otolaryngology. 2017;156(5):901–5.

    Article  Google Scholar 

  22. Gosa MM, Suiter DM, Kahane JC. Reliability for identification of a select set of temporal and physiologic features of infant swallows. Dysphagia. 2015;30(3):356–72.

    Article  Google Scholar 

  23. Rommel N, Dejaeger E, Bellon E, Smet M, Veereman-Wauters G. Videomanometry reveals clinically relevant parameters of swallowing in children. Int J Pediatr Otolaryngol. 2006;70(8):1397–405.

    Article  CAS  Google Scholar 

  24. Rosenbek J, Robbins J, Roecker E, Coyle J, Woods J. A penetration-aspiration scale. Dysphagia. 1996;11:93–8.

    Article  CAS  Google Scholar 

  25. Steele CM, Grace-Martin K. Reflections on clinical and statistical use of the penetration-aspiration scale. Dysphagia. 2017;32(5):601–16.

    Article  Google Scholar 

  26. Cicchetti DV. Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychol Assess. 1994;6(4):284–91.

    Article  Google Scholar 

  27. Reed MH. Ossification of the hyoid bone during childhood. Can Assoc Radiol J. 1993;44(4):273–6.

    CAS  PubMed  Google Scholar 

  28. Lieberman DE, McCarthy RC, Hiiemae KM, Palmer JB. Ontogeny of postnatal hyoid and larynx descent in humans. Arch Oral Biol. 2001;46:117–28.

    Article  CAS  Google Scholar 

  29. Miller AJ. Deglutition. Physiol Rev. 1982;62:129–84.

    Article  CAS  Google Scholar 

  30. Curtis DJ. Radiologic evaluation of oropharyngeal swallowing. In: Gelfand DW, Richter JE, editors. Diagnosis and treatment of dysphagia. New York: Igaku-Shoin; 1989. p. 161–82.

    Google Scholar 

  31. Dodds WJ. The physiology of swallowing. Dysphagia. 1989;3:171–8.

    Article  CAS  Google Scholar 

  32. Steele C, Molfenter S, Peladeau-Pigeon M, Stokely S. Challenges in preparig contrast media for videofluoroscopy: letter to the editor. Dysphagia. 2013;28:464–7.

    Article  Google Scholar 

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Authors and Affiliations

  1. Speech Science, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand

    Aimee Riley & Anna Miles

  2. Toronto Rehabilitation Institute – University Health Network, Toronto, ON, Canada

    Catriona M. Steele

  3. Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada

    Catriona M. Steele

  4. Speech Science, School of Psychology, Tamaki Campus, The University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand

    Anna Miles

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  1. Aimee Riley
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  2. Anna Miles
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Correspondence to Anna Miles.

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Riley, A., Miles, A. & Steele, C.M. An Exploratory Study of Hyoid Visibility, Position, and Swallowing-Related Displacement in a Pediatric Population. Dysphagia 34, 248–256 (2019). https://doi.org/10.1007/s00455-018-9942-3

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  • DOI: https://doi.org/10.1007/s00455-018-9942-3

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