Role of ultrasound in evaluation of pharyngeal dysphagia in children with cerebral palsy

Abstract

Background: The aim of this study was to evaluate the clinical reliability of ultrasound (US) examination using relative laryngeal movement of 40% as a cutoff point to diagnose pharyngeal abnormalities of swallowing using ultrasonographic examination in dysphagic cerebral palsy (CP) patients and comparing its results with a flexible fiberoptic endoscope. Methods: Twenty-five cerebral palsy children suffering from clinical dysphagia were included in this study. The rest distance between the thyroid cartilage and the hyoid bone and the shortest distance between them during swallowing were measured by ultrasound, then the approximation distance and the percentage of relative laryngeal movement were calculated. All children also have been submitted for flexible fiberoptic endoscopy (FEES). Results: The mean value of the percentage of relative laryngeal movement was significantly less in the CP children with pharyngeal phase abnormality diagnosed by the flexible fiberoptic endoscope (p < 0.001). The mean of relative laryngeal movement in CP patients with and without pharyngeal abnormality diagnosed by the flexible fiberoptic endoscope was 20.10 ± 13.73 and 66.19% ± 3.42 respectively. Conclusion: Ultrasound can efficiently measure the relative laryngeal movement, and as it gives a numerical value, it can be used as a follow-up bedside test in children suffering from dysphagia.

Enhanced rapid review of the applicability of ultrasound in the assessment of sucking, swallowing and laryngeal function in the paediatric population

“…Nine studies reported complete protocols for conducting the US assessment. A complete protocol was predefined as including probe and frequency information and details of probe placement and participant position (Geddes et al ., 2010; Abdelrahman et al ., 2019; Friedman et al ., 2018, 2019; Huang et al ., 2019; Lee et al ., 2018; Sayyid et al ., 2019; Shaath et al ., 2012; Zhang et al ., 2020).…”

“…One study (Garcia‐Torres et al ., 2020) did not report frequency information. Use of B‐mode was reported in two studies (Abdelrahman et al ., 2019; Lee et al ., 2018). Mode was not specified in the other studies.…”

“…Two of the 12 included studies used US to assess swallowing (Geddes et al ., 2010; Abdelrahman et al ., 2019). Geddes et al .…”

“…Abdelrahman et al . (2019) evaluated the clinical ability of US to diagnose swallowing abnormalities in 25 children. The percentage of hyoid–larynx approximation during a swallow was calculated by measuring the distance between the hyoid and mandible at rest and at the height of the swallow.…”

Automatic Hyoid Bone Tracking in Real-Time Ultrasound Swallowing Videos Using Deep Learning Based and Correlation Filter Based Trackers

“…Many studies used manual labeling [ 14 , 17 , 19 , 20 ] to identify the change in hyoid location, hyoid movement pattern, and maximum displacement during swallowing. Identifying the locations of the hyoid bone in ultrasound images is a laborious and time-consuming task.…”