Sonographic assessment of hyoid bone movement during swallowing: a study of normal adults with advancing age

Abstract

Our aim in this study was to evaluate hyoid bone movement trajectories and the age-related changes during swallowing in healthy subjects by ultrasonography. Data were obtained from 30 healthy volunteers (15 men, 15 women) in three age groups (20-39, 40-59, 60-79 years). The subjects were examined while sitting in an upright position, with the back against a wall to control movement. The transducer was placed in a longitudinal scan above the larynx. The subjects were then given 5 mL of mineral water. The water bolus was held in their mouth until they were forced to do a rapid swallow. The imaging was repeated five times for averaging. The movement was divided into 4 phases: slowly ascending phase (A-B, Elevation); rapidly ascending phase (B-C, Anterior); temporary pause phase (position of maximum rise, Remain); and rapidly and slowly descending shifts toward the resting position phase (C-D, Return). We easily visualized the hyoid bone trajectory by using ultrasonography. In all cases, ultrasonographic analysis of the hyoid bone was confirmed to have a similar trajectory, as determined with videofluoroscopy. The average swallowing duration measurements increased with age. The measurement of the maximally elevated point of the hyoid bone decreased with age. The movement of the hyoid bone during swallowing can be visualized by US. The trajectory of the hyoid bone in sagittal section indicated the capability of swallowing, and may detect some anomalies in swallowing.

Ultrasound applicability in Speech Language Pathology and Audiology

“…From the search of the descriptors ultrasound versus swallowing, papers that are presented in Chart 5, the investigation of the displacement of the hyoid bone during the act of swallowing was frequent (19,(23)(24)(25)(26) . In addition to this, three other papers further investigated the thickness of the lingual musculature (20,27) and the pressure exerted by the tongue on the palate (19) .…”

“…As for the sample evaluated in the mentioned papers (17,19,20,(23)(24)(25)(26)(27)38,39) , the groups comprised individuals with typical swallowing (from children to the elderly) and with altered swallowing, due to some underlying diseases, such as cerebral vascular accident (CVA). The number of participants varied considerably from 5 to 104 among the articles, with an average of 42.5 participants.…”

“…The research (19,(23)(24)(25)(26) highlighted the ultrasound as an important tool for evaluating the displacement of the hyoid bone in swallowing research. Reducing the movement of the hyoid bone has been associated with the increased risk for intrusion of waste in the larynx and the air passages.…”

“…Acoustic analysis of speech and voice has been used for a long time as tool for analysis of altered cases, for promoting more accurate diagnoses, and as the monitoring procedure of the therapeutic process, both by speech language pathologist and by the patient (1)(2)(3)(4) . The articulatory analysis in the area of speech and orofacial motricity emerges as a new possibility, especially at the national level (5)(6)(7)(8)(9)(10) , for integration of these analyses already mentioned, using, for example, the ultrasonography for evaluation of tongue movements (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22) , and of the hyoid bone (19,(23)(24)(25)(26)(27) , without inserting devices within the oral cavity.…”

Ultrassonografia e deglutição: revisão crítica da literatura

“…US is a noninvasive examination that provides dynamic images that focus on the soft tissues and body structures (2) . The technique is widely applied in clinical practice because of its low cost, safety, speed and lack of radiation (3) . US is a viable option for studying the oral and pharyngeal structures involved in deglutition (2,3) .…”