Ultrasonographic Evaluation of Hyoid–Larynx Approximation in Dysphagic Stroke Patients

Huang, Ya-Ling; Hsieh, Shih-Fu; Chang, Yeun-Chung; Chen, Hsiang-Chen; Wang, Tyng-Guey

doi:10.1016/j.ultrasmedbio.2009.02.006

« Previous Next »Ultrasound in Medicine and Biology
Volume 35, Issue 7 , Pages 1103-1108, July 2009

Ultrasonographic Evaluation of Hyoid–Larynx Approximation in Dysphagic Stroke Patients

Ya-Ling Huang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Shih-Fu Hsieh
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Department of Physical Medicine & Rehabilitation, Buddhist Tzu Chi General Hospital, Taipei, Taiwan
Yeun-Chung Chang
- Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Hsiang-Chen Chen
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
Tyng-Guey Wang
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
- Address correspondence to: Tyng-Guey Wang, Department of Physical Medicine & Rehabilitation, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan.

Received 4 November 2008; received in revised form 26 January 2009; accepted 26 February 2009. published online 08 May 2009.

Abstract

Hyoid–larynx approximation is an essential part of the swallowing process, and is related to airway protection. We aimed to evaluate the reliability of ultrasonographic examination of hyoid–larynx approximation and measure the approximation in stroke patients with or without dysphagia. Fifteen normal subjects and 40 stroke patients with or without dysphagia admitted to the Department of Rehabilitation Medicine of a tertiary hospital between July 2006 and February 2007 participated in this study. The distance between the thyroid cartilage and hyoid bone during swallowing was measured by ultrasound. Hyoid–larynx approximation was defined as the distance obtained by subtracting the shortest distance between the hyoid bone and thyroid cartilage during swallowing from the initial resting distance. Ten stroke patients with dysphagia also underwent standard videofluoroscopic swallowing study (VFSS). The change percentage of hyoid–larynx approximation was very similar between ultrasonographic examination and VFSS. There was no significant difference in resting distances between the thyroid cartilage and hyoid bone between normal subjects and stroke patients with or without dysphagia. Among stroke patients, hyoid–larynx approximation was less in the dysphagia group than in the nondysphagia group. In conclusion, ultrasound can quantitatively measure hyoid–larynx approximation with good reliability. Hyoid–larynx approximation was significantly reduced in stroke patients with dysphagia. (E-mail: tgw@ntu.edu.tw)

Key Words: Dysphagia, Stroke, Larynx, Ultrasound