Application of Ultrasonography in Neurogenic Dysphagia: A Systematic Review.
Paola Potente, Alex Buoite Stella, Monica Vidotto and 4 others
PMID 35556172WHAT IT FOUND
In acute stroke, the less the hyoid and larynx came together during a swallow, the worse the patient's oral intake and bedside screening scores.
Ten small studies, all with different protocols, so no cut-off values yet.
Key findings
01In acute stroke, less hyoid-larynx approximation during swallowing went with worse clinical swallowing: the measure was significantly associated with oral intake on the Functional Oral Intake Scale (distance p = 0.001, degree p = 0.005) and was significantly smaller in dysphagic than in non-dysphagic patients (p = 0.013 and p = 0.011).
02In stroke patients, mean hyoid bone displacement during swallowing was significantly shorter in those who penetrated or aspirated on FEES than in non-aspirators, and shortest in those who aspirated.
03In amyotrophic lateral sclerosis, tongue thickness measured on ultrasound was significantly lower than in healthy controls (p = 0.016) and fell significantly over the course of the disease (p = 0.002).
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
Only 10 studies, each with a small number of patients, and nothing was combined, so every result rests on one small sample. Machines, probes and measurement protocols differed between studies, even within the same condition, so the findings cannot be compared or generalised; the authors note ultrasound also depends on who is holding the probe and on the setting. Because of this, the authors state that no normal values can be proposed and that single findings should not be used as cut-off values. One included study mixed 45 stroke patients with 7 patients who had other conditions, so its stroke results are not clean. The review does not report any assessment of study quality or risk of bias, and the search stopped on 1 November 2020. Almost every finding is an association between an ultrasound measurement and a clinical score. The review does not test whether acting on the ultrasound measurement changes what happens to a patient.
Declared interests
The article text supplied contains no funding statement and no competing-interests declaration, so who paid for the review and what the authors declared is not reported.
The easy way to misread this
Do not read this as ultrasound being ready to replace videofluoroscopy or FEES, or as any of the measurements being usable as a cut-off. The studies used different machines, probes and protocols on small samples, and the authors state that no normal values can be drawn from them.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →