Assessing Hyolaryngeal Excursion: Comparing Quantitative Methods to Palpation at the Bedside and Visualization During Videofluoroscopy.

Ratings were taken from standard-of-care reports, so it was unclear whether clinicians judged hyoid movement in real time or after reviewing the videofluoroscopy study. The videofluoroscopy raters were not blinded to the bedside exam results. Normal bedside ratings were inferred when the reduced hyolaryngeal rise box was left unchecked. Hyoid measurements were based on a single puree bolus per patient, not the range of boluses used during a clinical exam. There was no standard definition or rater training for what counted as reduced versus normal hyoid movement. The sample had a mean BMI over 25, which may have affected palpation, but neck circumference and other body measures were not recorded. The C2-C4 reference used to size-control hyoid movement may be less stable in older adults because age can change spine length. The experience analysis used unequal rater groups and may have lacked power.

The only conflict or funding statement provided is that the first author's research was supported by the Diane M. Bless Endowed Chair in Otolaryngology.

Do not conclude that bedside palpation or videofluoroscopy visual ratings are reliable measures of hyoid movement. Palpation showed a difference only in forward movement, and videofluoroscopy visual ratings showed no difference from any measured hyoid position.