Emerging Role of Ultrasound in Dysphagia Assessment and Intervention: A Narrative Review.
Ming-Yen Hsiao, Chueh-Hung Wu, Tyng-Guey Wang
PMID 36188819WHAT IT FOUND
Ultrasound shows promise for bedside dysphagia screening, measuring hyoid movement and guiding injections.
However, diagnostic accuracy varies widely, and no standard protocols exist. Use it only as a supplementary tool, not a replacement for formal swallowing assessments.
Key findings
01Hyoid bone displacement measured by ultrasound correlates with dysphagia severity and can screen for aspiration risk, with reported sensitivities and specificities ranging from 67% to 88.9%.
02Ultrasound can guide botulinum toxin injections for upper esophageal sphincter dysfunction, but evidence is limited to small, non-randomized studies without comparison to other guidance methods.
03There is no standardized protocol for ultrasound swallowing assessment, and reference values for muscle structure and function remain to be established.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
This is a narrative review with a non-systematic search strategy, meaning selection bias is possible. The included studies vary widely in design, sample size, and methodology, making it difficult to draw consistent conclusions. Many studies are small or preliminary, with limited statistical power. There is no standardized protocol for ultrasound swallowing assessment, and reference values are not established. Diagnostic accuracy measures (sensitivity/specificity) reported in different studies are not directly comparable due to methodological differences.
Declared interests
The authors declare no commercial or financial relationships that could be construed as a potential conflict of interest. The research was funded by the Ministry of Science and Technology, Taiwan.
The easy way to misread this
Do not use ultrasound as a standalone diagnostic tool for dysphagia. The review emphasizes that diagnostic criteria are not established, techniques vary significantly, and accuracy is operator-dependent. Relying on ultrasound alone could lead to missed diagnoses or inappropriate management, especially since it lacks the robustness of validated instrumental assessments like VFSS or FEES.