The Prediction of Risk of Penetration-Aspiration Via Hyoid Bone Displacement Features.
Zhenwei Zhang, Subashan Perera, Cara Donohue and 4 others
PMID 30919104WHAT IT FOUND
A measure of how far the hyoid bone moves forward during swallowing was associated with disordered penetration-aspiration scores.
Older age and thin liquids also raised risk. This was a preliminary risk calculation, not yet a clinical tool.
Key findings
01Maximum anterior-horizontal hyoid bone displacement was the only aspect of hyoid bone displacement significantly predictive of normal versus disordered PAS scores.
02For each additional year of age, the odds of a disordered PAS score increased by 3% (OR=1.03, 95% C.I. = 1.00 1.05; p=0.0178).
03Thin liquid swallows had significantly greater odds of a disordered PAS score than cookie swallows.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The videofluoroscopy exams were routine clinical care, with bolus choices, consistencies, utensils, head positions, and swallow counts varied by the clinician and patient presentation. More than half of the original video clips could not be used because poor image quality or obstruction made hyoid tracking impossible. The model did not perfectly match observed risk, and it underestimated risk for patients with disordered PAS scores. Only some hyoid displacement features were included, and the authors state other swallowing movements may also predict aspiration risk. The model was described as preliminary and not yet ready for clinical settings.
Declared interests
The authors declare no conflict of interest. The supplied publication types note NIH extramural research support.
The easy way to misread this
Do not treat this as a ready clinical tool. It was a preliminary model built from routine videofluoroscopy exams, and it underestimated risk for some patients with disordered PAS scores.