PURPOSE: Sufficient hyoid excursion plays a critical role in facilitating multiple facets of functional pharyngeal motion, phonation, and nutritional intake; however, objective quantification of hyoid displacement during modified barium swallow studies relies on variable practice protocols. This study sought to compare hyoid displacement methodological differences in the dysphagia literature to establish new clinically feasible references of normative values and measurement strategies.
METHOD: The current study incorporated re-analysis of Molfenter and Steele (2011)’s meta- analysis according to measurement strategies (anterior and superior versus hypotenuse (total) displacement as well as rest-to-peak versus frame-by-frame quantification), bolus volume, and participant characteristics (sex and age). Conversion of data was completed using the Pythagorean theorem, and resulting data was then compared within the study itself and externally to Leonard et al. (2000). Two Tailed Independent t-tests and a linear regression were completed to assess the relationship between analysis factors and hyoid displacement.
RESULTS: Males were found to have significantly higher hypotenuse hyoid displacement than females. No statistical significance was found between the predetermined age groups (“old” and “young”) or newly determined age groups (“old,” “young,” and “middle age”). A linear relationship between increasing bolus volume and hypotenuse hyoid displacement was established. Rest-to-peak and frame-by-frame internal measurement strategies were statistically identical, but the rest-to-peak strategy incorporates qualitative improvements regarding efficiency. The re-analysis of anterior and superior hyoid displacement norms within Molfenter and Steele (2011) resulted in slightly lower hypotenuse normative values when compared to Leonard et al (2000).
CONCLUSION: The current findings suggest that measurement of hyoid hypotenuse displacement is a more efficient measurement strategy and is effective in incorporating the hyoid’s anterior and superior displacement. For clinicians, these findings suggest that normal hyoid excursion may not need to be as large as Leonard et al.’s (2000) norms proposed to be classified as within normal limits for healthy individuals. New references on normative values suggest that as bolus volumes increase, so too does the hyoid displacement, with an expected plateau due to anatomical constraints, to facilitate safe swallows. Furthermore, although rest-to-peak and frame-by-frame internal measurement strategies were statistically identical in quantifying hyoid displacement, the rest-to-peak measurement strategy stood superior when considering the qualitative improvement in a clinician’s time management. Moreover, analysis of participant characteristics identified that hyoid excursion is larger for males than females and that presbyphagia likely results in slightly reduced displacement. Further investigation is warranted and required to better understand hyoid excursion variability and refine best practices.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/44467 |
| Date | 19 May 2022 |
| Creators | Fanucci, Isabella Grace |
| Contributors | Stepp, Cara E |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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