Association of tongue-hyoid bone motion parameters measured dynamically by submental ultrasound with the severity of post-stroke dysphagia.

Abstract

Post-Stroke Dysphagia (PSD) is a common complication after stroke. An efficient, noninvasive assessment method is especially crucial for dysphagia. Submental ultrasound is an emerging noninvasive method for evaluating swallowing, enabling dynamic, real-time monitoring of the movements of the tongue and hyoid bone methods. This was a cross-sectional, single-center, observational study involving 213 stroke patients admitted to the department of rehabilitation between June 2023 and June 2024. All patients underwent assessment using the Penetration-Aspiration Scale (PAS) via videofluoroscopic swallowing study or flexible endoscopic evaluation of swallowing. All patients' tongue-hyoid bone movement parameters, such as hyoid bone displacement, hyoid bone displacement/resting distance ratio, geniohyoid muscle movement speed, and tongue muscle movement speed, were measured by submental ultrasound. The Aspiration and Penetration group had smaller hyoid bone displacement and slower geniohyoid and tongue muscle movement. All of these differences were statistically significant (P < 0.001). The predictive model for assessing the risk of severe-PSD (PAS 6-8 grade) achieved an area under the receiver operating characteristic curve of 0.927 (95% CI: 0.886-0.967). All tongue-hyoid bone movement parameters showed negative correlations with PAS grading when PAS was used as a continuous variable. Parameters related to hyoid bone movement and geniohyoid muscle velocity serve as key indicators of PSD severity. Submental ultrasound measurement of tongue-hyoid motion parameters demonstrates excellent assessment and predictive value for PSD severity, warranting clinical implementation.